Whistleblowing

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Whistleblowing

• UK Health and Safety Representatives Conference
• October 15 2010

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• The longer I worked the more certain I felt
  that, as improbable as it might seem, there were
  moments when an individual conscience was all
  that could keep a world from falling

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Dame Janet Smith - Shipman Report 2004

• I believe that the willingness of one
  healthcare professional to take responsibility
  for raising concerns about the conduct,
  performance or health of another could make a
  greater potential contribution to patient safety
  than any other single factor

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Whistleblowing v Grievance

• Whistle blowing is generally about a risk,
  malpractice or wrongdoing which affects others
  the complainant is generally a witness
• Grievance is generally about an individuals own
  employment position. The person is normally a
  complainant

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Some headline events

• Zeebbruge
• Piper Alpha
• Graham Pink
• Bristol
• Margaret Haywood
• Stanley Adams
• Dr Harold Shipman
• Maidstone and TW
• Mid Staffordshire

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Brief recent History

• 1993 NHS Guidance
• 1995 Nolan report
• 1997 NHS Reminder and second Nolan report
• 1999 PIDA plus new part IV(15)a to ERA 1996
• NHS Policy Pack on Whistleblowing
• 1999 PID (Prescribed Persons) Order
• 2003 NHS pack (HSC 1999/198)
• April 2010 ETs can report to regulators eg SFO
• Raising Concerns RCN Campaign Congress 2009
• SPF NHS Guidance June 2010
• AFC Section 21 Right to raise Concerns September
  2010
• NMC Guidance November 2010

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Nolan seven principles of standards in public
life

• Selflessness
• Integrity
• Objectivity
• Accountability
• Openness
• Honesty
• Leadership

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Nolan W/Blowing policy should make clear

• That the organisation takes malpractice seriously
  gives examples and distinguishes a w/blow issue
  from a grievance
• Concerns can be raised outside of line
  management
• Access to confidential advice from an independent
  body
• Will respect confidentiality if requested
• When and how concerns may be raised outside the
  employer eg with a regulator
• It is a disciplinary matter to victimise a
  w/blower or to make a false allegation

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NMC Code you know this!

• Regulatory body for Nursing
• act without delay if you believe that you or a
  colleague or anyone else may be putting someone
  at risk
• inform someone in authority if you experience
  problems that prevent you working within this
  code or other nationally agreed standards
• report your concerns in writing if problems in
  the environment of care are putting people at
  risk
• July 2009 NMC meet with unions and others to
  improve advice Guidance expected November 2010

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PCAW/Nursing Standard Survey 2008

• most nurses will speak up even if means personal
  risk to themselves
• 68 had concerns over serious risk and 68 had
  raised them
• 77 say culture same or better than 1999
• 85 said they would raise a concern

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PCAW/Unison

• 50 not know if there is a policy
• 90 had blown whistle
• 33 said their managers would want/expect them to
  report
• 30 said managers would not want to know
• 1/3 say suffered personal comeback
• 25 said culture improving
• 50 felt issue dealt with reasonably
• Better results where there is a w/blowing policy

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RCN Survey Congress 2009

• 50 of employers had a whistleblowing policy
  and 82 knew how to access it
• 21 felt they had been discouraged from using
  policy
• 63 had raised concerns
• 99 understood the NMC duty
• 43 would report even if it meant putting
  themselves at risk

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Public Interest Disclosure Act 1998 - PIDA

• Effective from July 1999
• An act to protect individuals who make certain
  disclosures of information in the public
  interest to allow such individuals to bring
  action in respect of victimisation and for other
  connected purposes
• No gagging clauses for protected disclosure
  issues
• Must show qualifying disclosure
• Suffered detriment (or dismissal)

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PIDA Coverage

• Workers
• No service requirement
• No cap on compensation
• Must be reasonable belief, raised in good
  faith and in the public interest
• Does not require that a Whistleblowing policy be
  in place
• Automatic unfair dismissal if dismissal for a
  protected disclosure

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(No Transcript)
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PIDA Protected Disclosure

• Required to attract the protection of the
  legislation
• Significance of the good faith requirement
• Three tiered disclosure regime
• i) disclosure to employer (or third party) in
  reasonable belief and good faith
• ii) disclosure in good faith, with reasonable
  belief and believed to be substantially true to a
  prescribed person
• iii) disclosure in good faith where believe to be
  true to persons other than the above and not for
  personal gain
• exceptionally serious

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PIDA Disclosure (Tier i)

• Criminal offence has, is or will be
• Has, is or will fail to comply with legal
  obligation
• That a miscarriage of justice has , is or is
  likely to occur
• That HS is being or is likely to be endangered
• That the environment is or is likely to be
  damaged
• That information tending to show any of the above
  has been, is being or likely to be concealed

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Regulatory Disclosure (Tier ii)

• Disclosure can be made in certain circumstances
  to a person prescribed by the Secretary of State
  e.g.
• PID (Prescribed Persons) Order 1999
• HMRC, Charity Commission, HSE, IFA, SFO,
• Can be made even if no internal disclosure -
  raised in good faith, reasonable belief and
  substantially true

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Wider disclosure (Tier iii)

• Wider public interest disclosure
• E.G. MPs press/ media
• Good faith, believe to be true, not for personal
  gain and must be reasonable in all the
  circumstances.
• Other than in the case of an exceptionally
  serious issue must be disclosed first to
  employer or a prescribed body or reasonably fear
  a detriment or fear that evidence will be
  concealed or destroyed by employer

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PCAW 10 year review

• 7000 claims lodged at ET for victimisation
• 3000 Judgements
• 70 of claims settled
• Of the rest 78 lost and 22 won
• In 1999 157 PIDA claims and 1761 in 2009

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Health and Safety Executive

• HSE strongly supports measures which protect
  whistleblowers from any form of victimisation.
  HSE has a complaints handling system to ensure
  that concerns about health and safety are dealt
  with effectively and efficiently. HSE and local
  authority staff do all that they can to preserve
  the confidentiality of workers who raise concerns
  about health and safety, whenever this is
  requested.

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Raising Concerns 2009
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RCN Raising Concerns

• 0845 772 6300
• Speak to your line manager
• Patient records
• Incident Report Forms
• Clinical Meetings / Supervision
• HSafety Committee
• RCN Representative

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How to respond?

• Dont be lone ranger involve the RCN
• Data/information
• Negotiate a whistleblowing policy
• Communicate in writing and get employer etc to
  put position in writing
• Use agreed procedures

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RCN Frontline First

• Waste in the service
• Job and service reductions
• Nursing innovation / solutions
• http//frontlinefirst.rcn.org.uk/

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Support for patient and staff safety

• Patient safety Module on RCN Learning Zone
• NPSA Foresight Training Programme
• Safety Climate Assessment Tool (SCAT)
• Infection prevention and control Minimum
  Standards 2008
• Dignity Campaign
• Nutrition Now

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RCN

• RCN guidance for workplace representatives on
  work related stress
• RCN e-learning on Violence
• RCN Work related violence toolkit

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PCAW

• Independent Charity
• Advice and Support
• Give advice to people on crime, danger or wrong
  doing at work
• NHS contract
• SPF Speak up for a healthy NHS July 2010
• www.pcaw.co.uk
• 0207 404 6609

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• http//www.hse.gov.uk/workers/whistleblowing.htm
• http//frontlinefirst.rcn.org.uk/
• www.pcaw.co.uk
• http//www.nmc-uk.org/Publications-/

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• The longer I worked the more certain I felt
  that, as improbable as it might seem, there were
  moments when an individual conscience was all
  that could keep a world from falling