Even though laws exist to protect NHS workers who want to raise concerns about patient care, a British Medical Journal (BMJ) investigation showed that a number of NHS (National Health Service) trusts still make it difficult for staff to blow the whistle.
The BMJ looked at the 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 investigation concluded that a number of trusts do not have measures in place to protect whistleblowers.
22 of the trust policies did not give examples of the kinds of concerns to be raised, while 4 did not mention the option for a person to raise concerns outside of the trust.
Over one third of trust policies say staff can go outside the trust with a concern, but are adamant that a person goes through management first. Some mention that staff must go to an outside organization “in good faith” but warn that there may be disciplinary action if they go to them unjustifiably.
20% of trust policies did not say specifically that a whilstleblower’s confidentiality would be respected, or it was not clear that they would do, and 106 trusts mentioned sanctions against any malicious or false claims made.
Twenty two trusts mention “disciplinary” in their policies, a term unlikely to make potential whistleblowers comfortable in coming forward with a concern, while 30 trusts mention staff have a duty, implied duty, or loyalty to the trust as well as to patient confidentiality.
Peter Gooderham, a law lecturer at the University of Manchester, says trusts should give assurances of protecting the whistleblower’s confidentiality, he added “It should be made clear that the finger won’t be pointed at them if they take steps to raise a genuine concern.”
Gooderham argues that policies need to be user friendly and encourage people to raise concerns.
Gooderham writes “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.”
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.
The BMA (British Medical Association) is also aware of the problems that some whistleblowers can face. Dr Mark Porter, Chairman of the BMA Consultants’ Committee, says: “We get very concerned about doctors who fall foul of these whistleblowing policies while following their professional duty. Members continue to raise examples with us, and there are high profile cases, some of which take place in organisations that have good policies. The BMA will support members before, during and after they raise concerns.”
According to a BMA survey, around 1 in 7 hospital doctors in England and Wales who reported concerns said that their trusts had indicated that by speaking up, their employment could be negatively affected.
Adrian O’Dowd, Josephine Hayes, Deborah Cohen
BMJ 2010;340:c2350
doi:10.1136/bmj.c2350
Edited by Christian Nordqvist