The price of fear: Estimating the financial cost of bullying and harassment to the NHS in England

Using a spectrum of measures, this paper estimates some of the financial costs of bullying and harassment to the NHS in England. By means of specific impacts resulting from bullying and harassment to staff health, sickness absence costs to the employer, employee turnover, diminished productivity, sickness presenteeism, compensation, litigation and industrial relations costs, we conservatively estimate bullying and harassment to cost the taxpayer £2.281 billion per annum.The evidence in this paper indicates the importance of urgent material engagement to address bullying in the UK NHS. Existing staff surveys fail to capture the types of behaviours often attributable to bullying and this should be a focus to design pertinent interventions. Capturing bystander/witness experiences are undocumented, as are workplace incivilities and staff satisfaction with policy and procedures for tackling bullying. Policy change is vital for accurately capturing the costs of bullying associated with absenteeism, staff replacement, productivity reductions and to use these as mechanisms to manage organizations that fail to address bullying.