Should nurses tell management about inaccurate ward statistics?

The NHS is awash with the collection of statistics covering every aspect of health care: waiting times; length of stay; death rates; rates of cross-infection; details of costs and so on. The collection of accurate data is at the heart of league tables and the ultimate assessment of health care and the performance of NHS organisations, healthcare professionals and patient compliance. There is thus considerable pressure on nurses, ward managers and other healthcare professionals involved in the collection and collation of data to ensure it is collected on time and is accurate.

Since salaries, performance awards, reputations and, ultimately, livelihoods depend on the results of these figures it is not surprising that there have been examples of fraudulent data being recorded, and senior figures within the NHS have lost their posts. If any fraud is suspected it is essential that the facts are clarified and false accusations are not made.

A health care professional who suspected that false statistics were being reported and whose senior managers failed to take action would be protected by the whistleblowing legislation in taking the matter further.

The first step would be for the nurse to check that she was correct in her suspicions. For example, if she herself provided figures and subsequently found they had been altered, she would have to ensure the timespan was the same that she used, or that they referred to the same activity. Once she had established her concerns were correct, she should discuss them with a senior manager who was not involved in the data collection.

If this manager failed to take her worries seriously, she would be entitled to take further action and should be protected in so doing.

The Public Interest Disclosure Act 1998 provides protection for any employee who takes action to bring to the attention of specified persons certain disclosures relating to the workplace.

The protected disclosures include:

• That a criminal offence has been, is being or is likely to be committed.

• That the health or safety of any individual has been, is being or is likely to be endangered.

Protected disclosures also include a situation where any such information has been,
is being or is likely to be deliberately concealed.

The nurse should make the disclosure in good faith, reasonably believing that the information disclosed, and any allegations contained in it, are substantially true and not make it for personal gain. If she failed to obtain internal response to her concerns then she could take her concerns to specified persons outside the organisation. Accurate and comprehensive documentation is essential.

Bridgit Dimond, MA, LLB, DSA, AHSA, is barrister-at-law and emeritus professor, University of Glamorgan, Pontypridd

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