Understanding and reducing unprofessional behaviour between healthcare staff.

A multi-year programme of work producing the first cohesive programme theories of how unprofessional behaviours between healthcare staff arise, whom they impact, and how they can be addressed — now informing national research and NHS practice.

This programme began with a two-year NIHR HS&DR-funded realist review (NIHR131606) at the University of Surrey, led with Prof Jill Maben, on which I was the sole research fellow. It produced joint first-author papers in BMC Medicine (highlighted as Editor's Choice and in the 96th percentile on Altmetric) and BMC Health Services Research, a 50,000-word NIHR report, and a practical guide for healthcare staff downloaded over 800 times in its first month.

The work has since grown into a wider research stream: a typology of unprofessional behaviours, a behavioural-science analysis of 44 interventions, and two major new grants — a £700k NIHR mixed-methods study on preventing and reducing unprofessional behaviour in English NHS Trusts (Co-Investigator), and a £300k NHS Race and Health Observatory project on addressing racialised bullying and harassment in the NHS, which I lead as Principal Investigator.

Publications so far

What drives unprofessional behaviour in healthcare?First author
2026 · Nursing Times
Addressing unprofessional behaviour in the NHS
2026 · British Journal of Healthcare Management
How unprofessional behaviours between healthcare staff threaten patient care and safetyFirst author
2025 · Expert Review of Pharmacoeconomics & Outcomes Research
Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist reviewJoint first author
2023 · BMC Medicine — Editor's Choice, 96th percentile on Altmetric
Drivers of unprofessional behaviour between staff in acute care hospitals: a realist reviewJoint first author
2023 · BMC Health Services Research — BMC Series Highlight

Grants in this programme

  • 2025
    Addressing racialised bullying and harassment in the NHS — £300k, Principal Investigator
    NHS Race and Health Observatory
  • 2024
    Understanding how unprofessional behaviour in English NHS Trusts can be prevented and reduced: a mixed-methods study — £700k, Co-Investigator
    NIHR HS&DR
  • 2021 — 2023
    Strategies to address unprofessional behaviours among staff in acute healthcare settings: a realist review — sole research fellow
    NIHR HS&DR (NIHR131606) · University of Surrey

Reach beyond academia

  • 2026
    Invited guest on NHS Race and Health Observatory Podcast: Race and Health Matters
  • 2025
    Invited panellist at NHS Employers "Disability Summit" on psychological safety
  • 2024
    Published guide for addressing unprofessional behaviours between healthcare staff — 800+ downloads in the first month
  • 2024
    Invited speaker at University Hospitals Birmingham "Freedom to Speak Up" day, alongside Prof Mary Dixon-Woods and others
  • 2024
    Presentations to ~200 HR/OD NHS employees ("Big Coffee Break") and to NHS HR professionals at Frimley ICS and wider
  • 2023
    Workshops with NHS Trusts including Great Western NHS FT on reducing unprofessional behaviours
  • 2023
    YQSR Seminar on findings from the realist review
  • 2023
    Publication selected as a BMC Series Highlight