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Content Article
NHS England has set a target that cervical cancer will be eliminated in England by 2040. Although progress has been made in detecting and treating cervical cancer, there are still many women who are reluctant to go for cervical screening, or who face barriers to accessing screening. These barriers include perceived discrimination, lack of understanding the risk of cervical cancer and unmet access needs. This contributes to persistent health inequalities amongst particular groups. Patient Safety Learning has pulled together nine useful resources shared on the hub about how to improve access and overcome barriers to cervical screening. 1. Cervical screening, my way: Women's attitudes and solutions to improve uptake of cervical screening This research by Healthwatch explored why some women are hesitant to go for cervical screening. Based on the findings of a survey of more than 2,400 women who were hesitant about screening, it makes recommendations to policymakers on how to improve uptake, including: improvements to the way data about the disability and ethnicity of people attending screening. producing an NHS-branded trauma card for affected women to bring to appointments. ensuring staff are effectively trained on accessibility and adjustments to care. looking at the possibility of home-based self-screening. 2. Exploring the inequalities of women with learning disabilities deciding to attend and then accessing cervical and breast cancer screening, using the Social Ecological Model Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. In this study, the Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England. The study highlights key barriers to access for women with learning disabilities. 3. “We’re not taken seriously”: Describing the experiences of perceived discrimination in medical settings for Black women Black women continue to experience disparities in cervical cancer despite targeted efforts. One potential factor affecting screening and prevention is discrimination in medical settings. This US study in the Journal of Racial and Ethnic Health Disparities describes experiences of perceived discrimination in medical settings for Black women and explores the impact of this on cervical cancer screening and prevention. The authors suggest that future interventions should address the poor quality of medical encounters that Black women experience. 4. Top tips for healthcare professionals: Cervical screenings This article by the Royal College of Obstetricians & Gynaecologists and the My Body Back Project offers tips for healthcare professionals to make cervical cancer screening attendees feel as comfortable as possible during their appointments. Cervical screening can be very daunting for some women, and for those who have experienced sexual violence it can be triggering and cause emotional distress. The article provides tips on communication, making the environment calm and safe, sharing control and building trust with women. 5. The Eve Appeal: What adjustments can you ask for at your cervical screening? The Eve Appeal want to raise awareness of what adaptations women and people with a cervix can ask for during their screening to make the appointment more comfortable. 6. How can reframing women’s health improve outcomes? An interview with Dr Marieke Bigg Dr Marieke Bigg is the author of a 2023 book, This won’t hurt: How medicine fails women. In this interview, Marieke discusses how societal ideas about the female body have restricted the healthcare system’s approach to women’s health and describes the impact this has had on health outcomes. She also highlights areas where the health system is reframing its approach by listening to the needs of women and describes how simple changes, such as allowing women to carry out their own cervical screening at home, can make a big difference. 7. Having a smear test. What is it about? This download A4 Easy Read booklet from Jo's Cervical Cancer Trust uses simple language and pictures to talk about smear tests. It explains what a smear test is, has tips for the person having the test and has a list of words they might hear at their appointment. 8. Health Improvement Scotland: Cervical screening standards Published by Healthcare Improvement Scotland in March, the new cervical screening standards include recommendations to ensure women receive accessible letters and information about screening and healthcare professionals are trained to support women to make informed choices. 9. Cervical cancer screening in women with physical disabilities This US study explored how the cervical cancer screening experiences of women with physical disabilities (WWPD) can be improved. Interviews with WWPD indicated that access to self-sampling options would be more comfortable for cervical cancer screening participation. The authors highlight that these findings that can inform the promotion of self-sampling devices for cervical cancer screening. Have your say Are you a healthcare professional who works in women’s health or cancer services? We would love to hear your insights and share resources you have developed. Perhaps you have an experience of cervical screening or cervical cancer that you would like to share? We would love to hear from you! Comment below (register as a hub member for free first) Get in touch with us directly to share your insights -
Content Article
In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this episode, emergency medicine doctor Chelcie Jewitt describes why and how she co-founded Surviving in Scrubs, a campaign that shares survivor stories of sexism, harassment and sexual assault in the healthcare workforce. She outlines the work the campaign is doing with professional regulators to set clear behavioural standards that will more effectively hold perpetrators to account. She also describes the training and support that Surviving in Scrubs offers healthcare staff and organisations on how to respond to harassment and abuse. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series- Posted
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Content Article
At the beginning of 2025 we launched our video interview series Speaking up for patient safety. The series is hosted by Peter Duffy, NHS whistleblower and Chair of the Healthcare Working Group at WhistleblowersUK, and Helen Hughes, Patient Safety Learning’s Chief Executive. In each interview we hear from someone who has raised concerns about patient safety in healthcare, often at great cost to their own career and personal life. They share their story and their reflections on what needs to be done to improve organisational cultures so that when staff raise patient safety issues, their concerns are responded to appropriately and not dismissed because they are inconvenient to address. Alongside the thread of bravery and tenacity that runs through each contributor, a number of common themes come up time and again as people share their experiences. In this blog, Helen and Peter look at some of these themes and outline their implications for people who speak up or whistleblow. We are now three months into the series, which seems like a good time to stop and reflect on what we have learned so far. Our introductory blog about ‘Speaking up for patient safety’ explains why we launched the series and what we hope it will achieve. It also explains in more detail what we mean when we talk about speaking up and whistleblowing. Briefly, speaking up in healthcare is when a member of staff raises concerns about something that is worrying them to a manager or someone else within, or outside of, their organisation. In some cases—but not all—when someone speaks up, it is also defined as ‘whistleblowing’. Whistleblowing always involves a concern that is in the public interest and might relate to a criminal offence, health and safety risks, failures to carry out legal obligations, a miscarriage of justice, or an attempt to conceal and cover up any of these things. Three key themes from the interviews so far These are the top three recurring themes we have noticed coming up in the interviews so far. Other issues we have noticed include the lack of clarity about who should take responsibility for whistleblowing and the reality of threats and bullying, and we will continue to explore these issues going forward. 1. “I didn’t realise I was speaking up, I was just doing my job!” Perhaps the comment we have heard most frequently is that people didn’t realise they were formally speaking up or whistleblowing—they just thought they were doing their job. Every healthcare profession has a set of professional standards which all practitioners are expected to keep to. For example, the General Medical Council (GMC) states that all doctors have a duty to take action by raising concerns if they believe patient care or safety are at risk.[1] In addition, each healthcare organisation has a code of conduct, which will include requirements for staff to be honest, open and accountable for their work. For the interviewees we spoke to, to not raise their concerns would be a failure to fulfil their duty to both their patients and their organisation. When people speak up, they often find themselves in the middle of a process that they had no idea they were entering. This can be very disorientating and leave them unprepared for the path ahead of them. At the end of this blog, we share some advice from our interviewees about what to do if you find yourself in this position. 2. There is a whistleblowing ‘playbook’ Most organisations have policies and support in place to listen to staff members who raise concerns, including access to a Freedom to Speak Up Guardian. We have interviewed Jayne Chidgey-Clark, the National Guardian, who described the good practice that many are developing. However, we are hearing about several common tactics that some organisations use when dealing with people who speak up or blow the whistle. The experiences of our interviewees suggest that these approaches may be deliberately designed to disadvantage the individual throughout the process—from investigation through to employment tribunals. Some of the key activities we have heard about include: Organisations not responding—or responding at the very last minute—to communications from the staff member. Interviewees said they received emails with key information at 5pm on a Friday, which left them with no opportunity to ask questions or respond until the next working week. They expressed their belief that this may be a deliberate tactic to exert pressure on the individual speaking up, which amounts to emotional bullying. The use of occupational health as a way to cast doubt on the mental state of the person. Occupational health providers are often very supportive, but we are concerned that organisations are fishing for reasons to question the believability and motives of staff who speak up. Over-focus on HR issues, rather than focusing on the patient safety issues someone has raised. Mandated isolation from colleagues while investigations take place. This can have a very damaging effect on the person’s mental health as well as restricting their ability to source evidence from other staff in support of the concerns they have raised. We have heard examples of colleagues agreeing to provide supportive testimony, but then feeling pressurised to withdraw this support. Retaliatory referrals against the person speaking up to professional regulators, such as the General Medical Council and Nursing and Midwifery Council, which can have a detrimental effect on a healthcare professional’s reputation and career. Regulators are aware of how such referrals can be used to intimidate whistleblowers and discourage them from raising concerns. Some have approaches to ensure that fitness to practice concerns are appropriately addressed without unfairly impacting doctors who have raised whistleblowing concerns. We believe it is important to identify and call out these tactics so that people raising concerns are aware of them and can seek support and advice. Organisational leaders need to look at their own practice and recognise the ethics of their approaches and whether their actions match their stated organisational values. They need to be aware of the significant damage these tactics cause to people who raise concerns and the chilling impact it might have on their organisational culture, effectively preventing others’ raising concerns. 3. Employment tribunals are unfit, unfair and imbalanced Every person we spoke to who had attempted to pursue justice at an employment tribunal commented that the process was unfit for purpose and not the right place for whistleblowing cases to be heard. Employment tribunals take no interest in the safety issues being raised. The main issue we keep hearing is that the tribunal system is weighted in favour of whichever side has the most financial resources—which will almost always be the employer. A single individual who has lost their employment can rarely succeed against the millions of pounds that organisations are willing to spend on highly specialised lawyers who have tried and tested ways of winning. The playbook we identified above also runs into employment tribunals, with whistleblowers reporting: The employer and their legal advisers withholding key documents, and emails, minutes, notes and other vital information going missing. Key witnesses, often in senior leadership positions, being unable to recall events. Receiving last minute threats from their former employer to come after them for costs and often being given a limited time to consider signing a non-disclosure (NDA) to settle a case. If rejected, often the NHS organisation will seek the full costs from the whistleblower, including expensive external legal costs and internal staff costs, which can amount to thousands of pounds—few whistleblowers can afford to take this financial risk, even if they and their advisers think they have a strong case. Advice from our interviewees if you find yourself speaking up Reflecting on their experiences, our contributors have made some observations about how you can protect yourself when speaking up, should the issue escalate. Try to resolve issues locally first. This is not always possible, but if a concern can be raised and dealt with within a team or with a manager, in some cases this will prevent the situation from escalating to a formal process. Keep a record of concerns and events as they happen. This means you will have some facts and clear observations to refer back to, if the situation does escalate. Don’t go to meetings alone. Take a trusted colleague with you so that every conversation is witnessed. Get your union involved if you are called to meetings about your concerns or receive counter-complaints or accusations. Regulation of NHS managers Some of the interviewees highlighted that regulating NHS managers may be a potential means of tackling some of these issues. The Department of Health and Social Care recently held a public consultation on proposals that could see managers who use misconduct to silence whistleblowers barred from working in the NHS. Patient Safety Learning has formally responded to the consultation, stating that there is a clear case for the regulation of NHS managers, for the protection and benefit of both staff and patients. Everyone in healthcare should be honest and transparent when something goes wrong. Patient Safety Learning’s response expressed support for a professional register of NHS managers and the requirement for individuals in NHS leadership to have a professional duty of candour. These measures would be a positive step in increasing accountability for healthcare organisations in how they respond to staff raising patient safety concerns. But this is only one part of a much wider set of changes needed—significant cultural change also needs to take place in tandem with these reforms. Staff across many organisations are still afraid to speak up, as indicated by the most recent NHS staff survey results. Thank you to our contributors, and an invitation to get involved We’d like to take this opportunity to express our gratitude again to each person who has been willing to share their experiences and insights with us—it can be very difficult to retell traumatic events that have changed the course of your life. We are also aware that there are many other individuals who have experienced unjust treatment because they have spoken up for safety. If that’s you, thank you for your commitment to standing up for safe, ethical care. We invite everyone with experience in this area to contribute to this vital conversation. We would particularly like to hear from: Allied health professionals. Staff from Black and minority ethnic backgrounds Staff in non-clinical roles such as administration. If you would like to share your story, you can: Contribute to our community conversation (you’ll need to sign up first). Comment on any hub post (you’ll need to sign up first). You can find information about organisations that offer support and guidance for staff about speaking up and whistleblowing on the hub. Watch the interviews Helené Donnelly Martyn Pitman Jayne Chidgey-Clark Gordon Caldwell Bernie Rochford Beatrice Fraenkel References General Medical Council. Professional Standards: Raising and acting on concerns about patient safety, 13 December 2024- Posted
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In March 2025, the UK Government announced that it was disbanding NHS England, the arm's length government body that oversees healthcare delivery in England. Although there is public support for change in the NHS, a polling report by UCL Policy Labs and More in Common concluded that the “British people are looking for change, but not chaos, radicalism, not recklessness.” This article looks at where the dissolution of NHS England falls in the current UK context. -
Content Article
It’s nearly 30 years since the Food and Drug Administration (FDA) Modernization Act of 1997, when Congress instructed the US Health and Human Services (HHS) secretary to consult with the National Institutes of Health (NIH) director and the pharmaceutical industry to “review and develop guidance, as appropriate, on the inclusion of women and minorities in clinical trials." In this JAMA article, Rita Rubin examines concerns that the Trump administration’s dismantling of diversity, equity, and inclusion (DEI) efforts at the FDA and NIH will result in a reversion back to the days when new treatments were tested mainly in cisgender White men—and not even all shapes and sizes of them.- Posted
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In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this episode, Beatrice Fraenkel, ergonomist and Non Executive Director at Stockport NHS Foundation Trust discusses the importance of understanding the issues that lead to poor culture and harm in healthcare organisations. She describes the Board's radical approach to establishing a Just Culture during her time as Chair of Mersey Care NHS Foundation Trust and the huge investment needed to build trust between healthcare staff and their employers. She also talks with Peter and Helen about the importance of understanding the needs, views and emotions of people in the wider community that each trust serves. They discuss the universal impact of fear and anxiety on human behaviour and the need to ensure lessons are really understood before attempting to put solutions in place to tackle issues, on any scale. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series- Posted
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NHS patient safety strategy – progress update (April 2025)
Patient-Safety-Learning posted an article in NHS England
This update highlights the significant achievements across the strategy’s national patient safety programmes. Martha’s Rule Martha’s Rule gives patients, families and staff a way to request a rapid review if they are worried that deterioration is not being addressed Piloted across 143 acute hospital sites and launched in May 2024. Between September 2024 and February 2025: - 2,389 calls made to escalate concerns; 73% from families seeking help and 47% relating to acute deterioration. 129 potentially life-saving interventions triggered, including: - 57 urgent admissions to high dependency or intensive care units - 60 transfers to specialist services (coronary care, respiratory care, return to theatre) - Changes in care for a further 336 cases, for example the introduction of a new medication such as an antibiotic. Calls unrelated to acute deterioration are also improving patient care, including: - 340 calls led to clinical concerns such as medication delays being addressed - 448 calls resolved communication issues. Maternity and neonatal care 1,499 neonatal lives saved through safer care bundle interventions, including improvements in optimal cord management and the administration of antenatal steroids 518 fewer premature babies with cerebral palsy from the administration of magnesium sulphate during pre-term labour; the estimated saving in lifetime care costs is £518 million Medicines safety 1,900 deaths prevented through medicines safety initiatives £9 million saved in admission costs Better management of long-term opioid use has significantly contributed to this. Against the 2021 baseline, data to November 2024 shows: - 596 lives saved over 2 years - a projected 1,802 lives saved from reversing the rising trend in opioid use - 3% reduction in high-dose opioid prescribing - 12,657 fewer patients a month on high-dose opioids, halving their risk of death from opioids - 5% sustained reduction in rate of opioid prescribing for chronic use. Safer use of valproate and oral anticoagulants, fewer incidents of gastric bleeding, methotrexate overdose and drug-induced acute kidney injury Early identification of deterioration (in addition to Martha’s Rule) New early warning system for staff treating children launched November 2023. Supporting 1,621 care homes to identify deterioration, reducing 999 calls, emergency admissions and length of hospital stays. Testing of PIER resources that help systems prevent, identify, escalate and respond to physical deterioration. Transforming how we learn and respond to patient safety events. Patient Safety Incident Response Framework (PSIRF) Patient Safety Incident Response Framework (PSIRF), a revolutionary new approach to incident response that centres on maximising learning and patient safety improvement now implemented in every NHS secondary care provider and being piloted in 50+ GP practices. Embeds systems thinking and improved engagement with patients, families and staff, promoting a patient safety culture. Providers report they are better able to identify safety priorities and act quickly. Learn from Patient Safety Events (LFPSE) service Learn from Patient Safety Events (LFPSE) service: full implementation by November 2024 across all NHS trusts of new national system for recording and learning from patient safety events. Real-time incident reporting across the NHS, with over 3 million patient safety events recorded each year. National medical examiner system National medical examiner system developed: local medical examiner offices cover the whole of England and Wales. Requirement for medical examiners to provide independent review of all deaths became statutory in September 2024. This system also provides enhanced support for bereaved families to ask questions and raise concerns about care, helping to identify hundreds of patient safety incidents that can then be responded to. Identifying and responding to patient safety risks The National Patient Safety Team’s statutory function to identify and act on emerging safety risks, including by issuing National Patient Safety Alerts. Annually this: - saves 160 lives - prevents 480 severe harm incidents - saves £13.5 million in treatment costs. New approach to National Patient Safety Alerts developed, including accreditation of alert issuing organisations. Building capability and capacity to address safety challenges Patient safety leadership Network of over 800 patient safety specialists created; they provide expert patient safety leadership, guidance and support at NHS organisations across England All patient safety specialists offered in-depth training in patient safety (see below) Patient safety training and education The first National patient safety syllabus launched in 2022 Over 1.47 million staff completions of the essentials for patient safety’ training Over 850,000 completions of the level 2 access to practice training. This is for staff who want to understand more about patient safety or go on to access higher levels of training Over 70,000 completions of the level 1 training for boards and senior leaders All patient safety specialists offered training in the advanced levels 3 and 4 of the syllabus – almost 500 completions to date 3,000+ digital clinical safety training completions Involving patients and the public in patient safety Framework for involving patients in patient safety published in 2021 Patient safety partner role introduced to enhance the involvement of patients in patient safety work at a national and local level From 2025/26 it will be an NHS Standard Contract requirement for all NHS trusts to have appointed and work with patient safety partners Simple steps to keep you safe during your hospital stay video and leaflet for patients developed Strengthening national patient safety systems Digital clinical safety strategy published September 2021 Primary care patient safety strategy published September 2024 Improving patient safety culture – a practical guide published July 2023 – setting out approaches for NHS organisations to improve their patient safety culture National work on assessing patient safety inequalities started to understand how harm is experienced unequally by different groups. -
Content Article
One of the most transformative changes to the US health care system in the last few decades has been the widespread adoption of electronic health record (EHR) systems and online patient portals. The patient portal has improved patient access to medical records and facilitated direct communication between patients and their health care teams, improving patient satisfaction, enhancing health care use and increasing treatment adherence. The implementation of online patient portals has altered clinical practice workflows considerably, allowing the streamlining of interappointment communication. However, direct messaging between patients and their health care team is also having a negative impact on healthcare professionals. Increasing reliance on portal messaging as a primary form of communication and more patients using portals increased the volume of messages being sent. Work associated with portal messaging has fallen primarily on doctors, and many of them end up using time outside of clinical work hours to respond. Limited access to appointments has led to more complex and time-consuming messages. This trend is causing higher levels of staff burnout and female doctors are disproportionately affected. This article looks at the issues and potential solutions.- Posted
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Despite progress in reducing neonatal and child mortality, inequalities in access to age-appropriate medicines remain, particularly in low-income and middle-income countries. The Global Accelerator for Paediatric Formulations (GAP-f), a WHO-hosted network established in 2020, addresses these gaps by uniting 33 partners to promote innovation and access to child-friendly medicine formulations. This article describes phase 2 (2022–24) of GAP-f's work, which focused on: therapeutic areas where innovation and access efforts often did not have stakeholder alignment and coordination of designing and implementing innovative clinical trial methodology. engaging with regulators to address systemic barriers. identifying novel technologies for safe and effective delivery. collaborating across stakeholders for product roll out.- Posted
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This blog describes the approach taken by researchers at the Exeter HSDR Evidence Synthesis Centre when they performed a systematic review on safety management systems in healthcare. They research practice in five English-speaking high-income countries: The Netherlands, Australia, Canada, Ireland and New Zealand. Having started their literature review, the team realised that whilst the components of a safety management system—leadership commitment and safety policy, safety risk management, safety assurance and safety promotion and culture—were present in the patient safety approaches of all of the countries we were looking at, only one of them had actually implemented safety management systems in their healthcare system. This resulted in a change of approach which looked at the differences in how key components of a safety management system were implemented. Read the research study: The implementation of Safety Management Systems in healthcare: a systematic review and international comparison (March 2025)- Posted
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This qualitative study looked at whether oncologists should ask children with cancer and their parents about their communication preferences before telling them about their prognosis. The results suggest that patients, parents and oncologists recommend asking patient and parent communication preferences in advance. Research participants provided advice for achieving this goal, relating to the questions that should be asked, giving multiple options and considering delivery and tone.- Posted
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Opioid-responsive cancer pain is a term used to describe cancer pain that can be effectively managed with opioid painkiller medications. This review aimed to explore a paradigm shift in the definition of opioid-responsive cancer pain. The authors argue that looking at the apparently unique properties of opioid-responsive cancer pain allows better understanding of the process by which acute (short term) pain may or may not transition into chronic (long term) pain. -
Event
untilDeNPRU Exeter is a Policy Research Unit in Dementia and Neurodegeneration based at the University of Exeter. This webinar will share learning from DeNPRU Exeter's policy research project on reducing inequalities for minority ethnic communities living with dementia, Parkinson's disease, motor neurone disease or Huntington's disease. The United Kingdom is composed of diverse range of ethnic and cultural groups. However, people from minority ethnic communities living with dementia or other neurodegenerative conditions often face significant inequalities in accessing healthcare. This can result in delayed diagnoses, poorer health outcomes and a reduced quality of life. This project has: identified and examined community campaigns aimed at raising awareness and/or reducing stigma around neurodegenerative conditions in minority ethnic populations. reviewed existing research on the barriers and facilitators influencing access to care and support for people from minority ethnic communities. learned from people with lived or professional experience about raising awareness of neurodegenerative conditions and addressing barriers to accessing services. Join the DeNPRU Exeter Reducing Ethnic Inequalities Project Team to hear about the findings. Deputy Director of DeNPRU, Professor Jan Oyebode Research Fellow, Dr Maria Caulfield There will be a chance to ask questions of the speakers. Register for the webinar- Posted
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In this piece for the BMJ, Chris Bennett shares her thoughts about the year she and her husband had together after he was found to have a brain tumour. Reflecting on the relative risks, costs and benefits of surgery, she describes the value of her husband being given a little more time to spend with his family. She discusses the importance of healthcare professionals giving of honest explanations of choices and their consequences. This can give patients a valuable feeling of having some personal control over their situation.- Posted
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Speaking up as an agency nurse cost me my career
Patient-Safety-Learning posted an article in Whistle blowing
In this blog, Justean Winter shares her experience of working as an agency nurse in the NHS. She describes how she was told not to report patient safety issues she witnessed. After raising concerns about patient care, Justean received several accusations and was eventually blocked from working in the NHS. She outlines why she continues to try and raise awareness of the patient safety and organisational issues she witnessed. Patient safety issues and reporting I have been a nurse for 33 years, and worked for an NHS Health Board via an agency for a number of years. In the Autumn of 2022, I was working in the A&E department when we were told not to submit Datix reports without checking them with managers first. Datix is the incident reporting software widely used in the NHS for reporting patient safety issues. We weren’t able to report anything we saw, including short staffing, bullying and patients being left without treatment. When I or another member of staff asked about why we couldn’t report what we witnessed, we were told by the managers to stop asking and just get on with our job. Later that year, I was asked to work in paediatric A&E, but knew I wasn’t up to date with all the relevant training. I raised this but was told to go and do the shifts anyway. The atmosphere in the wider A&E department was one of keeping quiet about any concerns. If you raised concerns you were seen as a trouble maker. Some examples of issues I raised were patients being denied end-of-life medication, patients with diabetic ketoacidosis being left without treatment and nurses wearing name badges that didn’t belong to them. There were also some issues with staff conduct that could pose a threat to patient safety that I was told not to mention if I wanted to keep my job. At this point, I started reporting incidents anyway, as I was seeing patient safety issues that I just couldn’t ignore. Accusations and suspension In October, I was told by my agency that there had been a complaint against me, dating from that July. I asked to see the details, but they wouldn’t show me anything. I also asked why it hadn’t been raised with me sooner, but was just told there would be no statement needed and there would be no investigation. Then in March 2023, my agency contacted me to tell me about another complaint they had received against me. It turned out to be the same one they had mentioned before, but now the Health Board wanted a statement from me. I did the statement and nothing came of it again. I felt that something underhand was going on. Then in April, one of the nurse managers pulled me into an office and accused me of stealing cash from one of the patients. At this point, I felt I was being bullied because I was refusing to keep quiet about issues on the ward. There were other incidents of intimidation, such as being squared up to in the corridor by another nurse about whose care I had concerns. I was on holiday in May when I received a series of texts from my agency telling me all my shifts had been cancelled. When I came back I realised I was unable to book any shifts, and it turned out that I had been totally suspended by the Health Board. My agency then told me that I had been accused of stealing morphine back in January. Five months had passed and I was only being told about it now! I vigorously defended myself against these accusations. In June, I was called to a Zoom meeting to discuss my suspension. I wasn’t allowed to see any of the complaints or any evidence, but the accusation was used as the reason for my suspension. I asked them to check the CCTV and was told that there was no CCTV in the department. My contact at the agency told me they would be collecting more statements and coming up with a plan for a way forward. When I asked about what the process was, I received no response. After the meeting, I wrote a long email to the Health Board detailing all my concerns, including about the inability to submit Datix reports and inadequate care standards I had witnessed . I later wrote a further letter to 18 members of the Health Boards as well as the Senedd and Healthcare Improvement Wales (HIW), sharing my patient safety concerns but heard nothing back. The Senned Minister for Health and Social Services said that the concerns I had raised were employment concerns rather than safety ones but that they would keep the letter on file for 10 years. At this stage, life was really difficult. I couldn’t get any work—there was a red flag against my name so I was basically unemployable. I asked the agency what was going on, but again got no response. My career and life were being ruined and I hadn’t done the things I was accused of. The same day I delivered the letters, my agency phoned to tell me I had been referred to the Nursing and Midwifery Council (NMC). It wasn’t until December 2023 that I heard from the NMC. The referral stated that I lacked insight to reflect and had refused to do a communication course—no missing money or morphine had ever been mentioned in the referral. I was cleared by the NMC in January 2024. I later found out through court documents relating to my employment tribunal that seven managers and an entire health board were responsible for referring me to the NMC—ostensibly on the grounds of communication issues. It just doesn’t add up. Employment tribunals When I contacted ACAS in September 2023, they told me that I was within the timeframe for an employment tribunal. But three judges since then have told me I am out of date and have refused to read my evidence bundle because it was too long. One judge told me I should “Stop criticising the NHS” and accused me of having a personal vendetta. But all I want is for the truth to come out and to be able to resume my career. I am now on my fourth appeal to try and get my case heard at tribunal. I’ll continue to do everything I can to pursue justice. Vulnerability as an agency nurse I believe that my status as agency staff made me vulnerable to repercussions. There is no support mechanism or process to follow as an agency nurse when raising concerns, and as I wasn’t employed directly by the Health Board, I was more easy to falsely accuse and get rid of. The personal cost of my experience has been huge. We have had to put our home up for sale because I’ve been unable to work since May 2023. I have developed post-traumatic stress disorder and a fear of the NHS because of what I have witnessed. I believe patients are dying because they aren’t receiving the care they need, and that it is being covered up. There are so many issues that the public need to be aware of and that NHS organisations need to deal with to keep patients safe and protect staff. Related reading My experience as an agency nurse A dropped instrument, washed in theatre and immediately reused: a story from a theatre nurse Speaking up for patient safety: A new interview series about raising concerns and whistleblowing My experience of speaking up as a healthcare assistant in a care home Share your speaking up story If you have spoken up about unsafe care or have been a whistleblower in healthcare or social care, we would love to hear from you about your experience. You can: contribute to our community conversation (you’ll need to sign up first) comment on any hub post (you’ll need to sign up first) contact us at [email protected] and we can share your story anonymously. You can find information about organisations that offer support and guidance for staff about speaking up and whistleblowing on the hub.- Posted
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