Student and trainee NHS workers have told stories to an independent whistleblowing inquiry with “alarming consistency” about suffering after speaking up about concerns during placements.
The Freedom to Speak Up Review, published today, looks at how NHS staff are treated when they raise concerns.
It found there were “far too many” stories of students being bullied and of their assessments “suddenly becoming negative” after speaking out.
“These were mainly young people at the start of their careers who genuinely believed they should raise issues for the benefit of patients. Of none of them could it be said that they had axes to grind,” said the review chair Sir Robert Francis QC in his introduction to the report.
“We heard all too frequently of jobs being lost, but also of serious psychological damage, even to the extent of suicidal depression”
Some respondents to the review also criticised universities for taking the side of mentors rather than students – particularly nurses – when they lodged a concern, claiming that higher education providers had biased processes and that they were not best equipped to consider fitness to practise cases.
One student nurse told the review how they had contacted the trust they were working at about a concern they had but were told because they were not an employee of the trust, the complaint could not be dealt with.
While the student attempted to change placements they were put on leave, but this resulted in them missing a part of their course and they were then marked as having failed that section.
— Niina Kolehmainen (@niinamk) February 11, 2015
Meanwhile, the “truly shocking” effects of bad treatment of qualified whistleblowers has also been exposed within the report.
Sir Robert said: “We heard all too frequently of jobs being lost, but also of serious psychological damage, even to the extent of suicidal depression.
“In some, sad, cases it is clear that the toll of continual battles has been to consume lives and cause dedicated people to behave out of character,” he said.
“Staff who have been badly treated can become isolated, and disadvantaged in their ability to obtain appropriate alternative employment,” he added. “In short, lives can be ruined by poor handling of staff who have raised concerns.”
One nurse spoke of how she was shouted at by two managers after raising concerns about patient safety during a team meeting and was thereafter criticised “at every opportunity”.
She told the review she believed none of her concerns were looked into.
Meanwhile, a practice nurse described how she was bullied after speaking out, resulting in her becoming unwell and taking time off work to recover. She is now out of employment and believes she has been “blacklisted”, noted the report.
From the review’s online survey of 15,000 trust staff, just over a third had raised a concern about suspected wrongdoing.
Of those, around 20% reported being ignored by management and 17%being victimised by management. Just 8% were praised.
Co-workers ignored or victimised these whistle-blowers in around 8% of cases, but praised them in 15% of cases.
The review, which puts forward a series of recommended actions based on 20 principles to help create an open reporting culture within the NHS, has called for training for all NHS staff and students about how to raise and handle complaints.
An employment support programme to help those that speak up get back into work has also been recommended.