Vol. 12 No. 1 (2019): The Timeless Mahatma

Incivility in Healthcare: A Systems Approach

Indranil Chakravorty MBBS PhD FRCP
St Georges University of London, UK
Gandhi on his salt walk

Published 2020-04-19


  • incivility,
  • workplace bullying

How to Cite

Chakravorty, I. (2020). Incivility in Healthcare: A Systems Approach. Sushruta Journal of Health Policy & Opinion, 12(1), 17–19. https://doi.org/10.38192/12.1.9


The link between civility, workplace safety and patient care is not a new concept. The 2004 Institute of Medicine report, emphasised the importance of the work environment in which healthcare professionals provide care. 1 Workplace incivility that is expressed as bullying behaviour was reported by at least 1 in 5 respondents in the NHS Staff survey in 2018. 2 Almost half of these go unreported and that number seems to be falling.


  1. Keeping Patients Safe: Transforming the Work Environment of Nurses. Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety; Page A, editor. Source Washington (DC): National Academies Press (US); 2004.
  2. https://www.nhsstaffsurveys.com/Page/1064/Latest-Results/2018-Results
  3. https://www.gov.uk/government/publications/race-in-the-workplace-the-mcgregor-smith-review
  4. Kline, Roger & Lewis, Duncan. (2018). The price of fear: estimating the financial cost of bullying and harassment to the NHS in England. Public Money & Management. 1-10.
  5. http://ombudsfac.unm.edu/Article_Summaries/Workplace_Bullying_causes_consequences_interventions_8-2007.pdf
  6. Blackwood, Kate & Bentley, Tim & Catley, Bevan & Edwards, Margot. (2017). Managing workplace bullying experiences in nursing: the impact of the work environment. Public Money & Management. 37. 349-356.
  7. Lewis, Duncan & Kline, Roger. (2019). Tackling bullying and harassment in the NHS: The critical roles played by managers. British Journal of Healthcare Management. 25. 7-10.
  8. Engeström Y, Virkkunen J, Helle M, Pihlaja J and Poikela R. The change laboratory as a tool for transforming work. Center for Activity Theory and Developmental Work Research, University of Helsinki. http://gerrystahl.net/teaching/spring09/782readings/Engestrom_Change_Lab.pdf