The chief nurse appointed as the first national NHS whistleblowing guardian for England has revealed her own experiences of being labelled an “agitator” during her career are what drove her to take on the role.
In an exclusive interview, Dame Eileen Sills said there had been “several” occasions, in both junior and senior nurse roles, when she felt she “couldn’t get my voice heard in the way I wanted”.
Dame Eileen – who will split her time between the guardian role and her current post as chief nurse at Guy’s and St Thomas’ NHS Foundation Trust – said in one case she left her job because it was the “wrong culture for her”.
“One of the key concerns from whistleblowers is the follow up…so our credibility will be based on the fact that we will see things through”
Although she did not class herself as a whistleblower, Dame Eileen said she wanted to use these experiences and also her current role, in which she works a weekly clinical shift, to help create a more open culture for staff to speak up in the NHS.
“Certainly in one post I had to leave because I didn’t thrive in that culture and I struggled to get my voice heard. I’ve also in my career been called an agitator, which did actually insult me, but what that does is make you go silent,” she said in a joint interview with Nursing Times and sister title Health Service Journal.
The post, appointed by regulator the Care Quality Commission, has been created as part of the government’s response to the Freedom to Speak Up report on raising concerns in the health service by Sir Robert Francis.
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Dame Eileen will advise a network of local whistleblowing guardians – to be appointed in each trust – responsible for supporting staff to speak up within their organisations and will help develop their required training.
She will also review cases in which staff feel their concerns have been poorly handled by trusts or other bodies.
However, her office – expected to initially comprise six people – will not investigate individual cases but will instead review processes used to deal with the complaint.
The role will have no statutory powers to demand action from trusts, but if its recommendations are not acted upon then it will inform the relevant regulators.
“One of the key concerns from whistleblowers is the follow up, that actually you’ve investigated something, a set of recommendations, but I’m still hearing it’s not changed and it’s not happened. So our credibility will be based on the fact that we will see things through,” said Dame Eileen.
“Sometimes in a multidisciplinary setting the nurse has more difficulties to be able to have the confidence to speak up”
She said she was still yet to confirm exactly how the role would work and interact with regulators and that further details would be available following the publication later this month of results from a consultation on the national guardian role.
But, she said she would be looking to spot particular organisations or parts of the country that were regularly failing to deal with whistleblowing concerns.
“If we’re picking up a common thread either in a locality, or a few things in one organisation, or issues that are common to a number of organisations… it would be remiss of me, even as a professional not to feed that into the system,” she said.
Student nurses and other trainees were highlighted by Sir Robert’s review as being particularly vulnerable when speaking up due to fears their marks could suffer while on placement.
Dame Eileen said she would work with national workforce body Health Education England to alert them, as a commissioner of training places, to problems.
When asked what difference it made having a nurse in post as the country’s first whistleblowing guardian, Dame Eileen said she hoped it would encourage clinicians to engage with her, because she knew “how difficult sometimes it is to provide care”.
She noted that nurses – as the biggest part of the workforce and being the staff members that are there 24-hours-a-day – were often seen by patients as their advocates, but could lack the confidence to speak up.
“Sometimes, in a multidisciplinary setting, the nurse has more difficulties to be able to have the confidence to speak up, especially if surrounded by very clear authoritative individuals in that team,” she told Nursing Times.
If every nurse felt able to raise concerns it would “hugely influence” the rest of the team, she said. However, she stressed that, despite her insight in this area, nursing and midwifery would not dominate her office’s work.
Asked if she felt it would be difficult to carry out both her chief nurse and guardian role on a part-time basis, following questions raised by some on social media, she said would deliver both jobs in the time it took to do them.
“I’m in this to make it successful and I really wish the issue of part-time status to drop off and people judge me on the deliverables”
“I can see why people have criticised the issue of part-time status, I completely get it but I would just like to say to people I fully understand my roles and responsibilities in both jobs and I will deliver both,” she said.
However, she noted that the guardian role would be reviewed after six months. She said she had requested this formal assessment because it was important to check that progress was being made and also to ensure it could be done part-time.
Dame Eileen said she had forfeited engagements and external responsibilities outside of her chief nurse role that are “really dear to my heart” to ensure there was time to take on the post.
“I’m in this to make it successful and I really wish the issue of part time status to drop off and people judge me on the deliverables,” she added.