Despite laws to protect NHS workers who wish to raise concerns about patient care, a BMJ investigation reveals that some NHS trusts still make it hard for staff to speak out.
The BMJ obtained whistleblowing policy documents valid up to November 2009 from 118 of the 122 NHS foundation trusts.
The documents were then compared against six standards set out in guidance produced by Public Concern at Work, an independent authority on public interest whistleblowing that also runs a helpline for NHS staff.
These include taking malpractice seriously, giving staff the option to raise concerns outside of the trust, and respecting the confidentiality of staff raising concerns.
The results, published on bmj.com today, show that some trusts do not have measures in place to protect whistleblowers.
Twenty-two of the 118 trust policies do not give examples of types of concerns to be raised, while four do not mention the option for a person to raise concerns outside of the trust.
More than a third of trust policies say staff can go outside the trust with a concern, but insist that a person goes through management first. Some mention that staff must go to an outside organisation "in good faith" but warn that there may be disciplinary action if they go to them unjustifiably.
A fifth of trust policies do not specifically say they will respect the confidentiality of the whistleblower, or it is not clear that they will do, and 106 trusts mention sanctions against any malicious or false claims made.
Commenting on the results, Peter Gooderham, a law lecturer at the University of Manchester, says trusts should give assurances of protecting the whistleblower's confidentiality. "It should be made clear that the finger won't be pointed at them if they take steps to raise a genuine concern," he says.
He argues that policies need to be user friendly and encourage people to raise concerns. "We need some positive recognition for people who have raised concerns … they shouldn't be treated as troublemakers, ostracising them, suspending them from work, and so on," he writes.
To address these issues, Public Concern at Work will launch a policy pack, developed in conjunction with a Social Partnership Forum working group, on whistleblowing for distribution throughout the NHS in June. It also recommends that trusts audit, review, and check how their whistleblowing policies are performing in practice and promote their use to staff regularly.
Your comments (terms and conditions apply):
"There are 2 types of whistleblowers: the genuine ones who have uncovered serious and potentially dangerous practices, and the ones who whistleblow because they want to get back at a particular member of staff. I have come across both, and the outcome is not always satisfactory. Years ago, I reported a very serious incident to my then nursing officer and this was swiftly brushed under the carpet and I was told to forget
about it. I then approached my RCN steward, who told me the same. As I had nowhere to go from there, I did. 10 years later, the same incident was brought up again, by a member of staff, who, at the time of the incident did not want to do anything, but had changed her mind because of an internal dispute with the person involved in the first incident. She approached me and asked me would I be willing to disclose the incident again. As it had played on my mind during the last 10 years, I agreed to it. I related the incident to a new Nursing officer, who was horrified, and things became quite nasty for a while. However I must say that even in those days, I received a lot of support form my colleagues, who knew I was telling the truth. There was a lengthy investigation and the person in question was made to retire. I never felt any personal repercussions, although the friends and colleagues of the person involved gave me a cold shoulder for a long time. The next incident was more recent, and involved a member of staff, who had been challenged privately by another member of staff about her laziness. A few days later she went to Management and made untrue allegations about her colleague. We all knew they were untrue, and we knew that she was lazy. Very soon the second member of staff was suspended pending an investigation which proved that she was not being genuine, and Management re-instated the member of staff
that had been suspended. She then contacted the NMC and whilst investigations took place, the member of staff was suspended again. The whole affair reached the Industrial Tribunal, as she maintained that she had been harassed by other members of our staff, for " whistleblowing". This was quite untrue, as she went on sick leave shortly after her allegations, and we had no further contact with her. The Tribunal dismissed her allegations. However, the whole thing traumatised the other member of staff so much, that he tried to take his life, due to the pressure. There are always 2 sides to a story, but I feel that the manner in which investigations by Management take place leave a lot to be desired and cause unnecessary trauma and suffering" - Name and address supplied
"Whistleblowing doesn't work as far as I am concerned because you will end up losing your job if care is not taking and if you do not have a good union team to fight for you...have been there...either NHS or private hospital all those managers are the same...they support the bad eggs of the team and that is why the care in most of the hospitals is nothing to write home about...believe me I have been there" - Helen A, London
"I have been the victim of bullying by incompetent managers but had no way of proving it. Although colleagues and other managers informed me that I was being victimised they were afraid to speak out. Needless to say I am no longer in the profession but the bullies and the fearful are. This is not the kind of environment conducive to promoting health for staff and patients alike. The business ethos in our health boards is destructive and leads to an unhappy fearful workforce which in itself is counterproductive" - Christina Milligan, Scotland
"Whistleblowing doesn't work, PCAW is incompetent, employment law is biased towards the employer, PIDA doesn't protect employees, the Unions are incompetent, the NMC doesn't act, CQC doesn't act, the DH doesn't act. Managers - you are incompetent if your team are saying you do not tolerate raising concerns (actions speak LOUDEST). The only thing employees have is your integrity. Managers and incompetent staff hate exposure BUT DON'T GIVE IN. Keep timely records and keep writing professional letters (your best friend in law). Be tenacious. Keep chipping away at your sculpture" - Craig Longstaff, Merseyside
"I worked in the NHS until 2004 and raised some serious concerns about a junior nurse who I was overseeing in the community. I was told to 'prove' my allegations which meant that I had to go through her caseload. This exercise produced far more worrying issues than I had at first suspected, including not having made entries for visits made, not turning up to planned visits and not attending multidisciplinary meetings to discuss serious issues with two clients. The nurse in question was allowed to work in isolation, updating her entries, some of which were over a month out of date. She was allowed to do this in the same office as the rest of the team and she made it public knowledge that I had been responsible for reporting her. I was sent to Coventry by the team and I became ill as a result, leaving my post after a 'witch hunt' in 2004. The nurse in question was placed in a responsible post giving her direct access to the team that I was still working in and she made accusations towards me on one occasion to cover her own ineptitude. The trust also removed another 'whistleblower' after she raised concerns about medication discrepancies in a community team, whilst the offending parties were allowed to correct their mistakes and remain, to this day, in post" - Name and address supplied
"I have raised concerns within trust and outside of trust and being targeted by senior management - now agency worker due to this - little support to good practice and whistleblowing or challenging of poor standard of care is difficult. No support for anyone in that position" - Name and address supplied
"I was going to say something about my experience of trying to raise concerns but really cannot open that book again. What happened to everyone involved was, without exaggeration, horrendous" - Name and address supplied
"I work for a charity. Whistleblowers have been bullied by management and issues raised appear not to be addressed, despite staff concerns. This incestuous approach to management clearly demonstrates the whistleblowers policy is used to root out those who will not comply with managers underlying agenda" - S Raven, Birmingham
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