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Showing results for tags 'Speaking up'.
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Content ArticleLast year we published a blog from Dr Chelcie Jewitt on the Surviving in Scrubs campaign. The campaign was created by Dr Becky Cox and Dr Chelcie Jewitt to give a voice to women in healthcare to raise awareness and end sexism, sexual harassment and sexual assault in healthcare. On their Surviving in Scrubs website they share the awful stories from women working in healthcare of sexism, sexual harassment and sexual assault.
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Content ArticleThe National Guardian's Office and the role of the Freedom to Speak Up Guardian were created in response to recommendations made in Sir Robert Francis QC’s 2015 report The Freedom to Speak Up. The office leads, trains and supports a network of Freedom to Speak Up Guardians in England and conducts speaking up reviews to identify learning and support improvement of the speaking up culture of the healthcare sector. This annual report shares intelligence and learning collated by the National Guardian’s Office, including data about the cases Freedom to Speak Up Guardians receive. Over 20,000 speaking up cases were brought last year, meaning cases remain at the record level set in 2020/21. The report also features case studies from different healthcare providers across England, sharing the experiences of people who have spoken up about a wide range of issues, and demonstrating the ways in which organisations have improved staff confidence in being able to speak up.
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Dr Freya Smith, a Specialty Trainee in General Practice, reflects on the sinister and toxic side of medicine, using the recent Paterson and vaginal mesh scandals to demonstrate how patients have been let down by the system. In an honest and personal account, she shares with us the horror and sadness she felt at learning of these scandals and how she aspires to keep her future patients safe. -
Content ArticleIn December 2022, the All Party Parliamentary (APPG) for Whistleblowing heard evidence on the state of the NHS following the recent report on the avoidable deaths and life changing injuries caused to mothers and babies at the East Kent Trust. The culture at this hospital was described as one where “everyone knew the problems” and where whistleblowers were “thrown to the lions”. A culture attributed to 45 of the 65 baby deaths reviewed. This blog first appeared on the Whistleblowers UK website in December 2022.
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Content ArticleIn this blog, journalist David Hencke shares his views on the ruling of Judge Anne Martin in the case of NHS whistleblower Dr Chris Day. He argues that Judge Martin was determined to find in favour of Lewisham and Greenwich NHS Trust, glossing over the disclosure of the deliberate destruction of 90,000 emails and the use of false evidence by the Trust. She discredited the evidence of Dr Day’s witnesses, including the present Chancellor of the Exchequer, Jeremy Hunt and two senior medical experts, on the basis that they were biased.
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News ArticleThe troubled agency that supplies blood to the NHS has a ’very serious problem’ with racism, a staff survey has revealed. Six hundred staff at NHS Blood and Transplant were surveyed and the results have been summarised in an internal memo, seen by HSJ. It said 55% of respondents felt the problem of racism at NHSBT is “extremely or very serious”, while half had little confidence in the organisation’s recent efforts to tackle racial inequality. When contacted for comment, a NHSBT spokeswoman said the results were “difficult to read” and added that “we are deeply sorry to those who have experienced negative behaviour”. The issues over race and leadership come at perhaps the most operationally challenging period in NHSBT’s history. It is struggling to find enough staff for its donation clinics, which meant it issued its first-ever “amber alert” over blood supplies recently. Read full story (paywalled) Source: HSJ, 21 October 2022
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News Article
Leadership review launched at ‘outstanding’ trust
Patient Safety Learning posted a news article in News
The Care Quality Commission has launched a review of leadership at an “outstanding”-rated specialist trust, after receiving multiple concerns from whistleblowers. The regulator is understood to have made an unannounced visit to The Christie Foundation Trust within the last week to inspect its medical services. The review will also cover the trust’s overall leadership. HSJ understands the review is, at least, partly in response to the regulator receiving a number of concerns from whistleblowers about the trust’s leadership culture and behaviour of senior staff. It comes after the trust came under scrutiny from NHS England last year, with independent reviews finding there had been multiple failings around the handling of a major research project. The reviews also criticised the trust’s reaction to staff who had raised concerns, but failed to answer a key accusation that was made about the detriment suffered by whistleblowers. Read full story (paywalled) Source: HSJ, 19 October 2022 -
News Article
'No-one joined the dots' - grandad who exposed an NHS scandal
Patient Safety Learning posted a news article in News
More than 200 families in south-east England will learn today the results of a major inquiry into the maternity care they received from a hospital trust. The investigation into East Kent Hospitals NHS Trust follows dogged campaigning by one determined bereaved grandfather. Derek Richford's grandson Harry died at East Kent Hospitals after his life support system was withdrawn. Sixty one-year-old Derek had never campaigned for anything in his life. His initial approach was to wait for East Kent Hospitals Trust to investigate the death, as it had promised. However, one nagging issue that was to become central to Derek's view of the trust, was the hospital's continual refusal to inform the coroner of Harry's death. The family repeatedly requested it, but the trust said it was unnecessary as it knew the cause, namely the removal of the life support system. The hospital also recorded Harry's death as "expected" - again because his life support system had been withdrawn. On both points, the family were left confused and increasingly angry. In early March 2018, some four months after Harry's death, the family finally received the outcome of the trust's internal investigation - known as the Root Cause Analysis (RCA). The RCA indicated multiple errors had been made in Harry and Sarah's care and treatment, and his death was "potentially avoidable". Prior to the meeting, Derek wrote to the Kent coroner's office outlining in general the circumstances of Harry's case, asking if that was the type they would expect to be notified of. The email response from the coroner's office was clear. It said: "Based on the facts you have presented, this death should have been reported to the coroner." Despite this, at the meeting with the trust, the lead investigator into Harry's death told the family: "If we have a clear cause of death by and large we do not involve the coroner." The family's insistence eventually paid off - five weeks after that meeting, the trust informed the coroner of Harry's death. While his son and daughter-in-law started trying to recover from the trauma of losing Harry, Derek turned his attention to investigating East Kent, one of the largest hospital trusts in England. "When I started investigating what was going on with Harry, it was very much like peeling back an onion. 'Hang on a minute, that can't be right, that doesn't add up.' Ever since I was a small kid, justice has been so important to me. "What I found was that, up to that point, no-one had ever joined the dots. And that's so important. I think this had to happen, someone had to do it. There will be families before us that wish they did it. We will be saving a level of families after us." Read full story Source: BBC News, 19 October 2022 -
News Article
Number of NHSE whistleblowers tripled in 2021-22
Patient Safety Learning posted a news article in News
The number of concerns reported by NHS England staff through the freedom to speak up process almost tripled last year, the organisation’s latest board papers have revealed. There were 152 cases received by the internal freedom to speak up guardians in 2021-22 compared to 56 in 2020-21. This year 54 cases were received in quarter three alone. The most common concerns are related to allegations of bullying and harassment. These accounted for nearly 40% of the total. People and team management concerns accounted for a third of FTSU cases. Within the latter, there were sub-themes of breakdown in relationships, failure to offer role models and sanctioning or ignoring poor culture. This week’s report also set out the NHSE FTSU guardian’s next steps. These include appointing a lead guardian, finalising a strategy and continuing to engage with Health Education England and NHS Digital staff as they are brought into NHSE next year. Read full story (paywalled) Source: HSJ, 7 October 2022 -
News Article
CQC triggers two reviews into whistleblowing concerns
Patient Safety Learning posted a news article in News
The Care Quality Commission (CQC) has commissioned an independent review into handling of a high-profile whistleblower case, and a wider internal review of how it responds when it is given “information of concern”. The independent review will be led by Zoë Leventhal KC of Matrix Chambers and will consider how the regulator handled “protected disclosures” from University Hospitals of Morecambe Bay Foundation Trust surgeon Shyam Kumar, alongside “a sample of other information of concern shared with us”. Mr Kumar won a tribunal against the CQC earlier this month, which found he was unfairly dismissed as a special advisor on hospital inspections after raising serious patient safety concerns. Between 2015 and his dismissal in 2019 Mr Kumar wrote to senior colleagues at the CQC with a number of concerns within his trust around bullying, patient harm and the quality of CQC hospital inspections. The tribunal drew particular attention to the two whistleblowing disclosures made by Mr Kumar about the CQC itself, which it found “clearly had a material influence on the decision to dismiss”. The CQC said in an announcement today that the independent review would aim to determine whether it took “appropriate action” in response to the information disclosed in Mr Kumar’s case and others. It will include consideration of whether the ethnicity of the people raising concerns impacted on decision making or outcome and is expected to conclude by the end of the year. Read full story (paywalled) Source: HSJ, 28 September 2022 -
News Article
Coffey warned of ‘significant risk’ posed by CQC restructuring
Patient Safety Learning posted a news article in News
Staff at the Care Quality Commission (CQC) have been left ‘in fear of speaking out’ against structural changes to the organisation which they believe ‘pose a significant risk’ to the CQC’s ability to regulate health services, trade unions have told the health and social care secretary. A letter signed by senior officers of Unison, Royal College of Nursing, Unite, Prospect and the Public and Commercial Services union has called on Therese Coffey to urge the CQC to pause its organisational change and enter into “meaningful discussions” with the unions. The unions have raised concerns that organisational changes to the CQC have been drawn up by consultants with no frontline experience in health and social care, or in regulation, and that staff have had limited input into the changes. They allege that staff raising concerns about the changes have been dismissed as being “disruptive” or “negative”, and significant numbers of experienced staff have recently left the regulator. The CQC said in response to the letter that the changes it was proposing were needed to enable the regulator to “work more effectively across the health and care system”, and that it has engaged with trade unions throughout the process. Read full story (paywalled) Source: HSJ. 23 September 2022 -
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 ArticleJacqueline McIntosh, Freedom to Speak Up Guardian at Homerton Healthcare NHS Foundation Trust demonstrates how adopting a reactive approach to guardian ring-fenced time, improved worker wellbeing when it's most needed.
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Content Article
A ‘Just Culture’ aims to improve patient safety by looking at the organisational and individual factors that contribute to incidents. It encourages people to speak up about their errors and mistakes so that action can be taken to prevent those errors from being repeated. Adam Tasker and Julia Jones are graduate medical students at Warwick Medical School. They wanted to explore doctors’ perceptions of culture and identify ways to foster a Just Culture, so they conducted a qualitative research study at one of the hospitals where they were doing their medical training. We asked them about why Just Culture is important in the health and care system, and what they discovered from their research. -
Content ArticleIf a manager approaches your desk, do you feel a sense of anxiety? If your team wants to challenge an idea or offer a different perspective, do they feel free to speak up? These are both examples of psychological safety - or a potential lack thereof - in the workplace. Organisations have focused heavily on mental health and well-being at work over the last few years, but many still lack an awareness of psychological safety, how it can impact your team and the consequences of an unsafe culture. This article looks at how you can measure and improve psychological safety.
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In this blog, Steve Turner reflects on why genuine patient safety whistleblowers are so frequently ignored, side-lined or victimised. Why staff don't speak out, why measures to change this have not worked and, in some cases, have exacerbated the problems. Steve concludes with optimism that new legislation going through Parliament offers a way forward from which everyone will benefit.- Posted
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Content ArticleOn 24 August 2022, the Employment Tribunal found that Mr Shyam Kumar, a consultant orthopaedic surgeon employed at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB), had been disengaged from his role as a Specialist Advisor within the Care Quality Commission (CQC) on account of having made “protected disclosures” to the CQC. This means he had raised concerns with CQC about the health of patients and other important issues and had done so in the public interest. The Employment Tribunal found that the fact that he had raised these various concerns with CQC had materially influenced its decision to disengage him. It awarded him £23,000 in damages for injury to feelings, on account of what it described as “the inevitable impact” of CQC’s actions upon Mr Kumar’s reputation among his peers and the shock, confusion and concern it caused to him. The CQC has accepted these findings and apologised to Mr Kumar. CQC’s Chief Executive, Ian Trenholm, issued a public statement on 6 September 2022 about what occurred, including a recognition of the importance of the concerns Mr Kumar raised, the importance of the information raised by staff and the public generally, and the “vital role” played by Specialist Advisors in CQC’s inspections. Following this, Zoe Leventhal KC was appointed by CQC’s Executive Board to carry out an independent review into whether CQC took appropriate action as a regulator in response to the protected disclosures that Mr Kumar made, and whether it dealt appropriately with a sample of other instances where concerns have been raised with CQC.
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Content ArticleThe concerns that health and care workers and the public share with the Care Quality Commission (CQC) about health and care services are critical to its work. It is also vital that CQC listens to its own staff. This review explores whether there are areas of culture or process within CQC that need to be improved in relation to listening, learning, and responding to concerns. The review focused on these key areas: Organisational findings Reviewing how well we listen to whistleblowing concerns. Reviewing our Freedom to Speak Up policy. Learning from the tribunal case. Reviewing how we listen to our staff. Reviewing the expectations and experiences of people who raise concerns with us.
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Content Article
In this blog, Patient Safety Learning looks in detail at the results of the NHS Staff Survey 2022, focusing on responses relating to reporting, speaking up and acting on safety concerns. It includes the following key points: It is difficult to imagine other safety critical industries would deem these results acceptable. Nearly half of all respondents did not feel confident their organisation would address their concerns about unsafe clinical practice. It is hugely concerning that over 40% of respondents could not say that they would be treated fairly if involved in a patient safety incident. This could significantly undermine the willingness of staff to raise concerns, with significant consequences for patient safety. There needs to be greater urgency to improve the safety culture in the health service. NHS England needs to recognise the scale of this challenge and provide clarity on how it will work with organisations to tackle this. NHS England, working in partnership with the National Guardian and the Care Quality Commission, should bring forward as a matter of urgency robust and specific commitments to drive forward the work of improving the safety culture in the NHS. -
Content ArticleThis editorial in BMJ Quality & Safety argues that patients' perceptions of their safety should not be dismissed when measuring healthcare safety. The authors argue that a differentiation between ‘feeling safe’, as defined through patient experience, and ‘being safe’, as defined through observation and evaluation using clinical outcomes selected by quality experts, creates a power differential and dynamic that degrades the role and value of patient experiences as valid patient safety indicators.
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Content Article
NHS Staff Survey Results 2022 (9 March 2023)
Patient Safety Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. 636,384 staff responded to the survey in 2022. The full results of the 2022 NHS Staff Survey are published on the NHS Staff Survey website. -
Content ArticleThe Fearless Organization by Amy C. Edmondson highlights the importance of psychological safety in the workplace. This article published by Conflux, pulls out some key take home messages from the book that can help in building an organisation where staff feel safe to speak up.
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Content ArticleIt's now a decade since the Francis Report, which outlined the causes of serious failures in care at Mid Staffordshire NHS Foundation Trust. The report and prior media coverage exposed a wide set of issues surrounding the culture and transparency of health care, and these topics remain of major concern today. In this article for the Nuffield Trust, Shaun Lintern has interviewed Sir Robert Francis KC about the weight of those patient stories and treatment of the NHS's staff, then and now.
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Content ArticleThis study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
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Content ArticleIn light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
