NHS Lothian has apologised to maternity care staff after an investigation found a toxic workplace culture across its women’s services.

The health board commissioned an independent review after a whistleblowing report revealed staff shortages and workplace relationships had compromised patient safety.

The review found there was distrust between managers and staff in maternity care, with just over a third of frontline workers saying they felt unable to report unethical behaviour without fear of reprisal.

NHS Lothian said it “fully recognises and apologises” for the poor experiences of some staff and said it had made several improvements in recent months.

In December last year, BBC Scotland revealed that 17 concerns about safety in the obstetrics triage and assessment unit at Edinburgh Royal Infirmary were upheld or partially upheld in the whistleblowing report.

It found major challenges with the working environment, including staff shortages that were leading to delays in women accessing treatment.

The findings of a follow up report into the organisation’s culture has been shared with NHS Lothian women’s services staff in recent days.

It found that relationships with leaders were often strained, causing problems with general wellbeing, stress and even bullying or perceptions of unfair treatment and frustration.

In a presentation of the report’s findings, staff were told that “some of the behaviours described in the report have no place in our or any other workplace, and we want to work with colleagues in women’s services to ensure they are not part of our culture moving forward”.

Tom Power, Director of People and Culture at NHS Lothian, said that many staff talked about their role in women’s services as “a calling”.

He said: “We commissioned this independent research because we wanted to leave no stone unturned in our efforts to get a truly comprehensive picture of the experience of our teams in women’s services.

“I apologise to those who have been let down at work and reassure them that we are determined to support them better to do the job they love.

“I would like to reassure women and their families that they and their babies will receive high-quality care from our committed and professional staff.”

Around half of the 1,195 staff in women’s services responded to a survey issued by the external reviewers.

Half of respondents said their manager deals fairly with everyone but 36% of respondents said they felt unable to report unethical behaviour without fear of reprisals.

A summary of the report’s findings stated, “many staff report feeling close to burnout due to high workloads and inadequate staffing, leading to increased stress and sick leave”.

It added that “concerns about bullying and a toxic work environment are prevalent”.

NHS Lothian said it has put in a rolling programme of improvements since concerns were first raised, including securing funding to employ almost 30 new midwives and other staff.