Around 18 months ago I answered my phone to hear: “I’m sorry to bother you, but I don’t know who else to turn to”. My heart sank.
We often receive calls from people with random queries or requests that we simply can’t help with.
I’ve had students asking me to send everything we’ve ever published on the subject of an assignment, authors asking for copies of articles they wrote over 20 years ago but can’t remember exactly when, and patients asking me for a second opinion on advice from their GP.
However, something told me this call was different – the caller was obviously struggling to control severe distress and I knew I had to at least listen, whether or not I could offer any practical help.
She was a nurse who had raised concerns about patient care and been rewarded with a horrific experience of bullying that had left her traumatised and unable to work. The only practical help I could offer was to refer her to Patients First, the organisation set up to support NHS whistleblowers. However, the call brought home to me the reality of just how badly some health professionals are treated when they try to take issue with colleagues’ poor practice, in a way that simply reading about similar stories couldn’t.
That call planted the seed that resulted in our Speak Out Safely campaign, organised in association with Patients First and Public Concern at Work. We decided to wait until the Francis report was published as we knew this would bring the issue into the spotlight. It was a long wait, but we hope it was worth it.
“Our petition calls for implementation of Mr Francis’ legal duty of candour for healthcare providers and professionals.”
We have since had people question elements of the campaign, and in particular, whether we are aiming only to improve protection for people who take their concerns outside their employing organisation. So, to be clear, we want to make it safe for health professionals to speak up about patient care and safety issues within their organisations, and to have their concerns taken seriously so that they don’t need to take them outside.
We realise that after serious harm or injury it is too late, so we want to achieve a situation where people will feel able to speak up when their concerns are at a level that can be easily addressed and nipped in the bud. After all, the dreadful examples we’ve all read about at Mid Staffs, Winterbourne View and elsewhere didn’t appear out of nowhere.
At some point, people got away with minor incidents that made them feel they had a licence to get away with worse.
So our petition calls for implementation of Mr Francis’ legal duty of candour for healthcare providers and professionals, obliging them to speak out when patients are harmed.
His other recommendation that it become a criminal offence to prevent someone speaking out was added to ensure health professionals have legal protection against the sort of bullying my caller and many others have experienced.
And we’re also adding to his recommendations that disciplinary action should not be taken when people speak out, unless a criminal offence has taken place or it would be unsafe for someone to remain in practice.
We believe this will enable organisations and individuals to learn from incidents, and for those responsible for poor practice to realise they can’t get away with it (and hopefully to receive training or support to improve before it becomes a disciplinary issue).
The other two elements of the campaign focus respectively on concerns raised internally and externally. Persuading trusts to make explicit that staff will be supported when raising genuine patient concerns should help to ensure their concerns can be addressed internally.
However, if they do need to take their concerns outside, we believe a full review of the Public Interest Disclosure Act is needed to ensure they are protected and that any as yet unidentified loopholes are closed to ensure others don’t have the experience of Jenny Feccit and her colleagues, who did not receive the protection from bullying they had hoped for.
We’re in it for the long haul on the campaign – asking governments to enact new laws or amend existing ones rarely results in a quick response. But if you all sign our petition – and persuade colleagues, friends and family to do so too, we’ll get there.
And that’s vital – for both patients and professionals.