Tackling toxicity | Why employers must learn from the NHS Lothian 'toxic culture' report

The recent independent review into NHS Lothian’s women’s services is a sobering reminder that even the most mission-driven workplaces can suffer under the weight of a toxic culture. It revealed a system where burnout, fear of speaking up, and distrust in leadership have taken root, despite the presence of dedicated, compassionate staff. For HR professionals across sectors, the findings offer a valuable opportunity for reflection: what practical steps must employers take to prevent dysfunction from becoming systemic?

A culture of silence is a warning sign

One of the most alarming insights from the NHS Lothian review is that just 36% of staff felt safe reporting unethical behaviour without fear of reprisal. This statistic alone should set alarm bells ringing for any HR leader. When employees fear consequences for raising concerns, issues go underground, often until they erupt into crises that are harder and costlier to fix.