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Steve Turner

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Everything posted by Steve Turner

  1. Content Article
    "Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
  2. Article Comment
    Was there an Assertive Outreach Service involved? Many areas no longer have these.
  3. Article Comment
    This is interesting and important, Rob Behrens (PHSO) reminded us all of the Messenger Review in the APPG for Whistleblowing Westminster Round Table Meeting in November 2023. It's a step forward, but we need to be vigilant, this could easily fall into the pile of endless reviews that lead to nowhere. Senior people's jobs and reputations are at risk, they will fight like mad to protect their positions and (as we see with the Post Office scandal) they will lie.
  4. Content Article Comment
    Time to act. Time to actually learn lessons. Time to change the law to protect patients. Time to join the dots and prevent further tragedies. There is an opportunity to link the planned inquiry, which I agree must be a statutory inquiry, to the current government review of the whistleblowing framework: framework: https://www.gov.uk/government/publications/review-of-the-whistleblowing-framework/review-of-the-whistleblowing-framework-terms-of-reference
  5. Article Comment
    This tragic case highlights the urgent need for independent external scrutiny of #whistleblowing and a change in the law to protect the public interest. The Protection for Whistleblowing Bill introduces an #Officeofthewhistleblower to help prevent events like this, where people blew the whistle & were silenced. The Pediatricians raised the alarm and were bullied and threatened with referral to the GMC. Current whistleblowing legislation - the Public Interest Disclosure Act [#PIDA] - fails everyone, #patients, relatives, clinicians, #healthcare staff, & the public. The Protection for Whistleblowing Bill [Hl] which passed its second reading in December 2022, proposes the repeal of the current Public Interest Disclosure Act [PIDA], replacing it with an Office of the Whistleblower [OWB]. This would prevent concerns of genuine healthcare whistleblowers becoming buried under an employment issue, and their original patient safety concerns being side-lined. PIDA is expensive, limited in scope and beyond the reach of most whistleblowers. PIDA is also overly complex, with cases currently waiting for over 2 years to be heard. Employers game the system to run whistleblowers out of funds. Fewer than 12% of cases that go to the Employment Tribunal win. PIDA does not protect patients and is not accessible to members of the public who blow the whistle. Currently there is no statutory provision to investigate or address the wrongdoing highlighted by whistleblowers. Many whistleblowers have been denied any protection because they are not workers. This Protection for Whistleblowing Bill Delivers: · Protection for EVERY citizen who is, has been or is perceived to be a whistleblower and those associated with the whistleblower. · Mandatory minimum standards for policies and procedures and Investigations of protected disclosures. · A new judicial process for deciding disputes arising from whistleblowing. · Significant fines and penalties for individuals and organisations that discriminate or retaliate against whistleblowers. · Dedicated helplines, Education and Support for the Public and Organisations and an ongoing Public Awareness Campaign to ensure that every citizen knows their rights and how to access them. I urge everyone with an interest to read the Bill itself and decide on your position based on the facts. For accurate info. on the Protection for #Whistleblowing Bill read it here: https://t.co/mIE77bjNTV
  6. Content Article
    This YouTube playlist containing 12 short vlogs (each lasting 10 minutes or less) is a cut-down version of Continuing Professional Development work commissioned by the NHS in England. These are part of our patient led clinical education work and involved working with patients, carers, and relatives as equals to produce the videos. These vlogs are based on the (UK) Royal Pharmaceutical Society Competency Framework for all Prescribers, and related guidelines from professional bodies in the UK. They are designed for clinicians (across all disciplines and specialities), patients, carers, parents, relatives and the public.  The short videos focus on providing refresher information, updates on hot topics and materials that can be used for reflection both individually and within clinical teams.  They cover: Shared decision making Information mastery Interpretation of numerical data Root causes on medicines and prescribing errors Taking a history Basic pharmacology Risk areas and red flags Ethics, the law and prescribing Deprescribing Remote prescribing Prescribing for frailty and multimorbidity Prescription writing and safe prescribing The original materials were accompanied by live sessions, questions for reflection (some of which are included here), separate refresher questions, detailed prescribing scenarios, and competency assessments.  
  7. Content Article Comment
    This important report highlights the #patientsafety minefield that exists in the UK. It is characterised by a fragmented system with both overlaps and gaps, plus very few opportunities for inter-disciplinary / inter-organisational learning. Featuring: - A Patient Safety Commissioner whose remit is limited to medicines and medical devices - A plethora of organisations that 'don't investigate individual concerns' (including Healthwatch and the Patient Safety Commissioner) - A lack of genuine patient involvement - A lack of ownership and leadership at the top #share4safety #health #healthcare #nhs #socialcare
  8. Content Article Comment
    I'm a nurse. I believe in the principle of 'do no harm' So I don't support this initiative in its current form and advise people to take care if they are thinking of talking to the local guardian. They may be able to help, or they may make the situation worse. It depends on their employer. The introduction of the National Guardian Office and Freedom to Speak Up Guardians in each NHS trust is problematic. This initiative has an inbuilt conflict of interest, as the Guardians are employed by the trusts themselves. Whistleblowers who have been failed by local Guardians have shared their experiences that included the disclosure of their identity to hospital management and boards, which resulted in retaliation. I also know of Local Guardians who were not supported and themselves the target of retaliation after supporting whistleblowers. In addition, the National Guardian Office appears to studiously avoid the word ‘#whistleblowing’ in its material and outputs wherever possible. This adds to the stigma around healthcare whistleblowers and is inexcusable. This potential for harm because the Guardians are employed by the trusts is a #patientsafety issue and something that the National Guardian Office should be addressing. Instead, the NG Office seems impossible to engage, with unless you agree 100% with their views and become one of their 'cheerleaders'. Patients deserve better.
  9. Content Article Comment
    What concerns me most about this, far from uncommon, story is the #leadership aspect. There's always been challenges for #healthcare leaders. Challenges when there are widely different perspectives on a situation, when there is ambiguity, when there is disagreement on approaches, when different staff groups and professions have strong views etc. This needs strong and accountable leaders from the top down. Leaders who can negotiate across what is often a 'minefield'. Leaders who support and mentor those who work for them. Leaders who recognize that reputation is judged by what an organization actually does, NOT by what it says it does. Leaders who are prepared to challenge those who set the strategy, and those in power who feel they are 'untouchable'. Leaders who avoid micromanaging, even when they themselves are being micromanaged. Leaders who treat and value everyone as equals, from the cleaner to the SoS for Health. Leaders who are in their posts because they believe that the #NHS 'belongs to the people'
  10. Content Article Comment
    A useful document from the DHSC. It contains vital information for NHS leaders, board members and educators. One anomaly stands out, however. The report lists one of the 'substantial measures' introduced in the last decade as 'legal protection for whistleblowers'. I'm at a loss to know what these improved legal measures are?
  11. Content Article Comment
    Thanks for sharing this important summary of the current harmful system for healthcare whistleblowers. I agree 100%, that the current system of governance fails whistleblowers. In fact, it fails everyone. It appears to be set up this way be design, rather than inadvertently. It's indefensible to have a system whereby the patients and relatives must struggle to have someone independently investigate their concerns, and staff who speak out are victimised and silenced. Even Healthwatch, as I understand it, doesn't investigate individual concerns. You couldn't make this up! Recently I replied to a HSIB survey asking if they investigated 'systematic problems' and the reply was that they don't. So that limits their helpfulness even more. This blog on HSIB and why it has been stripped of maternity investigations, is also interesting & relevant: https://minhalexander.com/2023/04/26/finally-revealed-the-suppressed-susan-newton-report-on-whistleblowing-governance-at-hsib-nhs-england/
  12. Content Article Comment
    Thanks for the comments. These are important points. I agree that U.S. bounty model of “whistleblowing” rewards would be inappropriate for the UK, and the way in which the Office of The Whistleblower provides independent oversight of whistleblowing will be critical. For me, the strengths of this approach are that it crosses all sectors and will include perspectives from other countries. I hope and expect that the core issues relating to whistleblower victimisation in health & social care will surface as a result, so they be dealt with effectively and patients protected. For me, the core issues include those related to leadership style & behaviour, nepotism & cronyism, governance, patient and public involvement, accountability, long-term planning, information and record sharing. If you are interested in patient safety, please read the Protection for #Whistleblowing Bill and assess for yourself the impact this will have, don't rely on someone else's summary of the Bill. 'The Public Interest Disclosure Act [PIDA] fails to address the public interest. PIDA turns patient safety concerns into employment issues. It kicks in after the harm has been done, turning a public interest matter into a costly private dispute. Taking the focus off the core issues. Further harming everyone involved in speaking up. The Office of the Whistleblower will strengthen existing initiatives and bring them together, emphasising prevention and early intervention by the most appropriate route. Right now, there is an elephant in the room. Where staff can't, or don't blow the whistle or are ignored or silenced, the onus to expose wrongdoing falls on patients and their relatives who then have no protection under #PIDA. Their concerns are often treated as individual cases and core learning, which would make services safer across the board, are delayed or even lost.' More information here: Read the Bill here: https://www.appgwhistleblowing.co.uk/ Here's a summary of the benefits of the Protection for Whistleblowing Bill [HL] comparing it to current law.
  13. Content Article
    In this blog, Steve Turner reflects on why genuine patient safety whistleblowers are so frequently ignored, side-lined or victimised. Why staff don't speak out, why measures to change this have not worked and, in some cases, have exacerbated the problems. Steve concludes with optimism that new legislation going through Parliament offers a way forward from which everyone will benefit.
  14. Event Comment

    Here's a link to download the Healthcare Whistleblowing Round Table programme and book onto the session: https://www.carerightnow.co.uk/wp-content/uploads/2023/03/AWARENESS-WEEK-HEALTH-ROUND-TABLE-INFO.pdf
  15. Content Article
    This short blog highlights the situations where patients, carers, parents and relatives are failed by healthcare systems and by the leadership. They are left to stand alone against powerful institutions, because when staff speak up and 'blow the whistle' it often results in retaliation. Investigating and resolving the patient safety issue then becomes buried under an employment issue.
  16. Article Comment
    This is mostly good news for patients & users of services. I believe that the urgent need for this change is an example of what happens when care services are driven by managerialism. By that I mean the unrelenting drive to fit everything into boxes and set up 'one size fits all services', often without any meaningful & thorough consultation with users of services. There are as many approaches to care for people with mental health problems and mental illness as there are people. Discrimination, sanctions, and punitive measures have no place. I do have concerns about the eradication of 'Police involvement in delivery of therapeutic interventions in planned, non-emergency, community mental healthcare'. This seems an unfair and unnecessary provision, driven by 'managerialism and the need to' box everything off.' As a mental health nurse, it's my experience that police support can be extremely helpful for patients/users of services in many situations, especially in early intervention, e.g., preventing escalation and in tackling discrimination and harassment of people with mental illness. This is backed up by the views of the people (users of services) I have worked with. To stop this is unfair to those police officers who are skilled at helping people in crisis and in preventing problems before the arise. I'd be interested in the views of users of services and the police on this.
  17. Content Article
    In December 2022, the All Party Parliamentary (APPG) for Whistleblowing heard evidence on the state of the NHS following the recent report on the avoidable deaths and life changing injuries caused to mothers and babies at the East Kent Trust. The culture at this hospital was described as one where “everyone knew the problems” and where whistleblowers were “thrown to the lions”. A culture attributed to 45 of the 65 baby deaths reviewed.  This blog first appeared on the Whistleblowers UK website in December 2022.
  18. Article Comment
    This crisis has its roots way back. Beginning with the removal of funding for long-term care from the #NHS in the 1980s, the functional separation of #health & #socialcare , the rise of managerialism and the embedding of a cover up culture including victimisation of genuine #healthcare #whistleblowers. All this has been supported by all governments regardless of party.
  19. Content Article Comment
    Time to examine the root causes of why these reports continue to show that lessons have not been learned. Three areas of concern stand out for me: 1. There is no independent official body that looks at systemic failings in #healthcare in the UK. (I understand that the remit of the Health & Safety Investigation Branch [HSIB] specifically excludes this). 2. There is no clear pathway that triggers major reviews of healthcare failings. (More often than not these shocking reports are prompted by #patients and their families). 3. When staff feel unable to blow the whistle, or are ignored and victimised for doing this, relatives take this on, at great personal cost. (Examples of where staff have not raised concerns or have had their concerns dismissed, include the death of Robbie Powell, Elizabeth Dixon, Oliver McGowan, Claire Roberts and ‘Gosport.) For too long inexcusable failings have been covered up. It's frequently said that it wasn't because nobody knew about it. It was something that everyone knew about. In the words of the late Professor Aidan Halligan, we need to 'Run toward problems, especially on a bad day'.
  20. Article Comment
    A very worrying report, sadly I'm not surprised to read this. As a registered nurse I am concerned about these types of behaviours and attitudes at the top. This has contributed to nurses & nursing organisations in the UK squandering many opportunities to lead on safe & ethical practice & failing to speak out on patient safety. We should be a strong professional group, setting an example.
  21. Article Comment
    'Independent' but funded by the DHSC & appointed by the SoS for Health... Isn't that an oxymoron? 'The PSC will be an independent statutory office holder, funded by the Department of Health and Social Care (DHSC) and appointed by the Secretary of State.' - Source UK Government https://www.gov.uk/government/publications/medicines-and-medical-devices-bill-overarching-documents/medicines-and-medical-devices-bill-patient-safety-commissioner#patient-journey (accessed 28.09.2022)
  22. Community Post
    Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views?
  23. Content Article Comment
    A significant role for the new Patient Safety Commissioner, in my view, will be through reference to improving prescribing competency, as set out in the RPS Prescribing Competency Framework. A framework which is for ALL prescribers. When speaking the 'truth to power' & reflecting on medicines' safety this framework is key. Link: https://www.rpharms.com/resources/frameworks/prescribers-competency-framework
  24. Content Article Comment
    An opportunity to reflect and act on the (UK) Prescribing Competency Framework:
  25. Content Article Comment
    I believe a review of the corporate governance of #health & #socialcare services in England is needed. This review need not be a long-winded process. There are many studies and reports available, this is the starting point. Plus, the #NHS constitution for England, which rarely gets a mention. Sadly, I don't think this will happen. The overriding ethos is to avoid confronting problems that could make the 'great and the good' look bad & break down the widespread rampant cronyism which is holding back the development of services and driving staff away. #Patients suffer as a result. #leadership #ethics #accountability #whistleblowing #whistleblower #share4safety 'Almost all whistleblowing creates positive change in the organisation which has its wrongdoing reported. Whistleblowers uncover 43% of corruption, compared to only 19% discovered by paid auditors. Whistleblowers lead to the recovery of enough money to give everyone on the planet, health care, many times over.' - WhistleblowersUK
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