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Freedom to Speak Up Review: live rolling news

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11th February 2014: Keep up with the latest news from the whistleblowing review by Robert Francis

07:00: Findings from Francis review into NHS whistleblowing out today

07.30: Speaking on BBC Radio 4’s Today programme, Sir Robert Francis trails some of the content from his review. Findings from the review’s survey of almost 20,000 NHS staff members included that more than 30% who had raised a concern said they felt unsafe afterwards, he tells listerners.

The Freedom to Speak Up Review, led by Sir Robert Francis, was announced by the government on 24 June 2014.

The independent review was asked to consider what further action was necessary to protect health service staff who speak out in the public interest, with the ultimate aim of creating an “open and honest reporting culture in the NHS”.

09:01: Our reporter, Nicola Merrifield, is one of the first to see the Francis whistleblowing review. Follow her on Twitter at @nic_merrifield for updates on the story.

11.33: About half an hour now till the report is expected to be published online. I understand that it’s 200 pages long.

11:37: Incidentally, the hashtag for discussing the review findings on Twitter is #NHSspeakup

12:00: Embargo due to lift on Freedom to Speak Up report.

Robert Francis

Freedom to Speak Up report

12:01: Breaking: Student nurses should to be trained in raising concerns.

All student nurses should in future receive training in how to raise concerns about care as part of their course, a major review into NHS whistleblowing has recommended. Nicola Merrifield reports.

12:04: Francis calls for stronger legal protection for whistleblowers

Ministers should extend the legal protection for NHS staff who raise whistleblowing concerns through a system to also help those out of work find new jobs in the service, the Francis review has said. Shaun Lintern reports.

12:05: Key points affecting nurses that the Freedom to Speak Up Review has recommended:

  • all student nurses should in future receive training in how to raise concerns about care as part of their course
  • a Freedom to Speak Up Guardian in every NHS trust – a named person in every hospital to give independent support and advice to staff
  • an employment support programme is needed to help those that speak up get back into work,
  • a national officer should be appointed who reviews cases in which complaints have suffered harm





12:10: Over 600 people shared their experiences with the review and over 19,000 staff responded to an independent online survey.

12:15: Sir Robert sets out 20 Principles and Actions aimed to create the right conditions for NHS staff to “speak up, share what works right across the NHS and get all organisations up to the standard of the best and provide redress when things go wrong in future”. These are designed to:

  • promote a culture in the NHS where staff feel safe and encouraged to speak up 
  • make sure all concerns are heard, investigated properly and the right support is on hand for staff
  • protect vulnerable groups, such as student nurses and medical trainees, from intimidation 
  • prevent discrimination against people who have been brave enough to speak up and help them get back into work



12:20: In a statement from the review’s press release issied today, Sir Robert says:

“Failure to speak up can cost lives. I began this review with an open mind about whether there are things getting in the way of NHS staff speaking up.

“However the evidence received by the Review has confirmed that there is a serious issue within the NHS. This issue is not just about whistleblowing – it is fundamentally a patient safety issue.”

Robert FrancisRobert Francis QC

12:30: Jeremy Hunt makes statement in Commons in response to findings from Freedom to Speak Up report.

The health secretary has accepts all the recommendations made by the Freedom to Speak Up review “in principle” and said he would be consulting on a package of measures to implement them. He says:

“The only way we will build an NHS with the highest standards is if doctors and nurses who have given their lives to patient care always feel listened to if they speak out about patient care.

“The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS.”

Jeremy Hunt

Jeremy Hunt

12.32: Chief executive of NHS England responds to findings from Freedom to Speak Up review. Simon Stevens says:

“As a nation we can rightly be proud of the fact that NHS care is now the safest it has ever been. But as I’ve sat down and listened hard to whistleblowers over the past year, it’s blindingly obvious that the NHS has been missing a huge opportunity to learn and improve the care we offer to patients and the way we treat our staff.

“These important proposals – particularly for a new national office of the whistleblower - will provide clear new safeguards and signal a decisive change in culture in every part of the health service.”   


Simon StevensSimon Stevens

12:35: Labour is next to respond to Freedom to Speak Up review. It claims current government to blame for “growing culture of fear and bullying”. Not really a day for trying to score political points, in my view, but then I suppose it’s inevitable with the election round the corner.

Jamie Reed MP, Labour’s shadow health minister, says:

“Any NHS worker must be able to raise concerns, feel confident they will be listened to and that action will be taken. Crucially, they must know that they will not be mistreated as a result.

“The problems we have seen develop over the last few years are this government’s fault, yet we have had no apology for the damage ministers have done.

“The sad truth is that by turning the NHS upside down with a damaging reorganisation and causing a crisis in A&E, David Cameron has made care problems more likely, not less.”

12:45: The Nursing and Midwifery Council unsurprisingly reminds nurses and midwives they have a duty within the NMC Code to raise concerns about issues that risk patient safety.

Jackie Smith, NMC chief executive and registrar, issues her response to the review recommendations, saying:

“We want a health and care sector where all staff can safely raise concerns in the best interests of their patients. The freedom to speak up is vital for patient safety and public protection.

Jackie Smith

Jackie Smith

“We will take careful account of the review’s findings and recommendations. We are reviewing the policies and procedures that we have in place to make sure they provide the help and support that whistleblowers need when they speak out against a fellow nurse or midwife’s practice.”

13:00: Nursing Times’ weekly #NTtwitchat will discuss reaction from nurses to the findings of the review and whistleblowing in the NHS more generally.

13.20: Health Education England Tweets: “Please look out for our new film on raising concerns being launched later today” #HEESpeakUp

13.40: Francis heard that student nurses were ‘discouraged’ to speak out on placements, reports @nic_merrifield

Student and trainee NHS workers have told stories to an independent whistleblowing inquiry with “alarming consistency” about suffering after speaking up about concerns during placements.

14.05: Response to review comes in from Unison. The union’s head of health Christina McAnea describes the findings as “damning but sadly not surprising”. She says:

“Raising concerns should never cost workers their jobs or their health. It is wrong that health workers are being persecuted, ostracised and left to suffer in silence after they’ve spoken out. And it is also unacceptable that patients are suffering as a result.

“Training health workers to report concerns and be confident in doing so is vital if we want our NHS to continue to deliver quality care. But changing the culture and moving towards a no-blame environment cannot be achieved by ticking a box.”

15:30: Chapter 8 of Francis review highlights that agency staff and BME workers need ‘more support’ to raise concerns, reports Jo Stephenson.

Agency nurses and staff from black and minority ethnic backgrounds are among those who may find it harder to raise concerns but must be encouraged and supported to do so, says the Freedom to Speak Up report.

15:33:Care Quality Commission “strongly welcomes” Freedom to Speak Up review, says its chief executive David Behan. He adds:

“In particular, we believe that the local ‘freedom to speak up guardians’ who Sir Robert has recommended should be appointed within every NHS trust could make a key difference to staff being able to raise concerns, as could an Independent National Guardian within CQC, who could support this network of individuals and encourage best practice on handling whistleblowing disclosures.

“We look forward to contributing to the Department of Health’s consultation on this,” says the regulator’s boss.

David BehanDavid Behan

15:40: Royal College of Nursing praises whistleblowing review as “timely and realistic”.

Peter Carter, the college’s chief executive and general secretary, who announced his resignation yesterday, said the review’s findings were “borne out by what RCN members have been telling us for a number of years”. He states:

“The measures outlined in Sir Robert’s review will create the conditions for staff to be able to speak out effectively and need implementation. Visible and supportive leadership, at all levels, as well as the right training are vital in allowing staff to be valued and able to raise concerns without fear of retribution.

“The vulnerable groups identified, like our student nurses who contributed to this review and who talked candidly and openly to Sir Robert about their experiences of raising concerns in the current culture, will be reassured that he has responded to their issues and taken them into account.”

Royal College of Nursing

Peter Carter at the health select committee

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