Sir Robert Francis’ Freedom to Speak Up review, published on Wednesday, set out 20 principles to improve whistleblowing standards within the NHS and create a 'more open and honest' reporting culture.
It calls on NHS trusts to establish ‘freedom to speak up guardians’ to support whistleblowers, in recommendations that were immediately ‘approved in principle’ by health secretary Jeremy Hunt.
Practice staff will be able to sign up to their local NHS trust guardian to receive support, according to the plans. Larger practice federations are told to consider appointing their own guardian.
The review was set up in response to continuing disquiet about the way the NHS has dealt with concerns raised by staff. The 2013 NHS staff survey revealed that only three quarters (72%) of NHS workers felt it was safe to raise concerns.
Mr Hunt said he had been ‘shocked at the nature and extent’ of the problem as revealed in Sir Robert's report.
He said: ‘I have accepted all of Sir Robert’s recommendations in principle and will consult on a package of measures to implement them. I am hopeful that we can legislate in this parliament to protect whistleblowers who are applying for NHS jobs from discrimination by prospective employers.’
Sir Francis aired concerns that ‘there is a culture within many parts of the NHS which deters staff from raising serious and sensitive concerns and which not infrequently has negative consequences for those brave enough to raise them’.
He added that this was especially difficult for primary care staff, who tend to have limited options and unclear structures in place to help them raise concerns or seek support.
Sir Robert said ‘little, if any, thought’ appeared to have been put in place ‘since PCTs were abolished’ on how best to support primary care workers.
People working within ‘very small organisations’ like GP practices should be able to seek support from ‘someone outside their practice particularly if their concern is about one of the senior figures’, he added.
National CQC guardian
The report compiled written evidence from over 600 NHS workers and over 19,500 responses to a staff survey.
The CQC welcomed the suggestion for whistleblowing guardians, and said it was begun talks about appointing an independent national whistleblowing guardian within CQC to ‘help support this network of individuals’.
Its chief executive David Behan said: ‘We strongly welcome the publication of the Freedom to Speak Up Review and the advice on how organisations and individuals can work together to create a more open and honest reporting culture across the NHS.
‘We are pleased that the health secretary has accepted these recommendations in principle and look forward to contributing to the DH consultation on this.’
GMC chief executive Niall Dickson said the regulator welcomed the report and had commissioned its own into how whistleblowing procedures could be improved.
He said: ‘Above all, changing the culture is a task for local managers and clinical leaders. That said, while national regulators of healthcare professionals such as the GMC have a limited role, it is a significant one and we are determined to play our part.’