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Whistleblowing – Speak Up
I’ve previously blogged about whistleblowing but, since NHS England has recently taken significant steps to make it easier for primary care staff to raise their concerns, I think there’s much more to be said about taking action so that improvements can be made. New whistleblowing guidance has been drawn up and is currently being consulted on. The new guidance comes following Sir Robert Francis’ recommendation that principles outlined in his Freedom to Speak Up report be modified for primary care where there are obvious difficulties for those working in small workplaces making it difficult for whistleblowers to remain anonymous.
Concerns must be taken seriously
We all aim to be good employers, encouraging open communication between GPs, managers and staff. Supported by robust practice policies we should provide every employee with the opportunity to comment freely and constructively on issues that may cause them concern in the workplace. There is of course an obligation for any member of staff to report genuine concerns. We all hope that these situations are unlikely but they could arise when there is a breach of legal obligation, danger to health and safety or the environment, unauthorised disclosure of information or breach of confidentiality, and particularly inappropriate or unprofessional conduct. If any of these, or similar issues, arise we must be committed to ensuring that any staff concerns will be taken seriously and investigated.
Disclosures must be treated as confidentially as possible and information only disclosed to individuals on a strict need-to-know basis. These individuals may include those named when making the disclosure and any witnesses or employees who can provide further information in relation to the disclosure. We have a duty to protect employees who raise concerns and we must not allow any comeback for raising legitimate concerns or questions or for reporting alleged breaches. Whistleblowers mustn’t suffer any adverse repercussions from individuals as a result of making the disclosure. Anyone found to be victimising a whistleblower should be subject to disciplinary action, including dismissal if necessary. However, concerns raised maliciously should be considered for disciplinary action against whoever raised it.
Course of action
When an individual feels there is a concern to be raised they may feel that speaking up could be considered disloyal to either their colleagues or to the practice, or the individual may feel they may be victimised or harassed if they do so. They must be able to report their concerns to someone outside the practice if necessary, who will review the allegations and advise the individual on the next steps or instigate an investigation themselves. Of course raising a concern under the whistleblowing procedure will probably be a daunting and difficult experience and the individual may choose to be accompanied or even represented by a companion or colleague at any stage of the procedure. A step by step approach should be followed with careful notes taken by whoever is investigating of all discussions that take place throughout the investigation. Whilst it is important that these matters are investigated quickly the quality of the investigation must not be compromised and sufficient time must be allowed.
The freedom to speak up report
In his report on the Freedom to Speak Up review Sir Robert Francis QC said “This Review is not about deciding on past judgements and I realise that I am asking something quite difficult of people; that they tell me about their personal experiences of making disclosures in the public interest without me being able to do anything to resolve their individual cases. Nonetheless I hope that people will come forward to the Review and share their views and experiences in order to help inform better practice in the future.” The review collected information using various sources including an open invitation to share their experiences in writing, through research projects, and seminars held with individuals and representatives of relevant organisations.
In addition, organisations and individuals that are listed in The Public Interest Disclosure (Prescribed Persons) Order 20141 (“Prescribed Persons Order 2014”) are referred to as prescribed persons. From 1 April, NHS England is a ‘prescribed person’ under the Public Interest Disclosure Order 1999, meaning primary care service staff working at GP surgeries, opticians, pharmacies and dental practices, can raise concerns about inappropriate activity directly. The Prescribed Persons Order 2014 sets out a list of over 60 organisations and individuals that a worker may approach outside their workplace to report suspected or known wrongdoing. The organisations and individuals on the list have usually been designated as prescribed persons because they have an authoritative or oversight relationship with the sector, often as a regulatory body.
The new guidance
New guidance on whistleblowing is available for consultation until 6 May 2016 and the responses will help inform NHS England’s final policy later this year. The intention is that the guidance should be used by primary care organisations to review their policies and procedures on staff raising concerns about safety. The policy sets out who can raise a concern, the process for raising a concern, how the concern will be investigated, and what will be done with the findings of the investigation.
Freedom to speak up
Whistleblowing guidance for Primary Care – Draft
Whistleblowing – Prescribed Persons Guidance
Alison Lowerson – QCS Expert GP Practice Manager Contributor