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Senior London nurse becomes first national ‘whistleblowing guardian’


The Care Quality Commission has appointed one of the country’s most senior nursing directors as its first national guardian for the freedom to speak up within the NHS.

Dame Eileen Sills, chief nurse at Guy’s and St Thomas’ NHS Foundation Trust, has been appointed to the role, which has been created as part of the government’s response to the review on raising concerns in the health service by Sir Robert Francis.

“I fully appreciate that this is a very big and challenging role”

Eileen Sills

Dame Eileen will be charged with helping lead a “cultural change”, initially within NHS trusts and foundation trusts, so that healthcare staff “always feel confident and supported to raise concerns about patient care”, said the CQC.

Among her responsibilities, she will “lead, advise and support” a network of local freedom to speak up guardians who will be responsible for developing a culture of openness at trust level.

She will also be required to share good practice, report on national or common themes and identify any barriers that are preventing the NHS from having a “truly safe and open culture”.

The CQC said Dame Eileen would be “completely independent, highly visible, and will speak freely and honestly about where changes are needed” among trusts.

While she will work in partnership with national regulators and NHS England, she will also take an “independent stand to report on any matters of concern affecting these bodies when required”, said the CQC.

Her immediate priorities will be to respond to the recently closed consultation on the role of the national guardian and establishing the office, which due to become operational on 1 April.

“I am very pleased that such an eminently well qualified healthcare professional has agreed to take up this post”

Robert Francis

Dame Eileen will remain in her post at Guy’s and St Thomas’ but has stepped down from her role as the trust’s executive lead for speaking up safely to avoid any conflicts of interest.

In addition, she has also stepped down as senior nurse advisor for the Nursing and Midwifery Council and chair of the Shelford Nursing Group of Chief Nurses, which represents the country’s 10 leading teaching hospitals.

The need for an independent national guardian for the NHS was highlighted by Sir Robert Francis in his Freedom to Speak Up report, which was published in February 2015.

Eileen Sills

Eileen Sills

Eileen Sills

His review on whistleblowing found that vital information about mistakes and concerns was not being raised by NHS staff routinely.

It concluded that reporting systems were either insufficient or not used or healthcare professionals did not feel able to speak up.

The creation of the national guardian was one of the key recommendations from the review, with plans to take the idea forward confirmed by the health secretary last July.

Commenting on the appointment of Dame Eileen, Sir Robert said: “I am very pleased that such an eminently well qualified healthcare professional has agreed to take up this post.

“The task of creating the post and supporting the freedom of NHS staff to speak up will be challenging but I am confident Dame Eileen is the right person for this role,” he said.

CQC chief executive David Behan added: “Dame Eileen is a leader of exceptional quality and so I am delighted that she will be the first national guardian for the NHS.”

Robert Francis

Robert Francis

Robert Francis

Dame Eileen herself said she understood “what it is like to provide care on the frontline” and “how difficult it is for staff always to have the confidence and courage to speak out”.

“In this role therefore, I will take my current experience, working with individuals and organisations to learn the lessons from reviews and investigations to date,” she said.

She added: “I fully appreciate that this is a very big and challenging role, but with the support of the staff who work in the NHS, I have no doubt that we can make the changes together that are needed to deliver a new culture of transparency and openness.”

Dame Eileen has been chief nurse at Guy’s and St Thomas’ since 2005. She was awarded a CBE in 2003 for services to nursing and made a dame in the 2015 New Year honours list.


Readers' comments (31)

  • She is NMC therefore not to be trusted

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  • I agree with the above comment, people like that is only interested in their own ambitions and not in what that currently happening on the ground. Board room, fame, status and probably do not remember what a patient looks like!

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  • Pussy

    What kept them? However I totally agree with the above comments so really it won't make one iota of difference!

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  • I have no personal knowledge of Dame Eileen but I cannot for the life of me understand how CQC and Dame Eileen consider that it is appropriate for her to continue in a role as Chief Nurse whilst holding responsibility for protecting whistleblowers' interests. This disregard of a serious conflict of interest is yet another blemish on this flawed office. However, as the National Guardian office is designed to be ineffective, it does not surprise me that CQC is content to operate it as a part time post. The key weakness of the National Guardian office is that its remit will not include examination of whistleblowers' disclosures. Anyone who knows anything about whistleblowing will be acutely aware that good whistleblowing governance requires a central focus on disclosures and their effective handling. Instead, the National Guardian is designed to be part of the distraction machinery which turns patient safety issues into employment quagmires, and will only examine process. Also, because Mr Hunt and CQC have stipulated that the National Guardian will not examine whistleblowers' disclosures, crucial information about trends in NHS whistleblowing and the nature and scale of staff concerns about patient safety will be airbrushed out of the National Guardian's periodic reports. "Meta-gagging" on a grand scale, in other words. I will just mention one other designed-in flaw (of which there are many). The National Guardian will have "wide discretion" as to which cases she will engage with. This is a recipe for arbitrary decisions and unfairness, and risks continuation of the disproportionate discrimination against whistleblowers with protected characteristics. In all, the construction of this office and this appointment say all there is to say about the government's real attitude to staff empowerment and transparency.

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  • Perhaps someone independent of the NHS would be more appropriate as there would be no conflict of interest?

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  • Eileen Sills as whistle blowing guardian?
    Her only agenda is, and always has been, her own self aggrandizement

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  • Completely agree that there appears to be a conflict of interest here. Also agree that this role would be far better utilized by the appointment of someone completely objective and independent of the NHS.

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  • As someone who reported concerns to the CQC and can see how they choose to respond I am a total cynic that a guardian can make any difference what so ever. How do those of us who have been preyed upon, disregarded and discarded by care organisations gain any sense of what they do is right? The problem now is that aspect of whistleblowing that needs where appropriate to expose the CQC with evidence that a political backdrop of conservative non-commital and massaging of corporate egos and alleged leaders is destroying care services. Dame Eileen in my view you are that part of tjhe establishment that is a part of the problem.

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  • cake

    I reported safety concerns to my hospitals chief nurse. Not a thing was done.
    What are we meant to do?

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  • michael stone

    I also think the National Guardian should really be independent of the NHS, although I did go through the consultation re the NG and I seem to recall being less 'negative' overall than some earlier posters. I think the structure/system of local guardians is less good than it could be, but we'll need to wait and see if this set-up does achieve anything helpful.

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