To Mr Danny Mortimer 19 September 2016

Dear Mr Mortimer,

Inclusion of whistleblowers in NHS Employers’ learning process

I write to ask if NHS Employers could re-consider its position of not allowing whistleblowers to join its whistleblowing events.

I along with other whistleblowers asked to attend NHS Employers’ forthcoming event, “Raising Concerns Share and Learn Forum” but access has been declined. This will restrict the range of experience and discussion at this event.

I note that NHS Employers has posted three blogs by trusts’ local Freedom To Speak Up Guardians, copied below for convenience. These seem to me to be ‘good news’ items, which lack sufficient facts about how the local guardian model is actually performing, or whether and how it is being evaluated. This is of concern given that Robert Francis’ local guardian model was not evidence-based to begin with. [1] To illustrate important information that does not feature in these blogs, I give some examples:

1) The local Guardian for UHMBT has omitted to mention (or perhaps did not know of), recent trust whistleblowing cases which resulted in litigation expenditure by the trust, and did not discuss evidence of how exactly UHMBT has learned from this.

2) The local Guardian for TSDFT has omitted to mention that his trust was famously found by an Employment Tribunal to have mistreated two whistleblowers who raised concerns about a former Chief Executive. The blog does not account for this failure, nor does it give solid evidence of organisational learning.

3) The local Guardian for HRCHT omitted to mention (or perhaps did not know of) 27 super-gags by the trust with a total settlement value of

£1, 211, 036, or how such matters will be handled in future.

Whistleblowers are very concerned that the NHS will take a tokenistic approach to the local Guardian project, and will not appoint those with the most appropriate insights and experience on how organisations cover up. 

I should additionally mention that two of the trusts in question had opportunities to employ whistleblowers with lived experience as advisors, but did not.

I hope that NHS Employers can acknowledge what is lost if whistleblowers are excluded from the NHS’ learning process.

I look forward to hearing from you.

With best wishes,

Dr Minh Alexander

cc Chair of Health Committee

[1] Critique of Francis’ model of Trust-appointed Guardians, 21 June 2015

https://sharmilachowdhury.com/2015/06/21/critique-of-francis-model-of-trust-appointed-guardians/

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THREE LOCAL FREEDOM TO SPEAK UP GUARDIAN BLOGS POSTED BY NHS EMPLOYERS:

 

 

My experience as a Freedom to Speak Up guardian

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19 / 8 / 2016 Midnight

Wayne Walker, Freedom to Speak Up (FTSU) guardian and multi-skilled technician at Torbay and South Devon NHS Trust, describes his experience in the guardian role.  This is the first in a series of blogs by Wayne.

My experience as a Freedom to Speak Up guardian

I’m one of seven Freedom to Speak Up (FTSU) guardians based in the south west – a beautiful part of the country. I’ve lived and worked here since I was 22 and have been employed in the NHS for the past 20 years. Day-to-day, the team I work in maintains the hospital building and complex medical equipment. We are often behind the scenes, but like so many essential services are very important cogs in the system. 

For the past 18 years I’ve been on call 24/7, often working at 3am in the morning. This is a side of the NHS that many people forget about – but the NHS does not close. Working in the hospital is different to a regular job, we’re directly effecting people’s health – one thing we all need, to be able to enjoy this journey we call life.

I first spotted an advert for the FTSU guardian role in January 2016, which led me to do some further research. I began to discover great people like Julie Bailey, Sir Robert Francis and Helene Donnelly – to name a few. They were really making a difference to people’s lives in the NHS, people not dissimilar to those in my organisation who want to speak up but think it will become more hassle than it’s worth, or depend on others to raise concerns. 

I began to feel very passionate about the subject and when that happens it stirs your beliefs, purpose and respect for the NHS – a great employer to many people. 

The interview for the FTSU guardian role was very rigorous, but I believe it had to be. The knowledge of policies, procedures, processes, employment law – the list goes on, all fall under this role. My previous experience as a union representative for ten years gave me a good base knowledge for those questions. Knowing these technicalities about the role is essential to be an effective guardian. When a member of staff raises a concern, you need to know whether it is an issue concerning acceptable behaviour, an employment issue, terms and conditions, data protection or to do with compliance. 

When I started in my new role as a guardian, one of the main things I loved about it was meeting people and hearing about their passions and role in the organisation. However, I did find that some senior staff didn’t like the idea of concerned staff being able to question their decisions – the body language says it all sometimes! 

As a collective of guardians, we’ve presented to a variety of people, from board level to managers to consultants. Standing up and discussing a subject that is feared including how we would like to change organisational culture, how we would like staff to be empowered and how we want them to speak up about patient safety is a pretty difficult task. Our talks did generate a lot of interesting feedback – mainly from the people who ask lots of questions. Like anything though, there are a few myths circulating that could install fear in staff – but we just remind them that they can speak to us in confidence so hopefully we can address them. 

In my role, I do sometimes question why such a caring community finds it hard to share their concerns through fear of detriment. Of course not all NHS communities are the same, but we as Freedom to Speak Up guardians/advocates/ambassadors want to make that change so that individuals feel confident to step forward.

My goal is a simple one – to make sure staff feel free to speak up about patient safety and effectiveness of the service so we can provide safe and compassionate patient-centered care. And the people who can make that work? You, the 1.3 million staff in the NHS.

Further reading

You can read more guardian related blogs from Christopher Hall and Heather Bruce in this section using the retain and improve and raising concerns filters.

Nearly a year as Freedom to Speak Up Guardian

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22 / 4 / 2016 12.25pm

Heather Bruce is the Freedom to Speak Up (FTSU) Guardian for the University Hospitals of Morecambe Bay NHSFT. This is her first blog explaining how the role has developed since she was appointed in July 2015

This has been a very busy year for me and that’s my excuse for taking so long to do my first blog! 

It’s more than ten months since I was appointed and it has been an exciting and challenging time.

Initially the work involved promoting the culture of raising concerns across the trust. With more than 6,000 staff and a distance of 45 miles between our two biggest sites, this has taken some considerable time.  But with much walking of the sites on my part, 4,000 leaflets and posters and promotion through the intranet, I am becoming well-known and staff are embracing the culture of raising concerns.  Our behavioural standards framework was launched simultaneously and our staff have found this empowering in standing up for their patients and themselves.

Now the majority of my time is taken up with helping staff to raise concerns where appropriate and to continue to support my colleagues. We have had some positive results from escalating issues and thereby improving services.
I still work as a radiographer two days a week and I am the industrial relations rep for the Society of Radiographers. Being clinically based and through my contacts with staff side, I have an ease of access to staff, which has increased the credibility and independence of the role. In line with the recommendations of the freedom to speak up review, I work alongside our lead non-exec director for FTSU and our medical director and I have direct access to our chief exec, Jackie Daniel. 

In August 2015, NHS Employers set up their quarterly “Raising concerns Share and Learn” forums and I have attended each of them. That has provided me with access to an invaluable network of freedom to speak up guardians.  Finding out what works and what doesn’t seem to, has been very useful.

At the moment, all new staff receive the freedom to speak up message at induction.  The next steps I will be taking is to liaise with learning and development on a training programme that we can use to reach out to all staff, using the e-learning package that is being developed by Health Education England. I am also hoping to set up training workshops for managers to support them in responding to concerns.

For me this has been a great opportunity to contribute to improving patient care and supporting our staff through the cultural transformation that has been initiated since the publication of the Mid Staffs Inquiry and the freedom to speak up review.

My experience so far as a freedom to speak up guardian

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15 / 12 / 2015 10.30am

Chris Hall is a freedom to speak up guardian at Hounslow and Richmond Community NHS Trust. in his second blog, he describes the importance of sharing good practice and his attendance at NHS Employers raising concerns share and learn event.

As more NHS trusts appoint freedom to speak up guardians and their equivalent, it becomes increasingly important that those already in the role share their ideas and experiences. Last month, I had the opportunity to attend the share and learn meeting hosted by NHS Employers in central London. This was my first real opportunity to exchange ideas for role development face-to-face with my peers. Some guardians had been in post for longer than me, others for less time, but what became clear was that without exception we all wish to make this new role a big success. There was much discussion and exchange of ideas, and a real spirit of mutual support and collaboration.

On a practical level, we were able to share some of the diagnostic and record keeping tools being developed. Also, as individual trusts work on raising and maintaining awareness within their workforce, examples of publicity campaign materials were shared.

With the imminent appointment of the new national guardian, hosted by the Care Quality Commission, who will oversee and support the work of guardians across the country, our hope is that the ideas generated from these early collaborations will influence the development of this national role, and also be of practical help to those trusts who are yet to introduce the role locally.

One of the recommendations of the Freedom to Speak Up review by Sir Robert Francis QC was for a single national whistleblowing policy for the NHS. A draft policy created by Monitor, the NHS Trust Development Authority (TDA) and NHS England has recently been published for consultation. Some of my fellow guardians and I had the opportunity to review this document and we have ideas that could be incorporated into the policy.

As the number of guardians across the country grows in the coming months, I hope this feeling of openness and enthusiasm is maintained. There will be many who bring new ideas and experiences to the table, all contributing to our mutual goal of an improving culture of openness in the NHS.