How can we best protect whistleblowers?

The issue of health professionals feeling they are able to ‘blow the whistle’ where they see poor quality care or when a colleague’s behaviour has fallen short of professional standards has never been more important. In light of the inquiries by Sir Robert Francis QC into both the Stafford Hospital scandal and creating an open and honest reporting culture in the NHS, health regulators have had to take stock of how to improve the way they deal with concerns raised by professionals and the public alike.

In this guest column Jackie Smith, the CEO and Registrar for the Nursing and Midwifery Council, talks about how the regulator has taken on board lessons and is doing more to listen to and support members who raise concerns.

Jackie Smith, CEO and Registrar, Nursing and Midwifery Council

The NMC welcomed Robert Francis’s Freedom to Speak Up review into whistleblowing in the NHS. As the regulator of nurses and midwives in the UK, we want a health and care sector where these professionals have the freedom to uphold our standards and practise to the best of their ability.

If a nurse or midwife has concerns about issues in their workplace that could put patients’ safety at risk, it is vital that they feel able to raise these with their employers.

We are reviewing our policies and procedures to make sure that people who speak out against a fellow nurse or midwife receive the help and support they need.

Our revised Code of Professional Standards, which becomes effective on 31 March, makes clear that nurses and midwives have a duty to raise concerns.

To make sure they are practising in line with our standards, they should bring any issues about patient or public safety, or the level of care people are receiving in their workplace, to the attention of their employer at the first reasonable opportunity.

Senior nurses and midwives are required to protect those they line manage from any harm or victimisation after a concern is raised. It is important that nurses and midwives, whatever their employment setting, scope of practice or level of seniority, are supported in bringing issues to an employer’s attention.

There should be open and transparent processes in place for raising concerns. Staff should be made aware of these and know how to access them. Employers have a part to play in making sure their working cultures enable nurses and midwives to raise concerns without fear of disciplinary action or unfair treatment.

Robert Francis’s review includes measures for vulnerable groups, who may experience more anxiety when raising concerns than others due to the nature of their term of employment.

Among these groups are students, who undertake practice placements in healthcare settings but are not fully integrated members of staff. Their need to pass each placement can constrain them from raising concerns freely.

We have published guidance on best-practice approaches to raising concerns, and the principles in this guidance also apply to students. We recommend that they talk to staff at their education institution or a union representative if they require further support.

The Public Interest Disclosure Act 1998 is being changed to define students as ‘workers’ and give them the same legal rights as employed staff. This is an important change that will allow students to raise concerns with greater legal protection.

Raising concerns is a complex matter, and our guidance, Raising and Escalating Concerns, addresses issues such as the difference between raising concerns and making a complaint, respecting individuals’ right to confidentiality, and where to go for help or advice.

We take raising concerns extremely seriously, and are committed to ensuring that our regulatory functions reflect the findings and recommendations of the Francis review.

If you are a veterinary surgeon or veterinary nurse who is concerned about inappropriate conduct in the workplace which you feel breaches the RCVS Code of Professional Conduct, please contact our Professional Conduct Department on 020 7202 0727. You can also view our supporting guidance on whistleblowing.