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'Employers must back speaking out safely drive'


It looks like the tide is turning on attitudes to people who speak up about poor healthcare practice.

The public vindication of nurse whistleblower Elaine Fernandez, covered in last week’s issue of Nursing Times, proves that those who have been silenced for too long are at long last being listened to.

And other changes are on the horizon too. After months of lobbying by Nursing Times and Action against Medical Accidents among others, health secretary Jeremy Hunt has finally agreed to take forward Sir Robert Francis’ recommendation and implement a statutory duty of candour in England from October (see page 5).

Mr Hunt has also launched Sign up to Safety, asking individuals and organisations to make a public pledge to deliver harm-free care, reducing avoidable harm by 50% and saving 6,000 lives in the next three years.

At the core of this is listening to patients, carers and staff, learning from what they say when things go wrong and taking action to improve patient safety. Sounds a lot like the Nursing Times Speak Out Safely campaign to us. But we’re proud to think we may have inspired Mr Hunt to actively encourage staff to speak out.

But let’s not pretend this problem is fixed. It will take more than the government saying what should happen - it’s employers who must make sure it does happen. And while we’re delighted that almost 100 NHS organisations have signed up to SOS, that leaves an awful lot apparently unwilling to support staff who raise concerns.

There are still too many health professionals afraid to challenge their colleagues or managers. Those who blow the whistle are still losing their jobs for no good reason, and patients are still suffering because others fear to speak out.

It should be the norm for employees to raise concerns. Things will go wrong, you will see them and you should be encouraged to speak up by organisations that see concerns as an opportunity to learn and improve care. How about making this a mandatory part of appraisals and revalidation - reflection on what you’ve seen, what you’ve challenged and what you’ve changed in the past year?

What else could be done to make health safer? Tell us on Twitter using the hashtag #NTSOS. You never know, Mr Hunt might even use your ideas - we think he may keep an eye on our hashtag.

And for the many organisations not yet signed up to SOS, show your commitment to safer care by signing up today. Go to

Jenni Middleton, editor Follow me on Twitter @nursingtimesed


Readers' comments (12)

  • michael stone

    Hi Jenny, the NHS has still got major problems re:

    'At the core of this is listening to patients, carers and staff, learning from what they say when things go wrong and taking action to improve patient safety.'

    'The NHS' isn't good at 'listening to laymen', nor at having conversations with laymen - the NHS is much happier with consultations as opposed to conversations, and to genuinely [systemically] learn from the 'lay experience' you need a further step (I'm not sure how to achieve this - it is easy to see the less-than-satisfactory consequences of not achieving it, but it isn't easy to see how to do it): that further step is to incorporate laymen WITHIN decision-making NHS Groups, instead of having only professionals inside decision-making groups. Listening to the laymen, and 'indirectly applying their perspective' simply isn't the same, as putting pateints, etc, inside the actual groups which come up with new protocols, plans, behavioural guidance, etc.

    Things somehow need to move from 'Tell us [professionals] your opinions, and then we [professionals] will go away and use your views when we make decisions', to 'Everyone - professionals and laymen - needs to be making decisions together'.

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  • michael stone

    PS I realise (belatedly) that I'm not just talking about 'safety' in that earlier post.

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  • The court case was concerned with what happened to me rather than what happened to the patient, or what might be learned to protect patients in future. If anyone would be willing to listen, to help me relate my concerns, including those about the actions of the registered nurses who were responsible for mistreating the patient and her husband, HCA training and delegation processes, and inspection and governance, I would be grateful.

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  • michael stone

    Elaine Fernandez | 16-Jul-2014 4:18 pm

    Hi Elaine,

    When you say 'If anyone would be willing to listen' do you actually mean 'anyone who could [directly] change behaviour' ?

    If you mean 'any old idiot' then I'm happy for you to relate your concerns to me, which you can do if you go to my piece at:

    and go to its end.

    But I'm not in a position to directly improve the bad behaviour you drew attention to,

    Best wishes, Mike

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  • I m having a horrible time at the moment as my elderly mother is in hospital and I have queried things the Dr said to me like her her blood pressure readings and the taking of vitamin D with Atrial Fibrilation after stopping her calcium channel blockers, the registrar agreed that it could cause calcification and he told me to "GO AND GOOGLE IT" I asked for referral to cariologist and he shouted and shook his arms at me, refused and then went to my mother after I left and said he would not speak with me unless I made an appointment to see him in private and then arranged with her to do a colonoscopy after he told me her ct scan was clear and no colonoscopy was required. My mother is so scared that she needs this treatment and he wont give her it unless I go away that I have been ostracised.

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  • I have spoken out twice in last 7 years and in both cases it was me that was investigated and eventually left my job to move on, due to work place pressure mainly for sernior staff/management, the last time was only 1yr ago. I do not think anything has changed, the trust's are just getting better at hidding it. I believe there should be a way to report outside the trust, ie direct to CQC or other body.

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  • You can raise issues with the CQC directly, easily. As an individual or group, professional or lay. Request an unannounced inspection though.

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  • To Anonymous | 19-Jul-2014 11:03 am

    I share your experiences. But I'm glad not that I did speak out, even at the cost of my career.

    We need more nurses with courage.

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  • "It looks like the tide is turning on attitudes to people who speak up about poor healthcare practice."

    Not in my experience, as I pick up the pieces of yet another nurse sacked on suspicious grounds last week, after a 4 month bullying campaign of slander and smear because she reported the failure of a ward in her Hospital, to be able to provide adequate quality of care to an ill patient over 3 successive shifts.

    The Hospital says in its Policy documents that it "Listens to, value and supports its Staff"... well this is a funny way of doing it.

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  • There is an opportunity for staff to provide feedback to the current review of whistle blowing by Robert Francis

    Also public concern at work is a charity which aims to support whistle blowers,

    I agree with other post - whistle blowing takes a lot of courage

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