Whistleblowing charity, Protect has called for a review of whistleblowing in the NHS to include the terms of reference of the Government’s inquiry to include leadership and accountability of senior managers in ensuring whistleblowers are not ignored.
Protect reports that a failure to act on concerns is a common problem it sees, adding that so far this year 40% of NHS whistleblowers who have contacted its legal helpline for advice say their concerns were ignored when they raised them.
Although the Nursing Director has been suspended, Protect points out that others may also share responsibility for failures at the Countess of Chester Hospital NHS Foundation Trust. It adds that it is senior managers who set the tone, and whistleblowers will not come forward if they fear reprisal, or if they believe it is futile to do so. Managers, it says, must be held to account when they fail to act on concerns or victimise whistleblowers.
Too many scandals over the years have demonstrated that staff knew there was something wrong but were either afraid to speak up or were ignored, and the promises of subsequent inquiries that lessons will be learned so such awful events will not happen again have proven to be sadly mistaken.
Dr Stephen Brearey, Lead Consultant on the neonatal unit at Countess of Chester, told BBC Radio 4’s Today programme how he raised concerns about Lucy Letby in October 2015 – her final two victims were in June 2016. Dr Brearey told the BBC there was “no apparent accountability” for managers in NHS Trusts, claiming that they were instead worried about reputational damage and that he and his colleagues felt under attack after speaking up.
Meanwhile, leads* at NHS England have jointly signed a letter to all Integrated Care Boards, NHS Trusts and NHS England regions setting out their support for the independent inquiry and the steps it is taking towards strengthening patient safety monitoring.
This autumn, the new Patient Safety Incident Response Framework will be implemented across the NHS, representing a significant shift in the response to patient safety incidents, including a sharper focus on data and understanding how incidents happen, engaging with families, and taking effective steps to improve and deliver safer care for patients.
NHS England wants everyone working in the health service to feel safe to speak up, and confident that their concerns will be promptly followed up, and the letter reminds all organisations providing NHS services that they are expected to adopt the updated Freedom to Speak Up policy by January 2024 at the latest. Good governance is also essential, and NHS leaders and Boards must ensure proper implementation and oversight.
Urgent action is now required to ensure staff have easy access to information on how to speak up, that steps are taken to support members of staff who may have cultural barriers to speaking up or be less confident or simply by working unsocial hours may lack awareness of the process for speaking up, as well as ensuring relevant departments are aware of the Speaking Up Support Scheme. Boards should also seek assurance that staff can speak up with confidence, that whistleblowers are treated well, and that they regularly report, review and act upon relevant data.
* Amanda Pritchard (Chief Executive), Sir David Sloman (Chief Operating Officer), Dame Ruth May (Chief Nursing Officer) and Professor Sir Stephen Powis (National Medical Director).
