NHS ‘whistleblower’ report calls for change of culture

Sir Robert Francis’ independent report on the Freedom to Speak Up review recommends ‘Guardians’ in every NHS Trust to ensure staff feel able to share concerns over patient safety.

The review was commissioned following a number of revelations about patient safety concerns in recent years, such as the poor care highlighted at Mid Staffordshire NHS Foundation Trust. Sir Robert led two enquiries into failures there so was well-placed to conduct this review.

His report to Secretary of State for Health, Jeremy Hunt, identifies an ongoing problem in the NHS, where staff are deterred from speaking up when they have concerns and can face shocking consequences when they do.

Over 600 people shared their experiences with the review and over 19,000 staff responded to an independent online survey.

The report found that NHS staff wanted to speak up and heard lots of examples of organisations supporting them to do so. However, many others feared victimisation or did not speak up because they felt they would not be listened to.

The review heard examples of staff facing isolation, bullying and counter-allegations when they raised concerns.

Managers told the review that they found it difficult to identify the people with genuine concerns from those who wanted to deflect from their own poor performance.

Sir Robert’s review sets out 20 Principles and Actions, including:

• action at every level of the NHS to make raising concerns part of every staff member’s normal working life.

• a Freedom to Speak Up Guardian in every NHS trust – a named person in every hospital to give independent support and advice to staff who want to speak up and hold the board to account it fails to focus on the patient safety issue.

• a National Independent Officer who can support local Guardians, to intervene when cases are going wrong and identify any failing to address dangers to patient safety, the integrity of the NHS or injustice to staff.

• a new support scheme to help good NHS staff who have found themselves out of a job as a result of raising concerns get back into work.

Speaking about the review, Sir Robert said, “The evidence received by the Review has confirmed that there is a serious issue within the NHS. This issue is 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. Everyone in the NHS needs to support staff so they have the courage to do the right thing when they have concerns about patient safety.”

He stressed that the NHS needed to move away from a culture of blame to one which celebrated openness and commitment to safety and improvement.

He recommended an overhaul of NHS policies to facilitate how people raised concerns with those who could take action, as well as training for all NHS staff in how to raise concerns and how to handle and act on them

The Freedom to Speak Up Review was announced in June 2014 and launched by chair Sir Robert Francis QC in August 2014. Professor Sir Norman Williams, Professor Katherine Fenton OBE and Dr Peter Homa CBE were advisors to the review.

Read the full Report: www.freedomtospeakup.org.uk

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