Patients will be able to anonymously log concerns about their NHS treatment, via a phone app, as part of efforts to boost safety.
The new strategy will see the creation of a centralised portal, allowing people to supply information about blunders they have experienced or witnessed.
The database – part of a strategy to be published next week – will also help experts to see trends and identify areas for improvement, they said.
The new digital service will create a single, portal to record problems with medical devices, errors in medicines administration, or difficulties in spotting a patient’s condition deteriorating.
Officials said patients and carers will be able to instantly log concerns about their care or treatment via their phones.
Caroline Dinenage, care minister, said: “This innovative new digital service for reporting and learning from incidents will provide a more holistic way of collecting and analysing vital data to help improve care right across the NHS.
“Our brilliant NHS staff have a vital role to play and this will empower them further, as well as giving every patient and their family a say on the safety of the care they receive. Patient safety is key to our Long Term Plan for the NHS and this approach will provide the NHS with new insight on how care and services can be improved, to make the NHS the safest healthcare system in the world.”
Patients, staff and families will be able to submit data to the system, helping the NHS to identify new insights to produce fresh lines of patient safety exploration.
Details about individuals – including their names and date of birth – will not be identifiable.
Dr Aidan Fowler, national director for patient safety at NHS Improvement and NHS England said: “The NHS Long Term Plan sets out a package of care which will save thousands of lives, and our new strategy to enhance patient safety will mean people get care in the safest possible setting.
“The NHS is already a trailblazer on safety with the world’s first and largest reporting system, and to futureproof the NHS for the 21st century this new system is part of a decade-long vision for improving patient safety in the NHS, using the latest technology to make it easier for patients, their families and staff to report incidents, learn lessons and keep the NHS in England safe and effective for our patients.”
Amin Abdullah died after setting himself on fire outside Kensington Palace
Health service bosses have been forced to overhaul disciplinary processes after a male nurse set himself on fire rather than face what campaigners called a “kangaroo court”.
The reforms have come after an independent inquiry found in August that Amin Abdullah was wrongly dismissed and unfairly treated by an NHS trust in London.
The inquiry was told that Mr Abdullah, 41, became so depressed at his treatment by the NHS that he set himself alight and burnt to death outside Kensington Palace.
The inquiry found that an unnamed investigating officer for Imperial College Healthcare repeatedly raised questions about the nurse’s honesty “on the basis of little or no evidence”. It has now been revealed that the head of the body that oversees standards and discipline in the NHS has told all trust leaders that processes must be reformed.
Baroness Dido Harding, the chairwoman of NHS Improvement, ordered trust bosses to consider the “likely impact on the health and wellbeing” of those in the disciplinary line of fire. She told trust chiefs to ensure that health professionals facing charges have “immediate and ongoing direct support”.
Lady Harding also stressed that NHS disciplinary panels must be independent and follow a series of best practice guidelines.
Hannah Martin said she had been forced out of her job and made to sign a gagging clause after having a baby
MPs have called for a ban on “gagging clauses” used by employers to silence allegations of unlawful discrimination and harassment.
Maria Miller, chairwoman of the Women and Equalities committee, said non-disclosure agreements (NDAs) were having a “destructive effect on people’s lives”.
NDAs were designed to stop staff sharing secrets if they changed jobs.
But MPs say they are now used to “cover up unlawful and criminal behaviour”.
The Women and Equalities Committee says the government needs to clarify the rules on whistleblowing and tackle the financial barriers employees face when trying to take cases to employment tribunals.
More than 90 people wrote to the committee sharing their experiences.
Hannah Martin, a mother-of-two from West Sussex, told MPs she was forced to leave her job at an advertising agency after having a baby.
“They said if I did not sign an NDA within 24 hours I would not get a payout,” she told the BBC in a separate interview.
“NDAs are a bullying tactic that forces you into silence. I felt like I had no other choice but to sign. I felt like I was being abused.”
She said that by signing an NDA, she not only lost her job and income, but also her self-confidence. “All the power is with the person with the money,” she said.
Miller: “A long-term mission to get rid of NDAs altogether”
Mrs Miller said it was “worrying” that gagging clauses were being traded by employers for job references.
“After signing an NDA, many individuals find it difficult to work in the same sector again,” she said.
“Some suffer emotional and psychological damage as a result of their experiences, which can affect their ability to work and move on.”
The committee said any use of confidentiality clauses needed to be clear and specific in scope and that employers should be made to investigate all allegations properly.
A senior manager should be appointed to oversee discrimination cases so that someone was held accountable, the committee said.
‘Abuse and silencing’
It also renewed calls for the three-month time limit for tribunal cases about sexual harassment and discrimination to be doubled, and added new laws should be introduced so that NDAs could not prevent people from sharing information which might support the claims of other victims.
Astrophysicist Dr Emma Chapman won a payout after being sexually harassed by a man at University College London but refused to sign an NDA in favour of a confidentiality waiver.
She said this was a positive first step towards “breaking the cycle of abuse and silencing in sexual misconduct” at universities in particular.
She told MPs she knew of two cases in London in the last five years where settlements totalling more than £100,000 in each institution were given to multiple victims of individual harassers.
But she said she was “concerned that even with the clearest terms alongside an NDA, the power imbalance between employer and employee will still serve to silence without explicit confidentiality waivers”.
UCL said it welcomed the committee’s findings, adding that it “no longer uses NDAs in settlement agreements with individuals who have complained of sexual misconduct, harassment or bullying as a matter of course”.
The confusion must be cleared away and guidance established if these deals are to remain trusted and useful, writes Iain Miller
Gagging orders were back in the spotlight this week when the women and equalities committee reported on non-disclosure agreements. Once more the legal profession felt the heat as MPs criticised its approach so far and called for more action from regulators.
It is a peculiar feature of NDAs that responsibility for the issues raised is spread across a wide range of bodies.
The courts have not traditionally supervised what are essentially private contractual agreements. But various other interested groups are proving influential. No wonder lawyers are confused on where they stand on use of the agreements.
What is becoming increasingly apparent is a need for authoritative guidance and agreed standard form documents that can be relied on by those dealing with NDAs.
This was certainly the view at a recent meeting of employment law specialists, law firm risk managers and ethics experts.
Attendees agreed that clarity is required about the precise boundaries of acceptable terms in the drafting and negotiation of NDAs and that the recent warning notice from the Solicitors Regulation Authority did not do this sufficiently. Equally, some said that a practice note from the Law Society, the body that represents solicitors in England and Wales, was equivocal.
Others raised concerns about shifting public attitudes. Hence a default form of wording being developed for the front of every settlement agreement — akin to the way in which standard form court orders such as freezing injunctions are used — was thought to be a good way forward.
It could state in plain English what was not/could not be prevented by the agreement, such as reporting to the police, regulators, medical practitioners and others. It would give solicitors the confidence they are acting appropriately, but also clients the confidence their agreement is bona fide. There is a danger that NDAs are becoming unnecessarily feared and toxic by their very notoriety.
Some argued that the use of NDAS should be the subject of greater controls and oversight within law firms given they have become such a risk factor. Suggestions included that NDAs might require approval at a higher level or that clients could only be allowed to enter into NDAs in employment cases with board approval.
Another idea discussed was whether a higher form of regulation should apply in relation to the use of NDAs in an employment context. NDAs could be signed off by a lawyer, specifically qualified and authorised to advise on such matters.
There has been a stream of events over the past 18 months that has drawn focus back to the legal profession on how it deals with NDAs. There is every reason to expect this to continue until the various issues surrounding NDAs are resolved.
As a profession, lawyers need to grapple with these or we risk government regulation or a total ban on NDAs, which would be a pity given that their use is not intended to be pernicious but often in the best interests of both signing parties.
Iain Miller is a partner specialising in legal services regulation at Kingsley Napley, a London law firm
Jonathan Penny worked for the ambulance trust for 17 years(Image: Jonathan Penny)
A whistleblower who spoke out about a bullying culture by senior ambulance trust managers is claiming he was wrongly dismissed over allegations of gross misconduct, causing him to contemplate taking his own life.
Jonathan Penny, who worked at South Western Ambulance Foundation Trust (SWASFT) for 17 years, told an employment tribunal in Exeter how his mental health was also affected by his colleague and best friend ending their life while his disciplinary proceedings were ongoing.
The court heard how Mr Penny was an air ambulance paramedic and then for the hazardous area response team (HART) as a team leader, training manager and national interagency liaison officer.
Mr Penny told in a statement how his service with the trust had been ‘exemplary’ until a National Ambulance Resilience Unit (NARU) report in June 2017 into the Hazardous Area Response Team (HART) identified concerns about management and leadership, and highlighted a culture of bullying and sexual harassment among numerous management team employees.
An independent investigation was commissioned by the trust looking into the practices of the HART team which led to disciplinary processes for three employees, including Mr Penny.
A formal investigation into alleged bullying, sexual harassment, violence and aggression by Mr Penny was recommended. Due to seriousness of the allegations, a disciplinary investigation was deemed necessary by the trust.
Mr Penny alleged in his statement: “A senior officer of the trust, who wishes to remain anonymous for fear of repercussions, was present at the disclosure of the (NARU) report which was witnessed by the board of executives via video link.
“He said that chief executive Ken Wenman was ‘fuming’ and shortly after held a meeting stating that, ‘I want them gone. Get rid of them’, with reference to who he believed was responsible for disclosing this dysfunctional management.”
Two months later, Mr Penny says he was informed he was to be removed from his post and demoted with immediate effect. He was sent to work at Exeter ambulance station and says he was not given any reason for the decision.
When no explanation had still been given nine days later, he said he formally requested one.
“I would have expected to receive notification of allegations against me within seven days as per trust disciplinary policy,” he said. “My mental health began to seriously decline and I also informed the trust I would be reporting sick due to unmanageable levels of work related stress.”
Mr Penny says his stress was further compounded when he was told the following month his former role as a training manager was being covered by an employee who had just moved in with his wife.
Mr Penny told how he wrote to the trust perceiving it to be a conflict of interest, and says he was told it was ‘unfortunate’.
In September 2017, Mr Penny says he told the trust he was now suffering from severe mental health illness and had nearly taken his own life.
He said: “The trust still attempted to put additional pressure on me to attend a disciplinary hearing despite the severity of my condition, which became dangerously unstable when I learnt that my best friend, an operations manager in the trust, had committed suicide by hanging himself a week before my hearing was due.
“Despite this, the trust still insisted I attend a three-day hearing after the funeral of my best man. The trust also removed the wellbeing officer who had been assigned to support me through my illness.”
Mr Penny claims it wasn’t until October 2017 – two months after he was removed from post – that he was informed of the allegations being made against him which were three accounts of gross misconduct following the trust’s cultural review.
The first was he had displayed a pattern of inappropriate behaviour towards colleagues. The second was he had been complicit in the deployment of safe working at height practices within HART Exeter that fell outside of national specifications and did not have necessary governance in place, resulting in HART operatives being put at risk.
he final allegation was in his role as course director, he led HART operatives into unsafe water during a training course in Llangollen. All three were denied by Mr Penny.
He said: “I expressed my concerns that I had been removed from post prior to the report being compiled, and that I did not think the report was fair or unbiased as all staff had been made aware that three senior managers had been removed from post due to allegations of bullying and sexual harassment prior to the report being compiled.”
He added: “The allegations were the findings of the cultural review and the fact I had used the interoperability panel as a platform to report what I believed was bullying and harassment.”
At the disciplinary hearing, where it was decided to terminate his employment, Mr Penny claims the trust refused to allow him to bring any witnesses, which the trust disputes.
During the appeal process he was told the disciplinary officer had not received his initial evidence package due to a ‘clerical error’.
Mr Penny said: “The investigation on which the hearing relied was neither reasonable or fair as the investigating officer made no attempt to undertake an impartial investigation, and failed to take into account all relevant witnesses and evidence freely available to him.”
Regarding some of the allegations made against him, Mr Penny claims he was never named as the responsible officer for safe working at height practices, and no complaints or safety issues were raised at any point.
He said: “Staff and patient safety were paramount in every action I took and every training event I organised, every live deployment I was involved in and without ever receiving a single complaint about my conduct.
“I believed SWASFT failed to comply to their own policies and failed to follow the Advisory, Conciliation and Arbitration Service (ACAS) employment guidance as this was an intentional, single-minded and unreasonable act to ‘get rid of me’.
“As a result of SWASFT’s actions I have suffered with mental health issues, financial issues, depression, anxiety, exacerbation of PTSD symptoms, and for many months I was unable to work due to issues directly relating to the way I treated, humiliated and bullied by SWASFT.
“I believe the only reason I have been singled out and treated unfairly and differently to others that were investigated is partly direct discrimination because of my mental health issues and as a direct result of my whistle-blowing of the bullying culture by senior managers in SWASFT.”
He added: “Bringing this case before the court has been hardest thing I have ever done as it has taken an enormous amount of effort to do so. However, I have felt compelled to do so as I just cannot move on with my life or come to terms with the horrendous and unfair way in which the trust I gave so much to, for so many years, has treated me.
“I also feel a duty of responsibility to speak out for excellent staff of SWASFT who still suffer in silence, and I feel I owe it to my friend and others before him who have been overwhelmed and taken their own lies as a consequence of the proven and documented toxic culture.”
Among statements in support of Mr Penny, HART operations officer Ben McGachy said: “I have experienced similar persecution in HART after I raised concerns about the culture and experiences of bullying and harassment that my staff and I suffered in the unit.”
Evidence was heard from the trust who refute Mr Penny’s allegations and believe their investigation of him was fair, impartial and reasonable.
Amy Beet, executive director of people and culture told how following the independent report into HART, she concluded it was necessary to investigate the issues raised, and Mr Penny was temporarily deployed pending investigation.
Ms Beet said: “Having reviewed the investigation report I concluded there was sufficient evidence to warrant a disciplinary evidence.”
She told in a statement how it was rescheduled twice to suit Mr Penny, the latter being on compassionate grounds, and he was invited to bring witnesses and provide statements, but the large number he was proposing – 29 to give evidence and a further 19 to attend for questioning – was ‘not practicable’. The hearing was held in Mr Penny’s absence, having been told he would not attend.
It was conceded at an appeal hearing Mr Penny’s mitigation documents were not passed on to the hearing in January 2018 and was due to an ‘administration error’ within the HR department, but they were considered by the appeal panel in April 2018.
Ms Beet said: “I deny that the decision to allow Mr Penny to call witnesses to attend the hearing or postpone the hearing was unfair. There were cogent reasons including practicability, the large number of witnesses and lack of clarity as to relevance.
“To allow all of the witnesses to attend the hearing was not proportionate, feasible or necessary. Although this decision was communicated to Mr Penny shortly before the hearing, I do not believe this prevented him from putting forward his case or having a fair hearing.
“I deny that including the sexual harassment allegations in the investigation was unfair.”
Paul Birkett-Wendes, who chaired Jon’s disciplinary hearing at the time he was head of operations in the north division, said: “My disciplinary outcome concluded that Jon had placed trust paramedics at significant risk, both in respect of their working at height and in respect of open water training.
“As such I consider there has been a complete breakdown in trust and confidence between the parties. In addition to the above health and safety concerns, there is evidence Jon has demonstrated a pattern of inappropriate behaviour towards his colleagues.”
Jennifer Winslade, executive director of quality and clinical care, who chaired the appeal hearing, said to ensure his appeal process was ‘absolutely fair’, Mr Penny was offered a further opportunity to gather witness statements but says she received no statements for her review and consideration.
She said: “After hearing all of the evidence, I concluded that Jon’s conduct was so serious it warranted a finding of gross misconduct by the disciplinary hearing.
“After a review of the findings of the disciplinary panel I found their conclusions to be fair and reasonable.”
Whorlton Hall was taken over by Cygnet Health Care this yearBBC/PA
An inspector whose report highlighting failings at a scandal-hit hospital was never published resigned from the regulator, protesting that some of its staff were too close to the private company that ran the hospital.
Barry Stanley-Wilkinson also complained of a “toxic” culture at the Care Quality Commission and said many of its inspectors felt that they worked in a “bullying, hostile environment”.
Mr Stanley-Wilkinson resigned six months after he led an inspection in 2015 of Whorlton Hall, a private hospital in Co Durham for adults with learning disabilities or autism. Police arrested ten carers at the hospital last month after Panorama on the BBC broadcast footage of staff appearing to mock and intimidate patients.
The inspector reported in 2015 that some patients had accused staff of bullying and inappropriate behaviour. He said patients did not know how to protect themselves from abuse and recommended that the hospital should be given a rating of “requires improvement”.
His report was never published and a new CQC team that inspected Whorlton Hall in 2016 gave it a “good” rating. Mr Stanley-Wilkinson’s resignation email, sent to the CQC in January 2016, was published yesterday by parliament’s joint committee on human rights, which took evidence from two CQC executives. He expressed frustration that his report on Whorlton Hall had not been published “despite significant findings that compromised the safety, care and welfare of patients”.
He referred to a complaint about his report by the hospital, which was then run by the healthcare company Danshell, and pointed out that it had previously been run by Castlebeck, which ran Winterbourne View, a care home where there had been an abuse scandal in 2011. Whorlton Hall was taken over by Cygnet Health Care this year.
“I am concerned about the relationship managers have had with the service,” Mr Stanley-Wilkinson wrote. “Discussions had taken place without my involvement despite me being the inspector.”
Paul Lelliott, deputy chief executive of the CQC, said the 2015 report had had inconsistencies and lacked evidence. Ian Trenholm, its chief executive, said the CQC planned to develop a new way to monitor institutions.
The initiative is part of an NHS safety strategy
SHARMILA CHOWDHURY 