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Agency staff and BME workers need 'more support' to raise concerns


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”

Robert Francis

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”.


Readers' comments (3)

  • The CEO from the Trust that I work for has identified institutional racism, which prompted him to call a meeting with BME members. The Trust will brand BME members as incompetent or fabricate lies, whereas, if a white member of staff raise issues it is dealt with promptly and sympathetically. As for 'the best man for the job' nonsense, the lack of BME groups in management only shows why the NHS is in such a bad way.

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  • Hi Nursing Times I would like to highlight a concern about employment practices in the NHS which I feel has been overlooked. There has been recent press coverage about the high levels of Agency staff in the NhS with it being identified there should be more fully employed staff. What seems to have been missed is the fact that Agency staff are very vulnerable and not covered by employment law to the extent of fully employed staff.
    I feel that unscrupulous NHS trusts and managers are trying to turn the clock back 100 years by hiring staff not covered by modern employment laws. I am an Agency Mental Health nurse and was subjected to degrading and inappropriate treatment from a manager at the Manchester Mental Health and Social care Trust. I had tried to leave my post and given 7 days notice as my contract allowed. The manager then contrived to summarily dismiss me which has harmed my future employment prospects. He would not have been able to do this if I was a fully employed staff member. I made a official complaint and the manager whom investigated was dismissive of me and upheld the previous managers behaviour, conveniently ignoring the issue I complained about and conducting a investigation which suited her purposes. I was represented by the RCN and the rep was hostile to me, treating the meeting as a job interview for he joining the H.R. Dept of the trust. My agency would not make any waves as keeping a lucrative contract rather than protecting their staff is their priority.
    I use this illustration to highlight the vulnerability of Agency staff in the NHS and the potential for them to be subjected to appalling treatment with impunity by the NHS. I feel this has been completely overlooked by the media, unions and organisations such as yours.
    Benefits for the NHS include hiring and firing as they please, no sick pay, no pension etc, complete impunity of unethical treatment of staff.
    Regards Paul R

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  • Well said and thanks for highlighting this. Its made me think twice as an agency nurse to speak out. Id rather keep my mouth shut than put myself through misery.

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