No action is taken in almost half of cases where nurses are whistleblowers about poor NHS care, according to a survey.
The poll of more than 3,000 nurses for the Royal College of Nursing (RCN) found nothing was done when fears were raised about issues including patient safety and too few staff on duty.
More than a third of nurses (34%) said they have been discouraged or told directly not to report their concerns about quality of care. Some 73% said managers had told them not to speak up, while 24% said work colleagues had said it was a bad idea.
The RCN said the results suggest pressure on staff is intensifying - in 2009, just 21% of nurses said they had been discouraged or told not to speak out.
The survey follows heavy criticism of nursing care in a series of reports from the Care Quality Commission (CQC) and the Patients Association.
It found that more than 80% of nurses had raised concerns with employers about issues relating to NHS wards. Yet 84% admitted they worried about being victimised or expected a negative effect on their career from whistleblowing. Of those who reported concerns, 38% had filled in incident forms (an official record regarding threat to patient safety), while 72% had told their line manager. Overall, just 20% of nurses said their employer took immediate action (down from 29% in the 2009 survey), while 48% said no action was ever taken (compared with 35% previously).
There has been an improvement in knowledge about whistleblowing, however, with 73% of nurses aware their trust has a whistleblowing policy (in 2009 45% did not know either way). But fewer than half (49%) of nurses surveyed knew they could report their concerns to other organisations such as the CQC. And only 42% were aware they were protected in law from reprisals if they raised concerns about wrongdoing.
Dr Peter Carter, chief executive of the RCN, said: “It is extremely worrying that nurses are being explicitly told not to raise concerns - after all we have learnt about the consequences when problems are not tackled. “Cases such as the terrible situation that arose at Stafford hospital, precipitating a major public inquiry, should be adequate warning about the consequences of slashing staffing levels and ignoring staff concerns.
“It’s very important that, when we know 56,000 posts are at risk in the NHS, staffing levels across the board don’t lead to another disaster.”
Dr Carter said senior managers “must demonstrate in practice” that concerns are welcomed and will be acted upon. He said staffing was an issue. “It is patients who suffer where staffing levels are eroded and concerns are not dealt with, so the impact of cuts cannot be underestimated.”
Public health minister Anne Milton said: “Nurses have a professional duty to express concerns about patient care and anything that goes against that is simply unacceptable. “We are enshrining whistleblowers rights in the NHS Constitution.”