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Staff must be free to raise safety concerns, says Heart of England chief exec


One of the largest hospital trusts in England has backed Nursing Times’ campaign to make it easier for staff to raise concerns.

Dr Mark Newbold, chief executive of the Heart of England Foundation Trust, has added his support to our Speak out Safely campaign.

The former histopathologist said it was vital the message that NHS staff were free to speak up and raise concerns was repeatedly made clear.

Dr Newbold, who joined Heart of England in 2010, is the first trust chief executive to announce his support for the campaign, which calls for NHS organisations to make an explicit commitment to staff that they will not face disciplinary action for raising genuine patient safety concerns.

He said: “The way we improve this situation is by constantly reiterating the message about raising concerns and the Nursing Times campaign is really helpful in doing that and I would encourage others to support it as well. It’s really helpful publicity on a really important subject.”

Dr Newbold said he personally spoke with new staff at his trust during their induction. “My final word to them is always that you can have any number of procedures and policies, but the ultimate fail safe is the 11,000 of them,” he said.

As a result, he said told Nursing Times he received three or four concerns a month, with staff sometimes finding it easier to approach him as chief executive than their line manager.

He added: “It would be hard to deny there isn’t an issue about [NHS] staff feeling they can speak up. The only way we can tackle it is to keep repeating that everyone should be free to raise concerns, particularly where it is about the care or safety of patients. We have to keep making it clear.”

Dr Newbold said a commitment to staff and support for the Nursing Times campaign would be included on his trust’s website.

Nursing Times has drafted a statement that trusts are being encouraged to endorse and place on their websites in support of the Speak Out Safely campaign. See

The Speak Out Safely campaign also aims to obtain a commitment from the government to carry out a full review of the Public Interest Disclosure Act to ensure it gives adequate protection to NHS staff.

In addition, we are calling on the government to implement a statutory “duty of candour”, requiring NHS staff and organisations to be open about mistakes. This would make it a criminal offence for any trust or manager to prevent staff raising concerns after a serious injury to a patient or death.

In its response to the Francis report last month, the government has said it will bring in a legal duty for board members but has not yet made a decision on applying that to staff.


Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care.



Readers' comments (13)

  • This article says nothing about the measures Dr Newbold intends to put in place to facilitate the raising of concerns. It could be sloppy journalism and under reporting. Or it could be that there is nothing to report in this regard.

    Wouldn't it be better to give actual details of policy, backed up with hard evidence that concerns being raised have been acted upon in a timely and appropriate manner? Simply jumping on the bandwagon and agreeing that this is a good idea, isn't anywhere good enough. This goes to the heart of the problem with managers. Making the right noises whilst remaining light on the details means nothing to me. I would like to think that there is substance behind these words.....but recorded history and my own experience tell me different.

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  • Are staff who continually raise concerns about poor staffing levels, inadequate skill mix also going to be protected? Are these even considered 'concerns'? If so why is nothing ever done about it, why haven't we got minimum staffing ratios, the proper skill mix, ward sisters who work internal rotation and are out on the wards looking after patients.

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  • michael stone

    At least Dr Newbold seems to have the right attitude ! The right implementation, follows after a desire to achieve the right objective.

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  • DH Agent - as if ! | 9-Apr-2013 10:06 am

    "The right implementation, follows after a desire to achieve the right objective."

    Not necessarily if the desire is only expressed and not acted upon, which is the norm within the nhs.

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  • Anonymous | 9-Apr-2013 9:43 am

    Because most nurses don't actually complain.

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  • anon 11.33 - surely every 'concern' should be raised, if just one nurse reports understaffing or inadequate skillmix then it should be investigated and acted on.

    patients 'concerns' are dealt with individually, why should staff 'concerns' be treated any different.

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  • Anonymous | 9-Apr-2013 11:44 am

    Every concern should be raised and dealt with, but do you really believe that it happens? Many nurses can identify, instantly, issues within their area. However, the vast majority do not act upon them.

    There will always be individuals who raise concerns, but the solutions to many of the issues affecting nursing, require investment and effort to fix them. If you are a manager trying to operate within a tight budget, your default response to a concern is to wait and see if it will go away. If that concern has been raised by a single nurse, then there is no motivation to spend time and money sorting it out. Most of the time, nothing else will happen. However, if every member of staff in the same ward/unit/area consistently and repeatedly voiced the same concern, put it in writing and ensured that the CEO and union were also given copies, then it would be very much harder to ignore. We have to make sure that ignoring our concerns will have consequences. If not, then nothing will happen.

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  • on my ward we had entirely open communications so most difficulties were seen, discussed, and dealt with fairly promptly before they became a major problem. However, it never occurred to me that I was not free to report any safety concerns. where one works as an autonomous professional in a relation of trust with employers and other members of the interdisciplinary team this should be no problem.

    it seems such is a natural, mature, healthy, and safer attitude which makes working relationships easier, frees staff to focus on their patients or whatever is the function of their organisation and needs to be fostered in all organisations, and for which every single employer and employee is responsible.

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  • Dr Newbold has got an online contact form - he seems committed to receiving feedback:

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  • I don't think there is a quick win on this. It needs constant reiteration that it is good to raise concerns, together with a range of different avenues for staff to use. As well as line manager, both staff governors and CEO should be ready to listen as staff may prefer to contact someone outside their work area.

    There also need to be several ways of easily getting in touch - directly, email, letter or Twitter for example. Minor concerns are raised (in public) on our intranet notice board which i answer personally. I accept and act on anonymous emails or letters if people prefer.

    I cannot say we have got it right yet, but we are trying. I personally receive between 4 and 6 concerns a month, so some success? My managers know that punishment of those raising concerns will not be tolerated, and I reinforce this when personally asking for concerns raised with me to be investigated.

    Ultimately we need a cultural change across the NHS and this will take time. Well done to the NT for highlighting this very important issue!

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