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First ever national NHS whistleblowing policy

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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”

Kathy McLean

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”.

Robert Francis

Robert Francis

Robert Francis

“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.

Eileen Sills

Eileen Sills

Eileen Sills

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”

CQC spokesman

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.

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.”

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Readers' comments (5)

  • bob cat

    Funnily enough though it coincides withe the National Guardian having stepped down and now the deputy as well!
    Is this a good omen?
    Do they feel able to speak up as to why??

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  • michael stone

    I got an e-mail from the policy development people the other day (I submitted one of those 165 responses) but I have been too busy to look at the published policy yet.

    I just hope it works - I hope the NHS can move from covering-up mistakes and problems, and too often 'bullying' staff who raise concerns, to a more open culture which seeks to improve by learning from concerns which are raised.

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  • Top priority is to ensure whistle blowing by NHS staff is used proactively by management.

    But the people Parliament terms "citizen whistleblowers" should also have protection and this cannot be achieved under the Employment Act.

    By pure chance the civil justice system judge came to understand that the false allegations made against me when I acted as a citizen whistleblower were exactly that - false. So I did not end up going through the criminal justice system framed for a crime I did not do and possibly ending up in prison, which was on the cards otherwise.

    How should it matter who comes up with concerns about patient harm? It only matters that management actually address the concerns. If bully culture managers put as much effort, time and resources into actually delivering care as they do into furthering the bullying of those forwarding concerns then all this costly process would be superfluous.

    Would it not save a lot of NHS money if these managers were sacked for dereliction of duty?

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  • On reading the national policy it is so generalised there is nothing of substance. If policy standardisation mean ambiguity then it hits this mark also. And what kind of monitor consultation just simply mentions debate over whether to use whistle blower or not?

    Standardisation should say sanitisation of essential individual components that are ignored in favor of fixed constituents that dismiss the individual nature of cases presenting. The CQC or Sir Francis's proposed team are unfit if they purely use empirical evidence without greater individual sense. On reading policy there are simply too many fingers in the pie and looks more like a power struggle of gov dept. values - If it depended on it I wouldn't trust any of you.

    The truth is the healthcare is on its knees and the only way to clean it up are high level maverick troubleshooters who are willing to look for trouble and put public healthcare before demand on privitisation - good luck with that one.....

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  • I work in the Charitable healthcare sector, a hospice and have recently experienced the harassment and bullying because I raised a concern. While I firmly believe that as nurses we must abide by our NMC code and I will always do so. However it was the worst experience in my 25yr career so I can understand why others may not feel able to speak out when they are working where there is a culture of intimidation, negativity and blame rather than support, encouragement and value. So I welcome anything that will help open up communication across any healthcare establishment to improve standards at all levels of service. Hopefully non NHS healthcare provider will also embrace this fully, not simply pay lip service to it.

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