Speaking out safely: patient safety congress
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Presentation made on Speaking out safely to the NHS patient safety congress 2014 by Gary Walker and Jenni Middleton

Presentation made on Speaking out safely to the NHS patient safety congress 2014 by Gary Walker and Jenni Middleton

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Speaking out safely: patient safety congress Presentation Transcript

  • 1. The analysis and now the solution How can NHS staff and managers make its culture safer to raise concerns? Harnessing the power of the NHS’s greatest asset – its staff – to make patients safer Exploring trust board solutions to ensure the NHS is a safe place to speak out Dealing with issues rather than blaming the staff – what can be done? Ensuring your organisation isn’t the next scandal-hit place to hit the headlines
  • 2. Helene Donnelly OBE In Mid Staffs, 515 incident report forms about patient care from staff were “misplaced” between April 2005 and August 2008 Nursing Times 8 February 2011
  • 3. A year after Francis we asked 470 readers how their concerns were handled… 20% 50% 30% Don't know Did NOT lead to an 'appropriate outcome' Did lead to an 'appropriate outcome' Survey carried out in February 2014 and published Nursing Times 6 March 2014
  • 4. Health professionals needed to think “very hard” before standing up against poor patient care, because it is “potential professional suicide” “Your employer won't thank you; the law won't protect you. You're on your own” Ramon Niekrash April 2010 garywalkeruk
  • 5. garywalkeruk
  • 6. Raising concerns garywalkeruk
  • 7. NHS Whistleblower (sample in public domain) Role Issues raised Employer Outcome Tracy Boylin Director (HR) Misconduct / Fraud The Christie Sacked David Drew Doctor Patient safety Walsall Healthcare Sacked Kim Holt Doctor Patient safety GOSH Kept job* Raj Mattu Doctor Patient safety Coventry and Warwickshire Sacked Edwin Jesudason Doctor Patient safety Alderhey Forced to resign John Watkinson Chief Executive Patient safety Royal Cornwall Sacked Jennie Fecitt Nurse Patient safety NHS Manchester Sacked Sandra Haynes Kirkbright Administrator Patient safety Royal Wolverhampton Hospitals Threatened with sack** Gary Walker Chief Executive Patient safety United Lincolnshire Hospitals Sacked Ramon Niekrash Doctor Patient safety South London Healthcare Kept job*** Helene Donnelly Nurse Patient safety Mid Staffordshire Forced to move job Narinder Kapur Doctor Patient safety Addenbrookes Sacked Margaret Haywood Nurse Patient safety Brighton and Sussex Struck Off Loo Blackburn Nurse Patient safety Oxford GP practice Forced to move Job Shiban Ahmed Doctor Patient safety Alderhey Kept job**** Steve Bolsin Doctor Patient safety Bristol Royal Infirmary Forced to leave UK Sharmila Chowdhury Manager Misconduct / Fraud Ealing Hospitals Sacked Mike Chester Doctor Patient safety Royal Liverpool Sacked Kate Clarke Administrator Patient safety Dudley Hospitals Sacked David Ore Security Patient safety Dudley Hospitals Sacked/Redund * Suspended 4yrs, reinstated, service transferred ** Ongoing – Jeremy Hunt intervened *** Left with £170,000 costs **** Left with £20,000 costs, suspended twice since, and still suspended on false allegations of mental illness. garywalkeruk
  • 8. 60% of whistleblowers didn’t get a response N-601 of a sample of 1000 garywalkeruk
  • 9. garywalkeruk
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  • 11. “I couldn’t encourage anyone to whistleblow.” “The patients have been forgotten in all this” University Hospital of Coventry and Warwickshire NHS Trust spent £6-10m victimising Raj Mattu April 2014 garywalkeruk
  • 12. http://www.inc.com/margaret-heffernan/3-reasons-whistleblowers-are-your-companys-best-friend.html Whistleblowers are an organisation’s best friend Treated properly, whistleblowers can save you time and money 1. Whistleblowers don’t want to go public 2. Whistleblowers are your best early warning system 3. Whistleblowers need a safe space to speak.
  • 13. Victimising NHS Whistleblowers is unlawful and is likely to be endangering patient safety and/or the financial stability of the organisation garywalkeruk
  • 14. NHS Confederation “Several of our interviewees identified a problem of a perceived or real toxicity in the wider system inhabited by chief executives, describing the environment as “brutal”, “arbitrary”, “prone to favouritism” and intolerant of risk-taking that isn’t successful.” Don Berwick “Fear is toxic to both safety and improvement” “A symptom of this cycle is the gaming of data and goals; if the system is unable to be better, because its people lack the capacity or capability to improve, the aim becomes above all to look better, even when truth is the casualty.” 20092013 https://www.gov.uk/government/publications/berwick-review-into-patient-safety garywalkeruk
  • 15. “I heard of a fear of bullying being a possible explanation for more staff not coming forward with concerns…there was also fear among staff about the repercussions of not complying with targets. “Finally and perhaps of most concern, I found a widespread culture of denial” Robert Francis QC garywalkeruk
  • 16. Repeated denials that whistleblowers exist has become a commonly held belief garywalkeruk
  • 17. Culture of Cover-ups £28m and 1000 compromise deals “There is simply no way of knowing how many of these special severance payments have been made across the public sector – or whether the compromise agreements have been used to ‘gag’ employees. To date neither the Treasury nor individual departments have monitored this adequately.” The Public Accounts Committee garywalkeruk
  • 18. Culture of Cover-ups £28m and 1000 compromise deals “We heard evidence of shocking examples of using taxpayers’ money to ‘pay-off’ individuals who have flagged up concerns about patient or child safety” The Public Accounts Committee garywalkeruk
  • 19. Q. Have you witnessed bullying by management or a colleague in the past 12 months? A. 22% said up to 10 times - that’s 374,000 employees NHS Staff Survey 2013 Q. Would you feel safe raising concerns? A. 28% said No/don’t know - That’s 476,000 employees
  • 20. Boards are accountable for the culture of their organisations “People at the head of an organisation set the tone for the quality of care that is provided” Jeremy Hunt 14 Feb 2014
  • 21. 1. Believe in whistleblowers (Don’t brief against them) garywalkeruk
  • 22. garywalkeruk The NHS must stop the dishonesty of public support and private condemnation The NHS must stop the secret briefings, profiling, denial, victimisation, and internal reviews that seek to cover up wrongdoing
  • 23. 2. Declare whistleblowers are an asset not a liability garywalkeruk
  • 24. 3. Act on a whistleblower’s concern: it protect patients (Don’t shoot the messenger) garywalkeruk
  • 25. garywalkeruk garywalkeruk
  • 26. 24. Refuse to disclose documents. No one cares about DPA and FOI 23. Accuse a whistleblower of not raising concerns early enough 22. Delay as much as possible to push up the legal costs for the whistleblower 21. Ignore PAC and other inquiries 20. Pretend that the Public Interest Disclosure Act offers adequate protection 19. If external investigation, the trust can still organise and pay for it, recruit the panel 18. Arrange an “in house” investigation. 17. Throw public money at High Court (unlimited budget) 16. Throw public money at an employment tribunal (unlimited budget) 15. Make vexatious complaints to a professional regulatory body 14. Publicly humiliate the whistleblower 13. Rely on the cowardice and apathy of the Department of Health 12. Make friends with the coroner to avoid scrutiny 11. Appoint consultants to rubbish the whistleblower’s claims. 10. Threaten to sue the whistleblower 9. Apply to the Treasury for public money to pay off and gag the whistleblower 8.Misuse the code of conduct for managers 7. Claim it’s an employment conflict 6. Allege mental health issues (very popular) 5. Threaten whistleblowers and the media with libel suits 4. Threaten reprisals against colleagues who support a whistleblower 3. Repeatedly ignore, deny or pretend to address the concerns 2. Allege actual or invented misdemeanours 1. Inflict subtle sanctions beyond legal protection garywalkeruk
  • 27. 4. Sanction those who victimise whistleblowers (Don’t promote them) garywalkeruk
  • 28. garywalkeruk
  • 29. The culture must change To protect patients To support whistleblowing Boards are accountable for the culture and how they support Speaking Out 1. Believe in whistleblowers 2. Declare whistleblowers are an asset not a liability 3. Act on a whistleblower’s concern: it protect patients 4. Sanction those who victimise whistleblowers 5. Publish how you support those raising concerns garywalkeruk
  • 30. Ashford and St. Peter's Hospital NHS Foundation Trust Bedford Hospital NHS Trust Birmingham Children's Hospital NHS Foundation Trust Blackpool Teaching Hospitals NHS Foundation Trust Buckinghamshire Healthcare NHS Trust Burton Hospitals NHS Foundation Trust Chesterfield Royal Hospital NHS Foundation Trust Countess of Chester Hospital NHS Foundation Trust Derby Hospitals NHS Foundation Trust Doncaster and Bassetlaw Hospitals NHS Foundation Trust Dorset County Hospital NHS Foundation Trust Dudley Group NHS Foundation Trust East Cheshire NHS Trust East Lancashire Hospitals NHS Trust Epsom and St Helier University Hospitals NHS Trust Gateshead Health NHS Foundation Trust Heart of England NHS Foundation Trust Homerton University Hospital NHS Foundation Trust Hull and East Yorkshire Hospitals NHS Trust Ipswich Hospital NHS Trust Leeds Teaching Hospitals Trust Liverpool Women's NHS Foundation Trust Medway NHS Foundation Trust Mid Cheshire Hospitals NHS Foundation trust Mid Staffordshire NHS Foundation Trust Milton Keynes Hospital NHS Foundation Trust Norfolk and Norwich University Hospitals NHS Nottingham University NHS Hospitals Trust Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Royal Free London NHS Foundation Trust Salford Royal NHS Foundation Trust Sherwood Forest Hospitals NHS Foundation Trust Shrewsbury and Telford Hospital NHS Trust Stockport NHS Foundation Trust South Devon Healthcare NHS Foundation Trust South Tees Hospitals NHS Foundation Trust University Hospitals of Leicester NHS Trust University Hospitals of Morecambe Bay Foundation Trust University Hospital of North Staffordshire NHS Trust Walsall Healthcare NHS Trust Warrington and Halton Hospitals NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust West Hertfordshire Hospitals NHS Trust Worcestershire Acute Hospitals NHS Trust Wrightington, Wigan and Leigh NHA Foundation Trust Wye Valley NHS Trust Yeovil District Hospital NHS Foundation Trust Acute Trusts Signed up so far…
  • 31. 2gether NHS Foundation Trust for Gloucestershire Birmingham Community Healthcare NHS Trust Bridgewater Community Healthcare NHS Trust Bristol Community Health NHS Trust Cambridge Community Services NHS Trust Central London Community Healthcare NHS Trust Derbyshire Community Health Services NHS Trust East London NHS Foundation Trust Gloucestershire Care Service NHS Trust Hounslow and Richmond Community Healthcare Leeds Community Healthcare NHS Trust Liverpool Community Health NHS Trust Lincolnshire Community Health Services NHS Trust Norfolk Health and Community Care NHS Trust Shropshire Community Health NHS Trust Solent NHS Trust Staffordshire and Stoke-on-Trent Partnership NHS Trust Sussex Community NHS Trust Wirral Community NHS Trust Coventry and Warwickshire Partnership NHS Trust Cumbria Partnership NHS Foundation Trust East London NHS Foundation Trust Greater Manchester West NHS Foundation Trust Hertfordshire Partnership University NHS Foundation Trust Leicestershire Partnership Trust Mersey Care NHS Trust Northumberland, Tyne and Wear NHS Foundation Trust South Essex Partnership University NHS Foundation Trust Sussex Partnership NHS Foundation Trust Tees, Esk and Wear Valleys NHS Foundation Trust Community and Mental Health Trusts signed up so far…
  • 32. NHS Blackburn with Darwen CCG NHS East Lancashire CCG NHS Eastern Cheshire CCG NHS Herefordshire CCG NHS Liverpool CCG NHS Northern, Eastern and Western Devon CCG NHS North Durham CCG NHS North Staffordshire CCG NHS Norwich CCG NHS Redditch and Bromsgrove CCG NHS Shropshire CCG NHS Solihull CCG NHS South East Staffordshire and Seisdon Peninsula CCG NHS South Tyneside CCG NHS Stoke on Trent CCG NHS Wyre Forest CCG Clinical Commissioning Groups signed up so far…
  • 33. What do we want from you? Sign up to SOS today (or email your Director/Manager) Put the logo and our pledge on your website We write a lovely story about your support on our website, which you share with all your staff Contact fran.entwistle@emap.com or jenni.middleton@emap.com
  • 34. The analysis and now the solution How can NHS staff and managers make its culture safer to raise concerns? Harnessing the power of the NHS’s greatest asset – its staff – to make patients safer Exploring trust board solutions to ensure the NHS is a safe place to speak out Dealing with issues rather than blaming the staff – what can be done? Ensuring your organisation isn’t the next scandal-hit place to hit the headlines