Mail on Line 5 February 2018

By DANIEL MARTIN, CHIEF POLITICAL CORRESPONDENT FOR THE DAILY MAIL

• Dr Raj Mattu warned about standards of Walsgrave Hospital in Coventry 
• Following his warning in 2001, Dr Mattu was ‘vilified and bullied’ by bosses
• Dr Mattu was unfairly sacked by the NHS in 2010 according to a tribunal 
• Now the NHS trust has to pay Dr Mattu £1.2 million in compensation  

The Mail On Line 18 Jan 2016

• Jonathan Brooks spoke out about lack of medical cover at his hospital
• Plastic surgeon worked at City Hospital, Nottingham, until suspension
• He’s seeking compensation plus interest but hopes to return to work 

By ANDY DOLAN FOR THE DAILY MAIL

Herald scotland 25 December 2015    David Ross

Dr Jane Hamilton, a consultant psychiatrist pictured in Glasgow… Dr Hamilton is a whistleblower who voiced fears over safety at NHS Lothian east of Scotland perinatal psychiatry service before a mother took her life in 2011 after she was allowed to leave

Dr Jane Hamilton, a consultant psychiatrist pictured in Glasgow… Dr Hamilton is a whistleblower who voiced fears over safety at NHS Lothian east of Scotland perinatal psychiatry service before a mother took her life in 2011 after she was allowed to lea

A whistle-blowing doctor who was at the centre of a gagging row, has retired after deciding her career in Scotland is beyond repair.

Dr Jane Hamilton now advises any doctor thinking of blowing the whistle in Scotland to think very hard before doing so as it has ruined her professional life.

The consultant perinatal psychiatrist has been working in Hull where her specialist expertise has been warmly welcomed. But her family is settled north of the border and she has finally found the weekly commute too demanding.
However she believes she is now seen as a trouble-maker within the NHS in Scotland. Jobs she has applied for have been re-advertised shortly afterwards.

“It would appear they would rather have nobody than have me,” she said.

She and her family had moved north in 2007 because Dr Hamilton had been appointed to the Mother and Baby Unit (MBU) at St John’s Hospital in Livingston. Her national reputation in the care of mothers with severe psychiatric problems had been recognised when she was asked to help draw up the UK guidelines before her appointment in Scotland.

By the end of 2007 she raised concerns over how the unit was being run and shortly afterwards warned in writing that patients could die. Two women patients subsequently took their own lives and the family of one is now suing the health board for medical negligence.
The unit continues to make headlines. Earlier this month there were reports of a vulnerable mother leaving her baby in the unit, before getting out and being hit by two different vehicles, in what some believe was a suicide attempt.

In June Erin Sutherland pled guilty to culpable homicide after she smothered her 10 month old baby Chloe.

Her doctor sought specialist help when Chloe was eight-months old, but support was not offered by the MBU. The suggestion made in court that post-natal depression was not deemed to be a problem after six months, was subsequently challenged by Dr Hamilton.

After raising concerns Dr Hamilton was off with stress related illness, then worked elsewhere but wasn’t allowed to return to the unit, officially leaving NHS Lothian earlier this year.
The health board and Scottish Government have always insisted her concerns were thoroughly and independently investigated and were unfounded. However sources suggested otherwise.

A more recent investigation by NHS Lothian, which is not to be published despite appeals, is understood to have found no fault with Dr Hamilton’s professional abilities nor did it criticise her actions.

In the aftermath of the controversy over an alleged attempt by NHS Lothian to gag her in a compromise agreement for her to leave, something the health board has always vehemently denied, ministers effectively outlawed the future use of any such clauses by public bodies.

Meanwhile Dr Hamilton has become an active member of the recently founded campaign group A Safe and Accountable People’s NHS in Scotland (ASAP- NHS) , which is calling for the setting up of a genuinely independent NHS regulatory body.

Dr Hamilton said: “I didn’t want my career to end like this, but it is clear to me my reputation has been irreparably damaged.”

She doesn’t believe her concerns were ever properly investigated, and added: “Of course health employees should blow the whistle, but should realise they may end up paying a very heavy price.”

Neil Findlay Labour MSP for Lothian, said:“Jane Hamilton’s case is shameful. Here we have a women with an unblemished career who has been victimised and effectively blacklisted from getting a job in Scotland for the ‘crime’ of raising concerns about patient safety and poor practices in what should be a national centre of excellence.”

He said people who want to make our health care better should not be treated this way.

But a Scottish Government spokeswoman said whistle-blowers were being protected. Health boards had to ensure it was safe for staff to speak about any concerns, particularly patient safety, which would be investigated.

She said there was the National Confidential Alert Line, and non-executive Whistleblowing Champions were being introduced in each health board

Ministers were also committed to establishing an Independent National Whistleblowing Officer, to provide an independent and external review on the handling of whistleblowing cases in NHS Scotland.

Report by the Commons public accounts committee  11 December 2015

‘The Care Quality Commission has made substantial progress since the Committee last reported in 2012. But it is behind where it should be, six years after it was established, in that it is not yet an effective regulator of health and social care. Because of staff shortages it is not meeting the trajectory it set itself for completing inspections of hospitals, adult social care and primary care. There are also concerns about the consistency and accuracy of draft inspection reports, and the time the Commission takes to finalise a report after carrying out an inspection. At the same time, the Commission is not yet ready to implement new responsibilities it takes on in April 2016 to assess the efficiency with which hospitals use their resources. In addition, the Commission does not yet have the quantified performance measures, linked to explicit targets, that are needed to show whether it is satisfactorily performing its statutory duties. We will be returning to this subject to review what further progress the Commission makes in the coming year.’

Listening to patients, carers and staff, and acting on their concerns

11.The number of concerns raised by whistle-blowers, complaints about providers, safeguarding calls and statutory notifications from providers increased from a total of 173,931 in 2013–14 to 208,720 in 2014–15. However, the National Audit Office found that one out of three safeguarding alerts raised with the Commission was not acted on within the Commission’s two-day target.17 The Department acknowledged that the Commission had long-standing problems with how it reported and responded to safeguarding alerts but assured us that the Commission had now put more rigorous systems in place.18 As part of its inspections, the Commission also looks at how hospitals, care homes and paramedical services respond to complaints. It has developed its methodology by speaking to people who have raised complaints about the quality and safety of care, as well as other organisations that people go to when they have a complaint.19

12.The Commission takes the time to talk to patients, staff and carers during an inspection. However, providers were concerned that this only provided the views of people inspectors met on the day of the inspection and meant the Commission could be at risk of placing too much reliance on anecdotal evidence. The Commission organises formal patient and carer consultation events in advance of its inspections, but these may not necessarily be well attended or representative of all people using the services inspected. A GP and Partner of the Jenner Practice in Lewisham told us that, for general practice, the Commission uses a patient questionnaire. However, he felt that the central questionnaire was not very sensitive to local circumstances. He also made the point that responses might reflect an unrealistic or outdated view of what people thought GP services ought to be, rather than how primary care is changing to best meet patients’ needs

Conclusions and recommendations

1.The Commission is behind on its inspection programme and is not, therefore, fulfilling its duty to be sighted on risks to the quality and safety of health and adult social care services. The Commission has struggled to recruit inspectors and analysts with the right skills. By mid-April 2015, the vacancy rate was 34% for inspectors, 36% for senior analysts and 35% for managers, and it did not expect to reach full complement for inspectors until June 2016. Staff turnover in 2014-15 was nearly 8%, much higher than the Commission’s 5% target rate, and was still at this rate for the first two quarters of 2015–16. Because of these staff shortages, the Commission is behind its original target dates for completing its programme of inspections. The Commission forecast that by the end of March 2016 it would be below its planned trajectory by 6% in adult social care and 8% in primary medical services. It expects to have completed its inspections of hospitals by June 2016, six months after its original target date of December 2015. It is likely that it will need to look for alternative solutions to its recruitment problems and is already, for example, using people on secondment to supplement its full time inspectors on mental health. The Commission’s current plans for inspection are based on funding plans made before the 2015 spending review. The Department has asked the Commission to model the impact of reductions in funding of 25% and 40% and, unless the Commission finds alternative solutions to its recruitment problems or changes its methodology, the Commission made clear that any such cuts are likely to lead to further delays to its inspection timetable.

Recommendations:

We are very concerned about the effect being below staff complement has had on the Commission’s ability to carry out its full programme of inspections. The Commission should write to us in July 2016, with an update on staff turnover rates and whether it has met the recruitment targets it gave us in evidence. Specifically, the Commission should set out: whether it has reached a full complement of suitably skilled and qualified inspectors; whether it has sufficient analysts; and what impact staff shortages have had on its forecast trajectory for carrying out inspections.

The Commission needs to demonstrate how it will deliver its programme of inspections in the face of substantial funding reductions. This should include a robust and transparent analysis of risk if it adopts a more flexible approach or prioritises resources. It needs to be clear to the taxpayer and the organisations it inspects about changes of approach.

2.Too often the length of time between an inspection and a report is too long, and the Commission’s draft reports contain too many basic factual errors. At a time when the Commission is asking providers to pay substantially more towards the cost of their inspection it is more important than ever that the Commission can demonstrate the quality of its work. However, providers told us they find too many errors in draft reports, reports take too long to produce and there is too much variation in the quality of initial judgements. On average, inspection reports are not completed within the target of 50 days — reports take an average of 49 days for adult social care, 67 days for general practice and 83 days for hospitals. The chief executive of Warrington and Halton Hospitals NHS Foundation Trust told us they had identified over 200 errors in its draft report. Some of these were just grammatical errors or duplicated points, but some were inaccuracies in the data that could have been resolved while inspectors were still on site. She told us that the Commission had accepted 64% of the points raised and amended the draft as a result. The Commission told us it had strengthened its internal quality assurance processes, but this had lengthened the time it takes to complete a report.

Recommendation: The Commission should set out how it will improve the quality of initial draft reports, and ensure that the time between inspections and publication of reports is shorter. We expect to see progress on this in the next 12 months.

3.The Commission has not always made best use of vital intelligence from patients, carers and staff about the quality of care, or acted quickly enough on their concerns. We are concerned that the Commission’s data suggests that one out of three safeguarding alerts is not acted on within the Commission’s two-day target. The Department acknowledged that there have been long-standing problems with how the Commisison has dealt with safeguarding alerts, and assured us that new processes are being put in place. More generally. the number of calls the Commission receives from the public and whistle-blowers in response to concerns about the quality and safety of care is increasing. During inspections, the Commission also takes time to talk to patients, staff and carers. Providers told us, however, that inspection reports could place too much emphasis on potentially anecdotal evidence inspectors heard on the day of the inspection.

Recommendation: As it continues to build user feedback into its work, the Commission should publicise its role, make it easier for people to say what they think of care, and prioritise action in response to safety concerns. It must work with other bodies – including the ombudsman, central and local government and the third sector — to ensure that concerns are addressed quickly, particularly those raised by whistleblowers. It also needs to improve the quality of information available to people who are choosing a care provider.

4.There is no way for parliament or the public to know whether the Commission is performing its statutory duties to protect the health, safety and welfare of people who use health and social care services. In its March 2012 report the previous Committee criticised the Commission’s lack of adequate performance measures, but over three years’ later the problem is still unresolved. The Commission has developed a new performance framework, but only 6 out of the 37 performance measures included in it have specific, quantified, targets. Reporting performance against clear targets is vital for both transparency and accountability and measuring improvements over time.

Recommendation: The Commission should publish quantified baselines and targets for its performance across the board from 2016–17 onwards.

5.The Commission will become responsible for assessing hospitals’ use of resource in April 2016, but it will take over a year for it to implement these responsibilities in full. The Commission plans to pilot its new approach in April 2016, but it does not believe it will be ready to roll this out to all hospitals until January 2017. The delay risks giving the public the impression the Commission is providing full assurance over the use of resources by all hospitals when it will not be doing so until January 2017. The Commission published a consultation document on the morning of our evidence session asking for views on how it should implement its new responsibilities. But it is not yet clear how the Commission will coordinate with, and draw on the expertise of Monitor and the NHS Trust Development Authority to avoid duplication of effort by providers. We are concerned that there is not adequate preparation for this important additional area of work, which has been introduced before the Commission has the capacity to implement it and while it is struggling to fulfil its exisiting responsibilities.

Recommendations:

The Commission should set out what its approach will be to provide assurance about the use of resources by hospital providers. It should do this as soon as possible as it takes on these responsibilities in April 2016.

The Department should clarify the roles of the Commission, Monitor, and the NHS Trust Development Authority for assessing the use of resources by health bodies, to avoid duplication of effort and unnecessary burdens. We have serious concerns about adding this responsibility to the Commission when it is not yet delivering its inspections.

6.The current regulatory system focuses on single providers and does not give adequate assurance over patients’ experience of the overall quality and safety of care they receive. It is becoming increasingly important for providers and commissioners to collaborate in order to integrate the services patients, particularly those with long term conditions, need from their GP, hospital and local community care services. But existing regulatory systems, including those operated by the Commission and Monitor, focus on services operated by individual providers, and do not look enough across organisational boundaries. A further complication is that providers’ performance is influenced by decisions taken by local commissioners, but the Commission has no power to scrutinise clinical commissioning groups or local authorities. The Department is developing, but has not yet completed, what it described as a ‘scorecard’ to assess the performance of clinical commissioning groups. The Department hoped that the Commission would be able to use this information, once available, populated and published, to assess the economy, efficiency and effectiveness of services to people living in a given locality.

Recommendation: The Department should report back to the Committee by the end of 2016 about how it will support the Commission to ensure that inspections take proper account of the needs of users in ensuring services provided by differenthealth and social care organisations are properly joined up. The Commission will need to work with other key bodies including, for example, the ombudsman, patient representative groups and local delivery partners to collect sufficient information to inform its judgements.

For full report:

http://www.publications.parliament.uk/pa/cm201516/cmselect/cmpubacc/501/50102.htm

Daily Mirror  21 NOV 2015
BY MARTYN HALLE , NICOLA FIFIELD

Ambulance worker Martin Jackson turned whistleblower to hand over a shocking picture of seriously ill people queuing on stretchers to be checked in at A&E

Northumbria Specialist Emergency Care Hospital  Delays: Patients wait to be booked in at the new hospital

A NHS whistleblower fears ­patients will DIE in corridors due to the crisis in hospitals .

The warning from ambulance ­worker Martin Jackson came as he ­handed over this shocking picture of seriously ill patients on stretchers queuing to be checked in at A&E.

He said they waited for two hours. The hospital denied it was that long.

The photo was taken at Northumbria Specialist Emergency Care Hospital in Cramlington which opened in June and has been described as a “vision for the NHS”.

But Mr Jackson, 51, said: “It’s only a ­matter of time before a patient dies on a stretcher waiting to be seen,” the Sunday People reports.

Flagship: The new hospital at Cramlington has been called “a vision for the NHS”

He said centralising A&E care for serious illness and injury in such ­“super” hospitals at the expense of other NHS units was not good for patient care. He believed it meant longer travel time for patients and waits for ­ambulance crews.

The emergency care assistant with North East Ambulance Service spoke after 98 per cent of junior doctors voted for three days of strike action next month.

On December 1 medics will provide only emergency care and on December 8 and 16 there will be a total walkout by thousands of junior doctors .

The action is over a contract being imposed by Health Secretary Jeremy Hunt which medics say would be ­unsafe for patients and unfair for staff.

Labour shadow health secretary Heidi Alexander said: “It is no ­exaggeration to say that the NHS is close to meltdown.”

Jeremy Hunt Under fire: Jeremy Hunt’s new contract for doctors has sparked a strike

Mr Jackson said: “It is frightening to think about what will happen during the strikes. What is happening here in Northumberland is insane.”

He pointed out patients are ­ambulance crews’ responsibility until booked in. “If a patient goes into cardiac arrest in the queue, we have to resuscitate them on a stretcher in a corridor, even though we’re inside what is supposed to be an emergency super hospital full of specialists.”

He said the delays meant the ­already stretched crews could not respond to other emergencies.

Mr Jackson, who has been ­suspended by his hospital on an unrelated matter, said he had to do a 120-mile return trip to Berwick from Cramlington to transport a sick baby.

Worries: Martin Jackson fears a patient will die on a stretcher

He said: “It was a ‘load and go’ ­situation. We needed to get that child to the next level of care very quickly.

“On the way back to Cramlington we drove past three hospitals. They no longer had the right specialists.

“How can this be better for patient care? Being in an ambulance for an hour and then enduring a wait of a further hour or two to be seen by a doctor when they get to hospital?”

He claims the needs of the local population and patients were ­better met when A&Es at Hexham, Wansbeck and North Tyneside hospitals handled more than just minor conditions.

Crisis: Ambulance and A&E services are feeling the pressure

Mr Jackson, of Amble, Northumberland, raised his concerns with the chief executive of North East Ambulance Service Yvonne Ormston in August. He has launched an online petition on the 38 degrees website.

Paul Liversidge, chief operating ­officer at North East Ambulance Service, said: “This has been a major change for hospital services in Northumberland and North Tyneside and we’re working closely with Northumbria Healthcare to ensure a smooth transition for ­patients into the new emergency department.”

But Dr Chris Biggin, clinical ­director of emergency care at Northumbria Healthcare NHS Foundation Trust, said there were no issues regarding the trust’s A&E performance.

He said: “Our new model of ­emergency care is working extremely well and has already exceeded our expectations in terms of the positive impact on patient outcomes.

Winter rush: Medical staff are dealing with high numbers of patients

“Having access to dedicated diagnostics 24/7 and the right ­consultant specialists on hand seven days a week means patients who are most seriously ill or injured are now being assessed, diagnosed and treated much quicker than ever before, which is excellent news for patient care.”

“Our urgent care centres at Hexham, North Tyneside and Wansbeck general hospitals remain open 24/7 and ­continue to see hundreds of patients every week with less serious problems.

“Like the rest of the NHS we are ­already seeing high numbers of people ­accessing both urgent and emergency care and, as we head into winter, we would urge the public to make sure they use NHS services wisely.”

A spokesman for the Cramlington hospital said it had met the ­government target of 95 per cent of A&E patients being seen within four hours.

She claimed that Mr Jackson’s claims of patients were waiting for two hours was untrue.

Warning: Labour’s Heidi Alexander says hospital deficits are “eye-watering”

But Labour MP Ms Alexander said: “Hospitals have racked up an ­eye-watering deficit of ­£1.6billion in just six months.

“This isn’t just a problem for ­hospital accountants. It’s a problem for each and every one of us.

“It could mean fewer beds, fewer staff and even longer waits at A&E.

“It could mean cancer treatments further delayed and some operations rationed or even denied.

“It could mean closures, as hospital bosses have to decide whether to ­balance the books or deliver safe and timely care.”

Picture from Jeremy Hunt’s flagship hospital is a vision of hell that shames Britain

This is the picture that shames Health Secretary ­Jeremy Hunt .

It was taken at one of his flagship new hospitals hailed as a “vision for the NHS”.

It’s a vision all right. A vision of hell.

Patients in pain have to queue in this corridor until hospital staff can see them.

Meanwhile they are in the care of the ambulance crews who brought them there.

Florence Nightingale would have had a fit to witness such appalling treatment.

And what was unacceptable in Victorian England should not be tolerated in 21st century Britain.

Andy Stenning/Daily Mirror

Unacceptable: Jeremy Hunt needs to sort out this crisis

But Mr Hunt is more ­interested in making junior doctors work longer hours for less pay than sorting out this mess.

Now those doctors intend to walk out for three days next month.

That will only make what is happening at this hospital and others like it even worse.

Yet it shows the strength of feeling among doctors for 98 per cent of them to vote to strike. They are rightly furious that Mr Hunt will not even ­have proper negotiations with them.

Read more: Check our online tool to see where you come in the health postcode lottery

This newspaper believes in a truly seven-day NHS. An NHS run more for the benefit of patients and less for the ­convenience of doctors.

But to create it Mr Hunt must take the doctors with him, not push them away.

Make plans: A Royal Commission may be needed to fix the NHS

As the population ages and medical science advances there is no doubt the health service needs a radical ­overhaul.

It is time Mr Hunt set up an old style Royal Commission to diagnose what is wrong and how to cure it.

It means looking at best practice at home and abroad. It means examining hospital administration. It might mean sacking ­managers. It might even ­recommend Mr Hunt should lose his job.

But it would end the scandal of patients dumped in hospital corridors.

Dr Hayley Dare was ridiculed after revealing culture of bullying and harassment at West London Mental Health NHS Trust

Britain’s largest mental health trust has been forced into a humiliating climb-down after finally admitting the whistleblower who spoke out about bullying and harassment of staff had acted in good faith and in the public interest.

Dr Hayley Dare revealed a culture of bullying and harassment at West London Mental Health NHS Trust – which includes Broadmoor high-security hospital among its 32 sites – but was ridiculed by bosses.

 

 The clinician, who had an unblemished 20-year career in the NHS, followed the trust’s whistleblowing policy and took her concerns to the trust’s then chief executive, Steve Shrubb. During one meeting with the HR director to discuss the issue, Mr Shrubb called Dr Dare “a very disturbed woman” when she was out of the room and compared her with his first wife. He apologised at her employment tribunal for his comments. 

READ MORE

Claims of bullying culture at biggest NHS mental health trust

The trust spent £130,000 fighting Dr Dare’s claims despite knowing it had serious problems about the issues she raised. Official NHS staff surveys in 2012 and 2013 showed that out of 51 mental health trusts, West London had the worst record for staff experiencing violence both from patients and colleagues. 

Steve Shrubb, chief executive of West London Mental Health NHS Trust

Thirty per cent of staff experienced harassment, bullying or abuse from other members of staff in 2013 and 26 per cent experienced discrimination. Almost one in 12 employees experienced physical violence from colleagues.

However, Dr Dare lost her employment tribunal against the trust last September on a legal technicality that no longer exists. The tribunal found against her because the judge said her disclosure had not been made “in good faith” – a provision whistleblowers no longer have to satisfy.

I can’t quite express how overwhelmed I feel. This has always been about patient care and staff welfare. I never deviated from that so I feel exonerated at last

Dr Hayley Dare

Dr Dare said she was then left feeling “paralysed” after the trust pursued her for almost £100,000 in costs and vowed to keep fighting. She appealed, and on Friday both sides agreed on a consent order at the Employment Appeal Tribunal in London. The trust conceded Dr Dare had “made a disclosure in the public interest about the bullying and harassment of the staff of the [trust] and that this disclosure was made in good faith” when she went to Mr Shrubb with her concerns in March 2013. The trust also agreed to pay back £10,000 Dr Dare had paid to the trust in respect of the latter’s costs.

Dr Dare said: “I can’t quite express how overwhelmed I feel. This has always been about patient care and staff welfare, which is what whistleblowing should always be about. I never deviated from that so I feel exonerated at last. 

“The trust has spent an obscene amount of taxpayers’ money fighting me. I never acted in bad faith and that was what the case was all about. This has always been about my integrity and the fact that I raised concerns about patient care as a clinician. If you bully staff, patient care will be affected.”

Dr Dare said she hoped the outcome would encourage other people in the NHS to speak out. She said: “My greatest sadness is that I lost my clinical role within the NHS, but I don’t regret what I did and the decision means more than I can probably ever express”

READ MORE

• Universal Credit ‘will make benefits system worse for mental health’
• What it’s really like to work on a mental health ward
• Government launches national campaign to end mental health stigma
• Mental health patients ‘do not always feel treated with dignity’
• Mental health and the metropolis: Are cities making us ill?

The trust, which employs 3,160 staff serving about 700,000 people, declined to apologise to Dr Dare and said it had “a number of ways in which staff can raise concerns safely”.

A spokesperson said: “The trust has not conceded the appeal by Dr Dare and no compensation has been paid to her. Both parties to the appeal will bear their own costs in the case. The trust accepts that Dr Dare raised concerns in good faith about bullying and harassment in West London Forensic Services and the trust took immediate action to investigate the concerns she raised.

“We do not now and have never accepted that Dr Dare made any other protected disclosures about the nature of services and patient care in the trust.”

The Independent on Sunday has revealed a catalogue of failings at the trust over the past year as a number of senior staff have either quit the organisation or retired early.

Former trust chairman Nigel McCorkell had been reappointed in January 2013 but stepped down 18 months later, and Mr Shrubb announced his retirement to staff earlier this year – just days after a CQC inspection revealed multiple failings.

The trust “requires improvement” in whether it is “safe”, “effective” and “well led” in three out of five main areas. Of the trust’s specific services, the Broadmoor and forensic services were rated “inadequate”. A fraud investigation was also launched after one of the trust’s departments went millions over budget.

Trust chairman Tom Hayhoe promised a new approach of “openness and candour” following his arrival in April, yet The IoS is still locked in a battle with West London to obtain a copy of the fraud report concerning the wasted millions. 

The trust wants to keep the report secret, claiming that revealing the details of what happened would prejudice its ability to carry out similar investigations in the future.

BBC News 27 October 2015

An NHS whistleblower who was accused of bullying after he spoke out about patient safety has been cleared of all allegations by the General Medical Council (GMC).

Surgeon Malcolm Loudon wrote to health secretary Alex Neil before leaving his job at Aberdeen Royal Infirmary.

His claims sparked a review which was critical of NHS Grampian but also brought bullying allegations against him.

The GMC has dismissed the claims.

It also questioned the standard of evidence put forward in the internal investigation.

NHS Grampian has accepted all the recommendations of the reports into Mr Loudon’s claims and apologised to patients.

It said it “strongly refuted any suggestion that NHS Grampian is uncaring or puts patients at risk”.

Mr Loudon, who left his post last December, said the health board’s actions were vindictive attempts to destroy him.

He said: “I think it’s been an attempt to silence me and it’s been done in a way that’s really quite ruthless – not so much silence but destroy.

“It’s a recklessly irresponsible way to behave merely to wreak revenge on those who have called the organisation’s conduct, and indeed values and standards, into question.

“And as every senior clinician leaves, patient care is further damaged.”

The GMC said it had examined the information it received about Mr Loudon, and “decided to conclude this case with no further action”.

Its official report said: “We conclude that none of the matters alleged meet the realistic prospect test, and the case should be closed.

“The evidence falls far below the standard required to prove these allegations. We find it difficult to understand how the investigator reached the conclusion.”

Mr Loudon, who now works with a different health board, described the conduct of NHS Grampian as “absolutely uncaring”.

He said: “We talk about person-centred care and I think this is being ignored completely.

“The government must get to the heart of what went wrong, why people behaved in this disgraceful fashion and indeed are continuing to behave in a destructive fashion.

“So the Scottish government must commission a judge-led inquiry into the actions and conduct of all the people involved in this process.”

The surgeon previously described the working environment at NHS Grampian as having “all the features of a toxic organisation”.

He said: “We are like an elastic that is stretched almost to breaking point but we have managed to maintain that level of safety despite everything.

“A toxic culture is defined by where people are unhappy, they don’t want to come to their work, turnover is high, there are high rates of sickness and there is no feeling of shared values between management and between those who are actually delivering the services.”

‘Widespread problem’

BBC Scotland has spoken to nine other doctors who say they raised concerns about the care being provided to patients by NHS Grampian.

Some, like Malcolm Loudon, said they felt forced to leave when accusations were made against them.

Others are currently under suspension by the health board.

Many expressed concern that other medical staff would see how they have been treated and be put off raising concerns that could ultimately save lives.

Donnie Ross, retired former medical director at NHS Grampian, said: “There is evidence of a very widespread problem in the culture.

“Doctors are crushed and got rid of because they criticise the system or they criticise some aspect of patient care. Actually doctors are supposed to do that.”

NHS Grampian said: “It is not appropriate for us to comment on confidential correspondence between an external organisation and an individual.

“NHS Grampian has not and does not take punitive action against any staff who raise concerns. We have not suspended or dismissed staff in response to the raising of concerns or ‘whistle blowing’.

“We strongly refute any suggestion that NHS Grampian is uncaring or puts patients at risk.

“The safety of patients and staff is a top priority for the Board. We believe the quality of care and the experience of patients in Grampian is among the best in Scotland.”

Daily MIrror  3 Oct 2015    BY SIMON WRIGHT , MARTYN HALLE

Liver surgeon Ditya Agrawal, 43, was sent home in 2011 after he spoke out working practices. The Trust has since run up legal bills of at least £250,000 fighting his complaint that he was unfairly treated

NHS bosses spent almost £1MILLION keeping a consultant suspended after he raised patient safety concerns.

Liver surgeon Ditya Agrawal, 43, was sent home on full pay in 2011.

He had spoken out about his fears over working practices at his hospital.

The hospital’s Trust was later placed in special measures over high death rates in the wake of the Stafford Hospital inquiry.

But the Trust has since run up legal bills of at least £250,000 fighting Mr Agrawal’s complaint that he was unfairly treated – and has spent more than £700,000 paying his salary for four years and on locums to cover his absence. A High Court judge ruled in the consultant’s favour when the General Medical Council sought to stop him practising pending a full disciplinary hearing.

But the Trust finally sacked him in May stating “a breakdown in working relationships between you and your colleagues”.

Mr Agrawal has now appealed, claiming he has been fired for speaking out. He is backed by Labour MP Lucy Powell and Tory Sir Peter Bottomley.

 
Sir Peter has supported a number of NHS whistleblowers and claims Health Secretary Jeremy Hunt is not doing enough to help them. He told the Commons recently the East Lancashire NHS Trust that runs the Royal Blackburn Hospital had suspended Mr Agrawal “in retaliation for raising concerns”.

He added: “There is something very fishy and wrong going on”. Mr Agrawal, now at a different hospital, said last night: “I raised concerns about patient safety and working practices. It turned into a nightmare. I want to restore my good name.”

A Trust spokesman said: “The Trust is defending Mr Agrawal’s current claims and, due to ongoing litigation, is unable to comment further.”

Mail on Line 29 September 2015 

By KATHERINE FAULKNER and ANDY DOLAN and JOSH WHITE and PAUL BENTLEY FOR THE DAILY MAIL INVESTIGATIONS UNIT

• 21-year-old mother of one left after four months due to pressure of the job
• She has spoken out because she is so concerned about operation of 111
• She said: ‘I was suddenly being asked to make life-or-death decisions’ 

Irsah Tahir, 21, worked for NHS 111 as a call handler earlier this year. But after four months, she decided she could no longer cope.

The mother of one from Derby was so concerned about what she saw that she has waived her anonymity to speak out.

Irsah Tahir, 21, worked for NHS 111 as a call handler in Derby, Derbyshire, earlier this year but quit after four months because she could no longer cope

When my friends or family members ask me about 111, my advice to them is simple: don’t call it. After four months working there, I saw enough to know that the service is simply not safe.

The people who take your calls at 111 have no medical training.

The NHS says we always have access to a clinically-trained person we can ask for help – but in my experience that is just not the case. Frequently we had no nurse at all to help us with the life or death decisions we had to make.

We’d come in, and the managers would just casually say: ‘We’ve got no nurses today, so just deal with things as best you can.’

At other times you’d log in to your computer, and a little instant message would pop up on your screen to say: ‘No nurse today, so please do your best to resolve calls yourself.’

It was awful to see that. When I started the job at 111, I had no idea it was going to be like it was.

I thought it was more of an administrative job – someone’s hurt their leg, we’re directing them to a walk-in centre.

Instead, I was suddenly being asked to make life-or-death decisions over the phone – with sometimes no one to turn to for help.

I worked the night shift – starting at 10pm, and finishing work at six in the morning.

The night-time shift is the shift that nobody wants to do. And as a result it is usually short-staffed.

And the pressure is absolutely non-stop.

In other jobs I’ve had, you know who your manager is, people say hello, you are briefed on what you will be doing.

But at 111, that rarely happens because everyone is too busy.

You are expected to get in, sit down – any seat will do – get your headset on and get on with answering the calls that are piling up. No one even says hello – there isn’t time. The chatter in the call centre can get incredibly loud at busy times.

It’s difficult to hear yourself think. You can see people with their fingers in one ear, trying to block out the noise.

It’s an incredibly isolated job. And because we are so stretched, there is very little support when things get difficult.

The pressure on the call advisers is just massive. Sometimes, you sit in your chair and don’t leave it for an entire eight-hour period. It just gets too much, particularly with the noise.

You look up at the screens that tell us how busy we are, and you can see they have turned back, because we are not answering people’s calls.

Where the numbers are against a red background, you know there are patients piling up, waiting to speak to a nurse.

It just gives you a sick feeling in your stomach.

At night, the people calling in are mostly worried parents with sick babies, elderly people who have had a fall – and people with serious mental health problems.

I once had a patient who believed he was possessed by the devil – I could hear that he was smashing his head against a wall.

On other occasions I had patients who said they were going to commit suicide. I had a man once who told me he was about to kill himself with his young son in the house.

Ms Tahir worked at this NHS 111 call centre in Derby, Derbyshire, but said she could never have prepared herself for the role, claiming on some days she was asked to make life-or-death decisions, often without help

We had had a workshop of about 20 minutes on suicide – and that was it. And yet we were supposed to be advising these people.

Sometimes, they would scream and shout at you down the phone, incredibly distressed. You just feel powerless. I felt physically ill all the time I was working for 111. It wasn’t just the hours, I felt stressed constantly: You’re just so under pressure all the time.

Anything with babies terrified me because it’s just impossible to tell anything over the phone.

The parents don’t know, and the baby can’t talk, so what chance do you have of making the right call?

There’s been at least one death of a baby associated with the 111 service in my area.

Call handlers at the 111 service have no medical knowledge beyond what we have learned on a basic two-week course.

This is despite the fact that – as our training documents state – we are responsible for an ‘incredibly complex process’ during which ‘a poor decision can cause a patient’s death’.

Because we are not medically qualified, we have to use a computer system called ‘pathways’ developed by the NHS to work out whether we think patients are in need of urgent treatment or not.

We are supposed to be able to consult a nurse – or transfer the patient to speak to a nurse directly – if we are not sure. But this was often impossible.

Even when we did have nurses on duty, it was usually just one, and they would quickly be overwhelmed. On the screens on the walls of the call centre, you could see how many people were waiting to speak to the nurse.

If there were three or four already waiting – as there usually was – it was pointless even trying to get through.

I once had to wait ages in the queue with a patient on the line who I believed was having a stroke.

 

 

Former NHS 111 worker and whistleblower Irsah Tahir, 21, (pictured), who has waived her anonymity to raise her grave concerns, said sometimes only nine call centre workers were available to take calls from a health region covering 2.3million people across Derbyshire, Leicestershire, Nottinghamshire and Northamptonshire

But the computer said they didn’t need an ambulance – and without speaking to the nurse, I can’t override the decision. So I had to wait in the queue. With strokes, after a certain amount of time, nothing can be done to stop the damage.

I just remember thinking: I’m wasting time waiting for a nurse and this person could be losing the use of their arms or legs.

It is horrendous. Even though we were paid only £7.10 an hour, we were so busy that people had to be brought in to bring us drinks at our seats.

These people would come around with mugs full of instant coffee to keep up going. It was ridiculous.

But I literally could not get up to go and get a cup of tea because there were just too many calls and too few staff.

People used to eat at their desk too – even though it wasn’t allowed.

They’d get fruit and sweets and pass them around to keep us all going. I never had a proper lunch break.

One of the biggest problems with 111 is that it relies on a computer system.

Sometimes, there are questions you want to ask, but you have to stick to the script on your screen.

If you feel the computer is taking you off in the wrong direction, there is nothing you can do. There have been numerous occasions when I think the computer has got the decision wrong.

In those cases, you have to call the nurse for advice – but often you can’t get hold of them.

I remember once, I had a patient – someone with a baby – I thought needed an ambulance straight away, but the computer said they didn’t.

I went to my manager but she didn’t have any medical training either. There was no nurse to ask and so you’re just stuck.

In the end, she agreed the patient did need an ambulance, and we sent one but by then we had wasted valuable time.

Most people who work at 111 find it utterly demoralizing.

Many of them panic and send too many ambulances out because like me, they don’t know what to do and have no one to ask. The managers check on everyone’s statistics, though, and you can get in trouble if you seek advice from nurses too much, or send out too many ambulances. I was once told off for trying four times in a row to get through to a nurse for advice on what do about a sick baby.

I was told I should stick to procedure – which was that we only try twice, then leave the patient in a queue.

But I didn’t want to leave them, I felt they urgently needed help. Another colleague of mine was hauled in by the bosses over sending too many ambulances.

He told them he’d rather be safe than sorry, and that if he had a nurse he could ask advice from he wouldn’t have to.

But the bosses were having none of it. They told him that East Midlands ambulances were stretched and we were putting too much pressure on them.

When he came out, he said well, until we’ve got someone to ask, what am I supposed to do?

After all, despite all the problems, it’s made very clear to us that if something goes wrong with a patient, we will carry the can.

If someone dies, we will be sent out to coroners’ court to explain why we didn’t send out an ambulance. 

Manchester Evening News  10 SEPTEMBER 2015
BY TODD FITZGERALD

Research revealed that the number of people who would consider blowing the whistle rose to 67pc if they could complain anonymously

A third of British workers would turn a blind eye to illegal or dangerous activity by their employer through fear of the repercussions, research by Manchester solicitors has revealed.

More than 50pc of respondents in a survey by Manchester employment law specialists Slater and Gordon said they would keep quiet if bosses were up to no good because they would be scared of losing their job.

Others said they would fear how would be treated by colleagues after coming forward – and if they’d even be believed.

But research revealed that the number of people who would consider blowing the whistle rose to 67pc if they could complain anonymously.

North West Trades Union Congress regional secretary, Lynn Collins, said: “These figures are worrying. Workers should be supported in speaking out about illegal or dangerous practices – after all it isn’t likely to be for their own benefit that they would speak out.

“The statistics show us that the balance of power in a workplace is tilted in favour of the employer and that should be tackled.

“This underlines the need for strong trade unions in the workplace. Where unions are present in work, they can ensure whistle blowers are protected and supported.

“Policies on such matters are often in place in unionised workplaces. It’s also likely that such practices would be raised by trade unions present in the workplace on behalf of their members, giving workers a voice on such issues.”

The study of 2,000 workers showed almost half – 49pc – said they would come forward if they had legal protection from being mistreated and would get financial compensation if they were sacked. And 17pc said they would speak out if there was a cash reward.

A quarter said they would keep quiet out of loyalty to their employer – and more than a fifth said they would feel it wasn’t any of their business to speak out.

Results revealed that 16pc of people had spoken out, with almost half of those exposing health and safety breaches. Some 29pc said they had raised concern over illegal activity.

Over half of those who had exposed wrongdoing said they were treated differently after coming forward, with 30pc saying they were constantly criticised by their boss.

And one in 10 were fired or made redundant after speaking out.

One respondent said they had reported colleagues who drove trains for smoking cannabis at work. Another raised concerns over a doctor who was secretly filming patients.

Other examples included employers avoiding tax; document forgery; stealing; witness harassment; and bullying.

Employment lawyer Samantha Mangwana said: “It is alarming that a third of people are scared to come forward and expose even the most serious wrongdoing at work because they are concerned about the repercussions.

“The fact that a large percentage of people said they wouldn’t speak out, even if they saw the law being broken, illustrates just how worried people are about what will happen to them if they do.

“It takes a lot of bravery to blow the whistle, but it needn’t be as terrifying as some people seem to think as long as they get the right legal advice.

“Being able to remain anonymous would make a big difference to employees’ thinking when it comes to speaking out, while a lot of people said they would blow the whistle if they would be protected.

“Our research shows most people don’t know that there are laws in place to protect whistleblowers – 63pc.”

HSJ    4 August, 2015 | By Lawrence Dunhill

According to  Will Hazell, HSJ,   31 July, 2015, the Care Quality Commission has set out proposals for how a ‘national guardian’ for NHS whistleblowers should be established.

http://www.hsj.co.uk/5089310.article?WT.tsrc=email&WT.mc_id=Newsletter2

By Anonymous whistle bower 28 July 2015

I am a NHS whistle blower. 

I can honestly say that today, I’m  better off Than I was 3 years ago , 2012 my money had run out , I’d been made redundant in 2010 , approx. 18 months after whistle blowing in the NHS . 

There was nothing else to do other than sign on, (claim job seekers allowance) in 2012 Job seekers allowance was 71.00 per week, on top of that my rent (some of the rent was paid as was some of my council tax) Any short fall had to be made up by my son, who was studying via university grant and working when he wasn’t studying. 

Living on £71.00 was to prove to be one of the biggest financial challenges life could bring. 

It was broken down like this :

£10.00 water rates per week taken direct from benefits 

£2.50 internet put away every week to meet DD payment

£5.00 telephone bill put away every week to meet DD payment

£20.00 gas per week

£15.00 electric per week 

£2.50 TV license

This left me £16.00 per week for toiletries, food, clothes. 

Barriers that stopped me from finding work straight away “I am a NHS whistle blower” 

The very first time in my life ever, I prepared to sign on. I’m looked up and down as if I’m some sort of alien object, I’m told I have an adviser (the idea is they are supposed to help assist you find you work) 

My name is called and I’m asked to take a seat, I hand over my CV, she asks “what have you done to find work? I explain I’ve scoured the Internet, knocked on doors, rang for jobs, that I have left a clear audit trail of job searches, applications. I show her the evidence

I explain I have a degree along with professional qualifications, she comes back to me very quickly and says, “So why can’t you find a job?”

I tell her I’m a whistle blower. That day a glimmer of hope in finding a little help and support left me. The words still echo in my ears “what is a whistle blower?”

Now everyone as their own view as to what is a whistle blower , I try to explain A whistle blower (whistle-blower or whistle blower) is a person who exposes any kind of information or activity that is deemed illegal, dishonest, or not correct within an organisation that is either private or public. 

She wasn’t the least bit interested, her reply was “sign here” 

I quickly learnt especially in winter months, that it could, some weeks, be a case of “eat or heat”

I learnt that some supermarkets reduce their bread and fresh products around 8pm, so I could In fact buy a full weeks shop for much less if I waited until everything was reduced. I’d buy, pasta, baked beans, eggs, as cheap as possible. The market would finish 4 pm on Tuesday’s Friday & Saturday’s , this is when I bought my veg at the very last moment I could get carrots , turnip cauliflowers, leeks, potatoes one big bag full, for a pound.

I learnt that “shy bairn’s get nowt” I’d ask the butcher every week for bones, I would ask the supermarket girls “what time do you reduce your fresh items”

My survival tips were cook one large pan of broth a week (it costs about 2.00 and will last all week) Pasta bought in bulk could be mixed with many things to make many meals. 

I did surveys online (and still do) and always asked for shopping vouchers. I struggled to keep the Internet, to some that might seem a luxury, but it’s absolutely needed to find work, to collect discount codes and coupons. 

I did voluntary work at the citizens advice bureau, they had heated offices 🙂 it meant I learnt, I could help others and my CV wouldn’t have a gap in it. They also had a unlimited supply of tea and biscuits. They do incredible work and taught me “try never to judge” 

In June 2013 almost a year of being classed as unemployed, I’d applied for a job in the private sector.  It was on minimum wage, and bore absolutely no resemblance to my old NHS  job , I didn’t get it, that was no surprise, what was a surprise was two days after being told no , I received a call , the voice told me their first choice left. I was second choice did I want the job? I took it without hesitation. 

Minimum wage was an incredible pay cut, but nowhere near as bad as £71.00 per week. 

It was the stepping stone to getting my life back. 

So I started work, my plan was keep my head down, be nice to everyone and make the best of it. 

In truth I had never stopped working ever, whistle blowing experience led me to others and to campaign work, it also led to a C4 news special, in Sept 2013 I took a day off work, went into London to be interviewed I spoke out about my experiences on behalf of many bereaved families who had lost loved ones in hospitals and whistle blowers.

8pm I came off set and the producer stopped me and asked if I would be OK, and did I realise I’d just outed myself on national TV as a whistle blower, did my new boss know? 

I can honestly say it had never crossed my mind, the next day I went into work 2 hours late, my train from London had been delayed. I had just got sat down behind my desk only to look up and find my boss walking towards me, he was grinning. I looked him straight in the eye and said OK are you going to sack me, he said what? For being a whistle blower? No way. I’ve come over to shake your hand. 

That was Sept 12th 2013 I am still in work 🙂  I wasn’t sacked , I was supported , I still campaign , my life is double sided now , half at a paid job (the job that pays the bills) the rest of my time , campaign work, surviving , helping as much as I can. 

I on one hand have lost so much yet on the other in that process learnt so much. On that journey I have been fortunate to meet incredible people, make new friends,  the person I consider one of my best friends is a journalist who I’m sure I’ll still be working with for many years to come . 

Like many whistle blowers out there struggling I have learnt what it means to be on the bones of my backside it’s not a great position to be in, but it’s survivable 🙂 

Over the past year we had the Francis review, a few weeks ago Jeremy Hunt made this statement.

“Sir Robert confirmed the need for further change in his report today. He said he heard again and again of horrific stories of people’s lives being destroyed because they tried to do the right thing for patients: people losing their jobs; being financially ruined; brought to the brink of suicide; and family lives being shattered. Eminent and respected clinicians had their reputations maligned.

There are stories of fear, bullying, being ostracised, marginalisation as well as psychological and physical harm. There are reports of a culture of “delay, defend and deny” with “prolonged rants” directed at people branded “snitches, troublemakers and backstabbers” and then blacklisted from future employment in the NHS as the system closed ranks.”

Like the Dr’s shouting out “I’m in work Jeremy” There are many shouting out #WearestillhereJeremy! The truth that so many have endured will one day come out…….

The government have yet to provide a real independent solid solution. 

So for all of you still struggling, take every day as it comes and remember all you did was tell the truth, you are not alone, there are many of us….