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CQC ratings should 'reflect how well whistleblowers are treated'


The way NHS organisations treat whistleblowers should be reflected in their inspection ratings, with the potential for a cash reward for best practice, says Sir Robert Francis.

The Care Quality Commission should look at how organisations handle cases as part of its assessment of leadership, and those with particularly good practice should be recognised, he concluded in his Freedom to Speak Up report, published earlier today.

At the same time, NHS settings which do not have an open and honest culture where staff feel safe to raise concerns should expect to be criticised and get poor ratings for leadership, he suggested.

“It is unlikely that an organisation which does not recognise the importance of instilling and maintaining this type of culture is one which is well-led,” he said. “Likewise any department or unit, such as a ward, exhibiting such deficiencies is unlikely to be well-led.”

To measure this, the assessment process should include a CQC analysis of data on raising concerns before inspection visits and questioning staff about policy and how easy it is to raise concerns while on site.

“Good practice should be viewed as a positive factor contributing to a ‘good’ or ‘outstanding’ rating”

Robert Francis

The CQC told the review its inspection teams would be looking at whether leaders and staff recognised the value of raising concerns and whether appropriate action had been taken when concerns were raised.

Inspections could also include looking at settlement agreements for staff who can no longer work at an organisation after raising a concern. Sir Robert said all such agreements should be made available to the CQC to inspect.

Organisations that are good at protecting and supporting staff who raise concerns should be “recognised and celebrated” possibly through some kind of financial incentive, he added

“Good practice should be viewed as a positive factor contributing to a ‘good’ or ‘outstanding’ rating as part of their well-led domain,” he said.

His other suggestions included the creation of a national award scheme. This could be an annual award for the organisation that could demonstrate the best safety improvements achieved as a result of staff raising concerns.

“It might be possibly within the NHS to devise some financial incentive to organisations for outstanding practice in this area,” he added.

Overall, Sir Robert said he wanted to see regulators play a bigger role in supporting staff to raise concerns and he concluded there was scope for better co-ordination between the CQC, Monitor and NHS Trust Development Authority.

Together with NHS England, they should jointly create a fund a new national role to review the handling of concerns.

The Independent National Officer – another idea mooted by the report – would review cases, advise NHS organisations and promote good practice.


Readers' comments (3)

  • I reported to CQC who did nothing I reported to Durham County Council safeguarding and had false allegations made against me by them and my employer. Who told my employer what I'd said??
    I dont trust either of these organisations.
    I fully understand why whistleblowers keep quiet. WBs go through hell
    Many providers employ bullys as managers who intern promote HCA who are known bullies to keep control.
    Jeremy Hunt has a long way to go to persuade WBs
    Safeguarding Units must act on reports
    CQC must take reports seriously
    NMC must back off from saying go through official channels

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  • Interesting about whistleblowing regarding a County Council. I had a similar experience when raising concerns about ‘failure of duty’. The response was as described in previous comment. The Council, rather than addressing the root cause of the concerns, shirked their responsibility, and attempted to turn my concerns into a personal dispute. This is still ongoing more than a year later.

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  • I have experienced all that you have been through and more after whistle blowing in a care home two years ago. The series of events which followed are truly outrageous. The reactions of the support systems are incredible to say the least. I am putting my name to this as two years on I am still fighting this for the safety of patients, then, now and in the future in care homes, community care, primary care and secondary care. I have spent the last two years defending my own practice, and have managed to do so, now its about time someone heard what I have to say, I have withstood the test, now I need to speak out.

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