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Found 441 results
  1. Content Article
    Babies would have survived if hospital executives had acted earlier on concerns about the nurse Lucy Letby, a senior doctor who raised the alarm has said. In an exclusive Guardian interview, Dr Stephen Brearey accused the Countess of Chester hospital trust of being “negligent” and failing to properly address concerns he and other doctors raised about Letby as she carried out her killings. Brearey was the first to alert a hospital executive to the fact that Letby was present at unusual deaths and collapses of babies in June 2015. The paediatrician and his consultant colleagues raised concerns multiple times over months before Letby, then 26, was finally removed from the neonatal unit in July 2016. The police were contacted almost a year later, in May 2017. Speaking publicly for the first time, Brearey told the Guardian that executives should have contacted the police in February 2016 when he escalated concerns about Letby and asked for an urgent meeting.
  2. Content Article
    Understanding of the significance of psychological safety has grown over recent years as we see the implications of people not speaking out—a culture that forces people to conceal rather than reveal. Concealing observations, ideas and thoughts can lead to major events that are harmful to organisations as much as individuals. Sometimes, individuals feel it is imperative to speak out somewhere, which leads to whistleblowing. This article looks at how to identify whether a workplace has a psychologically safe culture and how to transform cultures where staff don't feel able to speak up. It describes The Wellbeing and Performance Agenda, which contains six elements for building psychological safety: Transforming managers into leaders Psychological responsibility Sharing responsibility for the future success of the organisation Adaptive and positive culture Intelligent management Safe and resilient individuals
  3. Community Post
    The Academy of Medical Royal Colleges have published the first National patient safety syllabus that will underpin the development of curricula for all NHS staff as part of the NHS Patient Safety Strategy: https://www.pslhub.org/learn/professionalising-patient-safety/training/staff-clinical/national-patient-safety-syllabus-open-for-comment-r1399/ Via the above link you can access a ‘key points’ document which provides some of the context for the syllabus and answers to some frequently asked questions. AOMRC are inviting key stakeholders to review this iteration of the syllabus (1.0) and provide feedback via completing the online survey or e-mailing Rose Jarvis before 28 February 2020. I would be interested to hear people's thoughts and feedback and any comments which people are happy to share which they've submitted via the online survey
  4. Community Post
    I am interested in what colleagues here think about the proposed patient safety specialist role? https://improvement.nhs.uk/resources/introducing-patient-safety-specialists/ https://www.independent.co.uk/news/health/nhs-patient-safety-hospitals-mistakes-harm-a9259486.html Can this development make a difference? Or will it lead to safety becoming one person's responsibility and / or more of the same as these responsibilities will be added to list of duties of already busy staff? Can these specialist be a driver for culture change including embedding a just culture and a focus on safety-II and human factors? What support do trusts and specialists need for this to happen? Some interesting thoughts on this here: https://twitter.com/TerryFairbanks/status/1210357924104736768
  5. Community Post
    A question posed by a delegate at our Patient Safety Learning conference 2019: 'Does your employer praise staff and patients for reporting safety concerns?' Tell us about your experiences of how reported concerns are received. Does it differ depending on whether they are raised by staff or patients? Are there any examples of great practice you can share where people are really praised for raising patient safety concerns?
  6. Community Post
    A question posed by a delegate at our Patient Safety Learning Conference 2019: 'How can we change the blame culture without blaming others?' What are your thoughts?
  7. Community Post
    Hi - I was wondering if anyone has used the freedom to speak up (FTSU) guardian service where they work? It is FTSU month in October and I was wondering if anyone had used the service, would they like to answer a few questions. We can post this on the hub, so people can see how the system works and how it felt to raise concerns. This of course would be dealt with strict anonymity, as these issues may be sensitive. Please get in touch!
  8. Community Post
    Have you witnessed poor care, reported an incident but you weren't heard or felt unsafe at work? Do you have the courage to speak up? Why should we need 'courage' to speak up at work?
  9. Community Post
    We know that blame and fear is toxic. It makes working in healthcare unsafe for staff and is a huge barrier to patient safety - staff won’t share what goes wrong if they expect not to be listened to or worse, will be criticised or blamed for errors that are really attributable to unsafe systems. It would be really valuable to better understand how this feels and the impact it has on clinicians and the safety of patients and service users.
  10. Content Article
    NHS England commissioned a limited scope independent review into patient safety concerns and governance processes related to the North East Ambulance Service. Chaired by Dame Marianne Griffiths DBE, the review considered the facts surrounding a number of individual cases, reviewed the processes surrounding coronial investigations and reviewed the seven previous investigations and reviews undertaken by the ambulance service to determine if they were sufficient to fully understand and resolve issues.
  11. Content Article
    The role of Freedom to Speak Up Guardians is to support staff working in healthcare raise concerns about their workplace. In this report, the National Guardian’s Office provides an overview of the latest annual speaking up data, summarising the themes and learning from information shared by Freedom to Speak Up guardians.
  12. Content Article
    In this article, Roger Kline looks at the responsibility of Board members in speaking up and responding to concerns raised about patient and staff safety concerns.
  13. Content Article
    Adverse incidents arising from suboptimal healthcare are a major cause of worldwide morbidity and mortality. Arriving at an understanding of the conditions under which adverse incidents occur has the potential to improve the safety of healthcare provision. Staff working in the NHS have been contributing their experiences via a narrative data capture platform – SenseMaker – to help gain contextual insights on a wide range of topics under exploration by the NHS Horizons team. This blog by Rosanna Hunt (Senior Associate, NHS Horizons) in collaboration with Lizzy MacNamara (Junior Research Consultant, The Cynefin Co.) and Taj Nathan (Consultant Forensic Psychiatrist, Cheshire & the Wirral Partnership Foundation Trust) describes how the SenseMaker® platform could be used to extract staff experiences on the topic of patient safety incidents both reported and unreported by staff, and the facilitated conversations that would be needed to transform the data into actionable insights and commitment to change. 
  14. Content Article
    An article from Roger Kline on the failure of many NHS organisations to create a climate where it is safe for staff to speak up. Roger reflects on the recent report published by the National Guardian’s office which summarises the results from the NHS staff survey completed by over 600,000 staff and highlights the story of a senior manager who tried to speak up and the consequences that followed. Further reading: Still not safe to speak up: NHS Staff Survey Results 2022 (Patient Safety Learning blog)
  15. Content Article
    A minor accident makes Emma Walker reflect on the safety culture of the NHS.
  16. Content Article
    An NHS consultant who was sacked after whistleblowing says it was because he raised concerns that “normal birth” ideology was putting the lives of women and babies at risk. Martyn Pitman, a respected obstetrician and gynaecologist, became a whistleblower to prevent “avoidable disasters” in NHS maternity care, but it cost him his career. Pitman lost his job last month after more than 20 years as a consultant at Royal Hampshire County Hospital in Winchester. His bosses cited an “irretrievable breakdown in his relationship with management”. His dismissal caused outrage from hundreds of former patients and doctors’ leaders, who say it highlights an NHS culture of “punishing those who dare to speak out”.
  17. Content Article
    Background to the independent review by Lewisham and Greenwich into Dr Chris Day's whistleblowing case.
  18. Content Article
    The NHS Staff Survey is an essential tool for assessing the experiences and opinions of NHS workers in Trusts in England. It also provides valuable insights to help understand the speaking up culture in the NHS. In this report the National Guardian’s Office analyse the results of the 2022 NHS Staff Survey, focusing on questions relating to speaking up.
  19. Content Article
    The NHS in England has largely relied on a human resources trilogy of policies, procedures and training to improve organisational culture. Evidence from four interventions using this paradigm—disciplinary action, bullying, whistleblowing and recruitment and career progression—confirms research findings that this approach, in isolation, was never likely to be effective. Roger Kline proposes an alternative methodology, elements of which are beginning to be adopted, which is more likely to be effective and to positively contribute to organisational cultures supporting inclusion, psychological safety, staff well-being, organisational effectiveness and patient care.
  20. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Stephen talks to us about his time as turnaround Chair of Mid Staffordshire NHS Foundation Trust, how NHS boards can ensure they live their values and why creating a safe space to share concerns improves patient safety.
  21. News Article
    The leadership of a prominent cancer trust acted in a ‘defensive and dismissive’ manner when serious concerns were raised about bullying behaviours and multiple failings in the handling of a major research contract, an external review has found. As previously revealed by HSJ, NHS England commissioned the review into events at The Christie Foundation Trust after whistleblowers raised numerous concerns over a research project with pharmaceutical giant Roche, and about the way they were treated as a result of speaking out. The NHSE review, which was led by Angela Schofield, chair of Harrogate and District FT, was published earlier today within trust board papers. It described the trust’s research division as “ineffective” and said it had “allowed inappropriate behaviours to continue without challenge”. The review added: “It may… be thought to be surprising that NHSE/I found it necessary to commission an external rapid review to look into concerns which had been raised by colleagues within the research and innovation division." “The root cause of this seems to be an apparent failure by those people in leadership positions who were aware of the concerns that had been raised, in the circumstances covered by the review, to listen to and take notice of a number of people who have some serious issues about the way they are treated and wish to contribute to an improvement in the culture." It also summarised the experiences of 20 current and former staff members who said they suffered “detriment as a result of raising concerns”, although it did not make a clear judgement on whether their claims were justified. They said: “An experience of bullying, harassment and racial prejudice was described along with lack of respect at work… Patronising behaviour, humiliation and verbal aggression by managers and clinicians in public and private spaces contributed to the perception that working environments were emotionally unsafe.” Read full story (paywalled) Source: HSJ, 27 January 2022
  22. News Article
    One of the NHS’ most high-profile mental health trusts has ‘multiple’ corporate governance problems and ‘deep-seated’ cultural issues, according to an external review. Tavistock and Portman NHS Foundation Trust, which provides mental health, educational and training services in London, commissioned an external firm to look into its leadership amid a period of intense public scrutiny in the latter half of 2021. Among cultural issues identified at the trust, which reviewers described as “deep seated”, was a reluctance of staff to speak up about concerns. Assessors said a recent employment tribunal, which ruled the trust’s treatment of a whistleblower had damaged her professional reputation and “prevented her from proper work on safeguarding”, had impacted the ability of staff to raise concerns. They urged leaders to review their Freedom to Speak Up and whistleblowing procedures. And while reviewers commended board members for commissioning an external review of race equality, they said it had “yielded an outpouring of emotion” which suggested many staff from minority ethnic groups do not feel consistently supported, respected or valued. Read full story Source: HSJ, 25 January 2022
  23. News Article
    NHS leaders have been accused of downplaying the impact of the Covid crisis and putting hospitals under scrutiny for declaring critical incidents and postponing surgeries. A leaked email urges hospitals to use the “correct terminology” and make NHS leaders aware when declaring their status. Sources said the message was a “thinly veiled threat” and that there was “subtle pressure” amid rapid spread of Omicron. At least 24 trusts have declared critical incidents this week, including one in Northamptonshire on Friday afternoon, while new figures show a 59% rise in staff absences in just seven days. Trusts in London were told hospitals will be scrutinised for declaring a critical incident if there is “doubt” over the decision, according to an internal email sent from NHS England on Wednesday. In light of media coverage, it would be “valuable” to “raise awareness of the key terminology and encourage you to ensure that you are clear ... when considering a declaration,” it said. “National scrutiny on the declaration on incidents has heightened ... and [senior managers] will need to make additional enquiries where there is doubt as to the status of an organisation’s incident.” Shadow health secretary Wes Streeting said: “We know that the NHS is under enormous pressure and it is important that local trusts are able to be honest and open with parliament and the public about the challenges they’re facing. We are increasingly concerned that ministers are more interested in covering up problems than solving them.” Daisy Cooper, the Lib Dem Health spokesperson, said: “This is an insult to every health worker who has given their all, and every patient with cancelled appointments and delayed surgeries. Read full story Source: The Independent, 9 January 2022
  24. News Article
    West Suffolk Foundation Trust’s investigation to find a whistleblower was “intimidating…flawed and not fit for purpose”, according to a damning review which is highly critical of the organisation’s leadership. The long-awaited review, published today, was triggered by ministers back in January 2020 following allegations that trust directors had ordered staff to give fingerprints and handwriting samples during a “witch hunt” for a whistleblower. The review, led by Christine Outram, has corroborated many of the allegations. It concluded trust leaders’ investigation to uncover the identity of the author of an anonymous letter sent to a patient’s family was “intimidating, flawed and not fit for purpose… impractical and unwise.” It said: “The decision to use fingerprinting and handwriting analysis in an NHS hospital, in the context of an anonymous letter and where no crime has been committed, was highly unusual and without doubt extremely ill-judged.” Read full story (paywalled) Source: HSJ, 9 December 2021
  25. News Article
    A ‘macho’ culture within ambulance trusts is leading to widespread abuse of female staff. HSJ has been told of multiple cases including sexual misconduct, harassment or abuse against staff in the last two and a half years. These include: women being told that giving sexual favours would help them get on to paramedic training a woman who was told she would pass her driving course if she gave oral sex to a superior a student on placement who could not take off her jacket without comments being passed on her breasts, and therefore would wear it even on the hottest days a student given a lift by her supervisor who then proceeded to rub his hands up and down her legs during the journey. In a freedom of information request, the 10 ambulance trusts in England were asked for the number of incidents in which allegations of sexual misconduct, harassment or abuse had been made against staff. The trusts reported 221 cases since April 2019, of which at least 27 resulted in dismissal and at least 44 resulted in other disciplinary action, with some cases still under investigation. Read full story (paywalled) Source: HSJ, 7 December 2021
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