AS senior clinicians at NHS Highland, we wish to make clear our serious concerns around the long-standing bullying culture that exists within the health board where we work.

It is our belief that, for at least a decade, this practice of suppressing criticism, which emanates from the very top of the organisation, has led to a culture of fear and intimidation. This has had a serious detrimental effect on staff at all levels of NHS Highland, but equally importantly, has had an adverse effect on the quality of care we are able to provide for patients.

With the recent publication of a report on governance at NHS Highland, and with the departure of the chief executive announced and now imminent, we feel now is the time to speak out and ensure effective action can be taken.

Indeed these recent events have seen more and more clinicians share with us their concerns on the impact this culture has had on them, the organisation and ultimately patients. While the majority are still fearful of speaking about these publicly, there have now been discussions at various forums for clinicians and we feel that, on behalf of the whole clinical workforce, it is vital this bullying culture is exposed and finally now dealt with.

Anyone working in our NHS needs to feel supported and able to speak out on issues as serious as this. Yet at NHS Highland, our belief is that some staff have not been able to raise concerns around bullying, or indeed some issues concerning patient care, due to the culture of bullying and fear that has pervaded across the organisation.

This is the moment that this has to change. We urgently need fresh leadership at NHS Highland to take the brave and extensive actions required to ensure NHS Highland is a safe positive place to work, based on a culture of openness, transparency, learning and honesty. That is the only way that we will be able to guarantee a safe environment, delivering high quality care for patients for the future.

Dr Eileen Anderson, Chair Area Medical Committee; Dr Lorien Cameron-Ross, Vice Chair, Area Medical Committee; Dr Jonathan Ball, Chair, GP Sub Committee and Highland Local Medical Committee Chair) and Dr Iain Kennedy (Professional Secretary, GP Sub Committee & Medical Secretary Highland Local Medical Committee),

c/o Riverside Medical Practice, Ness Walk, Inverness.