When I meet people at all levels in NHS Scotland, they are always immensely proud of what the NHS achieves – and rightly so. Wherever I go, I see inspiring examples of care, and I see people working every day to improve the quality of what we do. This year’s inpatient experience survey showed that 90 per cent of patients rated their care and treatment as good or excellent, the highest rating since the survey began in 2010.
But I also see and hear about things that go wrong, and when they do, it’s essential that people working in the NHS feel that they can raise concerns without fear.
Because what I also see is this: when staff raise legitimate concerns, and these are investigated fairly and openly, this often results in improvement. And ultimately, that leads to better, safer and more effective patient care. There are a number of ways in which staff can raise issues, but in the case of serious concerns, one option is whistleblowing.
Raising concerns doesn’t have to be complicated.
Through the Scottish Patient Safety Programme, we have introduced daily safety huddles in hospitals. I’ve attended some of these – an opportunity for staff all across the hospital to raise any concerns about safety, for resolution that day.
And in the Scottish Ambulance Service, a member of staff raised a concern that non-emergency vehicles were not properly designed to transport patients who needed to be moved by orthopaedic stretcher, with a risk that the stretcher could come loose resulting in an injury to the patient. This was raised this with the Area Service Manager who made sure that orthopaedic patients were not transported in this way until the problem was solved, and worked with the Ambulance Fleet department. As a result, stretchers for orthopaedic patients were retro-fitted to these ambulances – a real improvement in patient safety.
The Ambulance Service has also been running an innovative programme called ‘Flying Lessons’ which focuses on lessons learned in the airline industry, moving away from a blame culture and encouraging staff to raise concerns at an early stage.
My stance as the Chief Executive of NHS Scotland is clear and unambiguous. Every member of staff in Scotland’s NHS should have the confidence to speak up without fear - safe in the knowledge that any genuine concern will be taken seriously and acted on.
We’re committed to adding to the routes already in place for raising concerns, to ensure that everyone has a choice about how they do so, and a route to escalate concerns if they are not resolved. That’s why the Government recently published its response to the recent consultation on establishing an Independent National Whistleblowing Officer (INO). The INO will provide external review where individuals have a legitimate concern about the handling of a whistleblowing case and is a further step in developing an open and transparent reporting culture in NHS Scotland. We welcome the range of views expressed in the consultation, and the support expressed for the proposals we set out.
The INO will complement a range of policies and procedures already agreed and in place to support and encourage staff to raise concerns. So why is this needed now?
Quite simply, if there is one member of staff who feels that they can’t speak up about a valid issue, that is one too many. When I meet staff and trade union representatives, I ask them about their concerns. The answers are interesting, and varied. Some say that they don’t think that there would be any point – nothing would happen if they raised a concern. Some say that they fear that there could be consequences for them – perhaps in terms of their career, or a fear of being victimised. And others say that they have raised concerns in the past, and nothing happened – or if it did, nobody gave them any feedback. That tells me that there is still something we need to tackle.
I will always welcome the fact that staff raise concerns, even when the outcome may be challenging, because it leads to a better and safer NHS for us all. There’s absolutely no room for complacency here. That’s why I will continue to champion a culture where genuine whistleblowers are encouraged, supported and valued in NHS Scotland.
So my clear message to all NHS staff is to have the confidence to come forward. You will be listened to and your concerns will be investigated. And you should tell me if they are not.
Paul Gray is chief executive of NHS Scotland.
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