Nurses who speak out about concerns in the NHS are likely to face negative consequences and are often ignored, according to a survey by Nursing Times to mark the launch of a major new campaign.
The survey of more than 800 nurses revealed that many nurses complain of a bullying culture in the NHS, with staff scared they will be labelled as troublemakers if they highlight problems or concerns about patient care.
The findings come as Nursing Times launches its Speak Out Safely campaign in order to help strengthen protection for frontline staff and increase honesty and transparency in the NHS.
The survey revealed that 84% of respondents had previously raised concerns about a colleague’s practice or attitude – of which 23% said they had done so “several times” or “regularly”, and 23% “at least once”.
But of those who had raised concerns, 52% said there had been no appropriate outcome as a result of speaking up and a similar percentage said doing so had led to negative consequences for themselves.
Almost 30% of nurses said being viewed as a troublemaker was the biggest barrier to speaking up, with inaction by managers cited by 23%.
One nurse said: “You cannot make a complaint about staff or standards without losing your job and potentially your whole career.”
“It is always the whistleblower who has to move on and who has their career threatened,” said another.
An overwhelming majority of respondents, 80%, said the ability to raise concerns in the NHS could be a lot better. However, only 22% said they would be prepared to whistleblow to the media if their concerns were not acted upon by managers or regulators.
Nursing Times has today launched a campaign to help tackle some of these problems and hopefully benefit both nurses and patients.
We are calling on the government to implement a statutory “duty of candour” for NHS organisations, as recommended in the Mid Staffordshire Foundation Trust Public Inquiry report. This would make it a criminal offence for any trust or manager to prevent staff raising concerns after a serious injury to a patient or death.
Nursing Times will also seek a pledge from all NHS employers to make an explicit public commitment to their staff that they will not face disciplinary action for raising genuine patient safety concerns. We also want the government to commit to a full review of the Public Interest Disclosure Act to ensure it gives adequate protection for NHS staff.
Nursing Times editor Jenni Middleton said: “I have personally spoken to nurses who, having raised concerns, have been sidelined and ostracised by their employers, bullied and marginalised by their colleagues – and end up feeling ashamed and guilty, as well as concerned that their careers are over.
“This must stop, and we intend to make it stop with this campaign. We must welcome the input of staff and ensure they are heard, without fear of reprisal.”
In last week’s issue, Helene Donnelly, former Mid Staffordshire Foundation Trust A&E nurse and whistleblower, called for “nurses who are bad apples” to be “named and shamed”.
She has given her support to the Speak Out Safely campaign and said it was “vital” nurses were encouraged and supported to speak up.
“As nurses, we are there all of the time and we are best placed to be see exactly what’s going on and raise concerns,” she said. “If the Francis report is going to be something that’s not just forgotten, then it’s essential for us as nurses to keep ploughing forward and keep speaking out.”
Whistleblowing charity Public Concert at Work and the Mid Staffs action group Patients First have both backed the Speak Out Safely campaign.
Cathy James, chief executive of Public Concern at Work, described the survey results as “shocking”. She said: “We wholeheartedly support Nursing Times. It really is time for change; time for there to be proper action on this issue.”
Dr Kim Holt, whistleblower and founder of Patients First, said: “What most concerns me is the culture of bullying that deters staff from speaking up – we support Nursing Times.”
Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “It is extremely worrying that a large number of nurses still feel their concerns are going unheard, even worse that some have to live with the threat of reprisal.
“Robert Francis’s report clearly spelt out what happens when members of staff are ignored. There needs to be greater transparency in the current system so that nurses feel supported when they do raise concerns,” he said.
“Ultimately it is patients that suffer when staff are ignored. We need senior staff across the NHS to know what is happening on their wards and pledge that no member of staff will suffer victimisation when they do speak out.”
Dean Royles, chief executive of NHS Employers, which represents trusts and other employers, said it was wrong for people to think whistleblowers were always ignored.
But he added: “We don’t get it right all the time and that can be tragic for patients and for staff.
“I support any campaign that shows the positive effects of raising concerns and how important it is.”