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Found 448 results
  1. Content Article
    In this report, Exploring Freedom to Speak Up: Supporting the introduction of the Freedom to Speak Up Guardian role in Primary Care and Integrated Settings, the National Guardian's Office illustrates the challenges and benefits of implementing Freedom to Speak Up in different primary care settings. In 2019, the National Guardian’s Office began a two-year project working with primary care providers to understand how the Freedom to Speak Up Guardian role could be introduced in primary care and integrated settings. This report describes some of the variety of organisations, and the different Freedom to Speak Up models they have adopted.
  2. Content Article
    National Guardian newsletter discussing current events, annual reports, and guidance.
  3. News Article
    Doctors in Wales have faced bullying and disciplinary action for raising concerns over working conditions and safety, a union leader has said. Dr Phil Banfield, of BMA Wales, said doctors who complained about work, both before and during the Covid pandemic, were seen as "troublemakers". He said there are worries bullying among staff will get worse as longer post-Covid waiting lists are tackled. The Welsh government said bullying of NHS staff was "entirely unacceptable". Dr Banfield, who is chairman of the BMA Welsh consultants' committee, said staff have faced the prospect of being victimised by colleagues, or even being forced to leave the Welsh NHS, for raising concerns over bullying or health and safety. He said: "Staff are quite good at raising concerns, but they don't raise concerns if they're going get in trouble for it, or they sense nothing is going to happen. What happens is you think 'I can't be bothered'. "Decent people develop a kind of learned helplessness and it means that people who keep raising concerns stand out." Read full story Source: BBC News, 15 May 2021
  4. News Article
    NHS whistleblowers have required counselling and medication and a quarter would not raise concerns again due to the stress and lack of support, a report found. A review of existing policy at NHS Greater Glasgow and Clyde found “concerning” evidence of a significant impact on the mental health of both whistleblowers and managers with little support provided. It found there was “no clear documented process” to highlight serious, urgent issues to the appropriate manager. Healthworkers’ union Unison said staff were often labelled ‘trouble-makers’ with senior managers "defensive from the outset". Sixty percent of staff reported that their mental health was negatively impacted by whistleblowing with some requiring counselling or medication to cope with the stress of disclosures. The report said it was of concern that a quarter of staff stated that they would not raise concerns such as unsafe clinical practices again given their experiences, a figure which it said was likely to be higher as this information was only recorded if it was volunteered by staff. Unison’s Regional Organiser Matt McLaughlin said, “Unison welcomes this paper and the Boards commitment to follow the updates national guidance. “However it will take more than a new policy for whistleblowers to feel valued within NHS GGC. The organisation is too defensive and staff who whistleblow often do so out of shear frustration that legitimate concerns are ignored – or worse, where the whistleblower is seen as a trouble maker. " "NHS Greater Glasgow and Clyde needs to embrace and welcome staff speaking out; rather than being defensive from the outset." Read full story Source: The Herald, 28 April 2021
  5. Content Article
    The National Guardian’s Office today publishes its Annual Report for 2020, highlighting the progress which has been made in Freedom to Speak Up in health and the impact of the pandemic on speaking up.
  6. Content Article
    In this blog the Safer Healthcare and Biosafety Network and Patient Safety Learning reflect on the results of the NHS Staff Survey 2020, considering how staff safety relates to patient safety in the context of this.
  7. Content Article
    This poster was presented by Hugh Wilkins at the UK Imaging and Oncology Congress in June 2019 and highlights the serious problem of retaliation against NHS staff who raise concerns in the public interest.
  8. Content Article
    In this story from a former Policy & Performance Officer, the truth is told about how ineffective hierarchies often result in a culture of dishonesty.
  9. Content Article
    This is the fourth year that the National Guardian’s Office has surveyed Freedom to Speak Up Guardians in order to understand how speaking up is supported within organisations. Their views give valuable insights into both how the Guardian role is implemented and what further support and learning is needed to truly create a culture where speaking up is business as usual. The results also reveal details about their perceptions of the barriers to speaking up, the sources of detriment for speaking up and the network’s demographics.
  10. News Article
    Clinicians within a major teaching hospital’s cancer services have raised multiple concerns over patient safety, which they believe have resulted from badly planned service changes in response to the covid crisis. HSJ has spoken to several staff members who have worked in the haematology speciality at University Hospitals Birmingham Foundation Trust since last June, when the services underwent significant changes to free up capacity for coronavirus patients. This involved most haematology services at Heartlands Hospital in east Birmingham moving to the trust’s main Queen Elizabeth Hospital site in Edgbaston. The staff, who all wished to remain anonymous, told HSJ the transfer happened at just one week’s notice and was poorly planned. Once implemented, they said QEH’s newly enlarged service suffered from extreme staffing shortages, leading to several “never events”, such as patients being given the wrong blood type. In one resignation letter, a nurse who had transferred to QEH told managers patients’ “basic care needs are not being met”. The nurse said most shifts were understaffed, with examples of three nurses looking after 30 patients and added in the resignation letter: “I am witnessing strong and knowledgeable colleagues breaking down on each shift. “Furthermore, never events are happening at an alarming rate, necessary resources are commonly unavailable and communication between all levels of seniority is poor…" Read full story (paywalled) Source: HSJ, 2 February 2021
  11. News Article
    A nurse who was threatened by colleagues for speaking out about care failings at Mid Staffordshire Foundation Trust has said bullying remains a “real problem” in the NHS. Helene Donnelly has told MPs that more than 10 years on from the scandal – commonly known as Mid Staffs – she was still seeing “echoes” of what she experienced happening across the country. “Although it is in the minority, as we saw at Mid Staffs the results can be absolutely catastrophic” She called for the development of a national body to improve workplace cultures in the NHS and “stamp out bullying once and for all”. The inquiry into poor standards of care and deaths at Mid Staffordshire indentified issues around staff behaviour, inadequate staffing levels and skills, and lack of effective leadership and support. Ms Donnelly told a Health and Social Care Committee hearing today that there were “real negative behaviours” at the trust that created a “real bullying culture of fear and intimidation”. “There was not a culture that encouraged and enabled staff to speak up and if they did as I did, we were bullied and threatened,” said Ms Donnelly, who now holds the roles of ambassador for cultural change and lead Freedom to Speak Up Guardian at the organisation where she works. Read full story (paywalled) Source: The Nursing Times
  12. News Article
    The UK’s most senior nurses and the nursing regulator are encouraging the profession to “speak up” if they feel unsafe at work amid the latest surge of COVID-19. The four chief nursing officers and the Nursing and Midwifery Council has today issued an open letter. Source: Nursing Times, 8 January 2021
  13. Content Article
    This study in BMJ Open considers how the usefulness of internal whistleblowing is affected by other institutional processes in healthcare organisations. The authors examine how the effectiveness of formal inquiries (in response to employees raising concerns) affects the utility of whistleblowing. The study used computer simulations to test the utility of several whistleblowing policies in a variety of organisational contexts. This study found that: organisational inefficiencies can have a negative impact on the benefits of speaking up about poor patient care where resources are limited and reviews less efficient, it can actually improve patient care if whistleblowing rates are limited including 'softer' mechanisms for reporting concerns (for example, peer to peer conversation) alongside whistleblowing policies, can overcome these organisational limitations.
  14. Content Article
    The Care Quality Commission (CQC) has published the second report of Professor Glynis Murphy’s independent review of its regulation of Whorlton Hall between 2015 and 2019. CQC commissioned Professor Murphy to conduct an independent review to look at whether the abuse of patients at Whorlton Hall could have been recognised earlier by the regulatory process and to make recommendations for how CQC can improve its regulation of similar services in the future. In addition, CQC asked Professor Murphy to conduct a review of international research evidence to look at how abuse is detected within services for adults with a learning disability and autistic people and how such detection can be improved. The first report of Professor Murphy’s review made a number of recommendations for CQC to strengthen its inspection and regulatory approach for mental health, learning disability and/or autism services. This second report outlines the progress that CQC has made to implement the recommendations. This includes publication of the final report of its review of restraint, seclusion and segregation; work on closed cultures and the development of a tool for rating support plans.
  15. News Article
    Nine months ago, Boris Johnson praised staff at St Thomas’ for saving his life. Now, a senior intensive care nurse at the London hospital has warned that patient care is being compromised because of staff shortages and a failure to plan for the second Covid wave. Dave Carr, an intensive care charge nurse, is one of many NHS workers desperate for the public to know what is going on inside their hospitals at a time when misinformation and scepticism about the virus are rife. “The public needs to be aware of what’s happening. This is worse than the first wave; we have more patients than we had in the first wave and these patients are as sick as they were in the first wave. Obviously, we’ve got additional treatments that we can use now, but patients are still dying, and they will die,” said Carr. As a representative for the union Unite, Carr feels emboldened to speak out. But across the NHS, many more staff claim they have been threatened with disciplinary action or even dismissal if they put their head above the parapet. In Devon, one nurse working on a Covid ward said safety standards had slipped at her hospital, but she feared for her job if she was identified by name. “The infection control restrictions are more relaxed. Before, we had to use a separate entrance but now we don’t, and some doctors feel they don’t have to obey the infection control protocols and are still unsure of how to properly remove the PPE,” she said. Read full story Source: The Guardian, 1 January 2021
  16. Event
    until
    Sir Robert Francis QC, Retired Barrister (specialising in medical law) and Queen’s Counsel. Before his retirement from full-time practice earlier this year, Sir Robert sat as a Recorder (part-time Crown Court judge) and as a Deputy High Court Judge. Sir Robert will be joining Professor Roger Kirby (RSM President) for an interesting discussion on his wide-ranging legal career, including previous inquiries such as the Freedom to Speak Up Review. He will also be talking about patient quality and care in the UK, and his view on the COVID-19 pandemic. Register
  17. Content Article
    So far in our 2020 overview series, we’ve heard an introduction to how the year has gone from our Chief Executive Helen Hughes, and looked at the impact of the COVID-19 pandemic on patient safety, as well as the work we’ve done in the areas of Long COVID and painful hysteroscopies. In our penultimate blog of the series, we turn our attention to the work we’ve done in staff safety.
  18. News Article
    The Care Quality Commission (CQC) has raised serious concerns about a major teaching trust’s maternity services and taken action to prevent patients coming to harm. The watchdog has imposed conditions on the registration of Nottingham University Hospitals Trust’s maternity and midwifery services at Nottingham City Hospital and Queen’s Medical Centre and rated them “inadequate”. Following an inspection in October, the CQC identified several serious concerns, including leaders lacking the skills to effectively head up the service, a lack of an open culture where staff could raise concerns, and staff failing to complete patient risk assessments or identify women at risk of deterioration. In its findings, the CQC reported how “fragile” staff wanted to escalate their concerns directly to the regulator, particularly around the leadership’s response to the “verbal outcome of the inspection”. The regulator called this “further evidence of the deep-rooted cultural problems” and escalated these concerns directly to trust CEO Tracy Taylor, who would be “personally overseeing the improvement process required”. Inspectors also found the service did not have enough staff with the right skills, qualifications and experience to “keep women safe from avoidable harm”. The CQC also issued the trust a warning notice over concerns around documenting risk assessments and IT systems. The trust has three months to make improvements. Read full story (paywalled) Source: HSJ, 2 December 2020
  19. News Article
    A review of a clinical commissioning group has discovered “microaggressions and insensitivities” towards Black, Asian and minority ethnic staff, and the use of derogatory slurs about other groups. The report into Surrey Heartlands CCG also uncovered incidents of shouting, screaming and bullying among other inappropriate behaviour. And it was reported some staff were unwilling to accept Black Lives Matter events as important, stating “all lives matter”. The review also discovered a culture of denial and turning a blind eye to consistent concerns, with staff fearful of speaking up. In particular, the HR department was said to have been repeatedly told about the behaviour of one staff member but had chosen to ignore or delay dealing with the issues. However, the review found “no evidence for widespread discriminatory practices” and “no clear evidence for a widespread culture of bullying and ill-treatment” — but it added the systems to deal with concerns had failed and there was a sense of “organisational inaction”. Read full story (paywalled) Source: HSJ, 27 November 2020
  20. News Article
    The chairman of an inquiry that has confirmed a 20-year cover-up over the avoidable death of a baby has warned there are other families who may have suffered a similar ordeal. Publishing the findings of his investigation into the 2001 death of Elizabeth Dixon, Dr Bill Kirkup said he wanted to see action taken to prevent harmed families having to battle for years to get answers. Dr Kirkup, who has been involved in multiple high-profile investigations of NHS failures in recent years, said: “There has been considerable difficulty in establishing investigations, where events are regarded as historic. I don't like the term historic investigations. I think that these things remain current for the people who've suffered harm, until they're resolved, it’s not historic for them. “There has been significant reluctance to look at a variety of cases. Mr and Mrs Dixon were courageous and very persistent and they were given help by others and were successful in securing the investigation and it worries me that other people haven't been. “I do think we should look at how we can establish a proper mechanism that will make sure that such cases are heard." “It's impossible to rule out there being other people who are in a similar position. In fact, I know of some who are. I think it's as important for them that they get heard, and that they get things that should have been looked at from the start looked at now, if that's the best that we can do.” Read full story Source: The Independent, 27 November 2020
  21. Content Article
    Those who have read Professor Edmondson's book "The Fearless Organization" will know that psychological safety is required for team high-performance. Psychological safety is defined as "a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes". If you do not feel safe in a group, you are likely to keep ideas to yourself and avoid speaking up, even about risks. Furthermore, if mistakes are held against you, you then look to avoid making mistakes and so stop taking risks, rather than making the most out of your talents. Low psychological safety, therefore, gets in the way of both team performance, innovation, learning, and personal success. For you to be successful in your team, and "as a team", psychological safety is the enabler. In collaboration with professor Amy C. Edmondson, The Fearless Organization has developed 'The Fearless Organization Scan'. This scan maps how team members perceive the level of psychological safety in their closest context. To improve team performance, it helps to know the Psychological Safety levels in your team, as this is a critical predictor of how your team will learn and work together. By improving the level of psychological safety, you significantly increase the likelihood of team success.
  22. Content Article
    Elderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated, a new Safeguarding Adults Review has found. The Morleigh Group, which operated seven homes in Cornwall and has since shut down, was exposed in a BBC Panorama investigation in 2016. A new Safeguarding Adults Review which was commissioned as a result of the TV show has been published making a number of recommendations to all agencies which were involved in the case. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
  23. News Article
    What does whistleblowing in a pandemic look like? Do employers take concerns more seriously – as we would all hope? Does the victimisation of whistleblowers still happen? Does a pandemic compel more people to speak up? We wanted to know, so Protect analysed the data from all the Covid-19 related calls to theirr Advice Line. They found: * 41% of whistleblowers had Covid-19 concerns ignored by employers * 20% of whistleblowers were dismissed * Managers more likely to be dismissed (32% ) than non-managers (21%) They found that too many whistleblowers feel ignored and isolated once they raise their concerns and that these failing are a systematic problem. Protect, which runs an Advice Line for whistleblowers, and supports more than 3,000 whistleblowers each year, has been inundated with Covid-19 whistleblowing concerns, many of an extremely serious nature. Its report, The Best Warning System: Whistleblowing During Covid-19 examines over 600 Covid-19 calls to its Advice Line between March and September. The majority of cases were over furlough fraud and risk to public safety, such as a lack of social distancing and PPE in the workplace.
  24. Content Article
    Speaking up protects patient safety and improves the lives of workers. When things go wrong, we need to make sure that lessons are learnt and things are improved. If we think something might go wrong, it’s important that we all feel able to speak up so that potential harm is prevented. Even when things are good, but could be even better, we should feel able to say something and should expect that our suggestion is listened to and used as an opportunity for improvement. Freedom to Speak Up is about encouraging a positive culture where people feel they can speak up and their voices will be heard, and their suggestions acted upon. Follow the below link to access training modules that explain in a clear and consistent way what speaking up is and its importance in creating an environment in which people are supported to deliver their best. It will help you understand the vital role you can play and the support available to encourage a healthy speaking up culture for the benefit of patients and workers. The training has been developed by the National Guardian and Health Education England for anyone who works in healthcare.
  25. Content Article
    Dr Henrietta Hughes speaks to HSJ on making the fear of retribution a thing of the past and speaking up business as usual in the NHS.
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