Title: What do whistleblower campaign networks seek from regulation to improve patient safety?
1What do whistleblower campaign networks seek from
regulation to improve patient safety?
2What are staff seeking when they raise concerns
- Transparency
- Investigations- - independent and robust into
concerns raised about patient safety - Improving patient care, reducing avoidable risk-
our main focus. - Fairness and respect for their professional
opinion.
3Ref Nigel Ellis Head of Investigations statement
to Mid Staffs Inquiry para 96,p27.
- On February 2008 the HCCs helpline received a
batch of 40 letters and local newspaper reports
which had been collected by Julie Bailey in
respect of various patients. - The allegations related to understaffing, and
poor nursing care and lack of hygiene. Many of
the concerns related to older patients and
failure to answer buzzers, change sheets, give
medication and change patients.
4Closing cure the NHS statement for the mid
staffs PI
- There are also deeper questions. What is it about
the culture of NHS hospital care that created a
system where the voice of the individual patient
or nurse is drowned out by political pressure,
targets and/or processes? A culture that seeks to
deny and defend, rather than be open and
self-critical, whose first response to criticism
is to seek an alternative explanation, rather
than investigate the most likely and most serious
cause or causes, and that fears to empower
patients and front line workers in hospital lest
their decisions on how to run a ward or a waiting
list are incompatible with the latest political
direction?
5Professor Michael WestLancaster University
- how staff are managed is the decisive influence
on quality and safety - the level and nature of staff engagement is the
best predictor of patient outcomes - organisations with high staff engagement are
more likely to be learning organisations with
better outcomes
6Transparency- relevant indicators and warning
signs
- Have we agreed this in regulation?
- What assessment of staff engagement is an
accurate measure? - The mortality alerts caused the Healthcare
Commission to investigate Mid Staffs- are we
taking enough note of such data. - Clinical incident reports- are all of them
investigated or logged? How do you know? Do we
take enough note? - Complaints- every one a gem.- verbal, email or
formal, are they all included? How do we know?
7Investigations.
- Regulators should investigate individual
concerns- this is potentially crucial for patient
safety. - Eg waiting times for AE being manipulated to
make it appear they are being met? should this
not be taken as a serious patient safety risk
issue?
8Staff expect regulators to recognise deal with
bullying behaviour
- In the worst cases, staff raising concerns are
explicitly told to stay quiet, threatened,
sidelined. Most often ignored. - All of these behaviours are dangerous for
patients and will lead to staff leaving, ill
health and disengagement. - Bullying of those staff leading the way in
speaking up needs to be urgently addressed. - Regulators have a responsibility towards patients
to ensure bullying is addressed.
9Investigations into complaints about doctors
- Competent case managers.
- Understand how vexatious referrals might happen
- Be supportive of doctors and nurses mental health
- Ensure that all case managers understand what
raising concerns is like , why staff do it, why
they escalate concerns and the levels of stress
associated with concerns - Ensure accountability for anyone who has
vexatiously complained about another health
professional.
10In the NHS, bullying is key
- Robust staff engagement and encouraging a
culture of openness and trust are key in
addressing under-reporting. Confidence to report
bullying is directly related to confidence to
report workplace concerns.
- Dean Royles NHS Employers in
- Nursing Times. 12 July, 2011
11summary
- Regulation needs to always be patients first and
not protecting the status quo or the
establishment- agree key indicators do we
really understand the issues? - Regulation needs to be transparent
- Investigations should include investigating
individual concerns and ensuring that patient
safety is addressed. - Investigations need to be transparent, involve
the whistleblower(s), be proportionate and
openly shared . - Bullying of staff who raise concerns needs to be
addressed by regulators to prevent patient harm