Alleged bullying, harassment and toxic culture at hospital revealed in leaked report

Staff members at Wales' largest hospital have faced disciplinary proceedings after a "toxic culture" leaving some feeling unsafe at work was uncovered.

The leaked Cardiff and Vale health board internal review included reports of "bullying and harassment" and "violent and aggressive" behaviour at a University Hospital of Wales (UHW) department.

The investigation, which was completed in August 2024 but not made public, found "systemic failure at all levels" and "unchecked" poor behaviour at the Cardiff HSDU unit, which is responsible for the sterilisation and decontamination of medical equipment.

The health board said it had acted "robustly and fairly" to deal with the "historic allegations".

It said five members of staff had since been "subject to disciplinary action", and that "leadership oversight, management arrangements and team culture" had also been strengthened.

The initial investigation was based on one-to-one interviews with 64 current and former members of staff, as well as 10 senior leaders who had been involved in the running of the department.

The review found a significant number of people reported "bullying and harassment" in the workplace, leaving some staff "not feeling safe" at work.

The culture was described as "toxic" and "mentally draining", with some staff feeling unsupported when they raised concerns.

The review also included complaints about "people behaving in a violent or aggressive manner", such as throwing trays, shouting or hitting trolleys when they lost their temper.

Staff "swearing or using unprofessional language" during office hours was reported, as well as examples of coercive behaviour, with some colleagues appearing to "thrive" on targeting individuals.

The review revealed there were two main "cliques'" operating in the unit, engaging in tit-for-tat reporting of each other's behaviours.

Complaints were also made about previous reviews and surveys, as far back as 2017, claiming they had made "no difference", giving the impression that "poor behaviour had been tolerated over a number of years".

The report also detailed specific incidents, including one in 2022 which saw HSDU managers and supervisors "inadvertently leaving an inappropriate message" on a team member's answerphone.

Concern that a member of staff's Lucozade bottle had been tampered with in 2020 was also included - although the police concluded "there was no evidence of criminal intent and no further action was taken".

But the review also found that some staff members, who had themselves raised concerns, failed to reflect or acknowledge that their own behaviour might have been a "contributory factor", with no willingness to "change their behaviour to improve the culture within the unit".

The report concluded "the culture within the HSDU is not safe" for those involved and was not open and transparent for "all to be able to speak up freely".

It recommended developing a "cultural action plan" to support the unit as well as "consequences" for individuals, along with measures to boost management oversight.

But it acknowledged "to change culture will take time and engagement from all involved".

The health board said it would not comment on the specific detail of the WalesOnline report in which the review was leaked, but in a statement to BBC Wales said it was "satisfied that we have dealt with the very challenging (and in this instance) historical allegations robustly, fairly, equitably and with compassion".

"Colleagues' recollection and accounts of events change over time and those investigating have to make a judgment based upon the evidence of all individuals concerned," it said.

"The review examined a range of cultural and behavioural issues within the service and resulted in clear recommendations and actions. Subsequently, five members of staff were subject to disciplinary action, two of which later resigned, two were redeployed into roles outside of HSDU, and one member of staff was dismissed.

"The health board has taken the review and the actions extremely seriously."

It added leadership oversight, management arrangements and team culture had "strengthened" with "more effective ways of working" and "a more positive team environment" in place.

The concerns were raised in the Senedd by Conservative member for South Wales Central, Andrew RT Davies.

During First Minister's Questions on 27 January, Davies asked Eluned Morgan how the Welsh government was making sure the issues raised in the review were being addressed.

The first minister replied it was not unusual for health boards to conduct internal reviews and for these not to be shared with the Welsh government, "especially in cases where it could prejudice any disciplinary action".

She added that, as a result of disciplinary proceedings being concluded, she had asked the health board to provide the Welsh government with a copy, but was "yet to receive it".

Cardiff and Vale health board insisted the report's findings and subsequent progress were formally presented to the health board's People and Culture Committee in 2024, with a further update provided in March 2025, and "has also since been shared with Welsh government officials".

The latest concerns follow the publication of another critical internal report in May last year into failures in the surgical department at the hospital.

In it, it described an "atmosphere of fear" with allegations of criminal behaviour including drugs and theft, going largely unchallenged.

In July 2025 the entire health board was placed into the second highest level of escalation and oversight by the Welsh government - one step below special measures.

According to health secretary Jeremy Miles, this was due to concerns about the size of its waiting lists but also "a series of worrying cultural and leadership challenges".