The first national whistleblowing policy has been published for the health service.
However, it comes amid turmoil over key roles at the new national office set up to support whistleblowers.
“This policy will help standardise the approach to whistleblowing across the NHS”
The policy document, published by NHS Improvement and NHS England, is intended to ensure all health service organisations support and encourage staff to raise concerns, including appointing a local champion for whistleblowers.
The formulation of a national policy was a key recommendation of Sir Robert Francis’ Freedom to Speak Up review into whistleblowing in the health service, which was published in February 2015.
NHS leaders accepted the recommendation and the policy was finalised after consultation on a draft document launched in November last year.
NHS England and NHS Improvement said the consultation had attracted 165 responses from whistleblowing bodies, unions, healthcare providers and commissioners, and many current and former NHS staff.
The document confirms NHS bodies must have a local “Freedom to Speak Up Guardian” to “act as an independent and impartial source of advice to staff at any stage of raising a concern”.
This person would have direct access to anyone in the organisation, including the chief executive, and could also link up with outside sources of support.
The document sets out the types of issues that could be raised including unsafe patient care, unsafe working conditions, inadequate induction or training for staff, and “a bullying culture”.
“Remember that if you are a healthcare professional you may have a professional duty to report a concern,” states the policy. “If in doubt, please raise it. Don’t wait for proof. We would like you to raise the matter while it is still a concern. It doesn’t matter if you turn out to be mistaken as long as you are genuinely troubled.”
It stresses that anyone who works in the NHS – or in an independent organisation providing NHS services – can raise concerns, including agency workers, temporary workers, students and volunteers.
It promises to treat whistleblowers “with respect at all times” and to thank them for raising concerns.
The policy noted that in many circumstances the best way to resolve a concern would be raise it formally or informally with a line manager, lead clinician or tutor.
However, if this was not appropriate, it provides advice on other people staff can approach with concerns such as the local guardian, risk management team or senior managers with responsibility for whistleblowing concerns.
If the matter is not resolved quickly – usually within a few days – it promises a “proportionate investigation”. This would be led by someone suitably independent within the organisation, completed “within a reasonable timescale” with the whistleblower kept informed of progress.
“The investigation will be objective and evidence-based, and will produce a report that focuses on identifying and rectifying any issues, and learning lessons to prevent problems recurring,” stated the document.
Trust boards will be given high level information about all concerns raised by staff through the policy, as well as the steps taken to address any problems.
The document also flags up the role of national guardian in reviewing how cases have been tackled.
NHS Improvement and NHS England said they would be working with organisations across the NHS to help them implement the policy.
“Staff working in the NHS are often the first to spot any issues with the safety or quality of patient care and to make improvements quickly, it is essential they feel able to speak up,” said Dr Kathy Mclean, executive medical director at NHS improvement.
“This policy will help standardise the approach to whistleblowing across the NHS,” she said.
In addition, from today, NHS England is inviting consultation responses on new draft guidance for whistleblowing in the primary care sector.
The Freedom to Speak Up review also called for the creation of a “national guardian” for whistleblowers, described as someone independent to monitor the treatment of staff raising concerns and take action if trusts failed to follow good practice.
“It is important for the person – once they have been appointed – to then decide how they want to run the office”
However, the new post has had teething troubles with the unexpected resignation of the first person appointed to the job, as previously reported by Nursing Times.
Dame Eileen Sills, chief nurse at Guy’s and St Thomas’s NHS Foundation Trust, was appointed national guardian in January but resigned two months later without formally starting the role.
She said she had taken the “difficult decision” to step down because she could not juggle her new responsibilities with her work at Guy’s and St Thomas’.
As an interim measure, Sir Robert Francis himself is providing “support and oversight” for the role, with help from the Care Quality Commission, NHS Improvement and NHS England.
It has also since emerged that Dame Eileen’s deputy, David Bell, has also returned to his old job with the South East Commissioning Support Unit.
- Senior nurse becomes England’s first ‘whistleblowing guardian’
- ‘Agitator’ label spurred nurse to become first ’whistleblowing guardian’
- Dame Eileen resigns from national whistleblowing post
A spokesman for the CQC, which has been tasked with setting up the independent office, confirmed Mr Bell was “not in post anymore”.
“The interim deputy national guardian, who was seconded to the role, has returned to his substantive post,” he said. “This was felt to be advisable as until a new appointment to the position of national guardian is made, it is not clear what level of support will be required from the role of deputy or indeed if they would wish to appoint one.”
He added: “David Bell’s contribution has been greatly appreciated, and the set up team will continue to work on those projects that can be progressed during this period in order to ready the office, with non-executive support and oversight provided by Sir Robert Francis.
“A full delivery team continues to be in place, which is on course to begin operation and provide advice and support to NHS Trusts on the role of local guardians, from the end of April as planned,” he said. “The national guardian role will be advertised later this month, with interviews planned over May and June.”