There is a “real and continuing problem” over the treatment of NHS staff who raise concerns about patient care, according to a report submitted to a national inquiry into whistleblowing.
The report, published by the whistleblowing campaign group Patients First, warned there was “little sign of the sea change” needed in NHS culture to improve safety levels and working conditions, despite the previous public inquiry into care failings at Mid Staffordshire Foundation Trust.
“There is a real and continuing problem over the treatment of those who raise concerns”
In fact, the report (attached PDF, top-right) said the divergence between organisations that demonstrate best practice on supporting staff raise concerns and the remainder “appears to be getting greater”.
The document has been submitted to the Freedom to Speak Up review, which is currently being carried out by Sir Robert Francis QC, who also led the Mid Staffordshire inquiry.
The work, carried out for Patients First by a team of employment law experts, looked at common themes from 70 cases involving whistleblowers.
It concluded that failure to provide support and following policies on raising concerns appeared to be the “norm rather than the exception” among health service employers.
The report also noted that some NHS employers were working to a “fundamentally wrong” definition of what a whistleblower was.
Patients First insisted there should be no distinction between “raising concerns” and “whistleblowing”, and no distinction between whether concerns were raised internally or externally.
In addition, it claimed the employment processes adopted typically lead to the isolation of whistleblowers and the containing of their concerns – for example, via confidentiality imposed during internal investigations and through suspension.
A “very striking feature” of the case review, the report said, was the loss of trained talent to the NHS, through termination of employment, ill health or, in some cases, suspension on full pay for long periods.
It warned that there seemed “little doubt” that the experiences of those who had raised concerns operated as a “serious deterrent” to those who might wish to.
The report also said that the number of whistleblowers referred to professional bodies, such as the Nursing and Midwifery Council, was “striking”.
“An overwhelming number were dismissed by professional bodies at a preliminary stage on the basis that there was no case to answer – calling into question the basis and motive for employers having made such referrals,” the report stated.
Patients First said changes were required “as a matter of some urgency” to ensure the early support of whistleblowers became the expected norm in NHS employment and that those who raised concerns received more legal protection to avoid significant loss of earnings.
Among its recommendations, it called on employers to avoid being distracted into turning patient safety concerns into employment issues, and to prevent the “marginalisation and isolation” of whistleblowers.
Meanwhile, it called on the NMC and other regulators to play a “concrete and positive” role in supporting whistleblowers and be “astute to detect reactive or malicious referrals for professional misconduct”.
In March 2013, Nursing Times launched the Speak Out Safely campaign to raise awareness about the problems staff faced when raising concerns.
- Find out more about the Speak Out Safely campaign, including its aims and targets, and which organisations and employers have pledged to support it.