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Exclusive: Pioneer nurse warns that 'whistleblowing guardians' must be screened

  • 20 Comments

Nurse whistleblower Helene Donnelly has called for “rapid” action to ensure the introduction of the new “guardian” role recommended by Sir Robert Francis is not “used and abused”.

Ms Donnelly said she wanted to see a checklist of qualities and standards drawn up swiftly for the new “freedom to speak up guardians” to avoid the “wrong people” being selected for the job.

The role was a key recommendation of Sir Robert’s independent review of whistleblowing – Freedom to Speak Up – which looked at the treatment of  staff who speak out and what measures should be introduced to create a more open reporting culture within the NHS.

“I am acutely aware that people will potentially use and abuse this role and so we need to make sure that it is monitored”

Helene Donnelly

Sir Robert’s report, published last week, said that a “freedom to speak up guardian” should be appointed in every NHS trust to provide independent support and advice to staff about raising concerns. This full-time employee should be able to intervene if the complainant suffers any harm and must be able to escalate concerns outside of the organisation to bodies, said the report.

In accepting all of Sir Robert’s recommendations “in principle”, health secretary Jeremy Hunt said he supported the idea of the guardian. He stated “there is no reason” for trusts not to get on with implementing the recommendations “right away, particularly in making sure staff have an independent person they can raise concerns with”.

Ms Donnelly, whose current job as Staffordshire and Stoke-on-Trent Partnership Trust’s ambassador for cultural change inspired the new role, said the position should become standardised across the country so that the Care Quality Commission can identify any wrongdoing.

“I am acutely aware that people will potentially use and abuse this role – that it will be used as a tick box or the worst people will be put in the position to do it – and so we need to make sure that it is monitored,” she told Nursing Times.

“The CQC has told me it would be happy to inspect the role to make sure it is not the bullies or people who are ignoring or not challenging issues [who are in post],” Ms Donnelly added.

She acknowledged that “a lot of staff” may not feel confident in the independence of the guardian, who would be expected to raise issues with chief executives and if necessary escalate issues externally to regulators.

However, she said, this should not be a cause for concern provided training is given to the guardian, they are scrutinised and are made to justify their decisions to the CQQ if they fail to act.

  • 20 Comments

Readers' comments (20)

  • These Guardian posts proposed by Robert Francis are worse than useless because he has made the *National* Guardian subordinate to several DH arms lengths bodies, including CQC, of which he is a non executive director. These bodies have abjectly & repeatedly failed whistleblowers. They are part of the top down bullying in the NHS. The so-called "Independent National Officer (the national Guardian) will be the opposite of independent. Their office will be under the control of the DH, thus introducing unworkable conflicts of interest. The DH has long deflected and stonewalled whistleblowers. The National Guardian should NOT have a reporting line to the DH, either directly or through bodies such as CQC. Furthermore, it should be noted that Francis has done whistleblowers an immense disservice, by not giving any description in his report of the scale and gravity of disclosures that have been covered up by the NHS. This was surely at the heart of his review. His silence on the patient harm and deaths is in my opinion, further concealment. His proposals are strikingly weak in relation to the evidence of enormous harm and suffering that was submitted to him. He dealt future whistleblowers a mortal blow by leaving whistleblowing investigations under the control of employers. This is utterly perverse in the light of all the evidence he was been given about the determined deceptions, and dishonesty of some NHS employers, including commissioning sham "independent" investigations. Francis actually knows all this, which makes his actions all the more baffling and concerning. He was on record last year, as Nursing Times knows, saying that whistleblowers need access to truly independent investigations. His U-turn is dizzying. Francis' disservice to whistleblowers, in not allowing a mechanism for truly independent investigation, is a flashing green light to employers to continue spinning & burying serious patient safety issues. In the absence of properly independent investigations and the toothlessness of the National Guardian, Francis has cut the legs from underneath future whistleblowers. As for CQC, a body under weekly operational supervision by the DH, they are not a credible resource for whistleblowers, let alone fit to oversee the National Guardian or to vet local Guardians. In short, the Francis review on whistleblowing is a DH-procured exercise in damage limitation, carried simply to claim that something has been done. All that has actually been done is that Francis has helped the NHS Establishment sit even more firmly on whistleblowers, until the next scandal forces another sham, hand-wringing exercise. The majority of whistleblowers are extremely disappointed. So are patients & relatives who are seeking redress. They understand only too well the serious harm that Francis has inflicted, through his review, on their rights to safe care & governance. Without effective whistleblowing governance, patients will continue to suffer & die unneccessarily.

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  • michael stone

    The guardians within organisations, need to be selected with a lot of input from the 'front-line staff': the Board must not be allowed to select someone it likes, the person selected has to have the trust of the front-line staff.

    Otherwise, this isn't likely to be successful, in my opinion.

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  • The guardians should not be employed by or awnser to the trusts/hospitals...they need to be a seperate entity liasing with the cqc but not always awnserable to them.At the end of the day the cqc is not what it should be...trusts know when they are arriving and from my experience the 2/3 weeks leading up to the visit means that everything all of sudden is possible...more staff on duty..everthing is available,cleaning is tip top..all very pretty,photo's on walls,paperwork all present and correct,and so on and on....but the same things go on...too much paperwork,staff nurses writing all day,hca's doing the graft and top heavy with senior staff who know all the right pc awnsers...i could no doubt walk into most hospitals as i could at ours and save £1m in the first few days without affecting care in any way and putting more nurses on the floor by doing it.Bullying is rife,in many different forms...holidays are messed with....shifts altered ...silent treatments ....and so on ...if the guardians work for the hospital they will be as innefective as a local union rep.

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  • Anonymous 6:23 I can agree with much of your concern but your final comment is unfair on many local union reps from all trade unions. I know (I have read transcripts of evidence reps gave during the Francis Enquiry) that there have been cases where the support of a rep has fallen below what they should have delivered but the fact is that reps too have found it hard to get listened to and have had to be very persistent to bring things to light. However, I have seen examples where they have done so despite obstacles and been an invaluable support to members at their most isolated. We care about services too, and read the transcripts to learn from errors made. Local reps should be a support to whistleblowing staff - if they are not, complain to your unions.

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  • What a powerful and comprehensive comment from Minh Alexander; it virtually says it all. It's hard to believe that the Francis Report is anything other than a blatant exercise in putting the lid firmly on those with the courage to report what desperately needs to be reported.

    Apart from this, all that his proposal will achieve will be to add yet another useless layer to the bureaucratic mess - wasting time, creating unnecessary and costly posts and raising false hopes in those who (sadly) believe that, at long last, something will be done to achieve safeguards for the whistleblower.

    When I last commented on this NT site some 2 years ago (I have been off sick from that time until now) I regretted that many contributors wrote anonymously; they still do. At that time I was taken to task (anonymously) for saying this. I feel that over the next few months an increase or decrease in the incidence of people not putting their name to their comment may be a litmus test of (lack of) confidence in these spurious whistleblowing safeguards. This is, of course, a minor matter compared with what staff are being subjected to on the wards etc; nevertheless, it can act as an accurate bellwether. We shall see.

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  • I am not so sure ' healthcare professionals can surely manage ' as another anonymous post states above, and I for one very much welcome the considered and balanced comments regularly made by michael stone as I have always found them to be ' spot on '.

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  • I bow to Minh and agree with her statement. All nurses on the front line would be in agreement with her but this only scratches the surface! The powers that be usually have had long term experience in handling staff and have perfected their tactics to ensure that, rightly or wrongly, what they say goes. It is no coincidence that many excellent, extremely experienced nurses have resigned t my own hospital purely due to the distress caused by the almighty's unwillingness to listen and act appropriately. I take my hat of to Minh for her statement and for her lack of anonimity as with others who have given their name. I am not so brave, but, then again, I am aware from experience there would be severe consequences of some form or another as the brave David says; long stints on night shift, moved to a different ward, supervised where unnecessary to deflate confidence, delegated junior task to deflate confidence etc. The power is in the hands of seniors and management many whom have been very well paid for a very long time BUT trained in a dictatorial manner and have not embraced the theory of 'change' as this would deflect some control to those who are actully 'hands on'. Sadly the safest way to work on a ward is to bow to the Seniors every word which only serves to breed a further generation of dictatorial nurses who are trained in the Seniors management style of bullying and intimidation at its worst. Promotion of the insisted academic nurses could perhaps go some way to encouraging openness and honest, however, would you be willing to give a Senior nursing post to a degree trained nurse who has only 10 years experienceof at the cost of taking away your 35+ K and your power no matter how approachble or how much sense the nurse makes?

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  • There is publicised reporting of the dire state of a NE hospital.
    Top (dictatorial, all powerfull) management have all but gone, perhaps due to their mismanagement over a lengthy time. This alone has restored a little faith to the work force.
    Maybe now the hospital and it's staff will start to see the light at the end of the black tunnel. Fingers crossed to prevent further loss of excellent nursing staff.

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  • michael stone

    David Francis Seelig | 17-Feb-2015 7:42 pm

    I can't agree that the Francis report is in some way supporting 'the status quo and the 'system'. He describes the problems with what appears to me to be great openness.

    But he doesn't necessarily 'impose rigid solutions'.

    Sir Robert wants organisations to employ 'guardians' but I have not yet had the time to read what [if anything] he says about how guardians should be selected - he does say they should be 'independent'.

    As I wrote above, Sir Robert pointed out that the more junior the member of staff, the more 'support' the person will probably need in raising a concern: hence my comment above, that front-line [junior staff] must strongly influence the appointment.

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  • I dare not reveal my name for fear of repercussions....it will always be a them and us situation whilst ever incompetent bullies are in charge.
    I made a complain once about the bullying attitude of a manager. I was called a liar and nothing came of it. To this day she still bullies her way around the place without a care for the staff she is allegedly supporting.
    I cannot wait to retire but cannot afford to just yet.

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