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Found 440 results
  1. Content Article
    This 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.
  2. Content Article
    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.
  3. Content Article
    The 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.
  4. Content Article
    It'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.
  5. Content Article
    This study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
  6. Content Article
    In 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.
  7. Content Article
    The National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
  8. News Article
    Two clinicians who say they lost their jobs at Berkshire Healthcare NHS Foundation Trust after raising patient safety concerns claim the trust’s legal team brought a five-figure costs threat against them to prevent witnesses from giving evidence in a tribunal. The threat of costs liability, intended to bring the case to a halt, was made halfway through the hearing – less than 48 hours before witnesses for the trust were due to give evidence. One of the claims put forward at the tribunal hearing was that the trust had destroyed crucial evidence by deleting the email account of a former staff member. The clinicians – Samir Lalitcumar and Ahmed Ghedri – brought allegations of poor practice against current and former staff at the trust. Berkshire NHS trust claimed their allegations, including claims that the trust had deleted email evidence, were “without merit”. A fortnight into the tribunal hearing, both out-of-work medics were threatened with costs liability, known as a “drop-hands offer”, totalling more than £300,000, had they opted to proceed with their case and lost. Lalitcumar and Ghedri had brought claims of whistleblowing detriment against their former employer, Berkshire Healthcare Trust. They say they were “victimised” and unfairly dismissed as a result of having blown the whistle on dangerous care within the trust’s geriatrics services – potentially affecting upwards of 2,000 patients. Read full story Source: Computer Weekly, 7 December 2022
  9. News Article
    Whistleblowers at one of England's worst performing hospital trusts have said a climate of fear among staff is putting patients at risk. Former and current clinicians at University Hospitals Birmingham (UHB) NHS Trust allege they were punished by management for raising safety concerns, a BBC Newsnight investigation found. One insider said the trust was "a bit like the mafia." The trust said it took "patient safety very seriously." It said it had a "high reporting culture of incidents" to ensure accountability and learning. Staff concerns included a dangerous shortage of nurses and a lack of communication leading to some haematology patients dying without receiving treatment, an investigation by BBC Newsnight and BBC West Midlands found. Read more Source: BBC News, 2 December 2022
  10. News Article
    Whistleblowers at one of England's worst performing hospital trusts have said a climate of fear among staff is putting patients at risk. Former and current clinicians at University Hospitals Birmingham (UHB) NHS Trust allege they were punished by management for raising safety concerns, a BBC Newsnight investigation found. One insider said the trust was "a bit like the mafia". The trust said it took "patient safety very seriously". It said it had a "high reporting culture of incidents" to ensure accountability and learning. Staff concerns included a dangerous shortage of nurses and a lack of communication leading to some haematology patients dying without receiving treatment. The deaths of 20 patients in the haematology department of the Queen Elizabeth Hospital, which is run by the trust, led to a review in 2017 by consultant Emmanouil Nikolousis. Mr Nikolousis, who left the trust in 2020, told the BBC he was shocked by the failings he found and believes patients' lives could have been saved. A report by Mr Nikolousis criticised a lack of "ownership" of patients and a lack of communication among senior clinicians. In some cases this led to patients dying without having received treatment, he said. "Certainly there should have been different actions done," he said. "They could be saved. Certainly, when you don't have an action done, then you don't really know the outcome." Mr Nikolousis said he felt he had no option but to quit after his findings were ignored and his position was made "untenable". He left the NHS after 18 years. "They were trying, as they did with other colleagues, to completely sort of ruin your career," he said. Read full story Source: BBC News, 1 December 2022
  11. News Article
    The Care Quality Commission (CQC) has hired two independent whistleblowing champions, Joy Warmington and Arpita Dutt, to oversee a major review of how it listens to concerns. The CQC previously announced it had appointed Zoe Leventhal KC, of Matrix Chambers, to lead the first phase of the review, which is considering how the CQC handled protected disclosures made by Shyam Kumar, an orthopaedic surgeon at University Hospitals of Morecambe Bay Foundation Trust, and whether ethnicity “played any part in the management of those disclosures”. On Friday it issued details of the second phase of the work, including that it had brought in two outside experts, and long-time champions of whistleblowers, to “help to ensure the independence and credibility of the review”. This was launched amid wider concerns about how it responds to whistleblowing concerns in the service and among its own staff, including potential discrimination and also comes as the CQC itself seeks to begin a major restructure. Read full story (paywalled) Source: HSJ, 22 November 2022
  12. News Article
    Doctors have warned of "unsafe" maternity services at a Sussex hospital in emails seen by the BBC. In the email chain between senior staff at the Royal Sussex County Hospital in Brighton, consultants wrote of "compromises" to patient care. One doctor said during a birth "we were one step away from a potential disaster". One senior doctor wrote in the exchange that "increasing workforce issues" had contributed to making the situation in the maternity unit "almost unmanageable at times". They added: "We are making compromises to patient care every day as a result." Another wrote that their workload was often "unmanageable, and obviously impacted by the staffing issues". A senior member of maternity staff said "we are delivering suboptimal care" and "we are one step away from potential disaster". A doctor also said staff were being "stretched", and that there were delays to women's care. Another consultant wrote: "We have an unsafe service and we have to strive for better than that." Read full story Source: BBC News, 16 November 2022
  13. News Article
    Following the blistering verdict last week of the independent review into the General Medical Council's (GMC) handling of the notorious 'laptop' case, which highlighted the "worrying trend" of ethnic minority doctors facing disproportionate regulatory action, the GMC has launched a new resource 'hub' to support doctors facing racism at work. A new dedicated area on the GMC website offers advice on how to address racism in the workplace, and sits alongside its existing dedicated whistleblowing webpage as the latest of 12 areas in an 'ethical hub' that brings together resources on how to apply GMC guidance in practice, focussing on areas doctors often query or find most challenging, and helping to address important ethical issues. Announcing the launch, the GMC said: "Tackling discrimination and inequality continues to be an urgent priority for health services." It added: "The GMC has committed to working with organisations to drive forward change, setting targets on tackling inequality." Its equality, diversity, and inclusion targets set last year aimed, inter alia, "to eliminate disproportionate complaints from employers about ethnic minority doctors, by 2026, and to eradicate disadvantage and discrimination in medical education and training by 2031". In March this year it published its first progress report, which showed that the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared with white doctors, had "reduced slightly". Read full story Source: Medscape UK, 15 November 2022
  14. News Article
    Lawyers acting for an NHS trust are being investigated over “gagging” clauses proposed in a settlement agreement with a whistleblower who raised concerns that mistakes by paramedics in the deaths of patients were being covered up. In June, the then health secretary, Sajid Javid, announced an NHS review into “tragic failings” by North East Ambulance Service after Paul Calvert went public with claims that reports into deaths were doctored to cover up failings by staff. The Guardian has learned that NEAS’s lawyers, Ward Hadaway, are also under scrutiny – by the Solicitors Regulation Authority (SRA) – over the terms proposed by the trust for his exit agreement. The agreement, offering him £41,000 in compensation, initially included confidentiality clauses relating to future disclosures. A SRA investigation does not mean there has been wrongdoing and it does not confirm or deny whether it is examining a solicitor. However, the Guardian understands that the regulator has been in contact with Calvert about the proposed agreement. Read full story Source: The Guardian, 3 November 2022
  15. News Article
    A boss at a trust which was heavily criticised in a damning report says patients have lost confidence in the care they provide. Raymond Anakwe, executive director of East Kent Hospitals Trust, said regaining patient trust would be "possibly the largest challenge". He was speaking at a board meeting two weeks after a review found a "clear pattern" of "sub-optimal" care. Mr Anakwe said: "The reality is we have lost the confidence of our patients." He also said the trust has lost the confidence "of our local community and sadly also many staff". The trust's chief executive, Tracey Fletcher, told the meeting that she believed many staff thought "enough is enough", and that the trust has to be "brave" if it's to move forward. Stewart Baird, a non-executive director, said: "I think it's clear the buck stops here with the people sat round this table, and where there are bad behaviours in the trust, it's because we have allowed it. "Where people don't feel able to speak up, it's because we have not provided an environment for them to do that." Read full story Source: BBC News, 3 November 2022
  16. News Article
    A nurse in the US sued Louisville, Ky.-based Kindred Healthcare this week, alleging the organisation fired him in retaliation for raising patient safety concerns. Sean Kinnie worked as an intensive care unit nurse at Kindred Hospital-San Antonio. Mr Kinnie claims he was suspended twice and then fired after leaders at the 59-bed transitional care hospital learned he anonymously reported patient safety concerns to The Joint Commission in November 2019 and January. Mr Kinnie said issues related to inadequate staffing and unsanitary care environments put patients in "grave danger," according to the lawsuit. He also said the hospital created a culture in which employees were afraid to stand up for patients for fear of retaliation from management. In January, Mr Kinnie told the hospital's chief clinical officer Sharon Danieliewicz that he was the staff member who reported the patient safety concerns to The Joint Commission. Mr. Kinnie claims he faced increased scrutiny after this disclosure and was ultimately fired Feb. 24 for violating facility policy. Read full story Source: Becker's Hospital Review, 24 August 2020
  17. News Article
    Hospital nurses were told their "lives would be made hell" if they complained over conditions on a coronavirus ward, a union has claimed. Unison has raised a group grievance for 36 employees, most of them nurses, at Nottingham University Hospitals Trust. It said staff on the Queen's Medical Centre ward were not trained properly, faced bullying for raising concerns and denied PPE "as punishment". The trust said the allegations were "very troubling". The union said the staff, which included nurses, senior nurses and healthcare assistants, volunteered to work on the hospital's only ward dealing with end-of-life coronavirus patients. It claimed they were not given any specialist training or counselling for dealing with dying patients and their grieving relatives. An anonymous member of staff described it as "incredibly stressful". Another worker said a board with everyone's record of sickness was put on display in a break room to intimidate staff. Dave Ratchford from Unison said: "This is absolutely shocking stuff. We're talking about a very high-performing team who fell foul of a culture that permits bullying and fails to address it" "Staff were told their lives would be made hell for complaining." Read full story Source: BBC News, 21 July 2020
  18. News Article
    Doctors have warned that a “culture of fear” in the NHS may prevent life-saving lessons being learned about COVID-19 after a leading hospital consultant emailed scores of staff saying those responsible for “leaks” would be found and fired. Dr Daniel Martin OBE, head of intensive care for serious infectious diseases at the Royal Free hospital, emailed a report to colleagues at the peak of the pandemic with a note claiming that the trust would “track any leaks to the media” and then “offer you the chance to post your P45 on Facebook for all to see.” The email, which described journalists at one respected newspaper as “parasites”, was sent to dozens of nurses and junior doctors. It has been examined by Liberty Investigates, the investigative journalism unit of the civil rights group Liberty, and the Guardian, after being shared by a recipient who said they found the language “intimidating”. Whistleblowers UK, the non-profit group, said it had been made aware of the email by a separate individual who was also concerned about its contents. The Royal Free London trust said the email was “badly worded” and did not reflect trust policy. However, the trust said it was an open and transparent organisation that “does everything it can to encourage our staff to raise concerns and, if necessary, whistleblow”. Read full story Source: The Guardian, 22 June 2020
  19. News Article
    A London NHS trust has been ordered to pay a leading heart doctor more than £870,000 after he was sacked for whistleblowing about safety concerns following a patient’s death. Dr Kevin Beatt, one of the UK’s most respected consultant cardiologists, was fired from Croydon Health Services in 2012 after reporting staff shortages, inadequate equipment and workplace bullying at the trust. The tribunal heard Dr Beatt’s dismissal “had a devastating effect on his career and his wellbeing”. He told the Evening Standard: “I was forced into a position where I lost my career for trying to highlight dangerous practices in the NHS. It has taken seven years to get to this point, which is just appalling. It has been a huge ordeal and I have the greatest sympathy for any whistleblower who has to go through something like this.” Read full story Source: Evening Standard, 11 March 2020
  20. News Article
    A senior NHS nurse was fired after warning the increased workload on her pressured staff had contributed to a patient’s death. Linda Fairhall, 60, had an unblemished record of almost 40 years’ service when she turned whistleblower at North Tees and Hartlepool NHS trust. In 2015 she raised concerns over a new requirement for district nurses to monitor patients’ prescriptions. She said it meant a sudden increase of around 1,000 extra visits a month for her hard-pressed team of 50 nurses with no extra resources. Over the next 10 months she reported 13 matters, alleging the health or safety of patients and staff was being or was likely to be put at risk. After a patient died in 2016 she claimed it may have been prevented if her concerns had been addressed. She told the trust’s care group director Julie Parks she wished to start the formal whistle-blowing procedure. Soon after she was suspended over allegations of potential gross misconduct relating to her leadership, and then sacked. Dr Henrietta Hughes, the UK’s national NHS guardian, said: “Workers who speak up should be thanked for doing so and the organisation should demonstrate they are taking action to address the issues raised.” North Tees and Hartlepool NHS Trust said it will appeal the decision. Read full story Source: The Mirror, 2 March 2020
  21. News Article
    There is a “strong association” between staff experience of senior management and whether an organisation acts on error reporting, exclusive analysis for HSJ of the staff survey data suggests. Analysis by health and social care charity Picker Institute examined statistical relationships between responses to staff survey questions regarding staff communication with managers and those relating to error reporting. The analysis, which included all trust types, looked at the relationships between statements such as “communication between senior managers and staff is effective” and “I know who the senior managers are here” to “When errors, near misses or incidents are reported, my organisation takes action to ensure they do not happen again” and other similar indicators. A high correlation to the questions does not categorically prove a direct causal relationship but the data suggested “strong associations”, Picker Institute chief statistician Steve Sizmur told HSJ. He said: “There are a number of strong associations in the latest staff survey data, to the extent that there is likely to be a link between staff experiences of senior management and their views about error reporting and whether the organisation addresses their concerns.” Read full story (paywalled) Source: HSJ, 27 February 2020
  22. News Article
    Concerns have been raised that NHS ambulance staff are being "silenced" over bullying allegations. Hundreds of East of England Ambulance Service (EEAS) employees reported bullying in 2018, while 28 non-disclosure agreements (NDAs) have been issued since 2016. The GMB union said the figures showed a "heavy-handed culture". The service said it took bullying and harassment "extremely seriously" and had policies to prevent such behaviour. EEAS faced scrutiny in November when it emerged three members of staff died in 11 days. One, Luke Wright, 24, is believed to have taken his own life. An independent investigation, which dealt in part with bullying claims, has been carried out with the results reported to the trust in January. The 28 NDAs had been made in cases where bullying, harassment or abuse by colleagues had been reported, according to figures obtained under the Freedom of Information Act. These involved an individual agreement, often with a payment, which prevented the person speaking about their case. In the latest staff survey from 2018, 23% of staff reported bullying, up from 21% in the previous year. The GMB said NDAs were seen as a "method of silencing rather than resolving" and called on the trust to discuss more meaningful ways of dealing with problems. Read full story Source: BBC News, 10 February 2020
  23. News Article
    Shipman, Mid Staffordshire, Morecambe Bay, and now Ian Paterson, the breast surgeon that performed botched and unnecessary operations on hundreds of women. The list of NHS-related scandals has got longer. It's tempting to say the health service has not learned lessons even after a string of revelations and reviews. But is that fair? asks BBC Health Editor Hugh Pym. The inquiry, chaired by Bishop Graham James, makes clear there were failings at every level of a dysfunctional health system when it came to patient safety. The public and private health systems did not compare notes about suspicious behaviour by a consultant. Staff working with Paterson thought that his surgical methods were unusual but, perhaps cowed by being ignored after raising concerns, kept their heads down. Add to that the power and status of a surgeon in the medical world and, in the words of the report, Paterson was "hiding in plain sight". So could it happen again? James says it's clearly impossible to eliminate the activities of determined criminals in any profession. He acknowledges that some improvements have been made on policing. But he says that a decade on from the Paterson scandal, he is not convinced that medical regulators, with a combined budget of half a billion pounds a year, are doing enough collectively or collaboratively to make the system safe for patients. The review chair notes tellingly that while regulators spoke of major improvements which should identify another Paterson, some doctors and nurses had told the inquiry that it was "entirely possible that something similar could happen now". Read full story Source: BBC News, 4 February 2020
  24. News Article
    In early January, authorities in the Chinese city of Wuhan were trying to keep news of a new coronavirus under wraps. When one doctor tried to warn fellow medics about the outbreak, police paid him a visit and told him to stop. A month later he has been hailed as a hero, after he posted his story from a hospital bed. It's a stunning insight into the botched response by local authorities in Wuhan in the early weeks of the coronavirus outbreak. Dr Li was working at the centre of the outbreak in December when he noticed seven cases of a virus that he thought looked like SARS - the virus that led to a global epidemic in 2003. On 30 December he sent a message to fellow doctors in a chat group warning them about the outbreak and advising they wear protective clothing to avoid infection. What Dr Li didn't know then was that the disease that had been discovered was an entirely new coronavirus. Four days later he was summoned to the Public Security Bureau where he was told to sign a letter. In the letter he was accused of "making false comments" that had "severely disturbed the social order". "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice - is that understood?" He was one of eight people who police said were being investigated for "spreading rumours". At the end of January, Dr Li published a copy of the letter on Weibo and explained what had happened. In the meantime, local authorities had apologised to him but that apology came too late. For the first few weeks of January officials in Wuhan were insisting that only those who came into contact with infected animals could catch the virus. No guidance was issued to protect doctors. "A safer public health environment… requires tens of millions of Li Wenliang," said one reader of Dr Li's post. Read full story Source: BBC News, 4 February 2020
  25. News Article
    NHS Trusts have spent nearly £20 million in four years battling whistleblowers, defending claims of workplace discrimination and fighting employment disputes, the Sunday Telegraph can disclose. Data obtained through Freedom of Information (FOI) has revealed that a minority of healthcare trusts, often advised by the same law firms, are repeatedly running up huge legal bills. Former health minister Sir Norman Lamb said some of the NHS employment cases he has witnessed in the last eighteen months involved ‘scandalous’ uses of public money. “It is not all NHS trusts in the country, but there are a small number where the culture is clearly wrong,” said Sir Norman. Commenting on the findings, Tim Farron, former leader of the Liberal Democrats, who has fought for whistleblowers in his own constituency, said: “Millions of pounds of tax payers’ money is being spent across our health service by NHS Trusts defending their actions in employment tribunals in cases of discrimination and unfair dismissal. It is only right that questions are being asked." Read full story Source: The Telegraph, 1 February 2020
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