Agency nurses and staff from black and minority ethnic backgrounds are among those who may find it harder to raise concerns but must be encouraged and supported to do so, says the Freedom to Speak Up report.
Alongside student nurses, it identified bank and agency nurses, those from BME background and nurses working in primary care among “vulnerable groups” who may find it harder to highlight problems.
Bank and agency staff can act as a fresh pair of eyes and have the benefit of having worked in a range of environments, said the report, which was published earlier today.
“They may be able to share good practice and identify areas that could be improved while they are working and at exit interviews,” it added.
However, the report goes on to highlight issues that can prevent bank and agency nurses flagging up problems.
“Employers and agencies must be aware of the vulnerable position that this group can find themselves in”
These include the fact they may not have received any formal induction to an organisation before coming to work there and, therefore, may not know how to raise concerns.
Temporary workers may also feel more at risk – and that they will not be employed again by an organisation if they raise a concern, or be given a bad reference.
“Employers and agencies must be aware of the vulnerable position that this group can find themselves in and ensure that they received appropriate induction, training and support, are encouraged to raise concerns and not penalised for doing so,” says the report.
Meanwhile, Sir Robert found evidence that BME staff may feel particularly vulnerable when raising concerns “perhaps more so than other staff groups”.
While many staff from BME backgrounds work in the NHS, they are more likely to be in junior roles and are under-represented in senior management.
The culture of the NHS and its informal networks can leave some BME staff feeling excluded, the review heard. Meanwhile, there were examples of “poor handling of cases, which may or may not have been exacerbated by cultural misunderstandings”.
A snapshot survey of staff for the review found BME workers were more likely to give fear of victimisation and lack of trust in the system as a reason for not raising a concern than staff from a white background.
BME staff were also more likely to say they had been victimised or ignored by management or colleagues after raising a concern, and less likely to say they had been praised for flagging up an issue.
Sir Robert said he had gathered anecdotal evidence that BME staff were more likely to be referred to a professional regulator like the NMC if they raise a concern and received harsher sanctions. Organisations “should consider the support and protection that may be required by BME staff”, he concluded.
He also said those investigating concerns should be representative of the make-up of the workforce and “have an understanding of issues relating to minority groups”.