Comment

Helene Donnelly: For the NHS to cope with this crisis, managers must listen to nurses

Mid Staffs whistleblower Helene Donnelly says with many services stretched to breaking point, those in positions of power need to listen to front line staff, who know what is going wrong and can suggest solutions.
Listen to Staff_tile_iStock.jpg

Mid Staffs whistleblower Helene Donnelly says with many services stretched to breaking point, those in positions of power need to listen to front line staff, who know what is going wrong and can suggest solutions

Staff throughout the health and social care system are determined to deliver the best possible care and treatment to their patients, but given the current pressures on the system, we have to consider what is possible, and how far away it is from the best care.

I know from my own experience at Mid Staffordshire NHS Foundation Trust how frustrating and soul-destroying it is to be prevented from delivering the best care to patients. The issues there were due to a lack of resources, including staff,

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Mid Staffs whistleblower Helene Donnelly says with many services stretched to breaking point, those in positions of power need to listen to front line staff, who know what is going wrong and can suggest solutions


To address the problems in service delivery, those in senior
positions must listen to the staff who provide care every day. Picture: iStock

Staff throughout the health and social care system are determined to deliver the best possible care and treatment to their patients, but given the current pressures on the system, we have to consider what is possible, and how far away it is from the ‘best’ care.

I know from my own experience at Mid Staffordshire NHS Foundation Trust how frustrating and soul-destroying it is to be prevented from delivering the best care to patients. The issues there were due to a lack of resources, including staff, and an inadequate supporting infrastructure. These problems were compounded by a historic culture of failing to listen to staff and in some cases intimidation and bullying. We are all now well aware of the consequence of such a combination. It would be naive to believe that a similar perfect storm could not be happening right now at other NHS trusts.

Any system is only as strong as its weakest link and, sadly, we are now becoming more and more aware of the weakest areas of the NHS. There will be no quick fix, but solutions can be found by listening to the staff who underpin the NHS 365 days a year. Many staff feel devalued and disrespected as they are often not consulted about changes to a system or service delivery. The staff who are actually doing the job of delivering care day in, day out should have their professional opinions valued.

I strongly believe that if we speak up about poor care and standards, and offer suggestions and solutions to improve service delivery, necessary efficiencies can be found. However, this is entirely dependent on those in positions of seniority and power listening and taking action to address staff concerns and suggestions. By failing to do this, they are failing their staff, patients and ultimately the NHS.

Guardians 

Most trusts have now appointed a Freedom to Speak Up (FTSU) guardian, giving staff an appropriate channel to raise their concerns. FTSU guardians should act as an ally for staff to raise issues that concern them and help get their message to the people who can act on it. The introduction of guardians, and the creation of the National FTSU Guardian Office, as suggested by Sir Robert Francis, is a positive step and should encourage staff to come forward.

Some may feel that the current situation throughout the NHS is reason not to appear to be ‘moaning’ or ‘complaining’. Some may feel sceptical or frightened about speaking up, and this is understandable. However, I believe that appropriately raising concerns and offering suggestions for improvements is needed now, more than ever.

When I tried to raise concerns about poor standards of care while working in A&E at Mid Staffs, I was ignored and even threatened, so I know how difficult it can be. But I do believe it is now becoming easier for staff to raise concerns, and negative cultures are beginning to change as a result. 

If you are concerned about pressures of demand or have ideas about how service delivery could be improved, it is your professional and moral duty to speak up. Certainly, if quality or safety is affected, you must raise your concern without delay, with your line manager or a senior leader. If this is not possible or effective, then speak to your local FTSU Guardian and/or union representative.

We all have a responsibility to support and encourage each other to make raising concerns a positive action.


About the author 

 

Helene Donnelly OBE is a nurse practitioner and Ambassador for Cultural Change/Freedom to Speak Up guardian

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