Protect whistleblowers to protect patients across healthcare

The NHS has been grappling with concerns surrounding its whistleblowing systems and cultural health following the trial of Lucy Letby, which showed multiple failures in their internal reporting processes. Safecall’s Chancelle Blakey says that this demonstrates the need for an independent reporting line for employees across the organisation. 

“NHS employees must have the opportunity to speak with an entirely impartial party who can process their concern and pass on the information to the appropriate team for further investigation,” she told Healthcare Digital. “Whistleblowers within the NHS have often faced challenges, making them hesitant to report wrongdoing due to fears of retaliation and detrimental treatment. Despite these obstacles, there has been a significant increase in NHS whistleblowers coming forward, highlighting the urgent need for reform in the whistleblowing process.”

Safecall is an outsourced whistleblowing hotline provider which has protected business and kept employees safe, in over 150 countries, for over 20 years. Safecall supports organisations that want to tackle whistleblowing issues, such as potential racism, sexism, fraud, discrimination, bribery, health and safety violations, modern slavery, bullying, and violence in the workplace. Here, Blakey tells us more.

Chancelle Blakey, Business Development Manager, Safecall

Healthcare employees fear speaking up

A record 25,000 NHS whistleblowers came forward in 2022. Of these cases, as has been reported by Freedom to Speak Up Guardians office, the most common reports were:

• Inappropriate behaviours and attitudes (30%)
• Worker safety and wellbeing (27%) 
• Bullying and harassment (22%)

“Reports indicate that NHS employees are lacking confidence in the current speak-up system, with many feeling labelled as troublemakers when they raise concerns,” continues Blakey. “This detrimental culture not only deters individuals from speaking up but also hinders the NHS's ability to identify and address wrongdoing, potentially endangering both patients and employees - and that’s before you take into consideration the damage to the NHS’s reputation.”

For optimal trust and confidence in a speak up system, employees must feel that their concerns will be taken seriously and investigated appropriately.

“Unfortunately, this most recent case is the most extreme example of that not happening, with Dr Stephen Brearey stating that if hospital executives had acted on concerns about nurse Lucy Letby earlier, lives may have been saved.”

To address these pressing issues, Blakey advises that steps need to be taken to: 

• Improve employee confidence
• Identify and combat wrongdoing
• Protect those who come forward to report concerns. 

“One crucial measure is to review and audit the NHS's whistleblowing policy, processes, and operations to understand the reasons for the breakdown of trust. Identifying and holding accountable those responsible for retaliating against whistleblowers is essential to foster a culture of transparency and accountability.”

Providing whistleblowing training to both employees and managers is another critical step to improve the speak-up culture. 

“When employees are aware of how to raise concerns, and the legal protections they have under the Public Interest Disclosure Act (PIDA), they are more likely to come forward without fear of retribution. Additionally, providing training to managers on how to receive and handle disclosures appropriately can help deter misconduct.”

The current Freedom to Speak Up (FTSU) Guardian scheme, which Blakey sees as a positive step towards improving whistleblowing culture, appears to lack confidence among NHS employees with many remaining hesitant to report serious concerns through an internal system due to doubts about confidentiality and impartiality. 

“One worker told the FTSU Guardians ‘The Guardian was excellent, but nothing has been resolved’. The Guardians themselves have said that managers need to be trained about their obligations once they receive a report. 

“To build trust, the NHS can consider offering an alternative means of disclosure, such as a dedicated, outsourced whistleblowing hotline provider, ensuring true anonymity and independence in the reporting process. Here at Safecall, we already work alongside several NHS Trusts helping make their processes more robust and transparent. Employees are much more confident speaking to and reporting through a third party.”

Blakey knows it is vital that the investigation procedure is handled in a fair and balanced fashion, and not conducted to undermine the whistleblowers' concerns. 

“To instil confidence in the reporting process, investigations should be conducted in an independent and confidential manner. Outsourcing the investigation process or ensuring that internal investigators undergo proper training and possess the necessary experience can help safeguard employees' well-being and protect the NHS's reputation.”

Protecting whistleblowers and fostering a culture of transparency and accountability in the healthcare sector

It is paramount for the NHS to take affirmative action in protecting whistleblowers and fostering a culture of transparency and accountability. No healthcare professional should face detrimental treatment for raising concerns that may impact patient safety. To achieve this, the NHS must review its systems, provide comprehensive training and offer reliable and independent reporting avenues.

“The NHS must strive to offer confidentiality, impartiality and independence when receiving and investigating concerns. These efforts should be continuous and consistent to create effective and sustainable change within the organisation,” says Blakey. “In conclusion, addressing whistleblowing concerns in the NHS is crucial for promoting a culture of transparency and accountability. By taking proactive steps, such as reviewing policies, providing comprehensive training and ensuring independent investigations, the NHS can create an environment where employees feel confident and protected when speaking up against wrongdoing.”

Fostering a culture that values whistleblowers and their contributions will not only strengthen the NHS internally but also enhance its reputation and commitment to patient care.