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Found 177 results
  1. News Article
    Repeated cases of bullying and a toxic environment at one of England's largest NHS trusts have been found in a review. The Bewick report was ordered after a BBC Newsnight investigation heard from staff at University Hospitals Birmingham (UHB) saying a climate of fear had put patients at risk. A first phase of the rapid review, headed by independent consultants IQ4U and led by Prof Mike Bewick, was published Tuesday. It is one of three major reviews into the trust, commissioned following a series of reports by Newsnight and BBC West Midlands in which current and former staff raised concerns. Summarising the findings, Prof Bewick, a former NHS England deputy medical director, said: "Our overall view is that the trust is a safe place to receive care. "But any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients across the organisation - particularly in the current nationwide NHS staffing crisis. "Because these concerns cover such a wide range of issues, from management organisation through to leadership and confidence, we believe there is much more work to be done in the next phases of review to assist the trust on its journey to recovery." The West Midlands trust said it fully accepted the report's recommendations. Read full story Source: BBC News, 28 March 2023
  2. Content Article
    The review were assured that services at the Trust remain safe and patients and service users should continue to access care as needed with confidence. However, the review found a number of areas of concern, particularly with regards to governance and leadership, culture and staff welfare and has made a series of recommendations for further action. The review was commissioned following concerns raised in December 2022 relating to patient safety, leadership, culture and governance. As part of this response, NHS Birmingham and Solihull (ICB) announced three independent reviews focusing on: Patient safety and governance (Bewick Review) - commissioned by the ICB, overseen by experienced senior independent clinician, Professor Mike Bewick, former NHS England Deputy Medical Director. Well-Led review of leadership and governance – in conjunction with NHS England, using established methodology. Culture - commissioned externally by UHB’s Interim Chair, incorporating findings from above. In order to bring the conclusions and recommendations of these two pieces of work together and provide additional independent assurance, Professor Mike Bewick has been commissioned to support both remaining reviews and also return at a later date to update on progress on implementing the recommendations following this report. In the patient safety review, the independent review team set out two concerns and four groups of recommendations. As part of this, they also make clear that their ‘overall view is that the Trust is a safe place to receive care’. The review team have highlighted the need for better understanding of raised Hospital Standard Mortality Rates, concerns regarding levels of staffing, particularly nursing at Good Hope Hospital. The review also finds that ‘any continuance of a culture that is corrosively affecting morale and in particular threatens long term staff recruitment and retention will put at risk the care of patients’. This was supported by feedback from the Trust’s Medical Staff Committee. The review team make 17 recommendations (available in the full report) across clinical safety, governance and leadership, staff welfare and culture, including: Haemato-oncology: A specific review of mortality should be conducted by an external specialist in this field with support from a governance lead. The terms of reference should include: An independent retrospective review of all the deaths first analysed by Dr Nikolousis to establish any lessons learned Consideration as to whether there an outstanding DoC responsibility relating to this patient cohort All deaths in the year 2021/22 An assessment of how integrated the department is following the merger in 2018 with a focus on how leadership and accountability of the service currently functions. That prospective appointments of senior medical, nursing, and managerial leadership are reviewed with a focus on developing core skills, including those required for leadership, collaborative working methods, professional interaction, and disciplinary processes. In light of the tragic death by suicide of Dr Kumar - Together with HEE, a review of the processes to support doctors in training who are concerned about their mental health, ability to speak up freely about concerns with colleagues and a clear message that they will be listened to. That the concerns of senior clinicians, expressed by the Medical Staff Committee in January 2023, are addressed specifically as part of the Phase 2 cultural review. That the Trust commissions a partner to deliver awareness training on how to identify issues of bullying, coercion, intimidation and misogyny.
  3. News Article
    Two external reviews have been carried out into a trust’s general surgery services amid concerns about whether it is a ‘safe interpersonal working environment’. But University Hospitals Sussex Foundation Trust has refused to make the reviews – which were both completed last year – public, partly because of what it says are concerns that they could lead to “harassment” of doctors who spoke to the authors. Both reviews were into aspects of the general surgery services at the Royal Sussex County Hospitals in Brighton. The trust has had a series of highly critical Care Quality Commission reports into some of its surgical services and a “well led” report is expected to be released in the next few weeks. The trust has refused HSJ’s Freedom of Information Act request to release the reviews, arguing that those interviewed had been promised confidentiality, and the issues involved are “emotive and sensitive matters”. “Disclosure could cause those involved in the reviews damage, distress and upset and could even lead to harassment,” it said. Read full story Source: HSJ, 27 March 2023
  4. News Article
    The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene. All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS. Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time. "It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out. Read full story Source: Medscape News, 9 March 2023
  5. News Article
    NHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
  6. Content Article
    The National Guardian’s Office undertook this Speak Up review as the speaking up culture in NHS Ambulance Trusts appeared be more challenged compared to other trust types. The Speak Up review heard from a number of ambulance workers, ex-workers, managers and senior leaders of their experiences of a culture of bullying, harassment and discrimination which contributed to not feeling able to speak up for fear of retaliation. The fear of the consequences was one of the main barriers to people speaking up about anything getting in the way of delivering great patient care. Those who did speak up, often faced intimidation or inaction as a result. The report summarises the key findings of the review into five themes: culture of ambulance trusts leadership and management experience of people who speak up implementation of the Freedom to Speak Up guardian role role of system partners and regulators. The target-driven, command and control environment of ambulance trusts meant that Freedom to Speak Up – and by extension – workers’ wellbeing, was often not viewed as a priority by leadership. One senior leader from an ambulance trust told the review: “When I first started, everyone I spoke to said we have a culture problem. Sexism, racism, homophobic, cliquey. We are going to fix it but not yet. We need to sort out other things like wait times.” This was having a negative impact on the culture of ambulance trusts and workers’ wellbeing, including experiencing poor mental health and moral distress and injury. It also found insufficient time and resources given to Freedom to Speak Up guardians which limited their ability to be effective .
  7. News Article
    A health minister has called for more staff to take part in an inquiry into deaths at a mental health trust. An independent review into 1,500 deaths at the Essex Partnership University Trust (EPUT) over a 21-year period was launched in 2020. It emerged earlier this month that 11 out of 14,000 staff members had come forward to give evidence to an independent inquiry. The trust said it was encouraging staff to take part in the inquiry. During a parliamentary debate, Health Minister Neil O'Brien said the trust was being given a "last chance" before the government intervened and instigated a statutory inquiry. A statutory inquiry would allow staff to be compelled to give evidence. In December, a further 500 deaths were made known to the review chair, Dr Geraldine Strathdee. She said the inquiry could not continue without full legal powers. Chelmsford MP Vicky Ford said she had been told by the chief executive of EPUT that staff were "very scared" to give evidence. Read full story Source: BBC News, 31 January 2023
  8. Content Article
    In 2015 the Government introduced a Freedom to Speak Up Guardian and a system of Local Speak Up Guardians in response to the recommendations made by Sir Robert Frances following the scandal at Mid Staffordshire. From the outset, this system has attracted significant criticism and the APPG has heard from whistleblowers who have been failed by local guardians sharing their experiences that included the disclosure of their identity to hospital management and boards – resulting in retaliation. The APPG has also heard from Local Guardians who were not supported and themselves the target of retaliation after supporting whistleblowers. Local Guardians in East Kent were described as, “dishonest” and that the Guardian system had failed in every case that had been investigated throughout the UK. Further evidence was provided of a tick box approach to the Duty of Candour introduced by the former Secretary of State for Health. The APPG was told that both the Guardian and Duty of Candour systems are beyond resurrection and that across the NHS there is no ownership of problems. All attempts to encourage speaking up have been hindered by a failure to introduce an effective and safe whistleblowing regime across the NHS, resulting in the NHS being unsafe for whistleblowers, making it unsafe for patients. The APPG were told that, in over 50 years of investigation experience, little has changed, and that “these issues are not new, nor are they confined to a small number of rogue hospitals”. That league table results are inaccurate because of a flawed regulatory system with no ownership of the problems and where the regulators are “caught up in the fraud”. The APPG was provided with a series of examples of what were described as “deep seated problems” relating to teamwork and culture, which resulted in the failure to join up clinical and ethical responsibilities. These responsibilities were described as being on separate tracks and a failure by the regulatory regime to identify or report on the impact of this has significant consequences for patients, whistleblowers and the future of the NHS, as demonstrated by the case of the Bristol Children’s Heart scandal brought to light by Dr Steve Bolsin 30 years ago. Dr Bolsin was shunned for exposing the failures that resulted in the death of so many babies because funding the unit was more of a priority that the lives of the babies (he has since made a successful career in Australia). In every case, a failure to listen to whistleblowers, followed by attempts to discredit the whistleblowers, and a deliberate cover up has proved in many cases fatal for patients. What has been proved time and time again is that The Public Interest Disclosure Act (PIDA) has made little or no difference to this failure to protect patients or whistleblowers or to learn and improve our NHS. Evidence provided to the APPG is of a lack of system-wide action and an absence of commitment to speaking up beyond excellent PR. It is unclear who, if anyone, is responsible for the monitoring and reporting on recommendations contained in investigation reports. In addition, there is no coherent process for triggering high-level independent reviews of major patient safety failings. This causes confusion, suffering and leads to missed opportunities. Mary Robinson MP, chair of the APPG for Whistleblowing, said: “We have a duty to support and protect whistleblowers because without them we cannot prevent more deaths like those in East Kent. My APPG is committed to making whistleblowing safe and will continue to press the Government to introduce the Whistleblowing Bill which will incentivise and normalise speaking up. I encourage everyone to write to their MPs and ask them to join the APPG and support the Whistleblowing Bill.” The Right Hon. Baroness Susan Kramer, said: “Doing nothing is not an option that we can afford. It’s time to put an end to ‘tick box culture’ and turning a blind eye to whistleblowers. Whistleblowing law must be meaningful, easily understandable and enforceable. The Whistleblowing Bill will do this and in doing so will save lives and protect our NHS.” Wendy Morden MP, member of the APPG for Whistleblowing, said: “I hear about problems when I am at the hairdresser because people are too afraid to speak up in their place of work. The Office of the Whistleblower will be the catalyst for meaningful change.” Dr Bill Kirkup, author of Reading the Signals Report, said: “I support the proposals set out in the Whistleblowing Bill because the NHS urgently needs an effective early warning system.”
  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
    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
  11. Community Post
    Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views?
  12. News Article
    Fresh concerns have been raised about the treatment of whistleblowers by managers at a trust recently embroiled in a high-profile bullying scandal, the hospital’s workforce director has disclosed. A series of further accusations have been made against managers at West Suffolk Foundation Trust, where executives were recently judged to have led an “intimidating, flawed” hunt for a whistleblower, prompting a series of high-profile departures. The trust’s executive director for workforce detailed in a paper for the hospital’s July board meeting how managers had been hunting to identify staff who had raised concerns through supposedly confidential channels. The report, by executive director of workforce and communications, Jeremy Over, said: “Feedback has been given indicating that some people have had a poor experience when speaking up. “In two separate cases, where people spoke up in confidence, it was reported that the managers were then asking and wishing to find out who had spoken up making the individuals very uncomfortable. “Another case reported that the individual was ‘told off’ by their manager for ‘going about their heads’ [sic] and another where staff felt discouraged from raising any points or suggestions as these were taken [as] a personal offence [by] the senior staff. In a further case, the person speaking up was criticised [for] doing so.” Read full story (paywalled) Source: HSJ, 3 August 2022
  13. News Article
    A whistleblower who worked at a hospital trust where hundreds of babies died or were left brain-damaged says there was "a climate of fear" among staff who tried to report concerns. Bernie Bentick was a consultant obstetrician at the Shrewsbury and Telford NHS Trust for almost 30 years. "In Shrewsbury and Telford there was a climate of fear where staff felt unable to speak up because of risk of victimisation," Mr Bentick said. "Clearly, when a baby or a mother dies, it's extremely traumatic for everybody concerned. "Sadly, the mechanisms for trying to prevent recurrence weren't sufficient for a number of factors. "Resources and the institutionalised bullying and blame culture was a large part of that." More than 1,800 cases of potentially avoidable harm have been reviewed by the inquiry. Most occurred between 2000 and 2019. Mr Bentick worked at the Trust until 2020. He said from 2009 onwards, he was raising concerns with managers. "I believe there were significant issues which promoted risk because of principally understaffing and the culture," he said. He also accuses hospital bosses of prioritising activity - the number of patients seen and procedures performed - over patient safety. "I believe that the senior management were mostly concerned with activity rather than safety - and until safety is on a par with clinical activity, I don’t see how the situation is going to be resolved," he said. Read full story Source: Sky News, 27 March 2022
  14. News Article
    West Suffolk Foundation Trust’s investigation to find a whistleblower was “intimidating…flawed and not fit for purpose”, according to a damning review which is highly critical of the organisation’s leadership. The long-awaited review, published today, was triggered by ministers back in January 2020 following allegations that trust directors had ordered staff to give fingerprints and handwriting samples during a “witch hunt” for a whistleblower. The review, led by Christine Outram, has corroborated many of the allegations. It concluded trust leaders’ investigation to uncover the identity of the author of an anonymous letter sent to a patient’s family was “intimidating, flawed and not fit for purpose… impractical and unwise.” It said: “The decision to use fingerprinting and handwriting analysis in an NHS hospital, in the context of an anonymous letter and where no crime has been committed, was highly unusual and without doubt extremely ill-judged.” Read full story (paywalled) Source: HSJ, 9 December 2021
  15. News Article
    A ‘macho’ culture within ambulance trusts is leading to widespread abuse of female staff. HSJ has been told of multiple cases including sexual misconduct, harassment or abuse against staff in the last two and a half years. These include: women being told that giving sexual favours would help them get on to paramedic training a woman who was told she would pass her driving course if she gave oral sex to a superior a student on placement who could not take off her jacket without comments being passed on her breasts, and therefore would wear it even on the hottest days a student given a lift by her supervisor who then proceeded to rub his hands up and down her legs during the journey. In a freedom of information request, the 10 ambulance trusts in England were asked for the number of incidents in which allegations of sexual misconduct, harassment or abuse had been made against staff. The trusts reported 221 cases since April 2019, of which at least 27 resulted in dismissal and at least 44 resulted in other disciplinary action, with some cases still under investigation. Read full story (paywalled) Source: HSJ, 7 December 2021
  16. News Article
    A ‘culture of distrust’ between consultants and the use of incident reporting as a tool of ‘reprisal’ impacted patient care at a trust’s cardiology department, a review has concluded. An external review undertaken for Hull University Teaching Hospitals Trust has made a series of recommendations after looking into allegations of bullying and several examples of poor care within its cardiology services. In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents, and, to undermine those who wanted to raise patient safety issues”. It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department. All of which reinforce a clear divide between the interventional and non-interventional consultant cardiologists." “There have been a number of allegations of belittling, intimidation and undermining…The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.” The review concludes: “This behaviour is impacting on patient care and therefore, all medical staff should be reminded of good medical practice as the [General Medical Council] code of conduct of how doctors must work collaboratively with colleagues.” Read full story (paywalled) Source: HSJ, 16 November 2021
  17. Content Article
    Everyone who works in health and social care should listen to this podcast in full. I've followed Will's search for justice and I am proud to know Will. A man of great integrity who is campaigning for an individual #dutyofcandour in #healthcare, for the benefit of us all. I remain shocked, when I teach on this, how few know Robbie's story. There has been so much lost learning, a failure of accountability, and a failure to deliver an effective statutory duty of candour. For me, this appalling story of failure and cover up highlights clearly why we have to recognise the value of whistleblowers in #healthcare. When staff don't/can't speak out, or are ignored and bullied, it falls to patients or relatives to do this, at huge cost. #Robbieslaw Related post: English and Welsh Ombudsman set out the case for '... a proper public inquiry into the tragic death of Robbie Powell'
  18. Content Article
    If you haven't had the chance to do the crossword yet, you can access it from the following links, in either PDF or Word formats. Blank crossword and clues (pdf).pdfBlank crossword and clues (word).docx The answers to each clue and the completed crossword can be found in the attachment below: SOLUTION - Glimpses of NHS whistleblowing terrain.pdf Notes on the answers can be downloaded from the following attachment: Notes on the solution to the Crossword Counterpoint (glimpses of NHS whistleblowing terrain) w.i.p. 8.5.22 (2).pdf A guide to the whistleblower's galaxy This crossword is offered as a travel guide to help others navigate the complex and at times treacherous track trod by NHS staff who have suffered retaliation after speaking up. It can be a bewildering trek. Everybody's journey is different but there are common experiences. Travellers' tales suggest a pattern in milestones often encountered along the way. Lonely planet One of the cruellest manifestations of organisational hostility towards some NHS staff who have raised concerns about poor patient care is that they are propelled into orbit, pushed around on a procedural merry-go-round by alien and sometimes unseen forces, but excluded from professional circles in which they have built and practised their career. This isolation is often a deliberate intended consequence of actions taken by those who orchestrate reprisals against staff whose 'crime' is identifying areas where improvements are needed to improve patient care. Isolation tactics include: suspending staff on some spurious pretext and instructing them not to speak to colleagues; denying them access to crucial documents or other information which supports their case; manipulating them into signing non-disclosure agreements – sometimes referred to as settlement agreements (formerly known as compromise agreements), confidentiality clauses or gagging clauses. Although such agreements are void and unenforceable under whistleblowing legislation in respect of protected disclosures they tend to inhibit communication nonetheless, and thus contribute to whistleblower isolation and exclusion. They also prevent true learning from whistleblowers' experiences. Crossword aims The aims of the crossword, this blog and others in this series,[1-5] are firstly to raise awareness of the realities of speaking up and, secondly, to support stakeholders who are trying to find a way through the morass. These stakeholders include policy-makers, legislators, leaders, campaigners and, last but not least, whistleblowers themselves. Their voices need to be heard. There seems to be a shared view amongst stakeholders that the current situation is unsatisfactory. All concerned say that they want NHS staff to speak up if they are aware of poor practice affecting patient care. However, the latest NHS national staff survey results show that only 62% of staff said they feel safe to speak up about anything that concerns them in their organisation.[6] This worrying statistic is an indication of the magnitude of the systemic problem which stakeholders are trying to solve, as well as being a reflection on the effectiveness of existing approaches. Effective problem-solving requires good analytical skills. It also requires knowledge and understanding of the true nature of the problem in question, and ability to challenge the status quo when necessary. The problem for NHS organisations is that large numbers of their employees are afraid to speak up about poor patient care. Not speaking up and hostility towards those who do speak up are linked to an ongoing series of patient safety scandals.[7-21] The problem for many staff who have suffered retaliation after speaking up is that they have lost their careers, their livelihood and sometimes much more. In such situations, NHS organisations tend to wash their hands of their responsibilities towards whistleblowers whose health and wellbeing they have harmed. This irresponsibility, and the culture which fosters it, has to change if leaders really want NHS staff to speak up when they are aware of sub-optimal and dangerous practices within their organisation. The 62% staff survey statistic illustrates interconnected problems for organisations, patients and members of staff. It is a symptom of an underlying pathology that needs to be treated – the mistreatment of whistleblowers. As always in attempting a cure, it is important to treat the cause not the symptoms. The aims of this contribution are to provide insight into the phenomenon of retaliation against healthcare professionals by their employers, and thus support effective action to address the root cause of these serious problems. It builds on foundations laid by many others. Whilst the contents of this blog are to the best of my knowledge correct, for the avoidance of doubt this is not legal advice. Comments, feedback and discussion are welcome. References Wilkins H. What is a whistleblower? Patient Safety Learning, the hub, posted 2 February 2022. Wilkins H. Crossword counterpoint: glimpses of NHS whistleblowing terrain. Patient Safety Learning, the hub, posted 16 March 2022. Wilkins H. Organisational culture and patient safety (MPEC 2021). Patient Safety Learning, the hub, posted 14 October 2021. Wilkins H. The right - and duty - of NHS staff to speak up. Patient Safety Learning, the hub, posted 22 June 2020. Wilkins H. The mistreatment of NHS whistleblowers must stop (UKIO 2019). Patient Safety Learning, the hub/Learn/Culture/Whistleblowing, posted 17 March 2021. NHS Staff Survey. 2021 National results briefing, March 2022, q21e, p27. Kennedy I. The Bristol Royal Infirmary Inquiry. Learning from Bristol - the report of the public inquiry into children's heart surgery at the Bristol Royal Infirmary 1984-1995: 2001. Smith J. The Shipman Inquiry (2002-2005), second report: the police investigation of March 1998: 2003. Holt K. Great Ormond Street and 'Baby P': was there a cover-up? BMJ 2011; 343. Francis R. The Mid Staffordshire NHS Foundation Trust Public Inquiry. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry volumes 1-3: 2013. Clwyd A, Hart T. A review of the NHS hospitals complaints system: putting patients back in the picture, October 2013. Dyer C. Whistleblower was unfairly dismissed in case lasting 12 years, tribunal rules. BMJ 2014; 348. Kirkup B. The report of the Morecambe Bay investigation 2004-2013: 2015. Kirkup B. Report of the Liverpool Community Health Independent Review: 2018. James G. Report of the independent inquiry into the issues raised by Paterson: 2020. Kirkup B. The life and death of Elizabeth Dixon: a catalyst for change - report of the independent investigation: 2020. Cumberlege J. First Do No Harm: the report of the independent medicines and medical devices safety review: 2020. Outram C. West Suffolk Review: 2021. Care Quality Commission. Monitor. Monitor and CQC review into whistleblowing concerns at the Christie NHS Foundation Trust: 2022. Ockenden Report. Findings, conclusions and essential actions from the Independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust: 2022. Dyer C. Whistleblowing: nephrologist who reported colleagues to GMC was unfairly dismissed. BMJ 2022; 376.