Search the hub
Showing results for tags 'Speaking up'.
Found 448 results
-
Content ArticleIn this blog, consultant on workforce culture Roger Kline looks at the case of Shyam Kumar, an orthopaedic consultant who was seconded as an inspector for the Care Quality Commission (CQC). After raising concerns about patient safety, harm, cover up and bullying of staff with the CQC, his secondment with them was terminated. An Employment Tribunal has found that Mr Kumar's concerns were well-founded and that he was then victimised for raising them by the CQC. The Tribunal accepted his claims that he was removed from his secondment as a CQC inspector as a result of making protected disclosures, accepted his evidence, and at a number of points did not believe the evidence provided by senior CQC staff. The blog raises the question of whether the CQC would fail on its own criteria for being a 'well led' organisation on the basis of this case. It also questions whether the CQC can credibly hold NHS organisations to account on whistleblowing after its response to having concerns raised by Mr Kumar, one of its own inspectors. The author asserts that "the CQC needs to urgently demonstrate it will apply accountability to its own decision making, and lack of support for those raising concerns, and hold its own senior leaders (up to the CEO) to account for decisions which are contrary to its own published standards."
-
Content ArticleIn this blog, Bob Matheson, Head of Advice and Advocacy at the charity Protect, explains the case of Dr Chris Day and how it highlights the vital importance of reforms to UK whistleblowing law. Protect is campaigning for Reform of whistleblowing legislation in the UK. The author highlights loopholes in UK law that Dr Day has faced throughout his long legal battle with Health Education England (HEE). These gaps mean that whistleblowers lack certain important legal rights and protections, and this in turn may prevent individuals from raising concerns.
-
Content ArticleThis cross-sectional study in BMJ Quality & Safety aimed to assess patient comfort in speaking up about problems during hospitalisation, and to identify patients at increased risk of having a problem and not feeling comfortable speaking up. The authors assessed the responses of 10,212 patients at eight hospitals in Maryland and Washington to the question, "How often did you feel comfortable speaking up if you had any problems in your care?" The study found that 48.6% of respondents indicated that they had experienced a problem during hospitalisation. Of these, 1,514 (30.5%) did not always feel comfortable speaking up. The authors concluded that creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience.
-
News Article
NHS whistleblower Shyam Kumar wins case against regulator
Patient Safety Learning posted a news article in News
A doctor who was sacked for raising patient safety concerns has won a case against England's hospital regulator, the Care Quality Commission (CQC). Orthopaedic surgeon Shyam Kumar worked part-time for the CQC as a special adviser on hospital inspections, but Manchester Employment Tribunal found that he was unfairly dismissed. Between 2015 and his dismissal in 2019, Mr Kumar wrote to senior colleagues at the CQC with a number of serious concerns. They included a hospital inspection, at which he claims patient safety was significantly compromised when a group of whistleblowing doctors was prevented from discussing their concerns. Mr Kumar said, on many occasions, he reported concerns about a surgeon at his own trust, Morecambe Bay, who had carried out operations that were "inappropriate" and of an "unacceptable" quality and harmed patients. He warned the CQC that the trust management wanted to bury it "under the carpet". The tribunal noted that his concerns were found to be justified and the surgeon eventually had conditions placed on his licence to practise. The CQC "accepted the findings". Mr Kumar, who has been awarded compensation, says his concerns were ignored. "The whole energy of a few individuals in the CQC was spent on gunning me down, rather than focusing on improvement to patient safety and exerting the regulatory duties," he said. Read full story Source: BBC News, 5 September 2022 -
Content Article
Nuffield Trust: Safety culture in the NHS (25 August 2022)
Mark Hughes posted an article in Culture
A good safety culture in healthcare is one that includes value and respect for diversity, strong leadership and teamwork, openness to learning, and staff who feel psychologically safe. In this article the Nuffield Trust use data from the NHS Staff Survey to look at safety culture in the NHS. -
Content ArticleThis is the witness statement submitted by the claimant at an employment tribunal between Dr Chris Day and Lewisham and Greenwich NHS Trust. Dr Day's claim is based on his belief that the actions of the Trust irreparably damaged his medical career and had a significant impact on his job security and other areas of life. The document contains Dr Day's statement about the following events: Misrepresenting the substance of the protected disclosures Misrepresenting formal investigation findings Cost threat detriments Events post-settlement Impact of the case on Dr Day and his family
-
Content ArticleThis webpage highlights press coverage of the Chris Day whistleblowing hearing which took place in June 2022. Dr Day's case originates in 2013, when he initially raised concerns about unsafe staffing levels at Woolwich Hospital ITU, run by Lewisham and Greenwich NHS Trust. Following this, senior management in the Trust made allegations about his conduct, he believes as a result of his whistleblowing action. As a result Health Education England (HEE) deleted Dr Day's training number, meaning he was unable to progress to become a consultant. Dr Day has been campaigning for a public hearing of the case since 2016, and believes HEE, Lewisham and Greenwich NHS Trust and other authorities have spent large amounts of money attempting to 'crush' his case and prevent it from being heard. The tribunal hearing finally took place in June 2022 and featured revelations about Trust staff deliberately deleting emails relevant to the case, partisan briefings made to senior NHS management about Dr Day and inaccurate press statements from the Trust.
-
Content ArticleRAND Corporation and MedStar researchers examined the intersection of patient safety and racism, focusing on patient safety and health equity from clinician leaders' perspectives. An overarching emphasis of the work concerned the impact of racism and other related factors (i.e., bias) on patient safety events and potential interventions or changes (such as creating a culture of speaking up about racism in care) that can help prevent such events.
-
News Article
Multiple reporting systems undermine patient safety, says watchdog
Patient Safety Learning posted a news article in News
A single system to report patient safety concerns would “keep people safer”, a newly appointed NHS watchdog has told HSJ. Henrietta Hughes – who will take up the post of patient safety commissioner in September – said both clinicians and patients faced a bewildering choice when looking to raise a safety concern, and that there was a need for a “report once” system. She said that when ”exhausted” clinicians “come to the end of a 12-hour shift, they don’t want to have to do a Datix report and a yellow card report, and if they’ve got a safeguarding concern or a concern about an individual condition, [to have to] send that somewhere else”. Dr Hughes added: ”Wouldn’t it be better if we had one report that you do, and all the information that comes from that report just gets sent to the appropriate authority? That’s the type of change that I think we’d like to see. I know, as a GP myself, that’s what I would rather do as a professional. But also, I think, for all the organisations, we could get so much more richness of information, we would get more reporting, and we’d keep people safer as a result of it.” She added that if a patient “wanted to report an individual clinician” they often ended getting bounced around the system, like a pinball. They get sent from pillar to post.” Read full story (paywalled) Source: HSJ, 8 August 2022 -
Content Article
7 Rules for persuasive dissent (22 July 2022)
Patient Safety Learning posted an article in Good practice
Decisions formed from a diversity of opinions usually lead to better long-term outcomes. So, when you believe that your team or organisation is missing something important, moving in the wrong direction, or taking too much risk, you need to speak up. Done effectively, dissent challenges groupthink, reminds those in the majority that there are alternatives paths, and prompts everyone to get creative about solutions. Six decades of scientific research point to strategies those without formal power can use to make sure their dissenting ideas are heard. First, pass the in-group test by showing how you fit in. Then pass the group threat test by showing how you have your team’s best interest at heart. Make sure your message is consistent but creative tailored for different people, lean on objective information, address obstacles and risks, and encourage collaboration. Finally, make sure to get support. Dissent isn’t easy but it can be extremely worthwhile. -
News Article
Fresh allegations of whistleblower mismanagement at ‘witch hunt’ trust
Patient Safety Learning posted a news article in News
Fresh concerns have been raised about the treatment of whistleblowers by managers at a trust recently embroiled in a high-profile bullying scandal, the hospital’s workforce director has disclosed. A series of further accusations have been made against managers at West Suffolk Foundation Trust, where executives were recently judged to have led an “intimidating, flawed” hunt for a whistleblower, prompting a series of high-profile departures. The trust’s executive director for workforce detailed in a paper for the hospital’s July board meeting how managers had been hunting to identify staff who had raised concerns through supposedly confidential channels. The report, by executive director of workforce and communications, Jeremy Over, said: “Feedback has been given indicating that some people have had a poor experience when speaking up. “In two separate cases, where people spoke up in confidence, it was reported that the managers were then asking and wishing to find out who had spoken up making the individuals very uncomfortable. “Another case reported that the individual was ‘told off’ by their manager for ‘going about their heads’ [sic] and another where staff felt discouraged from raising any points or suggestions as these were taken [as] a personal offence [by] the senior staff. In a further case, the person speaking up was criticised [for] doing so.” Read full story (paywalled) Source: HSJ, 3 August 2022 -
Content Article
The NHS whistleblowing crisis (8 February 2022)
Patient Safety Learning posted an article in Whistle blowing
Tommy Greene and David Hencke report on a number of worrying NHS dismissal cases in this Byline Times article. -
EventuntilBringing together a community of human factors in patient safety advocates across Ireland and abroad, the annual Human Factors in Patient Safety Conference will offer the opportunity to gain valuable knowledge and insights from human factors experts. The conference will include contributions from: Martin Bromiley OBE, Founder of Clinical Human Factors Group UK – Listening Down to Develop your Safety Behaviours Mr Peter Duffy, Consultant Urologist – Whistle in the Wind: a Personal Exploration of the Consequences of Whistleblowing in Healthcare Professor Eva Doherty (Chair), Director of Human Factors in Patient Safety – The Irish Context, panel discussion Healthcare professionals can register for the event here. For more information, please email mschumanfactors@rcsi.ie.
-
News Article
CQC probes bullying allegations at national NHS agency
Patient Safety Learning posted a news article in News
Bullying and harassment allegations made against leaders of the organisation that supplies blood to the NHS have prompted a Care Quality Commission (CQC) review, with staff claiming poor culture has exacerbated the crisis around low blood stocks. HSJ has learned whistleblowers at NHS Blood and Transplant raised concerns with the CQC. As a result, the regulator has been carrying out a review of the organisation’s leadership. Several current and former staff, who wished to remain anonymous, told HSJ there are widespread concerns about the organisation’s culture, which they claim has enabled bullying and harassment from senior employees, including some racist behaviours. They said the culture has resulted in a significant number of staff being absent due to stress and anxiety, which alongside the latest wave of coronavirus, has contributed to an ongoing staffing crisis. Read full story (paywalled) Source: HSJ, 28 July 2022 -
News Article
Speaking up ‘still not business as usual’, national guardian warns
Patient Safety Learning posted a news article in News
Whistleblowing is still not ‘business as usual’ and leaders must take action after an unusual drop in the proportion of staff viewing their organisation as having a positive speak up culture, the national guardian for freedom to speak up has said. Speaking to HSJ, Jayne Chidgey-Clark highlighted some “really concerning” findings from the National Guardian’s Office’s most recent survey, both about speak up culture and the wellbeing of the freedom to speak up guardians. The NGO survey found a 10 percentage point drop in freedom to speak up guardians agreeing senior leaders supported workers to speak up, dropping from around 80% to 70% between 2020 and 2021. She also highlighted an increase in FTSU guardians reporting staff had experienced “detriment” for speaking up within their organisation. Ms Chidgey-Clark, a nurse by background who took up the role last December, said it was the first time the National Guardian’s Office had seen a drop on this question since the survey began in 2017, and that it also “chimed” with the latest NHS staff survey. She added: “Workers are saying the same thing, and that’s really concerning. And it will be even more concerning if we see a similar trend next year. It’s almost like an early warning sign to leaders." Read full story (paywalled) Source: HSJ, 28 July 2022 -
Content ArticleThe National Guardian’s Office has published its latest annual speaking up data, which summarises the themes and learning from the speaking up data shared by Freedom to Speak Up guardians.
-
Content Article
In this blog, student midwife Sophie Dorman describes some of the issues that have led to a chronic shortage of midwives, including a culture of fear, poor pay and conditions and a lack of basic facilities for maternity staff. She highlights the impact this is having on the safety of maternity services and argues that valuing and looking after midwives will make pregnancy and childbirth safer and better for everyone. -
Content ArticleIn this episode of Speak Up, Listen Up, Follow Up, Dr Jayne Chidgey-Clark, National Guardian for the NHS, speaks to Chris Hopson and Saffron Cordery, Chief executive and Deputy Chief executive of NHS Providers, about speaking up’s role in work force retention and how they will use speaking up in their new roles.
-
Content ArticleHealthcare is traditionally a hierarchical industry. This structure can foster a culture of division amongst staff that is sometimes made worse by significant differences in background and training. However, in order to make sure care is safe and of a high quality, healthcare teams must develop good teamwork and communication. This is only possible if every member of the team feels respected and is free to speak up when they think something is wrong. In this podcast, host David Feldman speaks to Michael Brodman, Professor and Chair Emeritus in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in the US. They discuss how mutual respect is essential for any institution developing a culture of safety and how the problems presented by medical hierarchy can be overcome.
-
News Article
Female doctors launch campaign against harassment in UK healthcare
Patient Safety Learning posted a news article in News
Female doctors have launched an online campaign that they say exposes shocking gender-based discrimination, harassment and sexual assault in healthcare. Surviving in Scrubs is an issue for all healthcare workers, say the campaign’s founders, Becky Cox and Chelcie Jewitt, who are encouraging women to share stories of harassment and abuse to “push for change and to reach the people in power”. The campaign has called for the General Medical Council (GMC), which regulates doctors, to explicitly denounce sexist and misogynistic behaviour towards female colleagues and “treat them with respect”. More than 40 stories have been shared on the campaign’s website, ranging from sexual harassment by patients to inappropriate remarks and sexual advances from supervisors. The campaign is bolstered by evidence that shows 91% of female respondents had experienced sexism at work within the past two years. The findings are a result of nearly 2,500 surveyed doctors working in the NHS – the majority of whom were women – published in a 2021 report by the British Medical Association (BMA). Read full story Source: The Guardian, 11 July 2022 -
Content Article
Surviving in Scrubs campaign
Patient Safety Learning posted an article in Staff safety
Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored. -
News Article
‘Innovation put over safety’ at world-famous hospital
Patient Safety Learning posted a news article in News
A world-famous hospital has a culture where some staff may put research interests above patient safety, according to an external investigation. A report published yesterday cited some employees at Great Ormond Street Hospital for Children Foundation Trust as saying “they feel that the hospital sometimes put too much emphasis on pushing the boundaries of science” and “are concerned [this] may lead to a culture where some prioritise innovation over safety in their practice”. The trust’s medical director Sanjiv Sharma commissioned the report into the effectiveness of its safety procedures, from consultancy Verita, in 2020, after families of several patients who died at the hospital raised concerns in the media about how it responded to safety incidents. The report said: “We believe that it is sometimes culturally difficult within Great Ormond Street to accept that things can go wrong and to respond appropriately. We were told that some see the organisation as ‘bullet-proof’ in the face of criticism." “There is also a view outside the trust that some clinicians at Great Ormond Street can find it difficult to accept that something had gone wrong. Some believe that this reflex is deeply ingrained. This is potentially indicative of a culture of defensiveness. Acknowledging this trait is the first step on the road to changing it.” Dr Sharma said in a statement yesterday that GOSH had already taken steps to improve its culture and systems, appointing patient safety educators and patient safety leads in each directorate. Read full story (paywalled) Source: HSJ, 7 July 2022 -
Content ArticlePsychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. More than 20 years of research demonstrates that organisations with higher levels of psychological safety perform better on almost any metric or key performance indicator (KPI) in comparison to organisations that have low psychological safety. However, achieving psychological safety is a challenge in the complex, ever-evolving health and care systems in which we operate. In this guide, Professor Amy C. Edmondson shares insights that emerged from exploring the experience of differing Integrated Care Systems; a range of case studies, and a wealth of tools and resources. This guide is not a 'how to' for how to create psychological safety; it is more of a reflection on the opportunities and challenges in our health and care system, and how you might seek to work with them.
-
Content ArticlePretty soon there won’t be a trust without an associate director or even board level director fully dedicated to all things equality, diversity and inclusion; relatively new senior roles that must have a purpose, job description and performance indicators. They will spend energy on yet more strategies, start from the top and hope something trickles down. Or they could start where the work is done, and build the tools to make equality, diversity and inclusion (EDI) everyone’s responsibility. Trusts are full of people passionate about EDI. So many roles, so many champions. They meet, share stories, and champion the importance of EDI. All this busyness typically outside a governed frame without the necessary reporting, investigating, actions, outcomes, learning, and measurable improvement. To normalise EDI and make it everyone’s responsibility will involve enabling reporting of EDI incidents, investigating it, taking action, and learning from it, writes Dr Nadeem Moghal in an article for HSJ.
-
Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
