It’s worth persevering to get your concerns heard, says Amanda Pollard
I started with the Healthcare Commission in 2008, as part of a national team inspecting infection control. The team comprised about 25 people, including specialists, and had successes at improving infection control practice in hospitals. A quality control panel assessed our conclusions and ensured similar regulation judgments were made countrywide. Inspectors had frequent specialist training, and at least one specialist was “on call” for questions that arose during inspections.
The Care Quality Commission took over the Healthcare Commission a few years later. Inspectors started to feel uneasy about the direction in which roles were moving during the first summer of registration. We were told we would lose our specialist role and become generic inspectors, responsible for hospitals, nursing homes, learning disability homes and domiciliary care services. We would also move from looking purely at infection control to all 21 essential outcomes. While this change was a shock to many of us, we tried to see the benefits of an extended role - working in different sectors could expand our skills and experience. We waited for the training; it never came.
My colleagues and I came from a range of backgrounds. I had worked as a senior NHS manager with no clinical background so to be told to “hit the ground running” and inspect dementia care, learning disability services and nursing homes with no experience, knowledge or training was more than puzzling to me - it was dangerous.
“You must tell a person/organisation who needs to know the concerns; if you don’t get a successful response, try another”
Equally, my colleagues from the Commission for Social Care Inspection were being asked to inspect hospitals when they had no experience or training in healthcare. There was real discontent and staff meetings saw angry, fearful and concerning scenes. Our protestations fell on deaf ears. I later learnt from Kay Sheldon’s evidence at the Mid Staffordshire Foundation Trust Public Inquiry that many of the managers had written a group letter to the board to raise their concerns. But nothing happened. It was becoming very clear that if the new methodology wasn’t to one’s taste, we needed to look elsewhere for a job.
I wrote to the National Audit Office, which was assessing the CQC. Asking for anonymity, I spelt out my concerns. The NAO told me to contact Public Concern at Work. PCaW appreciated the nature of what I was trying to raise and knew it would be relevant to the Mid Staffs inquiry. The NAO finally replied to me on the eve of my appearance at the inquiry; they concluded my concerns about training and patient safety were outside their remit. Luckily, the inquiry didn’t share their view. This is key - you must tell a person/organisation who needs to know the concerns; if you don’t get a successful response, try another.
I remember the conversation with the inquiry’s lead solicitor about losing my anonymity; my evidence would be inadmissible if anonymous. He believed my role was protected by the Public Interest Disclosure Act; he was right. I didn’t lose my job, but I did leave the CQC earlier this year. I’m unable to comment further for legal reasons.
I genuinely believe if I hadn’t told the inquiry what CQC inspectors were being told to do, the CQC would not be starting to change its inspection methodology now. Thankfully, many inspectors contacted the inquiry after my appearance to reinforce my concerns, albeit anonymously.
If you have concerns about practice at work, contact PCaW. There’s been some movement in the right direction about whistleblowing and more people appreciate that whistleblowers don’t want to cause trouble but have genuine concerns that organisations need to see as opportunities to learn and change.
● Sign up to Nursing Times’ Speak Out Safely campaign at nursingtimes.net/sos
Amanda Pollard was compliance inspector at the Care Quality Commission