A report outlining the work of a national whistleblowing scheme for nurses and other healthcare staff has been laid before parliament.
The most recent annual report of the National Guardian’s Office, which oversees the Freedom to Speak Up guardians scheme present in many NHS workplaces, was recently published.
“There are pockets of excellent practice across the NHS”
Jayne Chidgey-Clark
This report covers the 2023-24 financial year and included testimonials from guardians themselves about the cases they had received.
Emma Randle, guardian at Birmingham and Solihull Mental Health NHS Foundation Trust, told the report that she had heard from two trainee nursing associates who both said they were being asked to perform procedures for which they were unqualified.
These trainees, Ms Randle told the report, were asked to perform unsupervised one-to-one observations with extremely vulnerable patients with complex needs such as constant self-harm concerns.
They were told “this is how it’s always been done”, which prompted a report to Ms Randle, who then escalated the concerns, leading to a review of the policies around who can undertake these observations.
“The trainees who raised their concerns created a safer environment for patients by speaking up,” said Ms Randle.
The 2023-24 report highlighted the barriers preventing people from speaking up in the first place, and also showcased workplaces that had improved the ability of staff to speak up.
The results of a research project into speaking up cultures in the health service was included in the report, which recommended the need to establish “what good looks like” regarding whistleblowing and speaking up in the NHS.
The report also reiterated many of the figures published in a previous report, which showed that a record number of cases were brought to Freedom to Speak Up guardians during 2023-24.
In total, 32,167 cases were received – a 28% increase on 2022-23.
There had been no change, the report found, in the proportion of people suffering detriment due to speaking up since the previous year, sitting at 4%.
It noted that 686 new guardians were trained between 1 April 2023 and 31 March 2024, with 569 existing ones having completed refresher training. There are now 1,198 guardians across England.
The National Guardian’s Office said, following the report’s publication, that “more work” was still needed to make speaking up “business as usual” in the healthcare sector.
On 6 March, the 2023-24 report was laid before parliament, a formality that is required as part of a government recommendation following the Gosport War Memorial Hospital opiate scandal.
Dr Jayne Chidgey-Clark, NHS national guardian and registered nurse, said following the report that despite evidence of improvement, “so much more” must be done to improve the ability of healthcare staff to speak up.
“There are pockets of excellent practice across the NHS,” she said.
Baroness Gillian Merron, parliamentary under-secretary of state for patient safety, women’s health and mental health, added in her foreword to the report: “Guardians are continuing to provide vital support to workers across the NHS, hospices, and the independent sector and I am very grateful for their work.
“From the outset, this government has been clear: we will not tolerate NHS managers who silence whistleblowers.
“It is hugely important that to change the culture in the NHS, NHS staff have the confidence to speak out and come forward if they have concerns.”
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