NHS England Whistleblowing Programme
Introduction and Context
The Freedom to Speak Up report published in 2015 set out the findings of the independent review undertaken by Sir Robert Francis QC into creating an open and honest culture in the NHS. The review highlighted the harrowing experiences of NHS staff that had raised concerns and called for the need to change the culture and improve the handling of concerns, including in primary care.
In response to the recommendations set out in the Freedom to Speak Up report, NHS England and NHS Improvement (formerly Monitor and the NHS Trust Development Authority respectively) are working in partnership and published a single national integrated whistleblowing policy earlier this year to support NHS employees to formally report incidents or raise concerns. In addition, separate guidance has been produced and is available for primary care as recommended in the Freedom to speak up report. Both policies have been developed in consultation with a wide range of stakeholders and whistleblowers including current and former NHS staff members and organisations including, trade unions, CCGs, local HealthWatch bodies, whistleblowing organisations and primary care providers.
Guidance to primary care providers on supporting whistleblowing in the NHS
In April this year, NHS England became a ‘prescribed person‘, meaning primary care service staff working at GP surgeries, opticians, pharmacies and dental practices, can raise concerns about inappropriate activity directly to NHS England. New guidance published in November 2016 has been specifically adapted for primary care, where smaller work settings can present challenges around anonymity and conflicts with employers.
The new guidance has been developed in consultation with key stakeholders and proposes key measures such as the following:
- Each NHS primary care provider should name an individual, who is independent of the line management chain and is not the direct employer, as the Freedom to Speak Up Guardian. They can raise awareness of how staff can share a concern and offer support to staff that do so.
- NHS primary care providers should be proactive in preventing any inappropriate behaviour, like bullying or harassment, or discrimination towards staff that raise a concern.
- All NHS primary care providers should review and update their local policies and procedures by September 2017, to align with the new guidance.
The intention is that the guidance should be used specifically 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;
- what will be done with the findings of the investigation.
Primary care staff with concerns about patient safety, quality of care or inappropriate activity, can raise their concerns with their appointed Freedom to Speak Up guardian or can raise their concerns directly to NHS England.
Employment Support Scheme
The Freedom to Speak Up report also recommended that staff that have raised concerns and suffered detriment as a result, should be supported to find alternative employment within the NHS. A proposal has been developed to deliver an Employment Support Scheme. The key aim of the scheme will be to support NHS workers and former NHS workers whose performance is sound but have experienced or are currently experiencing difficulty in finding employment in the NHS as a result of raising a concern. NHS England is responsible for the delivery of the scheme for primary care with NHS Improvement leading implementation of the scheme for secondary care.
Pilot Employment Support Scheme for Primary Care
NHS England is running a pilot support scheme for individuals whose employment has been impacted as a result of raising concerns in primary care. The learning from this scheme will help to inform future schemes being run for primary care by NHS England. The scheme will deliver a tailored package of training, support and advice to support and assist individuals in developing their skills and building the confidence needed to get them back into work or remain within their current employment.
The initial pilot scheme for primary care involves working with a small, mixed cohort of around 10 individuals who have worked in primary care and have expressed previous interest in the Employment Support Scheme. To access the scheme, they will need to provide a range of evidence and be assessed by independent review panels which will be hosted and coordinated by NHS England.
PCC, through one of its Associate Consultants, is supporting NHS England to develop and test an operating model for the pilot Employment Support Scheme which will aim to ensure there is a robust process and decision making framework to facilitate fair, open and transparent access to the scheme.
The specific deliverables of this work include:
- Developing the terms of reference and criteria for the independent employment support scheme panels;
- Defining and implementing a process and framework for the panel meetings including documentation required to assess eligibility, review evidence, agree decisions and communicate outcomes to applicants;
- Designing and testing the application process to the scheme;
- Securing initial feedback from all participants to help inform the formal evaluation of the pilot scheme.
The pilot panels are running between November 2016 – February 2017 and feedback from panel members and applicants will be used to further improve the operating model for when the scheme goes live across the NHS in April 2017.
For further information on the Employment Support Scheme, please contact Andrew Milner, Delivery Support Manager in the Patient Experience Team, NHS England (email@example.com), or Cathy Regan, PCC Associate Consultant (firstname.lastname@example.org).
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