Freedom to Speak Up Report

Transcription

1 Title: Reprt t: Freedm t Speak Up Reprt Trust Bard Date: 30 March 2015 Security Classificatin: Public Reprt Purpse f Reprt: This reprt prvides a summary f the Freedm t Speak Up Review by Sir Rbert Francis which was published n 11th February The Review cncluded that there is a culture in sme parts f the NHS which deters staff frm raising cncerns withut fear f reprisal, and recmmends a wide-ranging refrm f culture in healthcare t encurage penness and transparency in handling cncerns. Recmmendatins: The Trust Bard is asked t: 1. Cnsider the reprt int the Freedm t Speak Up Review. 2. Cnsider the next steps as set ut in Sectin 6 f the reprt. 3. Agree t appint Mary Sextn, Executive Directr f Nursing, Quality and Gvernance as the Trust s Freedm t Speak Up Guardian. Reprt Spnsr: Cmments / views f the Reprt Spnsr: Mary Sextn, Executive Directr f Nursing, Quality and Gvernance The Freedm t Speak Up reprt requires the Trust t cnsider reviewing its apprach in supprting staff, service users and their carers t raise cncerns regarding the services they receive frm the Trust. By May, t adpt the principles laid ut within the reprt, the Trust will need t cnsider hw it cntinues t address the culture within the rganisatin s that raising cncerns and speaking ut becmes a nrmal part f every emplyee s usual wrking practice. Reprt Authr: Name: Barry Ray Title: Trust Secretary Tel Number: barry.ray@beh-mht.nhs.uk Reprt Histry: Budgetary, Financial / Resurce Implicatins: First Reprt Nne.

2 Equality and Diversity Implicatins: Links t the Trust s Objectives, Bard Assurance Framewrk and / r Crprate Risk Register The Freedm t Speak Up Review prpses that whistleblwers and ther vulnerable grups are prtected frm discriminatin. Existing Trust plicies will need t reviewed t incrprate the prpsals. Objective 1: Excellent and innvative services fr patients; Objective 2: Develping ur staff and ur rganisatin. List f Appendices: Appendix 1 Freedm t Speak Up Executive Summary

3 1. Intrductin and Backgrund Reprt 1.1 The Freedm t Speak Up Review was an independent review, led by Sir Rbert Francis QC, int creating an pen and hnest reprting culture in the NHS fllwing cncerns raised by NHS staff and the treatment f sme wh had spken up. 1.2 The review has prduced a cmprehensive reprt prviding a detailed descriptin f what staff, emplyers, unins and natinal bdies have tld the review team and als include the utcmes f research and internatinal cmparisns. The reprt details gd practice which is taking place and t address the gap and variatin, the reprt cvers hw rganisatins can create the right culture, hw cncerns shuld be handled and what is needed t ensure the system wrks. The verall purpse f the reprt is t make the NHS a better place t wrk and a safer place fr patients. 2. The Freedm t Speak Up Review 2.1 A cpy f the Freedm t Speak Up Executive Summary is attached as Appendix 1. A full cpy f the reprt int the Freedm t Speak Up Review can be fund n the Freedm t Speak Up website: The Review has tw ver-arching recmmendatins, 20 principles and 36 specific actins that cver lcal and natinal rganisatins, which have been gruped under five key themes. These are intended t ensure that patients, their families, service users and staff have a rbust framewrk within which t raise their cncerns. With many f the lcal actins there is a parallel recmmendatin t Regulatrs abut hw they shuld assess whether an rganisatin is well-led. 2.3 The tw ver-arching recmmendatins are: 1. All rganisatins shuld implement the Principles and Actins set ut in in the reprt in line with gd practice described in the reprt 2. The Secretary f State fr Health shuld review, at least annually, the prgress made in the implementatin f these Principles and Actins. 2.4 The 20 Principles within the review are themed arund: Culture change Better handling f cases when cncerns are raised Measures t supprt gd practice Particular measures fr vulnerable grups Enhancing legal prtectin 2.5 The Review des nt recmmend the creatin f any further regulatry bdies, and ntes in particular recent develpments including the intrductin f the new Statutry Duty f Candur, the Fit and Prper Persn Test and the Care Quality Cmmissin s (CQC) new inspectin and ratings regime and cncept f a well-led rganisatin. Hwever, the Review des envisage sme imprtant legislatin changes fr the NHS. 3. Key Principles 3.1 Culture (Principles 1-6) The Review is clear that culture change is a pririty f the recmmendatins and needs t be achieved by effective, visible leadership, instilling teamwrk and reflective practices and

4 nt prmting a culture f hierarchy. Six f the 20 recmmendatins deal specifically with culture Sme f the specific actins task Bards lcally with the need t: Ensure prgress in creating and maintaining a culture f safety and learning is assessed regularly thrugh being measured, mnitred and published. Be practive in detecting and changing behaviurs which amunt t bullying t create a culture free frm bullying and ther ppressive behaviurs. Shw they value staff wh raise cncerns, cnsider and implement ways in which the raising f cncerns can be publicly celebrated. Create structures which facilitate bth infrmal and frmal raising and reslutin f cncerns. Reinfrce that raising cncerns shuld be part f the nrmal rutine business f any well led NHS rganisatin. Regulatrs shuld regard any departure frm principles f gd practice, as identified in the reprt, as relevant t whether an rganisatin is safe and well led All staff shuld receive training in their rganisatin s apprach t raising cncerns, receiving and acting n them. In this regard, NHS England and Health Educatin England have been asked t jintly develp a curriculum t ensure training cmplies with natinal standards. 3.2 Supprt fr thse wh raise cncerns (Principle 11) Althugh this will nt be a legal requirement, the Review recmmends the appintment f a Freedm t Speak Up Guardian t whm staff knw they can g t raise cncerns. The Guardian shuld be independent and impartial, have the authrity t speak t anyne within r utside the rganisatin, be expert in all aspects f raising and handling cncerns and the tenacity t ensure safety issues are addressed. They shuld have the dedicated time t perfrm this rle This rle is based n the ambassadr fr cultural change mdel frm Staffrdshire and Stke n Trent. In additin, there shuld be a range f ther peple that staff can g t fr advice and supprt, including at least ne executive directr, a nminated manager in each department, and ne external rganisatin such as the Whistleblwing Helpline ( 3.3 Supprt t find alternative emplyment (Principle 12) The Review reminds emplyers f their mral bligatin t ffer supprt t current and frmer whistleblwers, including acting n an Emplyment Tribunal s recmmendatin that a wrker shuld be reinstated fllwing a claim. The Review als recmmends that a supprt scheme shuld be jintly established t assist NHS staff wh are having difficulties finding NHS emplyment as a result f having made prtected disclsures. 3.4 Transparency (Principle 13) This principle is cnsistent with anther Francis principle, the Duty f Candur. A specific impact n NHS emplyers will be in relatin t settlement agreements. Where an NHS rganisatin enters int such an agreement, they shuld nly include verall cnfidentiality clauses if they are genuinely in the public interest. Chief Executive Officers shuld persnally review all settlement agreements and such agreements shuld be available t the CQC fr inspectin.

5 3.5 External Review (Principle 15) The Review recmmends the appintment f an Independent Natinal Officer (INO) jintly established and resurced by the CQC, Mnitr, NHS TDA and NHS England. The INO wuld be authrised t review the handling f cncerns raised by NHS wrkers, their treatment, advise rganisatins n apprpriate actin, act as a supprt fr Freedm t Speak Up Guardians, prvide natinal leadership and gd practice guidance. The INO will nt have its wn binding pwers and will be reliant n regulatr bdies t implement its recmmendatins. 3.6 Measure fr Vulnerable Grups (including Principles 18 and 19) The Review defines these grups as lcums, agency and bank staff, students and trainees wrking twards a career in healthcare, and staff frm black and minrity ethnic backgrunds. The legislatin envisaged in Principle 20 will in sme measure g twards prtecting these vulnerable grups. 3.7 Legal Prtectin (Principle 20) Sme key steps have been prpsed: Extending prescribed bdies t include NHS England, all CCGs and all Lcal Educatin and Training Bards. Extending discriminatin legislatin t prtect peple seeking emplyment frm discriminatin n the grunds that they are knwn t be a whistleblwer. Sir Rbert cnsiders this t be a key missin f either the Equality Act 2010 r the Emplyment Rights Act 1996 in this regard. Refrm is already underway t extend prtectin t student nurses and student midwives. 4. Gvernment Respnse 4.1 The Secretary f State fr Health has indicated that in principle he accepted all f the recmmendatins and wuld be prpsing new legislatin t prtect whistleblwers frm discriminatin when applying fr new jbs. The Gvernment is expected t undertake cnsultatins n the a number f the aspects raised in the reprt including the establishment f a new Natinal Whistleblwing Guardian t prtect thse wh speak up, with a lcal Whistleblwer Guardian in every NHS rganisatin, reprting t the Chief Executive. 4.2 The Department f Health has published a reprt n Culture Change in the NHS utlining prgress n actins taken frm the Francis public inquiry int Mid Staffs and the subsequent reprts frm Berwick, Cavendish, Clwyd/Hart and cnfirms that the NHS Cnstitutin will be subject t changes prpsed by the Department f Health s that it includes key safety and transparency principles. The NHS Litigatin Authrity has indicated that it will be seeking t incentivise Trusts t be pen and safe thrugh financial rewards and penalties. 5. Existing Whistleblwing Arrangements 5.1 The Trust already has in place relevant plicies and prcedures t supprt staff in raising cncerns, including the Staff Cncerns and the Disclsure f Infrmatin - Whistleblwing and the Anti Harassment and Bullying at Wrk plicies. 5.2 The Staff Cncerns and the Disclsure f Infrmatin - Whistleblwing Plicy states that any cncerns that cannt first be raised with a line manager r senir cmmissin can be raised in the fllwing ways:

6 1. Thrugh cntacting either Mary Sextn r Simn Gdwin, wh have been given special respnsibility in dealing with whistleblwing cncerns. 2. Thrugh cntacting Maria Kane where step ne abve has been fllwed but where cncerns remain. 3. Thrugh cntacting the Bard member wh versees the Plicy (Chair f the Quality and Safety Cmmittee), via the Trust Secretary. 4. Cncerns can als be raised with the NHS Cunter Fraud Line (fr cncern abut financial malpractice) r the Department f Health (via the Custmer Service Centre). 6. Next Steps 6.1 The Trust Bard is asked t give cnsideratin t: Hw it will emphasise its cmmitment t supprting and encuraging staff at all levels t raise cncerns. Engagement with key stakehlders, including staff side representatives, t reinfrce and achieve rbust accuntability. Frmally appinting the Executive Directr f Nursing, Quality and Gvernance as the Trust s Freedm t Speak Up Guardian. Hw investigatins shuld be undertaken t ensure facts and circumstances f cncerns are investigated prmptly, independently, and withut unreasnable delay. Thse leading investigatins t be supprted in priritising this activity. Reviewing the Staff Cncerns and the Disclsure f Infrmatin - Whistleblwing and the Anti Harassment and Bullying at Wrk plicies t ensure: The cntent is cnsistent with the Freed t Speak Up Review. The vulnerable grups referenced in the Review are explicitly included. The prcesses t enable cncerns t be reprted easily and withut frmality are clear. That all staff are able t understand the Trust s apprach and respnse t the raising f cncerns. 7. Budgetary / Financial Implicatins 7.1 Nne. 8. Risk Management Implicatins 8.1 The cntent f this reprt is expected t have a lng-lasting impact n the culture f the NHS. Whilst the Freedm t Speak Up Reprt cntains recmmendatins fr NHS England, Mnitr and the TDA t actin, it is imprtant that the Trust ntes in particular that Sir Rbert Francis has said his recmmendatins shuld be put in place with immediate effect.

7 9. Equality and Diversity Implicatins 9.1 Sir Rbert Francis has prpsed extending discriminatin legislatin t prtect peple seeking emplyment frm discriminatin n the grunds that they are knwn t be a whistleblwer. The Secretary f State fr Health has already cnfirmed that this will be intrduced in this Parliament. 9.2 Steps will als be taken t prtect vulnerable grups defined in the Review as lcums, agency and bank staff, students and trainees wrking twards a career in healthcare, and staff frm black and minrity ethnic backgrunds. Ends.