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'Action must be taken to create a safer NHS'


The government needs to do something now the dust has settled on Francis 2, Cavendish, Keogh and Berwick.

I said that a couple of weeks back. The time for reporting and reviewing is done, and now it’s time for action. People working in the NHS and the public who use it want to see implementation. They want to see change. 

Last week, Patients First, the network of health professionals and supporters campaigning for an open and transparent NHS, wrote an open letter to the prime minister calling for action. The letter was in response to the Berwick review’s call for the NHS to become a learning organisation. Of course, Professor Berwick and Patients First both recognise that openness is a big part of that. 

The group is asking David Cameron to read their case studies of staff who have tried to raise concerns but been silenced, bullied or gagged. They want him to see their files so he can understand the full extent of what is going on, and hopefully stir him into action to create a culture that is more receptive to those concerns being raised. Patients First believes – and our experience since we launched the Speak Out Safely campaign echoes this – that cases where serious concerns are ignored are far from isolated. 

Patients First has also been calling for a Truth and Reconciliation Commission related to the NHS, so that mistakes can be acknow-ledged, and the learning environment Professor Berwick called for can actually be fostered.

Certainly, we know something needs to change in the NHS. Stuart Poynor, chief executive of Stoke and Staffordshire Partnership Trust, has worked closely with ex-Mid Staffs nurse whistleblower Helene Donnelly, transforming her role into ambassador for cultural change to ensure staff are encouraged to raise concerns. But such cultures are not consistent. Many people still report being ignored, demonised, ostracised or paid off – with public money.

The only things that so-called compromise agreements seem to do is compromise patient safety. This must stop. Public money must not be used to silence those trying to protect the public.

It must be accepted that sometimes things will go wrong – and that mistakes can be owned up to and learnt from.

Our ambitions in organising Speak Out Safely are similar to those of Patients First, and we urge trusts to sign up to our campaign. Visit to find out how you can get involved in creating a better NHS.



Readers' comments (10)

  • Thank you Jenni!

    An excellent opinion piece.

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  • Jenni Middleton

    Thanks Roger!

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  • Great piece as always Jenni?, fantastic to see some positive movements coming out of Mid Staffs now.

    I agree totally with your article.

    Patient safety first and foremost, we must strive for excellent health care provision at all times

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  • I agree Jenni that something needs to change if we are to have a safer NHS. Speak out Safely (SOS) is a welcome campaign but unfortunate that only 7 acute trusts have signed up so far. Let's hope that more will join and follow the example of Stuart Poynor in acknowledging the courage and integrity of whistleblowers who tried to advocate for their patients.

    This comment comes from Scotland where intimidation of whistleblowers is endemic. NHS Trusts and some politicians are complacent that all is well, when in fact all is far from well.

    The 2012 Independent Investigation found a longstanding culture of fear. Has any whistleblower been transformed into an ambassador for cultural change to ensure that staff are encouraged to raise concerns? Or more importantly has any whistleblower who was hounded out of post during the regime of fear been offered their career back? I'm not aware of such and until that happens healthcare will continue to suffer. Those who raise concerns are still being subjected to intimidation.

    In October 2012, an unannounced inspection found understaffing and scandalous neglect of older people in our flagship hospital. Neglect continues behind closed doors, and this has to change.

    NT might be able to kickstart this change by inviting Scottish NHS Trusts and other relevant bodies to sign up to the SOS campaign.

    Keep up the good work Jenni & NT staff.

    Kathleen White (Edinburgh)

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  • kathleen white | 21-Aug-2013 0:44 am

    Terry Bryan, whistleblower at Winterbourne, I think now works for CQC. Not sure about anyone else.
    Most people are probably put off raising concerns due to perceived or real victimisation in the work place.

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  • Thanks Andy21-Aug-2013 07:47am.

    It is good to hear that Terry Bryan might be working for CQC. Also that Helene Donnelly has been appointed as an ambassador for cultural change. That is in England.

    I made an error in my 0:44am post. The 2012 Independent Investigation should have said "at NHS Lothian in Scotland". I'm not aware of any of the many courageous whistleblowers here have been commended for their brave attempts to improve healthcare. The victimisation was and is very real.

    Many of the bullies on the other hand sailed into the sunset with big payouts and protected pensions.

    As I said, this has to change. Jenni's article refers to Patients First. This network of champions for improved patient care in Scotland can be contacted by email to;

    Kathleen White (Edinburgh)

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  • michael stone

    Jenni, you haven't allowed much time for some of that dust to settle - Berwick was very recent, wasn't he.

    I agree with the objective. But I see 2 main issues. First, the exact meaning of 'safer' will get complicated in practice - it is one of those words which seems to become contentious (for example, when we read reports of 'awkward elderly' being sectioned, when they have not got any mental health problem beyond 'being difficult for the system to interact with'). And second, you say the Goverment must do something: I'm pretty sure the Goverment will say the details of what is done, are down to NHS England and CCBs. The whole 'theme' of this Goverment's approach to the NHS seems to have been to try and 'pass the buck' for any problems to others. That also make it easier for the Goverment to be critical when there are problems in the NHS.

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  • kathleen white | 21-Aug-2013 0:44 am

    Terry Bryan, whistleblower at Winterbourne, I think now works for CQC. Not sure about anyone else.
    Most people are probably put off raising concerns due to perceived or real victimisation in the work place.

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  • Great article – I am hopeful that all this media attention will bring about the changes that are needed to make it safe to raise concerns.

    Being human means we will all make mistakes – it’s a fact.

    It takes a strong and moral person to acknowledge problems and put them right.

    If something is going wrong and you try to raise concerns every way you can and find you are being ignored and bullied, it means the only option is to ‘blow the whistle’ or get ‘back in your box’ and say/do nothing.

    Both are costly.
    Both bring sleepless nights and worry.

    Roll on this proposed and needed improvement to the system.
    There are many factors involved in this on going saga – the government failing to provide the funding needed to enable the NHS to function properly is a big part of this

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  • Maryam Omitogun

    Before Change can occur those the leaders in all Health Organisations must be active and carry out their duty diligently.If a leader is not leading by good example and just sitting in the office or have necessary skills and aspiration to do the job, there will be no change.

    Moving forward and having vision for health improvement and maintenance will actually bring change.

    For the fact that some people are been in an organisation for many years has not automatic certified them to have aspiration or transformational skills. For the fact that some people are shouting about change does not mean that they really want the change to occur.

    The steps to take when we want change is to love our neighbours as our selves,do to others as you will like them do unto you.Take work seriously,every body should do whatever is good that will benefit the service users and carry out duties competently and confidently based on the level of your Skills,experiences and education.

    I think change will gradually be occurring if all the above are put into consideration/practice.

    Maryam Dolapo Omitogun
    Greater London

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