Health secretary Jeremy Hunt has written to trusts warning them against having a “defensive culture” over patient safety and whistleblowing.
The letter was sent on Friday to the chairs of all NHS trusts and foundation trusts in England. In it, Mr Hunt stated that raising concerns “can be a brave thing to do, even in an open culture”.
“When our staff have the courage and professional integrity to raise concerns in the patient interest, we need to recognise and celebrate that behavior, listen to their concerns and take action to ensure any problems are properly addressed,” he said.
He added: “I would …ask you to pay very serious heed to the warning from Mid Staffordshire that a culture which is legalistic and defensive in responding to reasonable challenges and concerns can all too easily permit the persistence of poor and unacceptable care.”
The letter follows widespread criticism over the last few days of “gagging clauses” in NHS pay-off agreements that are designed to prevent staff speaking out. Such clauses are referred to in formal terms as compromise agreements for departing employees.
The case of Gary Walker, the former chief executive of United Lincolnshire Hospitals Trust, has received widespread media coverage, after he chose to break his own gagging clause. He claims he was forced out of his job in 2010 for refusing to prioritise meeting targets at the expense of patient safety.
Mr Walker’s actions themselves came in the wake of the publication earlier this month of the Mid Staffordshire Foundation public inquiry report, which recommended the introduction of a legally enforced “duty of candour”.
Mr Hunt’s letter noted that the inquiry report had highlighted the “critical importance of fostering and sustaining an open culture in which concerns about care can be raised, investigated and acted upon”.
“Fostering a culture of openness and transparency is essential if we are to ensure we never repeat the mistakes of Mid Staffs – which means creating a climate where it is easy for staff, present and former, to come forward with any concerns they have relating to patient safety,” he wrote.
The health secretary reiterated that trusts should follow DH guidance dating back to 1999, which states that NHS trusts should “prohibit” the use of gagging clauses in contracts of employment and compromise agreements, which seek to prevent the disclosure of information in the public interest.
NHS Commissioning Board chief executive Sir David Nicholson wrote to trust chief executives in January 2012 on the same issue, highlighting that such clauses to prevent disclosures in the public interest were “contrary to policy on supporting whistleblowers”.