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Found 447 results
  1. News Article
    More than half of NHS staff believe bosses would ignore whistleblowers amid fresh concerns hospitals could be covering up potential scandals following the Lucy Letby case. New national figures seen by the The Independent reveal that in the majority of hospitals, most doctors and nurses do not believe their concerns would be acted upon if they were raised with senior managers. It comes after The Independent revealed that NHS bosses accused of ignoring complaints about Letby were the very same people later appointed to act on whistleblower concerns at the hospital where she murdered seven babies and tried to kill six more. Several doctors who worked alongside her during the killing spree say they attempted to raise the alarm with hospital managers – only to have their pleas ignored. They believe the lack of action by bosses resulted in more babies being killed, stating managers who failed to act were “grossly negligent” and “facilitated a mass murderer”. In nearly three-quarters of general hospitals – such as the Countess of Chester where Letby worked – fewer than half of staff believed their trust would act on a concern, according to results from the latest NHS staff survey. Read full story Source: The Independent, 27 August 2023
  2. Content Article
    In this letter, Rob Behrens, the Parliamentary and Health Service Ombudsman, calls on the Secretary of State for Health and Social Care, Steve Barclay MP, to prioritise improving patient safety in the wake of the Lucy Letby trial.
  3. News Article
    A paediatric nurse who called in to LBC news during a discussion on Lucy Letby, says she can see how Letby was able to get away with her crimes as she herself was 'blacklisted' when she reported a colleague. Watch the video Source: LBC News, 19 August 2023
  4. Content Article
    On 18 August 2023, Lucy Letby was found guilty of murdering seven babies and convicted of trying to kill six other infants at the Countess of Chester Hospital. Looking ahead to the forthcoming independent inquiry into this case, Patient Safety Learning, reflecting on the inquiries of the past, sets out some key patient safety themes and issues that should be considered as part of this.
  5. Content Article
    Following the Lucy Letby case, letters to the Times discuss workplace rights and safety in hospitals. Keith Conradi, former chief investigator, Healthcare Safety Investigation Branch, highlights a current NHS workforce too frightened to raise safety concerns, working in a toxic and bullying culture, where the predominance of HR approaches undermine the culture of safety. And Andrew Harris, professor of coronial law, William Harvey Research Institute, Queen Marys University London, writes that there is a duty on medical practitioners to report the circumstances of a death and not to limit disclosure to avoid investigation. In his letter he questions whether medical examiners across the country are acting independently of their trusts and properly notifying such cases.
  6. Content Article
    We now know that Lucy Letby is a murderer, responsible for the deaths of seven babies and the attempted murders of six more. But as unimaginable as her crimes were, this verdict raises as many questions as it answers. Letby was not working in a vacuum. Could the killings at the Countess of Chester Hospital NHS Foundation Trust have been stopped sooner? Did organisational failures cost the lives of babies who could have been protected? The timeline gives us a clue, writes Minh Alexander, a retired consultant psychiatrist and NHS whistleblower, in this Guardian opinion piece. In June 2016, Letby’s hospital trust commissioned a review of neonatal care by the Royal College of Paediatrics and Child Health after “concerns about increasing neonatal mortality”, which oddly did not feature a case-note review. This prevented detailed examination of the deaths, which should have been the prime objective. The college reported “extremely positive relationships” among staff but “remote” relationships with executives. Astonishingly, the college’s report seemingly did not explicitly acknowledge a possibility of deliberate harm. Nevertheless, the college raised concern that not all deaths were followed by postmortem investigations – as they should have been, according to guidelines – and that where postmortems did take place, they did not include systematic blood tests and toxicology. It noted concerns from obstetrics staff about four unexpected deaths. In the coming days, there will be many questions. Why did it take so long for the hospital to refer matters to the police? Were doctors pressured not to persist with their concerns about Letby? How many trust board members knew there was a possibility of deliberate harm but failed to act?
  7. News Article
    Conduct guidelines for UK doctors are being updated to spell out what constitutes workplace sexual harassment, amid concerns abuse is going unchallenged. The General Medical Council, which regulates doctors to ensure they are safe and fit to care for patients, says it is adopting a zero-tolerance policy. The new advice explains it is not just physical acts that can be a breach. Verbal and written comments or sharing images with a colleague count too. The new guidance will not come into effect until the end of January, after a five-month familiarisation period for staff. And some say there is still a long way to go. Dr Chelcie Jewitt, an emergency-medicine doctor who is part of the Surviving in Scrubs campaign group, which aims to raise awareness of sexism, harassment and sexual assault in the healthcare workforce, said: "We have spoken with the GMC about the guidelines and we do think that they are a step in the right direction - but there is still a long way to go on this journey to eradicating the culture of sexual misconduct within healthcare. "The GMC has the potential to make a real difference and we need to see them supporting victims when they report perpetrators. "We need their reporting processes to be transparent and clearly explained to victims. "We need cases to be thoroughly investigated rather than dismissed. "And we need appropriate, proportionate sanctioning of perpetrators." Read full story Source: BBC News, 22 August 2023 Read a blog Dr Chelcie Jewitt wrote for the hub: Calling out the sexist and misogynist culture within healthcare
  8. News Article
    Lucy Letby sat with her parents in a meeting with senior managers at the Countess of Chester Hospital, where she worked, waiting patiently for an apology. She had prepared a statement that was read out by her parents to Tony Chambers, the hospital’s chief executive, about being bullied and victimised on the neonatal unit. It was December 22, 2016, and for the previous 18 months, two doctors on the unit had been trying to find an answer for a series of mysterious deaths of babies. Their detective work had led them to a single common denominator: Letby. The neonatal nurse had been on shift for each of the incidents. Rumours of a killer on the ward had spread and Letby had complained about the doctors and their finger-pointing, claiming she was being wrongly blamed. Chambers, who had trained as a nurse, was convinced by Letby’s account, and in front of her parents, John and Susan, offered sincere apologies on behalf of the hospital trust. The doctors in question would be “dealt with’’. Except the doctors were right. By that point Letby had secretly murdered seven babies and tried to kill six more, one of them twice. An investigation by The Sunday Times, based on a cache of internal documents, reveals in detail how the hospital delayed calling the police for months and that senior management, including the board, sided with Letby against doctors after commissioning perfunctory investigations. Read full story (paywalled) Source: The Times, 19 August 2023
  9. 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.
  10. 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
  11. News Article
    An ambulance trust accused of hiding information from a coroner about patients that died is keeping a damning internal report about the deaths secret, the Guardian can reveal. A consultant paramedic implicated in the alleged cover-ups continues to be involved in decisions to keep the report from the public. Earlier this month, North East Ambulance Service (NEAS) apologised to relatives after a review into claims it covered up errors by paramedics and withheld evidence from the local coroner about the deceased patients. But a bereaved family left in the dark about mistakes made before their daughter’s death have rejected the apology. Now, it has emerged that a 2020 internal interim report on the alleged cover-up continues to be kept secret by the trust. The damning report by consultants AuditOne has been leaked to the Guardian after first being exposed by the Sunday Times. Paul Aitken-Fell, a consultant paramedic blamed in the report for amending information sent to the coroner and removing crucial passages about mistakes by the trust’s paramedics, remains in post. He also holds the gatekeeper role of FoI review officer, and as such has endorsed decisions to refuse to release the report to members of the public who ask for it. Read full story Source: The Guardian, 24 July 2023
  12. Event
    This conference is for staff involved in managing concerns in NHS Scotland, including the promotion, delivery, and use of the Whistleblowing Standards. The Independent National Whistleblowing Office are supporting the event. It will explore the legislative requirements around whistleblowing and the benefits of effective management of concerns. The programme concludes with a focus on what a healthy speak up culture looks like and how that can be delivered. The day will be chaired by John Sturrock, KC, and include a keynote presentation from Rosemary Agnew, the Independent National Whistleblowing Officer. It also brings together expert speakers from NHS Scotland, Scottish Government, trade union and academia with expertise in speaking up, culture change, quality, safety and candour. The programme will consider the Whistleblowing Standards since their launch in April 2021, as they approach their anticipated 3-year review. It offers an opportunity to share good practice, support ongoing improvements and promote an effective Speak Up culture that works from the bedside to the boardroom. Programme Register
  13. News Article
    Just one in five staff who were approached in a trust’s internal inquiry – prompted by an undercover broadcast raising serious care concerns – engaged with the process, a report has revealed. Essex Partnership University Foundation Trust said it took “immediate action” to investigate issues highlighted in a Channel 4 Dispatches programme into two acute mental health wards last year. This included speaking to staff identified as a high priority in the investigation. However, a new Care Quality Commission report has revealed, of the 61 staff members the trust approached, only 12 engaged with the process. Read full story (paywalled) Source: HSJ, 19 July 2023
  14. 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.
  15. News Article
    An ambulance service has apologised to families following a review into claims it covered up errors by paramedics and withheld evidence from coroners. The families of a teenager and a 62-year-old man were not told paramedics' responses were being investigated by North East Ambulance Service (NEAS). The deaths, in 2018 and 2019, were raised by a whistleblower last year. Among the findings of the independent review carried out by Dame Marianne Griffiths, were inaccuracies in information provided to the coroner, employees who were "fearful of speaking up" and "poor behaviour by senior staff". The study, commissioned by the former health secretary Sajid Javid in August, examined four of the five cases that were highlighted by the whistleblower, initially in The Sunday Times. It found two bereaved families were left in the dark about investigations into the response of paramedics called to help their loved ones. Read full story Source: BBC News, 12 July 2023
  16. News Article
    A former breast cancer surgeon has said the NHS needs a MeToo movement because of sexual harassment in hospitals. Dr Liz O'Riordan said she experienced sexual harassment from colleagues on a weekly to monthly basis in some of her jobs as a junior doctor. In her first week as a junior doctor, she recalled a colleague asking if she "got an erection" after removing an 11-year-old boy's appendix. "We need to be able to say this is not good enough," said Dr O'Riordan. "When you are a trainee in a practical field, you are relying on your boss to let you operate to show you how to cut; it is a craft that you learn." "Basically you are naked in scrubs stood from shoulder, to hip, to knee, next to someone all squeezed in; a lot of body contact; you are relying on them to let you cut, and if you call them out they may say 'I don't like you, you are not coming to theatre today'. "It's very, very, very hard to stand up for yourself and say 'that is not on' and the minute you let them get away with it, it is accepted and they can carry on getting away with it." Read full story Source: BBC News, 12 July 2023 Related reading on the hub: Under the knife: Life Lessons from the operating theatre by Liz O’Riordan Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign
  17. 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.
  18. 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.
  19. News Article
    NHS whistleblowers need stronger legal protection to prevent hospitals using unfair disciplinary procedures to force out doctors who flag problems, the British Medical Association has said. Doctors are being “actively vilified” for speaking out, which has resulted in threats to patient safety, including unnecessary deaths, according to the council chair of the doctors’ union, Phil Banfield. Despite a series of scandals in recent years, it is becoming more common for hospitals to use legal tactics and “phoney investigations” to undermine or force out whistleblowers rather than address their concerns, he warned. Banfield said: “Someone who raises concerns is automatically labelled a troublemaker. We have an NHS that operates in a culture of fear and blame. That has to stop because we should be welcoming concerns, we should be investigating when things are not right. “Whistleblowers are pilloried because some NHS organisations believe the reputational hit is more dangerous than unsafe care,” he added. “Whereas the safety culture in aviation took off after some high-profile airplane crashes in the 70s, the difference is that the aviation industry embraced the need to put things right and understand the systems that led to the disaster – the NHS has not invested in solving the system, it’s been bogged down in blaming the individual instead of the mistake.” Read full story Source: The Guardian, 2 July 2023
  20. 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. 
  21. News Article
    Ambulance staff in the West Midlands have had their ability to speak up as whistleblowers stifled for many years, an independent inquiry has found. The investigation, commissioned by NHS England, also identified failings in financial governance at West Midlands Ambulance Service (WMAS). Five senior and former members of staff spoke out to NHS England. WMAS accepts it has learning to do, but says the report expresses confidence in the service's ability to address the issues raised. The whistleblowers included a finance director, medical, operations and quality control staff. They raised issues through the Freedom to Speak Up scheme with the National NHS England Team. The inquiry, led by Carole Taylor Brown, had terms of reference which included "Governance, probity, the difficulty of speaking up about these issues and the alleged behaviour of some senior leaders". Read full story Source: BBC News, 28 June 2023
  22. News Article
    A new six-year study, which aims to prevent the ‘silencing’ of patient voices and improve patient trust in the healthcare system, is due to begin thanks to a major funding award Researchers at the University of Nottingham, University of Bristol and University of Birmingham have received a £2.6M Wellcome Discovery Grant for the 'Epistemic Injustice in Healthcare (EPIC)’ project. The study will use philosophical expertise to explore forms of 'silencing'. Patients regularly report that their testimonies and perspectives are ignored, dismissed or explained away by the healthcare profession. These experiences are injustices because they are unfair and harmful - and philosophers call them ‘epistemic injustices’ because they jeopardise patient care and undermine trust in healthcare staff and systems. By studying these epistemic injustices, EPIC will find ways to correct them and improve the relationship between patients and healthcare practitioners. "Patients have long reported feeling ignored, dismissed, or silenced in ways that jeopardise their care and intensify their suffering. The challenge is to understand how this silencing happens and what can be done about it, in ways that can help patients and healthcare practitioners alike. The NHS is right to seek 'patient perspectives' and listen to 'patient voices'. Project EPIC will help them to do that better by fully diagnosing the causes of that silencing." Dr Ian James Kidd, EPIC Co-Investigator & Assistant Professor in the Department of Philosophy. Read more Source: University of Nottingham
  23. 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)
  24. Content Article
    A minor accident makes Emma Walker reflect on the safety culture of the NHS.
  25. Content Article
    The Right Honourable Sir Anthony Hooper was asked by the General Medical Council (GMC) on 5 September 2014 to conduct an independent review of how the GMC engage with individuals who regard themselves as whistleblowers. The terms of reference were: “To conduct a review of how the General Medical Council handles cases involving individuals who regard themselves as whistleblowers and who have appropriately raised concerns in the public interest. These are individuals: whose fitness to practise is being investigated or determined under the General Medical Council (Fitness to Practise) Rules 2004; or who have reported such a concern to the GMC.” This is the report by the Right Honourable Sir Anthony Hooper to the GMC presented on the 19th March 2015.
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