Around 40% of NHS staff in new posts designed to encourage colleagues to speak out about concerns do not agree that their role is making a difference, according to the national office co-ordinating the work.
Meanwhile, some NHS trusts have so far not received any cases to send on to the national office, which is designed to oversee concerns and alert the Care Quality Commission and other bodies if issues are not handled correctly by local employers.
“Boards need to be…. sighted on both the issues being raised, and apparent barriers to speaking up”
National Guardian’s Office report
However, where problems are being alerted to the new “freedom to speak up” guardians in NHS trusts, nurses are raising more issues than any other staff group – and most who speak out say they would do so again.
The guardians were first recommended in a review of whistleblowing in the NHS by Sir Robert Francis in 2015, which found there was still a “serious issue” with the treatment of people who raise concerns.
Since October 2016 it has been a requirement for all 233 NHS trusts in England to have appointed a guardian. In January, 33 were still yet to do so but now all trusts have at least one.
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A survey of those in the new role by the National Guardian’s Office in June has revealed only 60% agreed or strongly agreed that their appointment was making a difference.
A total of 234 people – 47% of all guardians – responded to the survey, a fifth of whom were nurses.
In many trusts, those responding to the survey said there was not sufficient time to carry out the role alongside their daily work.
Half (51%) of respondents said they did not have any part of their week ring-fenced for the guardian role and only 38% said they believed they had sufficient time to fulfil the demands of the post.
Meanwhile, 14% of guardians said they did not have direct access to their chief executive, despite this being recommended by the National Guardian’s Office.
More than half said they did not present information to board meetings in person, which was “disappointing”, according to a report on the survey by the national office.
“It could be that [the trusts reporting no whistleblowing cases] got it absolutely perfectly right; I suspect probably not”
“Boards need to be kept abreast of all matters related to speaking up. This encompasses being sighted on both the issues being raised, and apparent barriers to speaking up,” said the report.
In addition, two thirds of guardians taking part in the survey said there was no specific budget set aside for them, though a quarter said they were able to access funds.
Russell Parkinson, head of office at the National Guardian’s Office, presented the results at an NHS workforce event last week. He said it was encouraging to see the majority of guardians felt supported but was “less happy” that only 60% believed their role was making a difference.
He suggested this was partly due to appointments only having been made in the past year. However, it may also be due to the fact guardians were “encountering barriers” when dealing with concerns, he noted. He also highlighted that 17 trusts had so far not received any cases through their guardian.
It was unlikely staff at these organisations did not have concerns, he said: “It could be that they’ve [the trusts] got it absolutely perfectly right; I suspect probably not,” he said.
However, 3,000 cases had been received by March and a further 1,124 between April and June, according to data collected from 144 trusts by the office – though it is expected that all trusts should be reporting information.
A third of concerns raised between April and June had elements of bullying and harassment, and a quarter were related to patient safety.
Nurses reported 30% of cases, while allied health professionals referred 15%, healthcare assistants raised 9% of concerns, doctors reported 8% and other staff accounted for the rest.
The vast majority (87%) of people who spoke out said they would raise a concern again. They said they appreciated the independence and confidentiality the guardian offered and felt their concerns were taken seriously.
However, others said investigations took too long, were pessimistic that anything would change, and were worried about repercussions.