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Found 423 results
  1. Content Article
    In this Guardian interview, Rob Behrens, the outgoing NHS Ombudsman for England, says that too much unsafe care is still happening in the health service and that a culture of cover up makes it hard for bereaved families to find out the truth about their loved one's death. He describes the NHS as a complex institution run by mostly excellent, committed staff that is beset by cultural issues and a focus on limiting reputational damage at the expense of transparency and fair treatment of staff who speak up.
  2. News Article
    A nurse has warned that she has been “crushed and silenced” over a battle with the NHS and the nursing regulator to investigate claims that she was sexually harassed by a colleague at work. Michelle Russell told Nursing Times of the “eight-year nightmare” she has endured since coming forward about her experiences and that she said had recently led her nursing career to come to an end. “Knowing what’s happened to me is not going to make it easier for anybody else to speak out" She has argued that “speaking up is not encouraged” in the NHS and that her case would discourage other nurses from coming forward about sexual harassment. Ms Russell said: “Anybody who has been around me would be able to see the emotional impact of all of this on me. “I’ve lost my job for highlighting a public safety concern.” The national guardian for the NHS told Nursing Times sexual harassment was a “patient safety issue” and warned that staff continued to face difficulties when speaking out. It comes as the latest NHS Staff Survey this month revealed that almost 4% of nurses and midwives had been the target of unwanted sexual behaviour in the workplace by another member of staff in the last 12 months. Read full story Source: Nursing Times, 15 March 2024
  3. Content Article
    The NHS will always need whistleblowers as healthcare is complex, rapidly changing and dangerous. However, whistleblowers continue to be treated very poorly by the health service, as this Private Eye special report highlights. The report looks in detail at several whistleblowing cases and how attempts to cover up mistakes and wrongdoing have resulted in patient deaths and devastated the careers and personal lives of staff who speak up for patient safety.
  4. News Article
    A trust which last year was ordered to pay a whistleblowing nurse nearly £500,000 must now give a surgeon £430,000 to compensate him for the racial discrimination and harassment he faced after raising patient safety concerns. Tribunal judges previously upheld complaints made by Manuf Kassem against North Tees and Hartlepool Foundation Trust and have published a remedy judgment this week setting out the levels of damages the NHS organisation must pay. The judgment comes just over a year after a former senior nurse at the trust was awarded £472,600 for unfair dismissal after she warned high workloads had led to a patient’s death. Mr Kassem raised 25 concerns regarding patients’ care during a grievance meeting in August 2017. He alleged patients had “suffered complications, negligence, delayed treatment and avoidable deaths”. A trust review concluded appropriate processes were followed in the 25 cases. However, the tribunal ruled Mr Kassem was subjected to detriment after making the protected disclosure. According to the judgment, Mr Kassem was subsequently removed from the on-call emergency rota and his identity as a whistleblower was revealed by clinical director Anil Agarwal. In September 2018, he was the subject of a disciplinary investigation following several allegations against him made by colleagues and others, which concerned “unsafe working practices,” “excessive working hours,” and “potential fraudulent activity.” The investigation lasted 17 months and none of the allegations against Mr Kassem were upheld or progressed to a disciplinary hearing. Read full story (paywalled) Source: HSJ, 15 March 2024
  5. News Article
    Staff whistleblowers have raised concerns over patient safety at one of Northern Ireland's biggest health trusts. Information received by UTV under Freedom of Information shows that most of the worries from health workers at the Belfast Health Trust relate to the Royal Victoria Hospital. Belfast Health Trust said any concerns raised by staff are investigated. The Royal College of Nursing NI was due to hold a webinar with members on Tuesday evening to discuss concerns members have about safety of patients being treated on corridors. The RCN's Rita Devlin said that the number of concerns raised with health trusts through the whistleblowing policy is only the tip of the iceberg. The concerns included unsafe staffing levels, bed shortages, boarding of patients, ED overcrowding, alleged drug dealing on a hospital site, staff sleeping on night duty, lack of mental health beds and the quality of staff training. The Belfast Trust said all staff are encouraged to make management aware of issues giving them concern through the whistleblowing process. The Trust added: "Any concern we receive is subject to a fair and proportionate process of investigation. "Whistleblowing investigations are of a fact finding nature and all relevant learning is shared as appropriate and taken forward by the Trust." Read full story Source: ITVX. 12 March 2024
  6. 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. Of the 1.4 million NHS employees in England, 707,604 staff responded to the survey in 2023.
  7. Content Article
    Martha's rule stipulates the right of patients and their families to escalate care as a way to improve safety while in hospital. This article analyses the possible impact of the proposed policy through the lens of a behaviour change framework and explores new opportunities presented by the implementation of Martha's rule.
  8. News Article
    A surgeon sacked by a hospital after raising safety concerns has accused the trust of a cover-up after a patient was partially blinded during an operation. Juanita Graham, 41, lost the sight in her left eye during an operation at Bath's Royal United Hospital (RUH) in 2019. She is now suing the trust. Serryth Colbert said he was put down as the lead author on an investigation into the incident, but said he "did not write a word" of it. Mr Colbert has described the hospital investigation into Mrs Graham's operation as "deeply flawed". The surgeon, who specialises in the head, neck, face and jaw, has made several serious allegations about patient safety at the RUH, and believes these claims led to him being regarded as a troublemaker and dismissed in October 2023. Mrs Graham, from Trowbridge, said she was still traumatised by the operation on her eye. "I remember coming round, seeing the time and felt like a gush and I couldn't see," she said. "The next time I remember waking up again, I thought it was my partner but it was a surgeon and he was crying. I said 'what's gone wrong?'". After the operation, a Root Cause Analyses (RCA) report produced by the trust said the hospital was not to blame, although it did say the risks could have been explained more clearly to Mrs Graham. Mr Colbert, whose name was added as the lead investigator, said his only involvement in the report was when he was called on the phone by a nurse, who he said did the RCA, to explain what the operation involved. The 48-year-old surgeon said: "I have been put down here to my amazement as the lead author on this. "That is not correct. I did not write a word of this. "The conclusion is the root cause of the complication was down to a bit of paperwork which could have been performed a bit better. "The root cause was not down to paperwork. It was all covered up... that was indefensible." Read full story Source: BBC News, 29 February 2024
  9. News Article
    Whistleblower Dr Chris Day has won the right to appeal when a a Deputy High Court Judge Andrew Burns of the Employment Appeal Tribunal granted permission to appeal the November 2022 decision of the London South Employment Tribunal on six out of ten grounds at a hearing in London. The saga which has now being going on for almost ten years began when Dr Day raised patient safety issues in intensive care unit at Woolwich Hospital in London. The Judge said today this was of the “utmost seriousness” and were linked to two avoidable deaths but their status as reasonable beliefs were contested by the NHS for 4 years using public money. In a series of twists and turns at various tribunals investigating his claims Dr Day has been vilified by the trust not only in court but in a press release sent out by the trust and correspondence with four neighbouring trust chief executives and the head of NHS England, Dr Amanda Pritchard and local MPs. This specific hearing followed a judgement in favour of the trust by employment judge Anne Martin at a hearing which revealed that David Cocke, a director of communications at the trust, who was due to be a witness but never turned up, destroyed 90,000 emails overnight during the hearing. A huge amount of evidence and correspondence that should have been released to Dr Day was suddenly discovered. The new evidence showed that the trust’s chief executive, Ben Travis, had misled the tribunal when he said that a board meeting which discussed Dr Day’s case did not exist and that he had not informed any other chief executive about the case other than the documents that were eventually disclosed to the court. Read full story Source: Westminster Confidential, 26 February 2024
  10. Content Article
    This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years.
  11. Content Article
    In this article, investigative journalist Scilla Alecci reports on a court case brought against medical tech company Medtronic by a US whistleblower. Former Medtronic sales representative Leanne Houston alleges that between 2016 and 2018 she witnessed the company engaging in “unlawful conduct” by offering several US hospitals free equipment in exchange for the exclusive use of Medtronic products. She also claims that the company failed to acknowledge and deal with reports from surgeons that one of its surgical staple devices was causing harm to patients.
  12. Content Article
    In a new series of blogs, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), discusses how coaching and developing teams can support patient safety and its outcomes.  In part one and part two, Dawn looked at the strategies and coaching methodologies that can be used to develop individuals and to support patient safety, and discusses the indicators of improvement, prosocial behaviours and the importance of good communication to improve culture and, ultimately, patient safety. In the final blog of the series, Dawn discusses the importance of reflective practice and how it encourages  learning and growth, and helps us to identify and address challenges.
  13. Content Article
    This report aims to understand the NHS response to racism, what trusts and healthcare organisations do about it and how effective they are at addressing it. It brings together key learning from a number of significant tribunal cases and responses from 1,327 people to a survey about their experiences of raising allegations of racism within their organisations.
  14. News Article
    Ambulance trusts have often prioritised capacity and response times over dealing with cases of misconduct, a review of culture in the sector for NHS England has found. The review says ambulance trusts need to “establish clear standards and procedures to address misconduct”. The work was carried out by Siobhan Melia, who is Sussex Community Healthcare Trust CEO, and was seconded to be South East Coast Ambulance Service Foundation Trust interim chief from summer 2022 to spring last year. Her report says bullying and harassment – including sexual harassment – are “deeply rooted” in ambulance trusts, and made worse by organisational and psychological barriers, with inconsistencies in holding offenders to account and a failure to tackle repeat offenders. She says “cultural assessments” of three trusts by NHSE had found “competing pressures often lead to poor behaviours, with capacity prioritisation overshadowing misconduct management”, adding: “Staff shortages and limited opportunities for development mean that any work beyond direct clinical care is seen as a luxury or is rushed. “Despite this, there is a clear link between positive organisational culture and improved patient outcomes. However, trusts often focus on meeting response time standards for urgent calls, whilst sidelining training, professional development, and research.” Read full story (paywalled) Source: HSJ, 15 February 2024
  15. Content Article
    This is an independent review commissioned by NHS England, chaired by Siobhan Melia, Chief Executive, Sussex Community NHS Foundation Trust, to support the improvement of the culture within the ambulance service. The review considers the prevailing culture within ambulance trusts in England. It considers the core factors impacting cultural norms and offers actionable recommendations for improvement. Based on insights from key stakeholders, this review has identified six key recommendations to improve the culture in ambulance trusts.
  16. News Article
    An integrated care board (ICB) has found its handling of whistleblowing “not fit for purpose”, after a complaint about safety incidents not being properly investigated. A report by North West London ICB, obtained by HSJ, states: “The whistleblowing policy is not fit for purpose and requires immediate updating. The [Freedom to Speak Up] Guardian has been left blank and the policy does not include key components of best practice.” It also found the “whistleblower should have been provided with a substantive response to their concerns within 28 days” but in fact waited 98 working days, “due to delays with starting the whistleblowing component of the grievance”. The ICB reviewed its processes after a complaint from a staff member who raised concerns early last year about “a lack of, or poor, response” to reported patient safety incidents in the system, which are meant to be routinely reviewed by ICBs “prior to closure”. Read full story (paywalled) Source: HSJ, 15 February 2024
  17. News Article
    A senior surgeon has raised concerns about the way whistleblowers are dealt with, claiming he was sacked after speaking out. Serryth Colbert told the BBC that following attempts to "stop wrongdoing", he was investigated by the trust at Bath's Royal United Hospital. As a result, he said he was dismissed for gross misconduct in October 2023. The RUH said it has "never dismissed anybody for raising concerns and never will". It added that Mr Colbert's dismissal related to "significant concerns about bullying" and its investigation into his conduct was "thorough" and "robust". Mr Colbert said he raised safety concerns without regard for the impact it might have on his career. "It was never a question in my mind. This is wrong. I'm stopping the wrongdoing. I stand for justice. I stand to protect patients," he said. The BBC has seen no evidence his most serious concern was ever investigated and Mr Colbert is now taking the RUH to an employment tribunal. Read full story Source: BBC News, 9 February 2024
  18. Content Article
    The Royal College of Surgeons of Edinburgh 'Let's remove it' hub is a platform to tackle bullying and undermining across the surgical workforce.
  19. News Article
    Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons in England. The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath. But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced. They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.” The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021. The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety. Read full story Source: The Guardian, 6 February 2024
  20. Content Article
    On 26 January 2023, University Hospitals Sussex NHS Foundation Trust contacted the Royal College of Surgeons of England to request an invited service review of the Trust’s general surgery department, with a specific focus on upper gastrointestinal surgery, lower GI surgery and emergency general surgery. The request highlighted that the general surgery department was a service which had been under scrutiny for many years, with a history of internal reviews, and concerns being raised by consultant surgeons as well as other members of staff within the department. This report sets out the findings of this review.
  21. Content Article
    This article looks at the judgements made by experts in the cases that are not covered by rules, focusing on the key role of stories and storytelling. Drawing on literature related to high-reliability theory, organisational learning and naturalistic decision-making, it examines how experts working in diverse critical contexts use stories to share and make sense of their experiences.
  22. Content Article
    In this animation, the Nursing and Midwifery Council (NMC) look at speaking up and what this means for you as a registered professional.
  23. Content Article
    Traditionally, recommendations regarding responding to medical errors focused mostly on whether to disclose mistakes to patients. Over time, empirical research, ethical analyses and stakeholder engagement began to inform expectations — which are now embodied in communication and resolution programmes (CRPs) — for how healthcare professionals and organisations should respond not just to errors but any time patients have been harmed by medical care (adverse events). CRPs require several steps: quickly detecting adverse events, communicating openly and empathetically with patients and families about the event, apologising and taking responsibility for errors, analysing events and redesigning processes to prevent recurrences, supporting patients and clinicians, and proactively working with patients toward reconciliation. In this modern ethical paradigm, any time harm occurs, clinicians and health care organisations are accountable for minimising suffering and promoting learning. However, implementing this ethical paradigm is challenging, especially when the harm was due to an error.
  24. Content Article
    Doctors At Work is a series of video podcasts hosted by Dr Mat Daniel. In this episode, Dr Gordon Caldwell shares his experiences of managing and preventing adverse events. He stresses the importance of creating a culture that encourages everyone to speak up. His top tips for preventing errors is to create systems, checklists and routines that ensure a focus on all aspects of care not just the obvious and urgent.
  25. News Article
    The medical leaders of the maternity unit of a flagship hospital threatened with closure have written to their chief executive saying the downgrade would not be safe, HSJ has learned. Nineteen obstetric and gynaecological staff, including the clinical director, wrote to the chair and CEO of the Royal Free London Foundation Trust this week saying the proposals to shutter services at the trust’s main site in Hampstead would increase the risk of harm to mothers. Their letter said: “Whilst we accept, and support, the need to review provision of maternity and neonatal services across [north central London], aiming for care excellence and best outcomes, we have significant concerns about the current proposals.” The letter said the Royal Free was the only unit in NCL to offer a “range of supporting specialist services for complex maternity care”, including rheumatology and neurology and is the “only hospital in NCL to provide both 24-hour interventional radiology and on-site acute vascular surgery and urology support”. The medics’ letter said co-morbidities from cardiac, renal, haematological and neurological conditions had driven an increase in maternal mortality over the past decade and that RFH’s services were well-equipped to manage these complex cases. Read full story (paywalled) Source: HSJ, 24 January 2024
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