Ministers should hold NHS managers to account if whistleblowers suffer reprisals for voicing their concerns, the National Audit Office has said.
The Department of Health should “take the lead” to make sure that people who come forward with concerns feel protected in the health service, according to a new NAO report.
The news comes after United Lincolnshire Hospitals Trust tried to silence a former chief executive from speaking out about patient safety concerns as part of a unfair dismissal case settlement.
Gary Walker was threatened with legal action related to his reported £500,000 payout after breaking his silence to allege he was forced out of his job in 2010 because he put patient safety ahead of Whitehall targets.
The trust is one of 14 being investigated by health chiefs over high mortality rates in the wake of the public inquiry report into serious failures at Mid Staffordshire Trust that led to hundreds of unnecessary deaths.
The NAO report, which examined concerns over Cornwall’s out-of-hours doctors service, said whistleblowers played a significant role in highlighting problems with the service.
“The Department of Health should take the lead in making sure that whistleblowers are, and feel, protected throughout the NHS,” the report states.
“Whistleblowers are a valuable source of intelligence and should be encouraged to come forward.
“To help reassure whistleblowers, the department should instruct NHS bodies to publish their whistleblowing policies. This would help ensure that local policies are transparent, consistent and fully compliant with national policy.
“The department should also make sure local NHS bodies hold managers to account if whistleblowers suffer reprisals.”
Serco, the company that provides the out-of-hours GP service in the Cornwall region, came under fire last year after a number of whistleblowers came forward with worries about the service.
Concerns were raised that Serco staff were altering data about the performance of the out-of-hours service.
An audit by the firm found that two members of staff made 252 “unauthorised changes” to performance data and, as a result, the performance Serco reported to the primary care trust was overstated in seven instances.
“Whistleblowers’ concerns had not been identified by routine management controls or by the primary care trust itself,” the report adds.
Subsequently the health regulator, the Care Quality Commission, said the firm was not meeting four of the essential standards of quality and safety.
The NAO report states that last year Serco regularly had insufficient staff to fill all clinical shifts, but a review found that there was “no evidence” that the service provided was clinically unsafe.
Dr Louis Warren, who manages the Serco service in Cornwall, said: “Over the last six months the GP out-of-hours service that Serco provides in Cornwall has been the subject of the most comprehensive scrutiny and exhaustive series of audits possible.
“The NAO report has not only substantiated what the CQC and other reports have already shown - that the service is safe and well regarded by patients - but also confirms that we have taken swift and decisive action in response to the previous CQC report.
“The only outstanding minor issue noted was that we need to take further action to increase the number of health advisers. Our recruitment campaign will have this resolved by the end of March.
“While whistleblowers highlighted concerns last year, I am confident that these issues have been addressed. We now have an outstanding culture and strong levels of staff engagement, where 79% of our team in Cornwall feel respected by their manager. That’s as good as any organisation in healthcare in the UK.”
Health minister Lord Howe said: “It is absolutely critical that all staff working within the NHS feel able to speak up and raise concerns and that every organisation providing NHS services takes concerns seriously and acts on them.
“We are pleased to note that after staff raised concerns at Serco, improvements are being made, and that both the PCT and Serco have been clear with staff of the importance of raising concerns.
“Staff on the frontline know when patient care needs to improve - better support for whistleblowers will help create a culture where staff are able to raise genuine concerns in good faith, without fear of reprisal.
“That’s why we have already taken action - strengthening the NHS constitution and setting up a helpline to give whistleblowers the support they need to raise concerns both inside and outside their organisation.”
We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care, and create a more open NHS. Support our campaign by signing our petition.
Visit our Speak out Safely page to find out more.