Trust in healthcare undermined by 'bad apples,' new research reveals

Research based on analysis of 6,714 cases of professional misconduct by health and care professionals, and published today, has identified three different types of perpetrator:

• the self-serving 'bad apple';
• the individual who is corrupted by the falling standards of their workplace, and;
• the depleted perpetrator struggling to cope with the pressures of life.

The study, led by Professor Rosalind Searle from Coventry University's Centre for Trust, Peace and Social Relations, examined 6,714 fitness to practise determinations from the Professional Standards Authority's database1 covering doctors, nurses, social workers and paramedics, amongst others.

Professor Searle and her team applied cluster analysis to identify how different kinds of misconduct group together for the different professions. They also looked in more detail at cases involving sexual boundary violations and dishonesty.

Chief executive of the authority, Harry Cayton, said:

"This research is the most ambitious project yet undertaken to use the information contained in the authority's database of fitness to practise determinations. In this report, Professor Searle offers us a rich and fascinating discussion of the complex and subtle interplay between individual professionals, teams, workplaces, gender and culture."

Professor Searle, who proposed this ground-breaking approach to the authority, and who is a professor of organisational behaviour and psychology, said:

"In shining the spotlight on professional practice in the health sector, we're examining relationships that are often intimate in nature and based on trust and confidence between health workers and service users. It's crucial, therefore, for us to analyse where and how these taken-for-granted notions are being undermined through misconduct, and to take steps towards reducing instances of such behaviour.

"The findings in our report represent important progress in understanding and tackling the issue, and in ensuring trust and confidence in the health professions is preserved."

The findings from the study have much broader implications, and go beyond the regulatory process. The authority said it was looking forward to discussing them widely, looking at how they can be used to support preventative interventions in future by regulators, employers and others.