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Showing results for tags 'Speaking up'.
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Content ArticleThis policy provides the minimum standard for local freedom to speak up policies across the NHS, so those who work in the NHS know how to speak up and what will happen when they do. All NHS organisations and others providing NHS healthcare services in primary and secondary care in England are required to adopt this policy. This includes a template where organisations can incorporate their own local information into the policy document.
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Content Article
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong. -
News Article
Bullying and harassment ‘normalised’ at trust put back in special measures
Patient Safety Learning posted a news article in News
An ambulance trust has been placed in special measures after the Care Quality Commission (CQC) rated its leadership ‘inadequate’ and said staff felt unable to raise concerns without fear of reprisal The CQC inspected South East Coast Ambulance Service Foundation Trust after being contacted by staff with concerns about bullying and harassment, inappropriate sexualised behaviour and a leadership team which failed to address concerns. Many of the concerns echo those raised in 2017 in an independent review into a “culture of fear” at the trust, shortly after it was first placed in regulatory special measures. It was taken out in 2019 but has now been placed back in the equivalent “recovery support programme” on the CQC’s recommendation. CQC director of integrated care Amanda Williams praised staff who had contacted the regulator. She said: “While staff were doing their very best to provide safe care to patients, leaders often appeared out of touch with what was happening on the front line and weren’t always aware of the challenges staff faced. Staff described feeling unable to raise concerns without fear of reprisal – and when concerns were raised, these were not acted on. “This meant that some negative aspects of the organisational culture, including bullying and harassment and inappropriate sexualised behaviour, were not addressed and became normalised behaviours." Read full story (paywalled) Source: HSJ, 22 June 2022 -
Content ArticleThis article in the Journal of Interprofessional Care highlights the challenges experienced by programme leaders and healthcare professionals as they work to improve patient safety. It discusses the complexities of translating organisation-wide speaking-up policies to local practices and settings.
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News Article
North Tees NHS nurse awarded £460k after unfair dismissal
Patient Safety Learning posted a news article in News
A whistleblower nurse who was sacked after warning that the workload on NHS staff had led to a patient’s death has been awarded hundreds of thousands of pounds. Linda Fairhall, who had an “unblemished” career as a nurse for almost 40 years, was suspended and then sacked in 2016 after raising concerns about patient safety. The 62-year-old nurse, from Billingham, has now been awarded a payout in excess of £462,000, her lawyers have said. It is thought to be a record for lost salary and remedies. Ms Fairhall had been a nurse at North Tees and Hartlepool NHS Trust. She started working with the NHS in 1979 and had been overseeing a team of about 50 district nurses in Hartlepool when she was suspended. In 2020, Ms Fairhall successfully challenged her employer's decision to dismiss her. Though the trust tried to appeal the decision last year, the appeal court found in her favour again – saying the tribunal had reached “an unimpeachable decision” that she was dismissed for whistleblowing. The trust says it is continuing to learn lessons and implement positive change. She said: "If it changes things for others then it will be worthwhile. I'm relieved it's over. Read full story Source: The Northern Echo, 14 June 2022 -
Content ArticleSeveral accidents have shown that crew members’ failure to speak up can have devastating consequences. Despite decades of crew resource management (CRM) training, this problem persists and still poses a risk to flight safety. This study aimed to understand why crew members choose silence over speaking up. The authors explored past speaking up behaviour and the reasons for silence in 1,751 crew members, who reported to have remained silent in half of all speaking up episodes they had experienced. Reasons for silence mainly concerned fear of damaging relationships, fear of punishment and operational pressures. The study identified significant group differences in the frequencies and reasons for silence and recommends interventions to specifically and effectively foster speaking up.
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Content ArticleIn this letter to the Guardian newspaper, a specialist nurse writes on an NHS service that puts women in control of pain relief, Sara Davies on the torturous pain she endured to have an intrauterine device fitted, and Lee Bennett on why it pays to speak up persistently. Have you experienced pain during a medical procedure? Share your experience along with hundreds of women to one of our community forums: Do women experience poorer medical attention when it comes to pain? Pain during IUD fitting Painful hysteroscopy
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Content Article
Safety Chats: Part 3 - Starting the conversation
Gina Winter-Bates posted an article in Good practice
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In Part 3, Gina shares with us how the Safety Chats were conducted and the key themes that came out of them, and what empowers and blocks staff in improving safety. -
Content Article
Safety Chats: Part 2 – Safety as measured
Gina Winter-Bates posted an article in Good practice
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In her first blog, Gina explained what motivated her to introduce Safety Chats into her Trust. In part 2, Gina reflects on how we know we are safe and the safety measures her Trust has put in place. -
News Article
North East Ambulance Service: Cover-up claims to be probed by government
Patient Safety Learning posted a news article in News
The government is to investigate claims an ambulance service covered up details of the deaths of patients following mistakes by paramedics. It follows the Sunday Times report that North East Ambulance Service (NEAS) withheld information from coroners. Labour's shadow health secretary Wes Streeting described the alleged cover-up as "a national disgrace". Health minister Maria Caulfield said she was "horrified" and there would be a further investigation. The newspaper reported that concerns were raised about more than 90 cases and whistleblowers believed NEAS had prevented full disclosure to relatives of people who died in 2018 and 2019. Speaking in the House of Commons, Mr Streeting asked why the regulator - the Care Quality Commission (CQC) - had failed to take action. Ms Caulfield said that while both the NEAS and the CQC had both reviewed the allegations, further investigation was required. The minister said non-disclosure agreements have "no place in the NHS", adding: "Reputation management is never more important than patient safety." Read full story Source: BBC News, 23 May 2022 -
Content ArticleAlready familiar to a number of NHS Trusts, Work In Confidence is a platform providing anonymity to those who wish to raise concerns.
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News Article
NHS ambulance service doctored documents to cover up truth about deaths
Patient Safety Learning posted a news article in News
Quinn Evie Beadle died in 2018. Her parents later found out that the “kind, caring” 17-year-old had been failed by a paramedic at the scene of her death — and that the ambulance service altered documents to try to stop them finding out the truth. The teenager, who dreamt of becoming a medic but suffered poor mental health, was found after she hanged herself near her home in Shildon, Co Durham, on the evening of 9 December 2018. The paramedic who attended the scene made basic mistakes, and made no effort to clear her airway or continue with basic life support — despite the fact her heart was still active. But instead of attempting to learn lessons, bosses at the North East Ambulance Trust (NEAS) set out to prevent the family learning what happened. They changed a key witness statement given to the coroner at her first inquest, removing references to mistakes the paramedic had made and inserting the claim that any life support offered would “not have had a positive outcome”. They also withheld from the coroner a key piece of evidence — a reading from a heart monitor — which demonstrated Quinn’s heart activity. It is thought Quinn’s death could be one of more than 90 cases in the past three years in which the NEAS failed to provide families with the whole truth about how their relatives died. Senior managers repeatedly withheld key evidence from coroners about deaths linked to service failures, an internal report shows. In some cases, bosses doctored or suppressed evidence to cover up failures by staff. An independent report into a small number of the cases, including Quinn’s, raised by whistleblowers found that, as in her case, statements were changed or suppressed and pieces of key evidence not disclosed. Read full story (paywalled) Source: The Sunday Times, 22 May 2022 -
Content Article"Shaming and punishing healthcare workers when an incident occurs sets a dangerous precedent for the industry. This will lead to a culture where healthcare workers avoid reporting near misses or errors for fear of repercussions, allowing process inefficiencies and systemic problems to occur." In this letter, Michael Ramsay, CEO of the Patient Safety Movement Foundation, highlights the negative ways in which criminalising healthcare workers who make mistakes will affect patient safety. He refers to the case of RaDonda Vaught, a nurse who was convicted of criminally negligent manslaughter in March 2022 for a medication error made while working at Vanderbilt University Medical Center in Nashville.
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Content Article“Freedom to Speak Up requires leadership commitment throughout the health and care system,” writes Dr Jayne Chidgey-Clark in a blog for the Health Service Journal. “In this way, we can foster the speak up, listen up, follow up culture, which will give workers, and ultimately those who use our services, the health and care sector they deserve.” She encourages all senior leaders to under take training to understand their role in forster a good speaking up culture that promotes organisational learning and improvement.
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News Article
Nurses take to streets ahead of RaDonda Vaught sentencing
Patient Safety Learning posted a news article in News
Nurses from across the country are heading to Washington, D.C., and Nashville, Tenn., this week to march for better working conditions and to show support for nurse RaDonda Vaught. Ms. Vaught, 38, was convicted of criminally negligent homicide and abuse of an impaired adult for a fatal medication error she made in December 2017 after overriding an electronic medical cabinet as a nurse at Vanderbilt University Medical Center in Nashville. Her case has spurred a national outcry from nurses who argue the ruling sets a dangerous precedent for the profession and will discourage nurses from speaking up about errors. Ms. Vaught's sentencing is scheduled for 13 May in Nashville, and she faces up to eight years in prison. Hundreds of nurses are planning to march in Nashville the day of the hearing to show their support for Ms. Vaught and to fight for better protection for nurses against criminal prosecution of errors. "We expect a large number of people to show up … just to show our strength in numbers and hope that the judge takes this into consideration and makes it slightly better by not sentencing her to any prison time," said Erica, a Las Vegas-based hospice nurse who is attending the sentencing. Read full story Source: Becker's Hospital Review, 13 May 2022 -
News Article
Medical director wins 'whistle blowing' unfair dismissal case
Patient Safety Learning posted a news article in News
A former medical director on the Isle of Man, who lost her job when she questioned decisions made on the island during the COVID-19 pandemic, has won her case for unfair dismissal at an employment tribunal. The hearing, which began in January, heard how Dr Rosalind Ranson was victimised and dismissed from her role after making 'protected disclosures' as part of her efforts to persuade the Manx Government to deviate from Public Health England (PHE) advice in the early stages of the pandemic. Dr Ranson, who had extensive experience as a GP and as a senior medical leader in the NHS in England, was appointed to her post as the island's most senior doctor in January 2020 with the aim of tackling what she identified as a disillusioned medical workforce, failings in management, and a bullying culture. She was soon called on to provide expert medical advice and guidance on how the Isle of Man’s health system should respond to the spread of COVID-19. In March, Dr Ranson channelled concerns from the island's doctors that the advice from PHE was flawed, and that a more robust approach should be taken to stem the spread of SARS-CoV-2. That included closing the island’s borders – a move that was initially ignored. Dr Ranson became concerned that her medical advice was not being heeded and that it might not be being passed on to ministers by the then Chief Executive of the Isle of Man’s Department of Health and Social Care (DHSC), Kathryn Magson, who was not medically qualified. The tribunal heard that because Dr Ranson had "blown the whistle" when she spoke out, she was sidelined and eventually dismissed unfairly. Read full story Source: Medscape, 11 May 2022 -
News Article
Blowing whistle on trust CEO ‘hardest thing I’ve had to do’, says his successor
Patient Safety Learning posted a news article in News
A trust chief who blew the whistle on her predecessor’s ‘aggressive’ behaviour and lack of interest in patient safety says it was the hardest thing she has had to do in her career. Janelle Holmes, who is now chief executive of Wirral University Teaching Hospital Foundation Trust, was among four Wirral University Teaching Hospital Foundation Trust senior executives who wrote to regulators in 2017 about the behaviour of the trust’s then CEO David Allison. They said he would react with “dismay and aggression” to concerns being raised about service quality, and staff were afraid to speak up as a result. The intervention led to Mr Allison’s departure and a subsequent independent investigation found “deep systemic cultural issues”. Mr Allison always denied his behaviour was inappropriate. In an interview with HSJ, Ms Holmes talked of the difficulties in taking those actions, and the subsequent efforts to overhaul the trust’s culture. She said: “From a personal integrity perspective, it was the right thing to do…and I [also] felt I had a personal responsibility to make it right afterwards. “But yes, it was the most difficult thing I’ve ever had to do.” She said: “I remember watching Sir David Dalton (the ex-Salford CEO) probably more than 10 years ago… say ‘we are harming patients’.. it was like ’you can’t say that’. “But actually [there was a] complete sea change and [it became] an organisation where [speaking out] was the right thing to do. That’s the only way you can ensure you’re delivering good quality high standard services. If you’re acknowledging mistakes happen, you’re learning from them, you’re correcting things… I think that then starts to shape how our clinicians and staff feel. Read full story (paywalled) Source: HSJ, 12 May 2022 -
Content Article
Safety Chats blog series: Part 1
Gina Winter-Bates posted an article in Good practice
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this first blog, Gina explains what motivated her to introduce Safety Chats into her Trust. -
Content Article"The inestimable, magnificent, Will Powell speaking on Radio Ombudsman about the long struggle to discover the truth about his son's death and the subsequent failure of accountability mechanisms" - Rob Behrens, Parliamentary and Health Service Ombudsman UK, Vice-President IOI Europe, Visiting Professor UCL. MCFC.
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Content ArticleSafety voice is the act of speaking up about safety in order to prevent accidents and physical harm. This systematic review in the journal Safety Science aimed to determine how safety voice differs conceptually from employee voice, is described across levels of analysis and could be best investigated. The authors found that there are important challenges for safety voice in terms of developing methodologies and interventions.
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News Article
Whistleblowing Bill launched in Parliament to widespread support
Patient Safety Learning posted a news article in News
The Doctors’ Association UK (DAUK) has expressed its support for the Whistleblowing Bill launched in Parliament last week, with its first reading in the House of Commons by Mary Robinson MP, Chair of the All Party Parliamentary Group for Whistleblowing. DAUK urged people to tweet their MP to show their support for the Bill. DAUK Chair Dr Jenny Vaughan said: "Healthcare staff need to be able raise patient safety issues all of the time. We’re trained to do that, expect it, point this out as best we can. But sometimes poor safety arises because of the way we are told to work. Then, it can be just as hard for staff to speak up as it is for anyone else, because we can also be threatened, sanctioned, isolated, ignored and bullied. "Blowing the whistle for us means saving lives, in the end. But we stand to lose as much as anyone. DAUK has supported many doctors who have been made to suffer because they spoke out, and there are many more who feel they should but are afraid to. That is why this Bill is so important. For all staff within healthcare. And most of all, for patients - the public. Stopping the greater harm for the greater good.” The most important changes in the private members bill, led by Baroness Kramer would: Require disclosures to be acted upon and whistleblowers protected. Provide criminal and civil penalties for organisations and individuals failing to do so. Establish a fully independent parliamentary body on whistleblowing, and provide easy access to redress. Read full story Source: Medscape UK, 26 April 2022 -
Content Article
In a previous blog, 'What is a Whistleblower',[1] Hugh drew attention to negative perceptions of whistleblowers in the eyes of some people. A crossword and clues were published on the hub to emphasise how wrong such perceptions are and how damaging they can be, with serious patient safety implications.[2] This follow-up outlines the nature of the journey travelled by some NHS staff who have spoken up and the problems which still exist with NHS whistleblowing culture. It provides a link to an attached file which contains the answers to each clue. The attachment also shows the completed crossword in larger, easier-to-read, format than the small illustration in this blog. There is a further link to companion notes which expand on the answer to each clue. These notes contain more detail about the realities of speaking up. They reinforce the link between hostility towards those who speak up and an ongoing series of patient safety scandals.[7-21] -
News Article
Trust board backs medical director who wrongly dismissed whistleblower
Patient Safety Learning posted a news article in News
A trust board has backed the medical director who oversaw the dismissal of a whistleblower in a case linked to patient deaths. Portsmouth Hospitals University Trust told HSJ John Knighton had the full support of the organisation when asked if he faced any censure over the wrongful dismissal of a consultant who raised the alarm about a surgical technique. Jasna Macanovic last month won her employment tribunal against the trust with the judge calling its conduct “very one-sided, reflecting a determination to remove [her] as the source of the problem”. The judgment found that the disciplinary process Dr Knighton oversaw was “a foregone conclusion” and as such had broken employment rules. The nephrologist was twice offered the opportunity to resign with a good reference, once during her disciplinary hearing and again on the day the outcome of that hearing was delivered. The trust told HSJ nothing in the judgment suggested Dr Knighton should face any action about his conduct and none had been taken. It said there were no reasons to doubt his credibility or probity. The trust did not respond when asked if any apology had been offered to Dr Macanovic. A spokesperson said: “We are committed to supporting colleagues raising concerns, so they are treated fairly with compassion and respect.” Read full story (paywalled) Source: HSJ, 13 April 2022 -
News Article
NHS whistleblowers still face consequences
Patient Safety Learning posted a news article in News
Criticism of NHS managers over the treatment of whistleblowers has been reignited by Donna Ockenden’s damning review of maternity services at Shrewsbury and Telford Hospital Trust. Her findings come seven years after the “Freedom to speak up?” report from Sir Robert Francis QC, which found that NHS staff feared repercussions if they blew the whistle on poor practice. He recommended reforms to change the culture and support whistleblowers. The Public Interest Disclosure Act 1998 makes it unlawful to subject workers to negative treatment or dismiss them because they have raised a whistleblowing concern, known as a “protected disclosure”. But critics say little has changed since the Francis review. According to Protect, a whistleblowing charity, 64% of those contacting it for advice said that they had been victimised, dismissed or forced to resign. Shazia Khan, founding partner at Cole Khan Solicitors, says that instead of being afforded protection, whistleblowers are “targeted as a form of retaliation by trust senior management and disciplined on trumped up charges to shut them down”. Those seeking to vindicate their rights before an employment tribunal, Khan adds, will often be “priced out of justice” by well-resourced NHS trust lawyers who at public expense “deploy a menu of tactics” to defend cases. When Peter Duffy, a consultant urologist at University Hospitals of Morecambe Bay Foundation NHS Trust, reported on allegedly unsafe practices by colleagues in 2016, he was demoted, falsely accused of financial irregularities, and threatened with a six-figure adverse costs order by Capsticks, the hospital’s law firm. “All my witnesses dropped out after the medical hierarchy told them that the department might be dissolved if the case went badly,” Duffy says, which meant there was no one to rebut the trust’s evidence. Read full story (paywalled) Source: The Times, 7 April 2022 -
Content ArticleThis report published by the National Guardian’s Office shows the experience of Freedom to Speak Up Guardians amid the continued pressure of the pandemic on the healthcare sector. Although the majority of guardians who responded to the survey were positive about the culture of their organisation, the results highlight a decline in factors that make it easy for staff to speak up, including support from leadership.
