Patients First – Kim Holt and Roger Kline

Patients First- how we got here & what next? 

When PF first got together, we were intending to legally challenge some Trusts, ( and the CQC)!, with regards to the lack of adherence to good whistleblowing practice. We were already aware at that stage of a number of cases that were worrying us. These included Sharmila’s. Our concern about the CQC was whether they responded appropriately to whistleblowers, ensuring patients were safe. They didn’t at that time.

What happened immediately was that the campaigning side grew an energy of its own, more people contacted us, an informal network developed and before we knew it we were being asked for our opinion on whistleblowing. Our first objective was to raise general awareness of the challenges that whistleblowers face, and to have some cases presented to the Health Select Committee. We have achieved both.

We anticipated that the Francis report into the poor care experienced by too many at Stafford Hospital, especially the elderly would highlight the cultural problems that plague our health service. It did, but disappointingly not strongly enough.

 There are numerous staff surveys  as well as reports on individual trusts – notably by the CQC and the Keogh review on 14 Trusts    that demonstrate a real culture of blame and fear. The learning culture as aspired to by Berwick is still a distant dream for too many.

Patients First has given advice to many whistleblowers but we know this is just a tiny proportion of the staff who have spoken out and not been listened to or, worse, been victimised for doing so.

 We published The Life Cycle of the whistleblower, based on our own files. and that evidence complemented academic research highlighting the risks to staff who do.

Despite a lot of rhetoric and much more awareness of the problem with our current culture there is as yet no system wide improvement to the support for staff raising concerns .

We understand the problem as being a tendency to ignore issues until either a very loud noise is made or something tragic happens, when there is a mad panic to clean things up and sadly too often a temptation to cover up.

 We have made a number of specific proposals. Some have been adopted – one  proposal for example, is that when the CQC inspects they should talk to some whistleblowers to find out what has happened to them. How that will shift the culture & be linked to inspections remains to be tested.

But other proposals as a constructive proposal we made for An Early Intervention Scheme, appear to have kicked into the long grass by the Department of Health. Do the DH care enough to get this right?

 Ministers and employers remain in denial about the scale or significance of the problem and are prone to downplaying both. But for patients – and staff who whistleblow – this remains a fundamentally important issue.

No NHS Constitution or whistleblowing policy will stop the violation of human rights happening to caring staff such as Sharmila and Professor Jesudason. There is still a lot of work to do which is why we have called on the Sec of State to hold a public inquiry into whistleblowing. We believe that hoping things will all be ok is not good enough for our society.

We as leaders of Patients First have been astounded by the strength of feeling and commitment that campaigners are showing to changing the culture. We are preparing to move on to the next stage & pass on to a new team who can further develop the organisation into one which is sustainable. What we have achieved as a small group of campaigners has shocked ourselves, but it shows the power of the truth and hopefully can give people heart that not everyone wants to hide things. There are some genuine people out there.

We wish we could have stopped the bullying and sacking of whistleblowers, but sadly that campaign still needs to go on.

Kim Holt