NHS whistle-blower report reveals staff fears

Sir Robert Francis, author of the damning Francis Report, has announced the publication of an in-depth review on the reporting culture of the NHS titled "Freedom to Speak Up".

A survey of 19,500 staff revealed a health service where "too many staff are afraid" to report concerns for patients' safety. Some staff reported that they felt they would be ignored, bullied or blamed for problems themselves if they blew the whistle.

NHS senior staff negligence not reported

Student nurses and untrained staff putting patients at risk were some of the serious failings identified in the 2013 Francis Report. The report's findings led to disciplinary action against senior staff at Stafford Hospital and the closure of the Mid Staffordshire NHS Foundation Trust in 2014.

Many of the problems facing the trust were exacerbated by a reluctance on the part of junior and agency staff to report their concerns. Despite "appalling care" at the hospital, anxious staff were reportedly threatened into silence. Following the closure of the trust, Sir Robert was invited by the Secretary of State to conduct a broader independent investigation into the state of the NHS as a whole.

Freedom to Speak Up

The "Freedom to Speak Up" report has canvassed people at all levels of the NHS, including management, clinical and support staff. The report found that many staff want to speak out about worries they had for the safety and welfare of patients, and that their managers want to support them. Some found it difficult to relive traumatic experiences, recounting clinical negligence, patients harmed as a result of poor care and lack of adequate support, and threats to keep silent.

Following the Stafford scandal, improvements have been reported in many areas of the NHS. A growing culture of voicing concerns in a constructive manner has led in many cases to prompt investigation and action, resulting in tangible improvements and better patient care.

Positive outlook but more needs to be done

The report makes a number of proposals, concluding that despite the positive changes, "more needs to be done" to protect both patients and NHS staff from harm. Sir Robert stated that:

"While we all accept that sometimes even the best medical care cannot cure us, it is difficult to accept avoidable harm from the service to which we have turned for help. If, as this Review has shown, safety issues known to staff are not always being addressed, then patient safety will be at risk."

In some cases, urgent action is required "to bring about an open, honest and transparent culture" in the NHS. With better reporting channels and a coordinated approach from those in authority, the NHS will become "a better place to work" and "a safer place for patients - a place in which avoidable harm is much less likely to occur".

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