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Francis to end 'climate of fear' as NHS whistleblowing review begins

  • 18 Comments

The role of investigating claims made by NHS whistleblowers could be taken out of the hands of hospital trusts, the head of a major government inquiry has indicated.

Speaking as the Freedom to Speak Up review was launched yesterday, Sir Robert Francis said he aimed to extinguish a “climate of fear” in the NHS that had “victimised” whistleblowers, deterring others from raising concerns.

“If people aren’t coming forward with what is worrying them then nothing can be done about that,” he said. “It’s not a safe system. We need to learn how to do it better.”

“We should no longer tolerate people being in effect exiled from the health service because they have raised concerns”

Robert Francis

In an early sign of the direction the inquiry could take, Sir Robert said whistleblower concerns should be subjected to outside scrutiny.

“In the same way I have suggested complaints from patients will often need a degree of external investigation and independent scrutiny [that] they haven’t had before, I don’t see why the same can’t be suggested for staff raising concerns,” he said.

While Sir Robert said such a step did “not necessarily” involve the creation of a new organisation, the inquiry would consider remedies for victimised whistleblowers which went “over and above what the law in theory offers”.

Sir Robert, who also chaired the public inquiry into care failures at Mid Staffordshire Foundation Trust, said the review would examine whether hospital managers should be held more accountable for their involvement in cover ups.

“There should be consequences for that,” he added. “We should no longer tolerate people being in effect exiled from the health service because they have raised concerns,” he said.

Sir Robert told Nursing Times sister title Health Service Journal that questions should be raised about the quality of leadership at trusts which allow whistleblower concerns to become “swallowed up” by divisive disputes and protracted employment tribunals.

“The polarisation seems to get to the stage where no one will get out of the hole they have dug for themselves, and the question has to be asked if that organisation is being well led,” he said.

“By the time someone is labelled a whistleblower it is already telling you something has seriously gone wrong”

Robert Francis

While accepting that some employers had to deal with vexatious whistleblowers, he said all cases should be properly investigated.

“It is in the interests of the employer that they look into concerns properly and transparently and completely separately from issues they may have with any individual employee,” he said. “At the moment I don’t think that happens as often as it should.”

While the introduction of a new duty of candour and fundamental standards of care would make it easier for staff to speak out, Sir Robert said a “significant number” of NHS staff still felt penalised for raising concerns.

He said: “People say they have raised honestly held concerns and as a result have been victimised, sometimes to the point of being forced to leave the service or being dismissed.

 

The Freedom to Speak Up review

Sir Robert Francis has appointed a series of advisers to support his work: Norman Williams, former president of the Royal College of Surgeons; Peter Homa, chief executive of Nottingham University Hospitals Trust and Kath Fenton, chief nurse at University College London Hospitals Foundation Trust.

The review will host a series of seminars in the autumn to explore key issues and solutions.

Two separate pieces of research into whistleblowing in the NHS and the views of NHS staff will be conducted at Middlesex and Greenwich universities.

The review secretariat will be led by Joanna Donaldson, the HR director of the Department for Business Innovation and Skills.

Take part in the review or email the secretariat

 

“For every one of those stories any number of people are deterred from coming forward to raise what they are worried about. By the time someone is labelled a whistleblower it is already telling you something has seriously gone wrong.”

In this year’s NHS staff survey 90% of respondents know how to raise concerns in public but only 44% believe anything will be done. Almost 30% said they would not feel safe at work if they did speak out.

The review, which was officially launched today, has appealed for evidence from whistleblowers, managers and organisations across the NHS.

Sir Robert will also meet personally with selected whistleblowers, but will not make judgments on individual cases. He said all information would be treated in the “strictest confidence”.

“We have gone to great pains to set up our website and emails so they are completely controlled by us and independent of any government organisations,” Sir Robert said.

The review’s final report will be published in November, a timeline Sir Robert admitted would be “tough” but necessary for it to be useful before the general election in May 2015.

  • In 2013 Nursing Times launched the Speak Out Safely campaign to encourage healthcare providers to develop cultures that actively encourage staff to raise the alarm when they see poor practice, and to protect them when they do so.

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  • 18 Comments

Readers' comments (18)

  • What about the thousands of agency workers providing NHS services? I am not talking about agency workers who do the odd shift in a Hospital setting - there are whole community-based care packages funded by NHS Trusts and managed exclusively by agencies / private companies (usually with staff on NHS-level pay). There is an anomaly here: the NHS Trust stipulates the care to be provided, the Agency (a private company) deliver the care. A nurse working for that Agency blows the whistle to both the Chief Exec. of the Health Board / Trust (decision maker for care provision) and the Agency (employer). The Health Board / Trust ignores the concerns, the Agency persecute the staff member. The Agency worker finds that they are unable to secure work with the Health Board / Trust. As things stand, the Health Board / Trust cannot be held to account for failing to listen, or later persecuting, an Agency employee who blows the whistle. Given that NHS care delivery is increasingly being outsourced to private companies, surely this is wrong? In order to improve care and protect genuine whistleblowers from harm, you need to look at protecting all staff providing NHS services, regardless of who pays their wage and who they are contracted to.

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  • Please please Sir Robert do not listen or let the RCN influence your final recommendations. The RCN and its cronies have totally destroyed real nursing.

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  • I really wish this is true and nurses can report abuse, poor standards, intimidation, bullying and harassment without fear of retaliation. Somehow I doubt it having suffered so much

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  • michael stone

    I do like Sir Robert - I'm sure he knows that you need to separate the person who raises the concern, from the concern, if the concern 'is a criticism of higher management policies'.

    I might look at the review stuff - but I'm sure he already knows, what I would be pointing out.

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  • Long, long overdue but breaking down the "barriers" will be an enormous task. Here's hoping for success, better patient care and major savings financially.

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  • I agree with the comment regarding the rcn
    The RCN positively discriminate against whistleblowers (nurses) and fail to support them in any sense either through negiotation and support or via the legal route
    The rcn was criticised in the mid staffs report and I hope this review looks at thier role in supporting whistleblowers more closely

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  • Tinkerbell

    Sir Robert, who also chaired the public inquiry into care failures at Mid Staffordshire Foundation Trust, said the review would examine whether hospital managers should be held more accountable for their involvement in cover ups.

    Of course they should Sir Robert, they are a big part of the problem of preventing change for the better.

    You continue telling it like it is. Well done Sir Robert.

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  • He has done a good job but look who he has appointed....... Peter Homa, chief executive of Nottingham University Hospitals Trust and Kath Fenton, chief nurse at University College London Hospitals Foundation Trust, surely they are management positions. Will they be able to be impartial and distance themselves from influence by fellow managers?

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  • I raised concerns, made an error in judgement, was sacked, reported to the NMC and totally blacklisted, 75 job applications with no success. Would I whistle blow again, absolutely when it involved patient care, that is why I went into nursing. Managers should be held accountable and NHS money should not be spent on their excuses. If a trust has been seen to cover up. bully and harass and be down right corrupted they should be made to pay back the money spent on legal representation. Please Sir Robert do something about the length of time it takes the NMC to hear a case. Iv been waiting two years. If I committed a crime I would have been through the judicial system by now

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  • Tinkerbell

    Anonymous | 9-Aug-2014 8:07 am

    Sorry you've had such a rough ride, about par for the course for whistleblowers, left hung out to dry, persecuted and hounded out of the profession, this must STOP!

    Hang in there! Good for you standing up and being counted and being prepared to do that same again. Wish you all success.

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