Analysis

Freedom to speak up? Extra protection mooted for NHS whistleblowers

NHS whistleblowers will have extra protection when they seek new jobs under plans being considered by the government.

NHS whistleblowers will have extra protection when they seek new jobs under plans being considered by the government.


Under the changes, staff who feel discriminated against for whistleblowing will be able to go to an employment tribunal or bring a claim in court. Picture: iStock

The plans have been drawn up to combat the difficulties that often follow nurses who raise concerns, including fears of being discriminated against by other employers.

Applicants who feel they have been treated unfairly by potential employers will be able to go to an employment tribunal or bring a claim in court.

But whistleblowing health staff have questioned whether the plans unveiled on 20 March would make any real difference to nurses facing discrimination.

'Serious detriments'

The changes were called for in the Freedom to Speak Up Review, a report commissioned after the Mid Staffordshire NHS Foundation Trust inquiry uncovered a culture that made raising concerns difficult. 

The review, published in 2015 by barrister Sir Robert Francis QC, concluded that many NHS staff were stalked by the legacy of having spoken out, and suffered 'serious detriments in seeking re-employment in the health service after making a protected disclosure'.

2015

the Freedom to Speak Up review is published.

Of the 19,500 NHS staff questioned in the report, more than one third said they had raised concerns, and more than 1,000 said they had felt victimised. Asked whether they had ever felt unsafe after raising a concern, more than one quarter of the 1,500 respondents said they had. 

'All too frequently we heard of jobs being lost, but also of serious psychological damage, even to the extent of suicidal depression,' the report, said. 'In short, lives can be ruined by poor handling of staff.'

Supportive culture

The government document, called Protecting Whistleblowers Seeking Employment in the NHS, said the changes were necessary 'to help embed in NHS bodies a culture that supports workers to raise concerns and welcomes new workers who have done so in the past'.

It will offer the same protection that those in employment receive from the Public Interest Disclosure Act 1998, although Sir Robert acknowledged in his review that its effect is limited.

The regulations planned for England, Wales and Scotland are possible after the government amended the Employment Rights Act 1996 in 2015.

Health secretary Jeremy Hunt said the plans, open for consultation until 12 May, would 'move another step closer to creating a culture of openness in the NHS, where people who have the courage to speak up about patient safety concerns are listened to, not vilified'.

Action needed

Evidence suggests there is still plenty of room for improvement when it comes to encouraging whistleblowing. In the NHS Staff Survey for 2016 for England, when asked whether their organisation treated staff involved in near misses, errors and incidents fairly, less than half of all staff (45%) reported that this was the case. More than half (53%) reported that their organisation gave feedback to staff about any changes that had been made in response to a reported incident.

1,093

the number of staff who told the Freedom to Speak Up Review they were victimised by managers and colleagues after raising a concern.

The government's consultation said it appeared that staff from black and minority ethnic backgrounds and women were more likely to face discrimination if they raised concerns.

The RCN welcomed the changes, but said urgent action was needed to tackle the understaffing that was leading to many of the problems.

RCN general secretary Janet Davies said: 'We welcome all measures to support staff in raising concerns, but the best way to provide safe patient care is to have enough staff in the first place. NHS staff must be supported in blowing the whistle, but the health secretary must also listen to their warnings.'

Changes unrealistic 

Former care worker Eileen Chubb's high profile campaign about the abuse of residents at the care home where she worked until 1999 left her struggling to find work.

The seven care assistants who made up the so-called 'Bupa 7' told an employment tribunal in 2000 that they were forced to resign after whistleblowing.

19%

had not raised concerns due to lack of trust in the system.

'We applied for hundreds of jobs and it followed us everywhere,' Ms Chubb, who now runs the charity Compassion in Care, says. 'As soon as I rang for a job, they would say "We will send you a form". Then when I gave my details, they would say "I'm really sorry, that job's just gone".

Ms Chubb says the changes being consulted on would not protect whistleblowers, as they would struggle to prove their case.

'It is shoddy, incompetent and clueless as to what the reality is for whistleblowers,' she says. 'An employer is not going to helpfully write down that the reason they are not employing someone is because they are a whistleblower.'

Freedom to Speak Up Review suggested changes

Creating whistleblower guardians and using a special app are among the approaches being used by trusts to encourage staff to raise concerns.

The Freedom to Speak Up Review recommended employers consider creating guardians who staff could seek out to easily and informally raise problems or concerns.

Radiographer Heather Bruce has been the Freedom to Speak up guardian at University Hospitals of Morecambe Bay NHS Foundation Trust since July 2015.

She says that since she started in the role, which takes up three days a week, there has been an increase in the number of people coming forward with concerns.

Where possible she will meet up with any member of staff raising a concern at a place they choose and agree how to escalate the issue. The trust launched an app at the beginning of the year for staff to raise concerns, and that has been downloaded 300 times.

One of the difficulties has been raising awareness among the more than 5,000 staff of the trust and 'walking the corridors' to provide a visible presence has been important, Ms Bruce says.

After the first almost 18 months, she had dealt with 65 concerns, although not all would be covered by the Public Interest Disclosure Act 1998.

'Some have been easier to sort than others,' Ms Bruce says. 'But because the board of directors is so supportive if I escalate a concern, I get a reply immediately. That makes me feel supported.'

At Wirral University Teaching Hospital NHS Foundation Trust, there are five guardians encouraging staff to raise concerns. Sharon Landrum, an organisational development facilitator and guardian, says there have been 185 concerns raised since the service began two years ago.

'The role is a pair of ears, first and foremost,' she says. 'Anyone can come to us and we will offer advice and support and be a listening ear. We signpost or take it forward.'

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