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Empower your staff to raise concerns


Don’t assume having a reporting system will make your staff confident about blowing the whistle on poor care.

It is critical that we have a climate of openness that empowers all NHS staff to raise concerns, without fear of victimisation, about any misconduct, malpractice or wrongdoing that may affect patient safety.

While most NHS organisations have systems to allow staff to raise issues, we have seen some high-profile cases involving tragic incidents where these systems have not worked.

The Speak up for a Healthy NHS guidance, published in June 2010, reminds managers of their responsibilities to support staff when they raise concerns in the public interest.

It also provides a practical governance tool to help create the right environment to encourage staff to use internal systems for reporting.

Top tips on handling concerns raised by staff

● Understand your board’s position on issues raised by employees

● Work in partnership with staff organisations to review local policy, communicate with staff and review your progress

● Be clear about your roles and responsibilities for investigating concerns, supporting staff through the process and feeding back to staff on outcomes

● Ensure your team are aware of what they need to do if they want to raise a concern, and know about the legal protection under the Public Disclosure Act

● Join up your information sources. Alongside any staff concerns, patient feedback, staff survey data and any other local survey feedback can provide an indicator of your progress to achieving an open and transparent culture.

● Keep checking and reviewing your progress with your staff and staff side representatives

While not a substitute for good risk management, having a clear policy in place that has been developed with staff-side representatives reaps benefits far beyond detecting issues of patient safety, malpractice or other risk.

A policy is of little value unless it is accompanied by board level commitment to an open and transparent culture throughout the organisation.

The commitment, the policy and the shared responsibilities need to be understood by line managers and communicated to teams.

All too often staff perceive that managers haven’t taken concerns seriously or taken action. In 2010’s staff survey, although 87% of respondents said they knew how to report concerns and 74% said they would be confident to do so without fear of reprisal, only 54% said they would be confident that their trust would act upon them.

Where concerns are raised, as a manager you must keep the individual fully informed throughout the investigation and report on outcomes.

Guidance and resources can be found on the NHS Employers website at

Nyla Cooper is NHS Employers programme lead for professional standards. She is responsible for managing operational issues on whistleblowing and embedding good practice in the NHS in England.


Readers' comments (2)

  • michael stone

    Nyla should be pushing this stuff at managers, not nurses (she probably is). Why is this issue so hard to get right !!!

    Unsuitable or offensive? Report this comment

  • If anyone is interested - here is a statement from PCAW (Public Concer at Work) released on 26th October 2011

    Unsuitable or offensive? Report this comment

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