The guidance, adapted for primary care from recommendations outlined in Sir Robert Francis’ 2015 Freedom to Speak Up report, states that all GP practices must review and update their local policies and procedures by March 2017 to align with the recommendations.
It comes after the Francis report recommended primary care should be reviewed separately, as a number of issues unique to the sector can make it particularly difficult for whistleblowers to report concerns.
The often smaller work settings in primary care make it difficult to raise issues confidentially or anonymously, and in many cases staff could be raising concerns about an individual who is their direct employer.
These challenges can make employees feel isolated, the guidance warns, and it is therefore important that they have access to someone independent of the management chain to raise concerns with.
The guidance calls for every primary care provider to appoint a ‘freedom to speak up guardian’ to fill this role and support staff in raising concerns. They may not be the employer or a manager.
Practices should ensure as best practice that staff working in primary care know it is right and safe to speak up, their provider organisation will be supportive, concerns will be followed up and they will not suffer in any way for speaking up.
The guidance says the best providers will promote an environment where staff have the opportunity to raise any concerns ‘routinely and early’. This will help prevent them from later escalating into bigger problems that could impact patients.
Examples of issues raised by whistleblowers could include poor clinical practice, malpractice, failure to safeguard patients, maladministration of medications or poorly-trained staff.
Neil Churchill, director for patient experience at NHS England, said: ‘Becoming the world's safest health system requires us to listen to staff and act on valid concerns. In order to do this, it's vital that NHS staff who witness something that risks patient safety feel able to speak out without reprisal.
‘This guidance builds on existing good practice, gives staff in primary care more options to share any concerns and sets out our expectations about how those concerns should be handled. A safe NHS is an open and honest NHS where we routinely learn from mistakes and use that learning to improve patient safety.’