NHS needs 'whistleblower guardians'

Written By Unknown on Rabu, 11 Februari 2015 | 19.21

11 February 2015 Last updated at 12:02 By Nick Triggle Health correspondent, BBC News

Every NHS trust in England should appoint a guardian to support whistleblowers, a review says.

The measure has been called for by Sir Robert Francis after he warned staff too often faced "bullying and being isolated" when they tried to speak out.

Sir Robert, who led the public inquiry into the Stafford Hospital scandal, also said a new national officer should be appointed to support the guardians.

Health Secretary Jeremy Hunt will respond to the report later.

The Freedom to Speak Up Review took evidence from over 600 people about their experiences, while another 19,000 responded to an online survey.

It said there were lots of examples of organisations supporting whistleblowers.

But it also said too many were put off speaking up because they "fear victimisation", while others do not raise concerns because they feel they will not be listened too.

The review heard stories of staff that have faced isolation, bulling and counter-allegations.

In some extreme cases when staff had been brave enough to speak up their lives lives had been ruined, it said.

Sir Robert told the BBC: "I've heard some frankly shocking stories about [staff] whose health has suffered, and in rare cases who've felt suicidal as a result of their perception of them being ignored or worse."

He said raising concerns should be "welcomed and celebrated".

His review called for:

  • A "Freedom to Speak Up Guardian" to be appointed in every NHS trust to support staff, particularly junior members.
  • A national independent officer to help guardians when cases are going wrong.
  • A new support scheme to help NHS staff who have found themselves out of a job as a result of raising concerns.
  • Processes established at all trusts to make sure concerns are heard and investigated properly.
Analysis

By Hugh Pym, BBC Health Editor

Perhaps the most eye-catching remark by Sir Robert Francis this morning is that two years, almost to the day, since his final report on the Mid Staffordshire scandal there is still a "serious problem in the NHS" relating to whistleblowers.

Sir Robert says that even after the drive for transparency following Mid Staffs there are still too many staff who are afraid and who had told his review they had seen colleagues suffer.

He proposes there should be "guardians" appointed at hospitals to support whistleblowers, but if the trusts pay their salaries will they be truly independent?

Sir Robert pointed out that the key change needed related to cultural rather than regulatory reform.

Few would disagree that culture change needs more than a report from an eminent QC.

The recommendations have been made despite a growing focus on patient safety since Sir Robert published his public inquiry in 2013 into the Stafford Hospital scandal.

One of the main findings of that report was that people within the NHS knew about the poor levels of care at the hospital, but did not raise the alarm.

Since then a number of initiatives have been launched to improve safety.

In 2012 NHS Employers launched its "Speaking Up Charter" asking trusts to commit to helping staff raise concerns.

And last year the government unveiled its "Sign Up to Safety Campaign" - a three-year plan to halve avoidable harm through greater transparency, collaboration with other trusts and support for staff.

But Sir Robert said the NHS had still not got it right.

He argued: "There is a serious issue within the NHS. It's not just about whistleblowing, it is fundamentally a patient safety issue.

"The NHS is blessed with staff who want to do the best for their patients. They want to be able to raise their concerns free of fear that they may be badly treated when they do so and confident that effective action will be taken.

"Unfortunately I heard shocking accounts from distressed NHS staff who did not have this experience when they spoke up."

Case study

Staff who gave evidence to the review complained of being labelled a "snitch" and being "punished" if they raised concerns.

One nurse described what happened to her after she complained during a team meeting about the care being provided at her trust.

She was later called into an office by two managers and shouted at until she was reduced to tears.

She then described being criticised at every opportunity thereafter and at her next appraisal the comments from managers were critical. Her mental health was also questioned.

She said, to her knowledge, the concerns she raised were never looked into and she did not pursue it for fear it would damage her career.

'Persecution'
Doctor Raj Mattu

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Dr Raj Mattu: "My safety concerns were turned into an employment dispute"

Dr Raj Mattu, a cardiologist who was suspended then sacked after raising concerns about patient safety in 2001, said it was frustrating and depressing that there had been "very few biting changes" to protect whistleblowers.

He said there was still "persecution of whistleblowers on a grand scale" in the NHS.

Asked why this was the case, he said medical staff were in their jobs because they wanted to help patients but many senior staff were there for a "career in management".

"What then happens is the interests of the trusts and the NHS conflict from time to time with those of the patient and many of us who are whistleblowers feel compelled under moral obligation to speak up," he said.

He called for independent assessment of whistleblowers' claims, and "real protections" for those raising concerns.

Have you been affected by the issues in this story? You can email your experiences to haveyoursay@bbc.co.uk

Please include a contact number if you wish to be contacted by a BBC journalist.

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