What does the National Guardian’s data hide?

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 17 November 2019

 Summary: After a concern was previously raised about misleading use of statistics, the UK Statistics Authority found that the Department of Health and Social Care and National Guardian breached its code by citing unpublished statistics and the Authority issued guidance to the National Guardian’s Office. Concerns remain. Unsavoury findings about poor whistleblowing governance and unsupportive management culture, such as high rates of whistleblower detriment and marked levels of anonymous staff reporting, are hidden in plain sight by the National Guardian’s Office’s failure to present national data in a meaningful manner. Relevant analyses are not provided to the public or to NHS staff faced with difficult decisions about when and how to whistleblow. Data is presented in a format which makes it particularly difficult for the public to follow and trace patterns. The National Guardian’s PR messaging concentrates crudely on global activity data, which she claims is evidence of success, and which she inflates by including concerns that are not whistleblowing. Publication of data from the last two quarters was inexplicably delayed, and her Office has stopped providing even the basic quarterly totals that it used to issue. Examples are provided of problem trusts, which have been identified by further analysis of the National Guardian’s data. The National Guardian has been asked to provide more meaningful, accessible and transparent data including analyses by individual trust.

Whistleblowers have been concerned since the National Freedom To Speak Guardian’s Office was first proposed by Robert Francis in 2015 that it was designed to help hide the truth more than reveal it.

The National Guardian:

-Has no powers

-Does not investigate whistleblowers’ concerns

-Interprets her remit in a most restrictive manner so as to give only a tiny number of NHS whistleblowers a very weak voice

–  Sometimes bends her remit when it suits, to deny whistleblowers a voice

Does not track crucial parameters, such as whether whistleblowers’ concerns are addressed 

What data she publishes is presented wrapped up and knotted so tightly, that only the most superficial impression is given. It is inconvenient to look further. Data is not supplied in easily interrogable spreadsheets, but on hard to read tables in tiny font, from which data must be transferred for any further analyses.

In the published data, obviously relevant analyses are not presented, and trends are withheld. In particular, trends for individual NHS trusts are not uncovered. The data for each trust is spread nebulously through each separate, hard to decipher, quarterly report.

The National Guardian’s main public relations thrust is to claim that the government’s Freedom To Speak Up project is a success because large numbersof staff have spoken up through NHS trust Freedom To Speak Up Guardians, which is a highly questionable assertion.

The Low Fact National Guardian

The National Guardian claimed: “Patient’s lives have been saved and untold harm has been prevented because Freedom to Speak Up Guardians have supported workers”.

When asked to provide the evidence for this claim, the best explanation that her Office could provide was some superficial activity statistics, and not evidence of any actual harm or deaths prevented:

Dear Mr Alexander,

Thank you again for contacting the National Guardian’s Office.

 The data we have collected over the last two years from FTSU Guardians in trusts and foundations trusts documents the number of cases that FTSU Guardians handled that include elements that indicate a risk to patient safety or the quality of care.  Our report for 2017/18 shows that FTSU Guardians handled 7,087 cases, 32% of which were reported as including an element of risk to patient safety or the quality of care.  We are finalising our report for 2018/19 but our figures so far indicate that FTSU Guardians handled nearly 12,000 cases and nearly 30% of these were reported as involving an element related to patient safety / quality of care.

I hope this information is helpful for you.

Kind regards,

Ellie Staite

Correspondence Officer

National Guardian’s Office

151 Buckingham Palace Road

London”

 

Moreover, the National Guardian’s assertion of success, based just on crude numbers, relies on unverified data supplied by trusts. The numbers are inflated by the National Guardian’s decision to include all manner of issues that are NOT whistleblowing in the data gathered. I am aware from a meeting with CQC that this expansion is controversial even with the CQC. Some Freedom To Speak Up Guardians themselves see through the ruse, and are fully aware of the centre’s inflation game.

Tellingly, on the National Guardian’s  new website, the national Speak Up data is now located under the section “Resources for organisations”. Indeed, there is no section on the website that is labelled “Resources for NHS staff” or “Resources for whistleblowers”. The website is primarily directed at Freedom to Speak Up Guardians and organisations:

National Guardian new website section labels

That is the clearest reflection of the mindset of those who front the government’s Freedom To Speak Up scam.

Most recently, the National Guardian’s Office inexplicably delayed in publishing the national Speak Up data for quarters 1 and 2 of 2019/20.

This overdue data has just been published. It does not even include the usual quarterly totals of the few parameters that are tracked:

  • number of cases
  • number of anonymous cases
  • number of patient safety cases
  • number of bullying and harassment cases
  • number of instances of detriment as determined by Freedom To Speak Up Guardians.

The National Guardian’s guidance to Freedom To Speak Up Guardians on how to collect and record data is cursory and the definitions of data to be collected leave a lot of room for interpretation and variation.

But nevertheless, I took a closer look. A few lowlights of what lies beneath the National Guardian’s superficial presentation of the national Speak Up data are provided.

 

Patient  safety disclosures – mission critical except when you want inflated figures

It seems the proportion of patient safety concerns raised with Freedom To Speak Up Guardians is diminishing overall, and that there has been a recent slowing down in total case numbers:

Reporting period Total number of Speak Up cases raised with NHS trust Freedom To Speak Up Guardians Cases with a patient safety element, as reported by NHS trust Speak Up Guardians
Q1 2017/18 1447 464 (32%)
Q2 2017/18 1515 529 (34.9%)
Q3 2017/18 1939 614 (31.6%)
Q4 2017/18 2186 659 (30.1%)
Q1 2018/19 2348 731 (31.1%)
Q2 2018/19 2604 799 (30.6%)
Q3 2018/19 3600 957 (26.5%)
Q4 2018/19 3406 928 (27.2%)
Q1 2019/20 3473 767 (22%)
Q2 2019/20 3156 844 (26.7%)
Total 25,674 7,289

Dishing detriment

The overall level of detriment due to speaking up based on data from NHS trust Speak Up Guardians, is 4.4% of cases (1,144 cases out of a total of 25,674 since 1 April 2017).

However, some trusts show markedly higher levels of detriment.

One has to feel some concern for the welfare of the Freedom To Speak Guardians at some of these trusts, who put themselves at risk just by reporting this detriment.

Indeed, it is not the limelight seekers who dance to the National Guardian’s tune who deserve credit, but unsung, diligent Guardians doing their best under fire.

The turnover in Guardians at problem trusts will in time most likely be another marker of the weakness of the Freedom To Speak Up project.

As an example of a problem trust, East Suffolk and North Essex NHS Foundation Trust has an eye watering 44.3% overall rate of detriment – ten times the national average.

Screenshot 2019-11-17 at 04.58.38

The trust’s CEO Nick Hulme has been in charge of both its predecessor bodies – Ipswich Hospital NHS Trust and Colchester Hospital University NHS Foundation Trust – since 2013 and 2016 respectively. Prior to that, he was the CEO of Croydon Health Services NHS Trust, which unfairly dismissed whistleblower Dr Kevin Beatt.

I previously asked the National Guardian to review Colchester Hospital University NHS Foundation Trust. I am not aware that she ever did so.

Of note, I see that the only listed, remaining Speak Up Guardian at East Suffolk and North Essex is a NED.

Closer inspection of the National Guardian’s data also shows that Croydon Health Services NHS Trust, another trust previously managed by Nick Hulme, has failed to submit data for the last two quarters and for almost a year before that it had zero returns. Both have been acknowledged to be ominous signs by the National Guardian.

Screenshot 2019-11-17 at 05.05.26

Another eye waterer is Walsall Healthcare NHS Trust, which has 40.5% detriment rate (58 cases out of 143 since 1 April 2017):

Screenshot 2019-11-17 at 05.10.53

The level of detriment at Walsall Healthcare NHS Trust is of especial concern, given that a higher than average proportion of the concerns raised with its Speak Up Guardians relate to patient safety (69.2%). Not to mention that Walsall failed to provide data returns for the first year.

Of note ‘Outstanding’ Northumbria Healthcare NHS Foundation Trust, whose CEO Jim Mackey was former CEO of NHS Improvement, also shows above average levels of detriment:

Screenshot 2019-11-17 at 05.39.32

Berkshire Healthcare NHS Foundation Trust which has to my knowledge rid itself of at least two whistleblowers in recent years, also has above average levels of detriment: 24.3% (19 of 78  Speak Up cases since 1 April 2017). The level of detriment has risen sharply in the last two quarters, to 91% in Q2 2019/20 (10 out of 11 cases).

Screenshot 2019-11-17 at 05.41.29

The notorious Royal Wolverhampton NHS Trust, which has seriously harmed whistleblowers such as Prof David Ferry who was targeted for racist abuse regarding his marriage to a black woman and who was vexatiously referred to the GMC, has above average levels of detriment as might be expected:

Screenshot 2019-11-17 at 05.43.38

But who cares? The Freedom To Speak Up machine not only looks the other way, but it actively provides a reputation polishing service for individuals such as the CEO of the Royal Wolverhampton:

 

Screenshot 2019-10-27 at 19.28.27

 

The fear that dare not speak its name

Nationally, the overall proportion of Speak Up cases that are raised anonymously is 13.8% (3538 cases out of 25,674 since 1 April 2017).

Some trusts show markedly higher levels of anonymous reporting.

For example, at Oxleas NHS Foundation Trust which is rated ‘Good’ overall and ‘Good’ on the well led domain by CQC, the vast majority of cases (88.5%) raised with the Freedom To Speak Up Guardian are anonymous.

Screenshot 2019-11-17 at 05.46.57

This is very worrying given that a higher than average proportion of Oxleas’ Speak Up cases are about patient safety (41.6%), and it is harder to investigate concerns that are raised anonymously. It does not reflect well on a trust’s safety culture if staff are too frightened to even identify themselves.

At Manchester University NHS Foundation Trust, rated ‘Good’ overall and ‘Good’ on the well led domain by CQC, a whopping 77.6% of Speak Up cases are anonymous.

Screenshot 2019-11-17 at 05.54.07

The listed Freedom To Speak Up Guardians at Manchester are:

a) Dr Ivan Benett trust NED

Screenshot 2019-11-17 at 05.56.56

b) David Cain former Chief Executive of Trafford Healthcare NHS Trust, who according to his LinkedIn details also sells management consultancy services.

Screenshot 2019-11-17 at 05.58.14

It’s mystifying why Manchester staff are reluctant to speak up on a named basis, it truly is.

At Great Western Hospitals NHS Foundation Trust where board members have also appointed themselves as Freedom To Speak Up Guardians, 60.6% of Speak Up cases are raised anonymously.

Screenshot 2019-11-17 at 06.12.08

Recidivist non-reporters & apparently disappearing Freedom To Speak Up Guardians at Worcestershire Acute Hospitals NHS Trust

The number of trusts that failed to submit Speak Up data to the National Guardian’s Office was high initially when data collection started in 2017, but settled. In the last two quarters, non-compliance has increased again.

Reporting period Number of NHS Trusts which failed to return data to the National Guardian’s Office
Q1 2017/18 106
Q2 2017/18 23
Q3 2017/18 18
Q4 2017/18 10
Q1 2018/19 7
Q2 2018/19 6
Q3 2018/19 6
Q4 2018/19 7
Q1 2019/20 27
Q2 2019/20 23

Are trusts suppressing bad news? Are there enough hands to process the data or have an increasing number of Freedom To Speak Up Guardians hung up their lanyards, or worse, been hounded out?

At Kingston Hospital NHS Foundation Trust, there has been recent, persistent failure to report:

Screenshot 2019-11-17 at 06.14.36

But who cares? Here is the selfie-afficionado-NHS-Chief-People-Officer lauding Kingston’s Director of HR, formerly of Capsticks LLP, for work on culture:

Screenshot 2019-11-17 at 06.24.55.png

There as also been persistent non-reporting by West London NHS Trust, (formerly West London Mental Health NHS Trust which unfairly sacked whistleblower Hayley Dare):

Screenshot 2019-11-17 at 06.47.43

Notably, the listed Freedom To Speak Up Guardian at West London is Sally Glen, one of the trust Non Executive Directors, who also sits on NMC Fitness to Practice panels.

Screenshot 2019-11-16 at 23.33.46

How would Glen view directors of nursing who are referred to the NMC for whistleblower reprisal?

At Worcestershire Acute NHS Trust, controversial David Nicholson  joined the trust as chair last year.

Screenshot 2019-11-16 at 13.16.36

This year, the trust defaulted on data reporting for Q1 and Q2 of 2019/20:

Screenshot 2019-11-17 at 06.52.07

As well as the appointment of David Nicholson as trust chair, an NHS trust director who was personally criticised for whistleblower reprisal at Mid Essex Hospitals NHS Trust   became an Improvement Director at NHS Improvement, and is the assigned NHSI relationship manager for Worcestershire Acute NHS Trust.

Here she is synergising with David Nicholson:

Cathy Geddes RT david nicholson

Old versions of the National Guardian’s directory of Freedom To Speak Up Guardians showed that at one point, Worcester Acute Hospitals NHS Trust had an absurd number of Freedom to Speak Up champions (25) in addition to a Freedom To Speak Up Guardian:

Screenshot 2019-11-16 at 23.45.12

Curiously however, the currently published National Guardian’s Speak Up Guardian directory does not list any Freedom to Speak Up Guardians for Worcestershire Acute Hospitals NHS Trust:

Screenshot 2019-11-17 at 07.05.56

Has Worcester Acute Hospitals NHS Trust  been deemed a FTSUG-free zone?

Has the Worcester Acute Speak Up Guardian decided to hand in their lanyard?

Something’s up at Kent and Medway

Another lowlight from analysing the National Guardian’s data is a marked escalation of reporting at Kent and Medway NHS and Social Care Partnership Trust in the last two quarters, much of it anonymous:

Screenshot 2019-11-17 at 07.22.30

A supportive and dutiful National Guardian’s Office would try to get to the bottom of it.

 

A request for better data

There are plenty more examples of concern in the long grass of the National Guardian’s data, hidden in plain sight by failure to analyse data, or at least to publicly acknowledge any analyses that have been conducted.

The National Guardian’s Office is quick enough to construct simplistic league tables of the professions that speak up:

Screenshot 2019-11-16 at 08.48.31

Her Office has also regrettably retweeted a post which implied criticism of staff who do not speak Up:

Screenshot 2019-11-16 at 08.50.56

But meaningful, analysed comparative data on named trusts? God forbid such a thing. It might result in transparency and accountability by the powerful. As the National Guardian’s new website let slip, her Office is there to serve institutions, not the public or the NHS frontline.

I have written to the National Guardian to request that she publishes her data via interrogable spread sheets and to suggest that she provides  cumulative analyses by individual trust. These should be updated with each quarterly reporting period. The request is posted below in the appendix.

It is very unjust to mislead NHS staff about the realities of whistleblowing, whether by omission or commission. Staff need complete data to make informed decisions that could affect the rest of their lives.

But ultimately, the Freedom To Speak Up project cannot genuinely help whistleblowers or patients because it is designed to be ineffective and is wielded by the unwilling.

We need reform of UK whistleblowing law.

 

UPDATE 18 NOVEMBER 2019

The CEO of Worcestershire Acute Hospitals NHS Trust has advised that there is a current Speak Up Guardian vacancy because the last Guardian passed away, and that interviews for a new Guardian are scheduled on 3rd December. However, the trust still has approximately the same number of Freedom To Speak Up Champions as previously listed (25), so I will ask the National Guardian’s Head of Office why they are no longer listed .

Screenshot 2019-11-17 at 20.42.25

 

RELATED ITEMS

Another empty promise by the National Guardian’s Office:  Freedom To Speak Guardians will listen and learn from ex-employees

Servalan rewards Rotherham, Doncaster and South Humber NHS Foundation Trust

NHS Improvement’s Kark FPPR implementation process & dissing dissent

Whistleblowers in Their Own Words: What’s wrong with UK whistleblowing law and how it needs to change

 

APPENDIX

BY EMAIL

Dr Henrietta Hughes

National Freedom To Speak Guardian

Care Quality Commission

16 November 2019

 

Dear Henrietta,

Presentation and analysis of national speaking up data, whistleblowing detriment at East Suffolk and North Essex NHSFT

  1. I write to ask if you would kindly publish the national NHS speaking up data in interrogable spreadsheets in future. This would give the public greater access and allow greater transparency.

At present, your Office’s published data tables are hard to read and the data within them has to be transferred to spreadsheets in order to be analysed, thus deterring those who do not have the time or other means. It means that the public cannot easily test the headlines reported by your Office

  1. I would also be grateful if you would provide the public with running averages of the parameters that you already track, (number of cases, number of anonymous cases, number of patient safety cases, number of bullying and harassment cases and number of instances of detriment as determined by Freedom To Speak Up Guardians)

3. I also suggest that your Office publishes analysed data for individual trusts according to the data parameters that you already track.

At present, any trends are hidden from anybody but the most determined searcher, willing to hop from quarterly table to quarterly table of hard to follow text.

I provide below a table of summarised data on East Suffolk and North Essex NHS Foundation Trust, which has an extraordinary rate of 44.3% detriment (51 out of 115 cases since 1 April 2017). This is a marked outlier from the national average of 4.4% of cases (1,144 cases out of a total of 25,674 since 1 April 2017).

You may recall that I previously suggested that you review one of East Suffolk and North Essex NHS Foundation Trust’s predecessor bodies, Colchester University Hospital NHS Foundation Trust. As far as I am aware, no review of the trust took place.

As I am sure you are aware, Nick Hulme the CEO of East Suffolk and North Essex, has been running both its predecessor bodies for some years now, and before that he was CEO of Croydon Healthcare NHS Trust which an Employment Tribunal determined had victimised and unfairly dismissed whistleblower Dr Kevin Beatt.

You will also be aware I believe that Dr Beatt’s FPPR referral to the CQC was one of those which were strangely rejected, despite being well supported with ET findings.

Yours sincerely,

Dr Minh Alexander

Cc Ted Baker CQC Chief Inspector of Hospitals

Tom Grimes NHS England and NHS Improvement whistleblowing lead

Dido Harding NHSI Chair

Tom Kark QC

Ed Humperson UKSA

 

DAY 17 cooking stats

Another empty promise by the National Guardian’s Office:  Freedom To Speak Guardians will listen and learn from ex-employees

Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 9 November 2019

The leitmotif of the National Guardian’s Office, a glorified minor outlet of the Department of Health and Social Care Press Office with a Head of Office who came from DHSC, is undelivered and undeliverable promises.

The National Guardian has recently got a new website, along with this catchy claim, in the usual declamatory style:

How to speak up

I no longer work in the organisation where the matter I want to speak up about took place – what do I do?

If the organisation you have left has a Freedom to Speak Up Guardian, you will be able to speak up to them. They will be grateful for any information that will enable them to support their organisation to improve.” [My emphases]

As usual, this claim is supported by no evidence whatsoever.

It is just non-governance by hollow, autocratic edict.

The claim is untrue of course.

But such glib assurance poses a threat to inexperienced staff who may take it on faith.

I have written to the National Guardian, with evidence, to suggest that she removes this claim and also that she sets a few hats straight on correct practice, as well as policy.

Some national NHS bodies and NHS trusts presently issue guidance that suggests only current employees can raise concerns, despite the fact that it has been established in law that former employees are also covered by UK whistleblowing law.

Self-explanatory correspondence with the National Guardian is provided below in the appendix.

The case of Dr John Bestley, which is not about whistleblowing but nevertheless falls within the remit of Freedom To Speak Up Guardians, is used to illustrate the issues. His Freedom To Speak Up Guardian took the trust line that his case was closed and indicated that he needed to produce ‘new information’ in order for her to get involved in his case.

In fact, Dr Bestley’s case was an exemplar of all that is seriously weak, wrong and wasteful in tNHS disciplinary processes, despite decades of inquiries and recommendations on how the system should change:

Waste Industry: The NHS disciplinary process & Dr John Bestley

Governments are not wont to listen to anything that involves giving up grip or ceding power to the frontline, and that is why the current government keeps on propping up its moribund Freedom To Speak Up scam.

It is extinct, deceased, no more, lifeless, passed on, defunct, departed, Mr Hancock.

 

dead parrot

 

APPENDIX: CORRESPONDENCE WITH HENRIETTA HUGHES, NATIONAL FREEDOM TO SPEAK UP GUARDIAN

BY EMAIL

Dr Henrietta Hughes

National Freedom To Speak Up Guardian

Care Quality Commission

9 November 2019

Dear Henrietta,

Accuracy of your claim that Freedom To Speak Up Guardians will engage with former trust employees who raise concerns 

On your new website it is claimed that:

I no longer work in the organisation where the matter I want to speak up about took place – what do I do?

If the organisation you have left has a Freedom to Speak Up Guardian, you will be able to speak up to them. They will be grateful for any information that will enable them to support their organisation to improve.”

I am concerned that this statement does not reflect the reality of the situation, and that you are making promises to workers that are not based in fact.

A number of former NHS staff have told me that they have tried to inform Freedom To Speak Up Guardians of poor experiences as NHS employees, but were told that this was outside of the respective Guardians’ remits because they are not current staff, because the organisation has closed their cases or simply with no reason given.

NHS Employers’ guidance is written only for staff currently employed by the NHS:

“f you are employed within the NHS and you wish to raise a concern,”

https://www.nhsemployers.org/retention-and-staff-experience/raising-concerns-whistleblowing/information-for-staff

Some NHS organisations have written their local whistleblowing policies so that instead of following the national template provided by NHS Improvement which states that “anyone who works (or has worked)” in the NHS can raise a concern, their local policy merely states that anyone who currently works in the NHS, or just the trust, can raise a concern.

These are some trusts that currently use more restrictive inclusion criteria that focus only on current employees:

Northumberland Tyne and Wear NHS Foundation Trust

“This Policy applies to all those working for the Trust, whether employed, workers, self-employed, or working on behalf of an agency or contractor. It also applies to volunteers, those offering their time in honorary positions, students, apprentices and trainees on placement.”

https://www.cntw.nhs.uk/content/uploads/2016/11/NTWHR06-RaisingConcerns-V05-Jul18.pdf

Sussex Partnership NHS FoundationTrust

“1.3.1 Who can raise concerns? Anyone who works in the NHS or for an independent organisation that provides NHS services can raise concerns. Including agency workers, temporary workers, students, volunteers, and governors.”

https://www.sussexpartnership.nhs.uk/sites/default/files/documents/freedom_to_speak_up_policy_april_2016.pdf

Royal Free London NHS Foundation Trust

“6. Application and scope 6.1 This policy applies to all those who are involved with the trust. This includes full-time or parttime employees, self-employed, those who are working in the trust through an agency or bank, as a volunteer, students, trainees, those on an honorary contract, patients, suppliers, providers etc. For ease, and where applicable the term “worker” will be used throughout the policy and associated procedure. Volunteers are not covered under the provisions of the Public Interest Disclosure Act 1998.”

http://s3-eu-west-1.amazonaws.com/files.royalfree.nhs.uk/Patient_safety/Speaking_up_Policy_and_Procedure_August_2016.pdf

West Hertforthordshire Hospitals NHS Trust

“This policy applies to all those involved with the Trust, including permanent employees, those working through NHSP or an agency, volunteers, students, those on honorary / fixed term contracts, providers, suppliers.”

https://www.westhertshospitals.nhs.uk/foi_publication_scheme/documents/trust_policies/HR047_Speaking_Up_Policy_v8.pdf

Nottinghamshire Healthcare NHS Foundation Trust

Target audience [of the trust whistleblowing policy]

All Trust employees, volunteers, students, bank workers, agency staff, Governors, NonExecutive Directors and contractors.”

https://www.nottinghamshirehealthcare.nhs.uk/download.cfm?doc=docm93jijm4n4822

I give an examples of a former NHS trust employee who approached their trust Freedom To Speak Guardians but was discouraged:

Dr John Bestley

Dr John Bestley was found by an Employment Tribunal to have been unfairly dismissed by Humber NHS Foundation Trust. In a separate process, he was also compensated for serious personal injury caused by his employer.

He asked to brief the Freedom To Speak Up Guardian at the trust about his experiences, because the trust had failed to engage with him after the ET found in his favour, and it learned no lessons.

His case is summarised here:

https://minhalexander.com/2017/10/21/waste-industry-the-nhs-disciplinary-process-dr-john-bestley/

The Humber NHS Foundation Trust Speak Up Guardian curtly informed him that she considered his case was ‘closed’ and indicated that she would require ’new’ information in order to take action.

The correspondence between Dr Bestley and the Humber Freedom To Speak Up Guardian is provided below .Dr Bestley’s case involved serious wrongdoing by the most senior managers at the trust, in terms of the way that he was treated, as found by the Employment Tribunal.

In consequence, an expensively trained senior clinician was lost from the NHS and made ill, and there has since been a lack of satisfactory learning and system change.

The deflective response by the trust Freedom To Speak Up Guardian, whose other role is of ‘Transformation  Programme Director,’ is disappointing.

By refusing to listen unless he had ’new information’, she was in my view effectively pre-judging the case and following the trust party line and arguments about the closure of the case, instead of coming to it with an open mind and fresh eyes.

This is quite extraordinary given the ET findings.

I would be grateful if you would;

1) Change the wording on your website from:

I no longer work in the organisation where the matter I want to speak up about took place – what do I do?

If the organisation you have left has a Freedom to Speak Up Guardian, you will be able to speak up to them. They will be grateful for any information that will enable them to support their organisation to improve.”

To:

I no longer work in the organisation where the matter I want to speak up about took place – what do I do?

If the organisation you have left has a Freedom to Speak Up Guardian, you should be able to speak up to them. They should be grateful for any information that will enable them to support their organisation to improve.”

2) Ensure your Office refrains in general from making un-evidenced promises to the NHS workforce that could cause staff to make unrealistically positive risk assessments of when and how to whistleblow, and potentially ruin their lives based on false promises of protection and support.

Whistleblowing, especially on serious matters that threaten the powerful, can be a life changing event that results in financial ruin, lifelong economic insecurity, serious ill health, homelessness, divorce and the fragmentation of families.

Your office should treat the information that it disseminates with utmost seriousness, not flippant promises written by those with public relations as their primary concern. This applies in particular to your Comms staff and the social media output.

3) Issue a bulletin to all NHS organisations making it clear that:

– NHS organisations’ whistleblowing policies should explicitly cover former as well as current employers [sic – employees], to reflect the scope of UK whistleblowing law

https://www.hempsons.co.uk/news-articles/whistleblowing-disclosures-made-after-a-workers-employment-ends-can-be-protected/

– Speak Up Guardians should engage with former employees who wish to raise concerns, whether or not their organisation has deemed the case ‘closed’, to make their own assessments

Yours sincerely,

Minh

Dr Minh Alexander

Cc Dr John Bestley

 

From: “SpeakUp (HUMBER NHS FOUNDATION TRUST)” <REDACTED>
Date: 4 July 2018 at 11:09:37 BST
To: John Bestley <REDACTED>
Subject: RE: Meeting

Dear John

Thank you for making contact with myself, I hope you are well.

I am aware that the issues regarding your case have been closed.  If you have new information or concerns please could you let me have these in writing so I can discuss further with Michele Moran as the Chief Executive.

Kind regards
Alison

Alison Flack
Transformation  Programme Director (Mental Health)
Humber, Coast and Vale Sustainable Transformation Partnership
NHS.net email – REDACTED
Telephone: REDACTED Mobile: REDACTED

Freedom to Speak Up Guardian
Humber Teaching NHS Foundation Trust
REDACTED

—–Original Message—–
From: John Bestley [REDACTED]
Sent: 02 July 2018 15:57
To: SpeakUp (HUMBER NHS FOUNDATION TRUST)
Cc: Google; Icloud
Subject: Meeting

Hi Alison,

I see that you have been appointed as Humber’s Speak Up Champion.

I think it might be helpful for you to know of my experiences, leading up to and after my unfair dismissal. There is an extensive article on Alexander’s Excavations Oct 2017, if you google my name and Humber you will easily find it. The website itself might be of interest to you.

I have repeatedly but unsuccessfully tried to engage with the Trust so that lessons could be learned. I suspect that Elizabeth Thomas blocked them perhaps because she could have been criticised.

I, of course, am very unpopular with Humber which I entirely understand.

My case was not concerned with whistle blowing. I was very open about my, and my colleague’s, concerns about service developments, patient safety and bullying. However I think my experience may be helpful to you in your role as Speak Up Champion.

If you do not wish to meet with me could I ask you to both confirm that and to copy it to the HR Director and Chair of the LNC, Dr Richard Smith.

BW
John

Sent from my iPad

RELATED ITEMS

A Serious Health Warning about the Freedom To Speak Up Project: What all NHS staff should know before they whistleblow

Whistleblowers in Their Own Words: What’s wrong with UK whistleblowing law and how it needs to change

BS FreedomToSpeakUpometer

 

 

 

 

Servalan rewards Rotherham, Doncaster and South Humber NHS Foundation Trust

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 7 November 2019

Clad in off-the-shoulder-black-hole-noir, Servalan Supreme Commander of the Freedom to Speak Up Division has rewarded NHS Trust Rotherham, Doncaster & South Humber NHS Foundation Trust (RDASH) with the ‘Freedom to Speak Up Organisation of the year award’.

RDASH Freedom To Speak Up Organisation of the year 2019

The Supreme Commander pays the Health Service Journal 16,500 Terran Federation credits a pop to sponsor this award, with the following benefits:

“…it comes with a range benefits including being involved in the criteria creation, judging panel and the publicity and platform which goes with that”

Yup, Servalan weighs in on the award of her own award.

 

 No expense spared on the latest reality-altering devices

National Guardian’s Office HSJ Award Sponsorship Partnership agreement

Henrietta Hughes signature on contract with HSJ for HSJ Award sponsorship and payment details

 

So how has RDASH pleased the Supreme Commander and what services has RDASH contributed to the Terran Federation?

 

 Unfairly sacking a worker with post-natal depression:

Ms K Payne v Rotherham, Doncaster and South Humber NHS Foundation Trust Case No. 1800475/2016

https://assets.publishing.service.gov.uk/media/59772b44e5274a2897000020/Payne_v_Rotherham_Doncaster_and_South_Humber_NHS_Foundation_Trust_1800475-16-Reasons.pdf

https://assets.publishing.service.gov.uk/media/59ddfc95e5274a11af27632f/Ms_K_Payne_v_Rotherham__Doncaster_and_South_Humber_NHS_Foundation_Trust_18004752016_-_Remedy.pdf

 

Handling 63 Speak Up cases in 2017/18 and 2018/19 with only 2 reported instances of detriment

Reporting period No of cases raised with RDASH Speak Up Guardians Cases with an element of patient safety Cases featuring detriment, as reported by RDASH Speak Up Guardians
Q1 2017/18 2 2 0
Q2 2017/18 8 2 2
Q3 2017/18 12 3 0
Q4 2017/18 3 1 0
Q1 2018/19 10 5 0
Q2 2018/19 13 5 0
Q3 2018/19 12 3 0
Q4 2018/19 3 1 0
Total 63 22 2

Source: Speak Up data published by the Supreme Commander, reported to her by NHS Trust Freedom To Speak Up Guardians, subject to no verification

https://www.cqc.org.uk/national-guardians-office/content/speaking-data

 

Making no apparent difference to trust staff feedback metrics as measured on the annual NHS staff survey since Freedom To Speak Up Guardians were established at the trust

The RDASH staff survey 2018 report can be found here.

According to Federation agents, RDASH colony morale has shown no troublesome blips following the introduction of Freedom To Speak Up Guardians.

In fact, central control notes there has been a pleasing, slight deterioration in scores on speaking up and overall score on safety culture.

RDASH staff survey 2018 speaking up graphs

 

RDASH staff survey 2018 safety culture flatline

RDASH staff survey 2018 safety culture graphs

Other domains are calmly flat.

RDASH staff survey 2018 quality of care flatline

RDASH Staff survey 2018 health &amp; wellbeing flatline

RDASH staff survey 2018 violence flatline

Screenshot 2019-11-07 at 15.15.14

 

Not acting on staff concerns about safe staffing

A trust patient Robert McNeill, 60, died at Great Oaks Hospital in Scunthorpe after being attacked by fellow patient Jamie Reed in January 2017.

Staff had raised concerns about inadequate staffing levels before the killing.

A BBC report 4 September 2019 gives summarised details:

Great Oaks Hospital: Staff had safety fears before patient killed

In a statement, RDaSH said: “We are sorry that staff felt anxious.”

This is the homicide investigation report by the company Niche, commissioned by NHS England and published September 2019:

An independent investigation into the care and treatment of two mental health service users Mr A and Mr O in Lincolnshire

“1.23 It is our view that the staffing levels and skill mix on the ward had a significant impact on the conditions in place at the time of the incident. However, the most significant was the observation policy. If the observations had been carried out differently it would have reduced the likelihood that Mr A would have been able to go into Mr O’s room and be undisturbed for 15 minutes.

1.24 We heard that staff had been anxious about risk assessment and risk levels within the unit. There were examples of:

  • patients being brought to the unit without adequate consideration of their motivations for admission or previous criminal activity;
  • staff raising concerns that a particular part of the ward was not safely staffed;
  • differences in how risk assessments and risk ratings were applied.

1.25 This in practice meant that risks were not adequately controlled and caused staff to be anxious about their own and patients’ safety. Staff reported that they did not feel safe, particularly on nights and on the part of the ward where they had raised concerns about staffing.

1.26 In our view the most significant contributory factor is the culture of safety on the ward. The tolerance of uncontrolled risk meant that staff did not have the resources or plans in place to manage risks effectively. We cannot say that Mr A would not have subsequently killed someone, but we can say that promoting a culture that is less tolerant of risk will reduce the likelihood of patient harm in the future.”

The Niche investigation was critical of the trust’s own investigation:

“7.25 The internal investigation was asked to consider previous safety concerns regarding MHU2, and whilst the report discusses progress made since concerns were historically identified, it does not draw any correlations between what was said in previous reports and what happened in this case. Despite many attempts being made to address previous safety concerns it is apparent that staffing levels, clinical leadership, record keeping, and risk assessment remained problems on the ward in 2017. The report does not make this clear.”

7.26 Our review of the report indicates that there was no comment on how the unit complied with national statutory obligations, guidelines or policies and procedures, although the report does have some references to internal protocols not being followed. There is no mention of whether Mental Health Act paperwork was correctly applied or updated, no consideration of either patients’ treatment compared with Care Quality Commission regulations (for example regarding seclusion records or safeguarding practice), National Institute of Health and Clinical Excellence guidelines, British National Formulary prescribing guidance, Royal College of Psychiatrists, Royal College of Nursing recommendations or otherwise.

7.27 Because of these omissions, the investigation report does not make clear what went wrong, what happened that should not have happened and what did not happen that should have happened in chronological order. The investigation report does not clearly identify issues as care or service delivery problems and does not draw out issues specifically as contributory factors.

7.28 There is a statement that there was nothing that the staff did not do that could have prevented the incident (paragraph 15.5 page 70). We disagree with this statement in that if staff had not been congregating in the communal area, one member of staff may have been patrolling the bedroom areas which may have meant that Mr A may have been seen entering Mr O’s room. In addition, if observation practice had been less routine and predictable to Mr A he may not have taken the risk of entering Mr O’s room at that time. In essence both those points are possibilities, rather than certainties, however this does not make either situation unlikely.

7.29 Predictability and preventability are subjective judgements, often applied in a legal sense associated with accountability and blame. In cases where it has been made clear that a death was preventable there are often legal repercussions. The purpose of root cause analysis is to examine systems so that the circumstances that allow a serious incident to arise are less likely to happen.

7.30 The internal investigation report made recommendations that may improve practice in the future. However, the report states that (page 60 paragraph 12.59) the investigation team could not identify any material contributory issue or root cause in Mr A’s clinical management and care which could have prevented the incident.

7.31 Because of this the report does not make clear the linkages and consequences of each of the issues identified. The report also does not identify which of the recommendations are the most significant or most important to address.

7.32 The lack of focus on what went wrong and why, and the lack of risk assessment of each of the recommended actions, means that in practice the gravity of not meeting the recommendations is not made clear.

7.33 The action plan lacked clarity about which recommendation was being addressed in each section. We do not consider it to be wrong to group or theme recommendations but there must be a clear line of sight of recommendations made in internal investigation reports and where they are subsequently addressed in an action plan.

7.34 The Trust must ensure that serious incident investigation reports make clear the links between the issues identified and the recommendation being made, ensuring that the most important or significant recommendations are identified. See our Recommendation 2.”

But enough of boring Nolan Principles like duty selflessness, accountability and evidence. Let’s have some selfies and evening wear:

Screenshot 2019-11-07 at 11.05.26

Screenshot 2019-11-07 at 15.07.10

Screenshot 2019-11-07 at 15.06.02

 

Screenshot 2019-11-07 at 15.06.25

 

What does RDASH say?

If readers wish to see what RDASH claims about itself, HSJ has obliged by printing the trust’s eulogy of its Speak Up practices under HSJ Solutions.

It includes the word “passionate”.

But based on the Niche homicide report’s criticisms, one must wonder how capable RDASH is of rigorous self-appraisal.

And how capable the National Guardian’s Office is of doing its duty.

 

RELATED ITEMS

The Unbearable Lightness of the National Guardian’s Office. Or how the National Guardian spends our money on publicity for the government’s Freedom To Speak Up Scam. A Night at the HSJ Awards

The DHSC, Robert Francis & National Guardian Cabaret: Inconsistencies & Obfuscation about whistleblowers’ concerns

Whistleblowers in Their Own Words: What’s wrong with UK whistleblowing law and how it needs to change

BS FreedomToSpeakUpometer

 

 

 

 

 

Housekeeping notes for whistleblowers: Your personal data & the Protect helpline

 

Summary: If you wish, you are entitled to a copy of the case note which Protect keeps as a record of whistleblower calls to its helpline.

 

A query arose on social media when an individual who had used the Protect helpline reported that they had unsuccessfully asked for a record of a call to the helpline, which they needed for evidential reasons, to demonstrate their motives at the time of raising concerns.

There was no guidance on data rights on the Protect webpage which gives information for prospective callers to the helpline.

Screenshot 2019-11-05 at 07.27.04

Advice Line – What advice do you need?

 

An enquiry to Protect’s CEO produced this guidance document, dated October 2019, which is uploaded elsewhere on the Protect website:

Advice Line Privacy Statement October 2019

Importantly, this document states:

“By seeking advice from us you are automatically agreeing to the collection and processing of relevant data including a note of the discussion we have had with you and the advice provided during the course of our engagement with you.”

So make sure you read the Protect data handling policy before you make contact.

The guidance document also states:

“Accordingly, you cannot request that we delete your data from our system as we are justified in holding it under the EU GDPR and required by law. You can however at any point during the course of your contact with our advice line service request a copy of the data we hold in relation to your case.” [my emphasis]

The document also indicates that data may be re-used by Protect:

to conduct research and compile reports in order to understand trends and identify areas in various sectors which require improvement. Please note no sensitive and personal information will be included in reports without your express consent”

I have suggested that Protect makes this policy document more visible to prospective helpline users.

Self explanatory brief correspondence with Protect is provided below.

Dr Minh Alexander

5 November 2019

 

From: minh alexander <REDACTED>

Subject: Handling of whistleblowers’ data by Protect

Date: 5 November 2019 at 07:11:56 GMT

To: Francsca West <REDACTED>

Morning Francesca,

Many thanks for the prompt response.

That’s helpful clarification.

It might be useful to display the link to your advice line data handling policy on the same webpage that provides information for prospective advice advice line users. I checked there as my first port of call and found no guidance.

The person in question reported that they provided Protect with their unique case reference number, and that Protect staff seemed familiar with their case, suggesting that records existed, but that Protect declined to provide case records:

Screenshot 2019-11-05 at 06.59.59

Screenshot 2019-11-05 at 07.00.32

The individual’s reason for requesting the records was apparently to evidence their motivation at the time of whistleblowing:

Screenshot 2019-11-05 at 07.06.53

Obviously, this may be germane in other cases too.

At a general level, if that is not already done, it might therefore be helpful if Protect staff as a matter of policy provide anybody who requests personal data with a copy of the organisational data handling policy, in order to avoid any misunderstandings and to ensure that whistleblowers are aware of their rights.

You may obviously wish to look into the particular case.

Thanks again.

BW

Minh

From: Francesca West <REDACTED>

Subject: Re: Handling of whistleblowers’ data by Protect

Date: 5 November 2019 at 06:47:34 GMT

To: minh alexander <REDACTED>

Hi Minh,

Our policies are all available on our website: https://protect-advice.org.uk/privacy-policies/

We do not record calls as we would be concerned that it would be off putting to individuals. However we take a note of the conversation and the advice. While obviously I cannot comment on this individual case, we are always happy to provide this note to the caller, with an explanation that if they share the note they will be waiving legal privilege to the note and other communications, but it is their right to waive if they wish.

Thank you for flagging this issue with me as I am concerned that a caller would be under this impression.

Best,

Francesca West
Chief Executive

Protect – Speak up, stop harm (formerly Public Concern at Work)

 

From: minh alexander <REDACTED>
Subject: Handling of whistleblowers’ data by Protect
Date: 4 November 2019 at 09:24:29 GMT
To: Francesca West <REDACTED>

Hi Francesca,

Following this assertion by an individual on social media:

Screenshot 2019-11-04 at 08.57.29

Would it be possible to have a copy of Protect’s policy and procedure covering the handling of all personal data pertaining to whistleblowers who contact Protect for assistance, including retention and destruction schedules, re-use for research (or any other purposes) and the recording of helpline calls?

Many thanks and BW,

Minh

The Unbearable Lightness of the National Guardian’s Office. Or how the National Guardian spends our money on publicity for the government’s Freedom To Speak Up Scam. A Night at the HSJ Awards

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 1 November 2019 

 Summary: The National Guardian pays for publicity by sponsoring a category of award by the Health Service Journal which is billed as independently judged. However, according to disclosed documents she is one of the judges for the award and her Office has also influenced the selection of other judges. Disclosed correspondence and the contract between the National Guardian and HSJ give the details of the marketing services and PR tactics that have been dubiously purchased by the National Guardian. The National Guardian admits to spending a total of £33, 394.85 on the HSJ awards over a two year period. The wrong values are promoted through a culture of superficiality, self-promotion and self-aggrandisement. They run counter to the Nolan principles of reflective public service and selflessness.

 

Background

The National Guardian repeatedly claims success and effectiveness of the Freedom To Speak Up project without producing any substantiating evidence, despite her training and understanding as a senior doctor, who knows the professional importance of acting in an evidence based manner:

The Low Fact National Guardian’s Office   

 Instead of evidence, there is a stream of lightweight PR activity, some unforgiveably distasteful.

For instance, posing for a selfie with David Loughton, the CEO of the Royal Wolverhampton NHS Trust who has been embroiled in repeated whistleblower controversies and who was personally criticised by a Verita investigation for his conduct towards a member of staff who had made protected disclosures.

Screenshot 2019-10-27 at 19.28.27

Whistleblower Professor David Ferry, another Royal Wolverhampton trust employee and senior doctor who suffered serious detriment under David Loughton’s management described to BBC File on Four how he received a death threat, and how his office was vandalised and racist graffiti was scrawled on his office wall because his wife is a Black woman:

“FERRY: Things were deteriorating, and after a particularly difficult day in the department, there was a lot of upset and that night, when I went to my car, there was a sticker on my car that said ‘Death to the bastard Geordie whistle-blower.’ You think, this is getting very difficult. And shortly after that, it was decided there was going to be an external inquiry into rectal radiotherapy treatments in the Trust. Ultimately, that inquiry by national level experts in rectal cancer supported my perspective.” 

“FERRY: Somebody entered my office and wrote racist graffiti on the wall, smashed my precious family photographs.

COX: When you found out about that, that your office has been trashed, there’s this racist graffiti, that must have been pretty worrying?

FERRY: It is very worrying and my eldest daughter was doing her GCSEs at the time and my wife is black, of course, and you have to consider carefully what you do. I think that some people were hoping I would react to that and say perhaps some inappropriate things, which would give them an excuse to suspend me or exclude me, but I think I managed that difficult episode with more control and dignity than I thought I might in the first days after it occurred.”

For the last two years, the National Guardian has squandered public money on sponsoring a Health Service Journal Awards category as a way of boosting her Office’s profile and spreading propaganda about the government’s Freedom To Speak Up scam.

This is especially galling to the whistleblower community which knows that she has not spent her limited budget on enough case reviews, and has inexplicably turned away some whistleblowers in distress on spurious grounds.

For example, she refused a case review on arbitrarily conjured up exclusion criterion at Brighton and Sussex.

In another case, she did so the basis of an extreme and uncaring but politically expedient interpretation of her remit, with devastating consequences for the whistleblower.

 

Henrietta pays for AND judges her own awards

Last year, the winner in the National Guardian’s Speak Up  category was East Lancashire Hospitals NHS Trust.

Jane Butcher Speak Up Guardian East Lancashire selfie with Henrietta Hughes HSJ awards 2018

Jane Butcher is a Human Resources Business Partner at East Lancashire Hospitals NHS Trust

 

This was highly questionable in view of the recent case of whistleblower Aditya Agrawal, a surgeon who was found to be unfairly dismissed by East Lancashire. Moreover, FOI data had shown that East Lancashire was also a super user of super gags:

FOI disclosure by East Lancashire Hospitals NHS Trust, 18 May 2016 Ref. 2016/222

“Please can you advise me in regards to the last 5 years:

1) How many compromise agreements has the Trust entered into with staff or former staff?

109

2) How many of these compromise agreements require staff members not to disclose the existence of the compromise agreement itself?

All

3) How many of these compromise agreements contain non-disparagement clauses that require staff members not to criticise the employees of the Trust?

All”

 

What is even more extraordinary is that documents disclosed under FOI reveal that Henrietta Hughes is actually a judge in her own sponsored HSJ awards category:

Award henrietta judging 2018

Screenshot 2019-11-01 at 05.41.10

 

As uncharmingly put by a member of Hughes’ Office, the attitude in short seems to be: ‘She pays, she gets to judge’:

HH pays, she judges

 

A check of the published 2019 list of HSJ Awards judges does not reveal Henrietta Hughes’ name amongst the throng, even though the correspondence disclosed by her Office indicates that she acted as a judge last year and is due to judge this year.

But to openly advertise her role as a judge might pop the bubble that the awards are independently judged.

In fact, the disclosed correspondence between HSJ and the National Guardian shows that the National Guardian was invited to make suggestions for judges, and to approach potential judges, and that her Office rather unflatteringly sent a round robin to a bunch of folk asking them to volunteer as judges:

Screenshot 2019-11-01 at 05.43.29

Ex Speak Up Guardians were favoured:

Award Ex Guardian non partisan

So unsurprisingly, it seems that she who pays the piper gets to call the direction of the judging.

 

Friends with benefits

Indeed, HSJ made it clear that sponsor influence over the award process is part of the deal:

“…it comes with a range benefits including being involved in the criteria creation, judging panel and the publicity and platform which goes with that”:

Award rack rate benefits

 

Puff, puff, puff

As part of the loot-for-limelight transaction, the National Guardian purchased two sponsored HSJ columns with the glamorous promise of:

 

·       “A maximum of 400 words written by and attributed to a client representative

  • Client logo which appears alongside the column
  • Author photo which appears alongside the column
  • One tweet via the HSJnews account
  • One mention of the column in an HSJ daily newsletter”

 

There was hypocrisy in that whilst cynically paying for publicity, the National Guardian’s Office did not want to appear to do so. They did not like the idea of a vulgar, visible reminder that these columns were sponsored:

Screenshot 2019-11-01 at 04.55.09

In addition to the sponsored columns guff, the National Guardian also bought herself an article about her award by an HSJ journalist, as part of the deal.

Here is how it apparently works: you write some stuff and “drive traffic” towards a particular award category. Everything’s a commodity, innit?

Award journalist interview

Spoken to the journalist

Journalist about article

 

Drum roll, cue uncontainable excitement

Here in a diagram is how the magical HSJ awards drama is constructed:

Award schedule of publicity build up

With regard to HSJ’s reference to a “constant email and social media campaign”, here is the National Guardian’s Office referring less than respectfully to “ratcheting up comms” to draw more responses to the National Guardian’s award:

Awards ratcheting up comms

An email from HSJ refers to “capitalising on the finalists”:

Capitalising

Commoditise, commoditise, commoditise.

Even award judges can be glamourised and used to stir up some buzz:

Judge vox pop

 

The National Guardian gags herself

This is the contract between HSJ and the National Guardian’s Office, signed by Henrietta Hughes herself:

National Guardian HSJ awards partnership agreement 2019

The contract contains a non-disparagement clause:

  1. “You will not do, or omit to do, (and you will procure that none of your employees, agents or contractors will do, or omit to do) anything which may:
  1. bring the Event or us into disrepute;
  1. disparage the Event or us;
  2. damage our goodwill associated with the Event; or
  3. otherwise prejudice the image or reputation of the Event or us.”

Oh the heavy burden and price of celebrity.

 

What on earth is a “poser table”?

In the National Guardian’s HSJ Awards goody bag is a “branded poser table”

Special price

Google only gives me a “Poseur table”:

Screenshot 2019-11-01 at 02.49.16

Nuff said.

 

Moonlighting regulators

 Repeating what we have seen on past occasions, the FOI data reveals that staff from NHS regulators are questionably willing to act as judges in HSJ’s beauty parades. Rachel Clarke from the whistleblowing team at NHS Improvement reportedly offered her services as a judge for the National Guardian’s award:

Rachel Clarke

This must surely conflict with the day job. For example, how might she respond to a whistleblower reporting about a trust to which she has awarded an HSJ prize? Could she be totally fair and unbiased? I am in touch with several NHS whistleblowers currently reliant on her doing her duty, so these are a very real considerations.

The National Guardian is not a regulator but is in the privileged position of being able to borrow power from the regulators, and she has the role of producing reports which potentially judge organisations’ probity. The same questions therefore apply to her.

  

The cost of buying ready-made gloss

How much of our money is the National Guardian prepared to spend in flattering the government?

The formal FOI disclosure can be found here.

These are the headline figures:

 

The total expenditure by the NGO, covering both years asked for, is

£33, 394.85.

“Please include the cost of: – Sponsoring HSJ awards”

This corresponds to the following:

2018: £16,500 2019: £16,500

Please note that both packages for each year include:

The award itself
The shortlisting process
The judging process
2 x tables of 10 people at the award ceremony Hospitality costs at the award ceremony
2 x sponsored columns in the Health Service Journal”

 

Then add in all the hefty personnel hours from disruption and time wasting caused by award applications, self-congratulatory local trust newsletters about being shortlisted as well as winning, contrived interviews, attempts to hawk non-stories to local newspapers and general parading about on social media.

The self-aggrandisement and me-me-me show is corrosive in the values that it instils. It runs counter to the spirit of Nolan standards, and it is lamentable that the National Guardian chooses to set such a poor example.

But it is no more than one would expect of a glorified minor outlet of the DHSC press office, complete with a head of office who arrived from the DHSC.   

 

RELATED ITEMS

Running true to form, the National Guardian’s 2019 ‘Freedom To Speak Up Organisation of the Year’ award was given to Rotherham, Doncaster and South Humber NHS Foundation Trust on 6 November 2019. This trust was found only in September 2019 to have failed to act on staff concerns on unsafe staffing, which was followed by an inpatient homicide of a patient. It also has mediocre scores, including on Speaking Up, on its latest annual staff survey.

Servalan rewards Rotherham, Doncaster and South Humber NHS Foundation Trust

Either the National Guardian undertakes zero due diligence, or does not care about such impediments, when handing out the baubles.

The National Guardian regularly tells everyone else they must prioritise learning, but shows little sign of learning herself. The stream of un-evidenced claims from her Office, which fall apart at the first ray of sunshine, continues unabated:

Another empty promise by the National Guardian’s Office:  Freedom To Speak Guardians will listen and learn from ex-employees

 

BS FreedomToSpeakUpometer

 

 

 

 

 

 

 

 

 

Norman Lamb MP has resigned from the Whistleblowing All Party Parliamentary Group

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 31 October 2019

Norman Lamb Vice Chair of the Whistleblowing APPG stated in a letter dated 24 October 2019 to a whistleblower who had raised concerns about the private company WhistleblowersUK – the APPG’s secretariat –  that he was standing down from the APPG.

He indicated that this was because he had not received a response from the secretariat to questions put to him by a concerned third party.

In July I raised questions about WhistleblowersUK with all APPG members.

Norman Lamb’s office informed me that he had put my questions to Georgina Halford Hall CEO of WhistleblowersUK, and that the information requested would be shared with me. It never was.

 

 

WhistleblowersUK Companies House 09347927 is a private company established in December 2014

It was appointed as the secretariat to the Whistleblowing APPG, which was set up in summer 2018.

The APPG register shows that WBUK has received remuneration from US bounty hunting lawyers Constantine Cannon to act as the Whistleblowing APPG secretariat

Whistleblowing APPG Constantine Cannon paid WBUK to act as secretariat

The Whistleblowing APPG website also reveals the APPG has received unspecified “support” from the company NAVEX Global, which sells compliance services.

As of 23rd October 2019, this was the published membership of the Whistleblowing APPG:

Screenshot 2019-10-31 at 09.25.26

 

After the above news of Norman Lamb’s resignation from the APPG, I asked his office if he had ever received the requested information from Georgina Halford Hall. I was informed that he had not received a response from WhistleblowersUK.

 

Email exchange with Norman Lamb’s office 31 October 2019

From: “COWIE, William” <REDACTED>

Subject: RE: Questions about the whistleblowing APPG’s relationship with its corporate backers and about its secretariat

Date: 30 October 2019 at 11:52:34 GMT

To: Minh Alexander ” <REDACTED >

Hi Minh,

Thanks for your email. Norman’s letter of resignation was dated 24 October; however it was sent on the 28 October. As such I’m not surprised he still features on the list dated from 23rd.

Norman didn’t receive a response to the questions which he put to the secretariat.

Best wishes,

Will

William Cowie

Parliamentary Researcher for Sir Norman Lamb MP

Liberal Democrat Member of Parliament for North Norfolk

From: LAMB, Norman <REDACTED>
Sent: 30 October 2019 11:43
To: COWIE, William <REDACTED>
Subject: FW: Questions about the whistleblowing APPG’s relationship with its corporate backers and about its secretariat

From: minh alexander <REDACTED>
Sent: 30 October 2019 11:41
To: LAMB, Norman <REDACTED>
Subject: Questions about the whistleblowing APPG’s relationship with its corporate backers and about its secretariat

Hi Will,

I gather that Norman has resigned from the Whistleblowing APPG because he did not “get responses from the secretariat [WhistleblowersUK] to questions put to me by a concerned third party”.

1) May I ask when Norman resigned?

I ask because all versions of the Whistleblowing APPG’s entry for the APPG register, including the 23th October version, list Norman as an APPG Vice Chair.

2) Also, am I correct in thinking that because I never received the further promised clarification from you, that Norman did not receive the information that he requested as below from Georgina Halford Hall?

Many thanks,

Minh

Dr Minh Alexander

 

 

A copy of Norman Lamb’s resignation letter of 24th October was shared with me. The letter was not addressed to the APPG chairs but to Georgina Halford-Hall, and it gave the reason for his resignation as the lack of response to his request for information on finance:

Screenshot 2019-10-31 at 06.44.01

 

Whether this was genuinely the primary reason for Norman Lamb’s resignation after several months from my raising the concerns, or whether the resignation was because his political instincts told him to step away for other reasons, it is a significant development.

It also seems extraordinary not only that an APPG secretariat behaved unaccountably, but that instead of an APPG dispensing with the services of such a secretariat, a tussle has ended instead with an APPG member resigning.

One has to ask what came first: the APPG and a passion for protecting the public interest, or the secretariat and the corporate interests behind it? Who instigated? Who is calling the shots and to what ends?

What were the questions from July that WhistleblowersUK did not answer? Here they are:

 

“Questions about the whistleblowing APPG’s relationship with its corporate backers and about its secretariat

I tweeted some of your members several times about what “support’ the private company NAVEX Global is providing to the Whistleblowing APPG, and whether the support includes finance.

https://twitter.com/alexander_minh/status/1143387940120403969

To date I have not yet received a substantive reply.

Norman Lamb responded this morning to say that he had seen my question for the first time.

He has agreed to find this information.

In case the APPG and or its members have apparently overlooked or not noticed my other recent tweeted questions, I would be grateful if you could note and respond to them, particularly as the Whistleblowing APPG is seeking to influence UK whistleblowing policy and has been asking whistleblowers for their contributions and support.

I think transparency and accountability is needed in the circumstances.

My as yet unanswered questions are as follows:

1) Has Whistleblowers UK, the APPG’s secretariat, or any officers of Whistleblowers UK had any business dealings or paid engagements with the Financial Conduct Authority (FCA)?

I ask as a post dated 21 January 2019 on the Whistleblowers UK’s website states that Whistleblowers UK’s CEO has been advising the FCA:

https://twitter.com/alexander_minh/status/1146093832653746176

2) If Whistleblowers UK or its officers have undertaken paid work for the FCA, what is the Whistleblowing APPG’s view on how this affects the APPG’s neutrality, and what action might it take in response?

3) Will the Whistleblowing APPG end its association with NAVEX Global given NAVEX Global’s claims that it has helped SERCO commit to ethical business conduct, when numerous scandals continue?

https://twitter.com/alexander_minh/status/1144120109428068352

4) Will the Whistleblowing APPG be willing to transparently list the organisations to which Whistleblowers has sold services, or to which Whistleblowers UK has provided NEDs to act as whistleblowing champions?

I ask as the CEO of whistleblowers UK appears to be advertising these services on her LinkedIn account:

“services include providing professional non executive directors in the whistleblower champion role. We provide training, consultancy, media advice.. a range packages to meet regulatory requirements.”

https://twitter.com/alexander_minh/status/1146052516263518208

These services may not exist yet. It is not clear if these services exist yet, as a post on the Whistleblowers UK website states that the company will be offering training to organisations, but that this training is “in development”.

https://twitter.com/alexander_minh/status/1146050970482294785

5) Can the APPG or its secretariat explain why a post on the Whistleblowers UK website of 15 May 2019 seems to be stating that Whistleblowers UK is a charity:

https://twitter.com/alexander_minh/status/1145785480216268800

when other material on the website states that the company is a ’not for profit’ organisation, and Whistleblowers UK tweeted explicitly on 22 June 2019 that it was not a charity?

https://twitter.com/alexander_minh/status/1145787106633142275

 

 

Susan Kramer, one of two APPG Co Chairs, appears not much troubled by my above questions and my concerns about the APPG sponsor NAVEX Global, as she is listed as a panel host for a NAVEX event.

But to exclude any doubt, I have written to her to ask if the APPG will replace WhistleblowersUK as its secretariat, and also to ask the APPG to review the contents of its first report published July 2019.

There are surely questions about this report, given WhistleblowersUk’s central role in handling the evidence that supported the report and the production of the report itself. This is not least because WhistleblowersUK also made a claim that its CEO stood trial, when this is contradicted by the Crown Prosecution Service

Mary Inman of Constantine Cannon – the US bounty hunting firm that has paid WhistleblowersUK to act as APPG secretariat – acknowledged last year that Brits have a “visceral” dislike of bounties. She suggested a more “culturally appropriate” version could be created:

“Inman says it is time for the UK to introduce incentives. While she says there is a “visceral” reaction here to anything seen as a “bounty”, she thinks the UK could create a culturally appropriate scheme which caps any rewards”

My reading of the APPG’s report is that whilst it pulled back from nakedly calling for US style whistleblower bounties, it tried to open the door.

It did so by calling for whistleblower protection to be extended to all members of the public – thus creating the conditions in which all members of the public could be deputised to file US style qui tam suits:

“Whistleblower protection should include all members of the public and include protection against retaliation.”

 Whistleblowing APPG report published July 2019, Recommendation 3, page 5

I have also asked Susan Kramer if she is willing to disclose the total number of concerns raised so far with APPG members, past or current, about WhistleblowersUK, what action broadly has resulted from such concerns and to confirm that all concerns have now been acted upon. This is partly because one whistleblower reported that they received no response from the APPG for three months, to a concern which had potential Safeguarding implications.

I have copied Vince Cable into the correspondence as he was involved in July in promoting the APPG’s ten point plan:

Screenshot 2019-10-31 at 09.20.52.png

Qui Tam suits – “In the name of the King”

These are, put very simply, legal actions by Joe Public regarding purported wrongdoing against the State. There is usually a bounty involved for the person suing.

Ms Inman explained it all here and threw in a historical reference to Ye Olde Englande:

 

She also stated at 37.24:

“…It’s exactly what you do in law enforcement…we pay informants”

It should be pointed out that such deputisation was a primitive form of governance in far away times and places where formal structures were lacking. It was abandoned centuries ago as the law and courts developed.

It was resurrected in the US under the exigencies of civil war, and designed to be an emergency measure which exploited the worst of human nature for the greater good.

“In short, I have based the…sections upon the old-fashioned idea of hold out a temptation,” and “setting a rogue to catch a rogue…a reward for the informer who comes into court and betrays his co-conspirator”

Not very savoury, but a last ditch attempt under extraordinary circumstances.

The modern day US version of bounties, revived in recent decades, is ruthless and exploitative, and makes a lot of money for middlemen. However, it leaves some genuine whistleblowers high and dry because they are not valuable enough to the State. It also focusses on protecting State financial assets much more than people.

I think we can and should do better than that.

 

RELATED ITEMS

Letter to the Whistleblowing APPG about the Duke of York Royal Military School whistleblowing matter

Whistleblowing v Bounty hunting. A new whistleblowing APPG with sponsorship from bounty hunters

The Whistleblowing APPG has been an unwelcome distraction from serious governance work on the desperate need to reform UK whistleblowing law. This is a brief summary of the current law’s serious flaws, and the main remedies that are so badly needed to protect whistleblowers and the public:

Replacing the Public Interest Disclosure Act (PIDA)

PIDA umbrella

 

 

 

 

More Fit and Proper Person lies: CQC & University Hospitals of Birmingham NHS Foundation Trust

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 26 October 2019

University Hospitals of Birmingham NHS Foundation Trust (UHB) previously claimed falsely under FOI to social care whistleblower Martin Morton that no CQC Regulation 5 Fit and Proper Person (FPPR) referrals had ever been made about its directors.

This was untrue because I had made an FPPR referral about a UHB director.

I am now aware of at least two other FPPR referrals that had been about the same individual.

Moreover, I was concerned that CQC may have colluded with UHB to exclude relevant evidence from the FPPR review triggered by my referral, by arbitrarily parking a later FPPR referral about the same director, for no good reason.

These events were summarised here:

FPPR: CQC’s & University Hospitals Birmingham NHS Foundation Trust’s economy with the truth

CQC was informed of UHB’s false FOI disclosure.

Following this, UHB claimed that it had made an error and admitted that it had received a single FPPR referral:

Dear Mr Morton

It has come to my attention that the information provided to you within our reply to your FOIA request was incorrect. I have conducted a brief investigation into how this may have occurred and it would appear that there may have been a miscommunication between the relevant members of our Corporate Affairs department. My sincere apologies for this error.

Please see attached email from myself to the Director of Corporate Affairs dated 23 August which provided the correct information but which unfortunately did not reach the FOIA team processing your initial request. I can confirm that during the relevant period the Trust has been made aware of one incident of concern raised under Reg. 5 Fit and Proper Persons. This concern was reviewed with the support of the external legal firm responsible for the management of related matters with an approximate cost of £5000 for the review and related matters.”

CQC subsequently regurgitated this claim of error to me:

CQC nigel acheson letter 11.10.2019 UHB FOI error

 

Nevertheless, I asked CQC to disclose the true number of FPPR referrals that it has received on the directors of UHB, including on directors of UHB’s troubled predecessor body, Heart of England NHS Foundation Trust.

This is the essence of CQC’s reply of 25 October 2019:

“CQC has received 6 referrals about the directors of University Hospitals of Birmingham NHS Foundation Trust, including the trust’s predecessor body Heart of England NHS Foundation Trust. We have passed two of these referrals onto University Hospitals of Birmingham NHS Foundation Trust and Heart of England NHS Foundation Trust and we have 3 further referrals at an earlier stage of our process. One further referral was handled by the local team.” [my emphasis]

So it seems UHB was still telling porkies when it “corrected” its original false FOI response of zero FPPR referrals received, and claimed it had received a single FPPR referral. The truth is it knew of at least two FPPR referrals.

Moreover, this latest FOI disclosure by CQC supports what is already known: CQC messes about on a grand scale with FPPR by simply not passing FPPR referrals to provider bodies.

CQC’s phrasing is ambiguous but at least four of six FPPR referrals on UHB directors have not yet made it out of CQC’s stalls. The worst reading of CQC’s FOI response is that only two out of ten FPPR referrals have been passed to the trust.

I have asked CQC to clarify the total number of FPPR referrals received.

It is of course not CQC’s job to withhold valid FPPR referrals from provider bodies, because the determinations on whether directors are fit and proper persons are supposed to be made by the provider bodies, not CQC.

It is CQC’s job to decide if providers’ determinations are adequate and sound.

PHSO has found that CQC should not close down FPPR referrals without seeking adequate evidence of assurance from provider organisations, as exemplified by the case of Paula Vasco-Knight and St Georges:

“We have found that the CQC’s decision to close the FPPR matter in relation to Trust P was made on the basis of incomplete consideration of the evidence.”

It is also troubling to hear that CQC allows its local inspection teams to handle some FPPR referrals. What is the point of CQC’s formal, specialist, lawyered-up central FPPR processes if the local CQC inspectors are allowed to do their own thing with some FPPR referrals?

But snuff out FPPR referrals at an early stage, continue dubiously uprating trusts, and nobody needs to be any the wiser. Job done. Ministers happy.

 

 

University Hospitals of Birmingham NHS Foundation Trust is currently rated ‘Good’ overall and ‘Outstanding’ in the well led domain:

UHB CQC rating

https://www.cqc.org.uk/provider/RRK

And how could anyone possibly expect CQC to make a fool of itself by admitting that an organisation that it has publicly lauded as ‘Outstandingly’ well led may not be led by a Fit and Proper Person?

Moreover, I asked CQC to produce any policy, law, government guidance or regulation which allowed it to park a second referrer’s FPPR referral on the UHB director on a pretext that a GMC investigation had to conclude first.

CQC has not produced any policy, law, government guidance which allowed it to act in this way.

Instead CQC has claimed that it had to wait for the outcome of the GMC investigation before acting on the second FPPR referral because it might otherwise be subject to a complaint:

CQC will share information of concern in relation to an FPPR referral with the provider. However, for the FPPR panel to fully consider all related information we would require the outcome of any relevant referrals made to other professional regulators to make an informed decision. This information would be essential to the process and if CQC were to take a decision on FPPR compliance before waiting for those outcomes, it would risk reaching a conclusion that could be overturned, criticised by the PHSO or which is unfair to the director concerned.

CQC will not refuse FPPR referrals on the grounds that a professional regulator has received a referral and or is investigating, however we are unable to consider the complaint fully without the outcome of this investigation.”

This claim is plainly nonsense because CQC originally proceeded with my FPPR referral in parallel with my GMC referral, about the same UHB director.

 

CQC clearly advised me on 22 August 2019 that there was an active FPPR review underway regarding the UHB director in question, at the same time that the GMC investigation into the individual was rolling on:

CQC nigel acheson letter 22 august 2019 ongoing fppr review at university hospitals birmingham nhs foundation trust

 

There is nothing in CQC’s memorandum of understanding with GMC which refers to delays in FPPR processes contingent on active GMC investigations, or vice versa. There is instead an emphasis on timely cross referrals.

But then, rules are just for plebs to follow. Oligarchs can make the rules up as they go along.

For the time being, there is little end in sight to the abuses. NHS Improvement’s implementation of the Kark FPPR review recommendations, a supposed antidote to these shambles, looks predictably half-hearted.

NHSI’s Kark steering group of vested interests has got the rose tinted specs out and NHSI is comically trying to sell voluntary, “light touch” governance as a remedy for serious managerial misconduct:

NHS Improvement’s Kark implementation process & dissing dissent

Previous exploration of CQC, NHS England and NHS Improvement’s role in the Paula Vasco-Knight FPPR affair illustrated why these bodies should not be calling the shots on how FPPR operates in the future:

Postscripts on Paula. NHS England’s apologia & regulatory reticence

Whistleblowers need major reform of UK whistleblowing law, which includes penalties for individuals who victimise whistleblowers, to deter reprisal.

Penalties directed at organisations, such as as fines currently proposed by Protect (formerly Public Concern at Work)  are pointless in the public sector as this would deprive already struggling services of resources without any effect on senior management behaviour. Fines are water off a duck’s back it is seen as spending nobody’s money.

Likewise, the largest, immensely wealthy corporations would have no trouble spending their way out of trouble.

Real deterrence will only come when would be abusers know they face serious personal consequences, but that day is a long way off.

UPDATE 28 OCTOBER 2019

CQC has today clarified that it has received a total of 6 FPPR referrals on the directors of University Hospitals of Birmingham NHS Foundation Trust:

“Dear Dr Alexander

Thank you for your email seeking clarification as to our response. I have confirmed the following with the FPPR Manager.

There were 6 referrals in total. These 6 are broken down as follows:

  • 2 referred to Trust
  • 3 at early stage
  • 1 handled by local team”

I hope that clarifies our response to you.

Kind Regards

Russell Wynn

Confidentiality, Privacy and Security Advisor

Information Rights

Governance and Legal Services”

RELATED ITEMS

Regulation 5, Fit and Proper Persons: Dissecting CQC’s Dissembling

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

Replacing the Public Interest Disclosure Act (PIDA)

Screenshot 2019-10-26 at 05.17.01

 

 

 

NHS Improvement’s Kark implementation process & dissing dissent

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 22 October 2019 

 

Summary: NHS Improvement has started a process of deciding which of several recommendations from the Kark Review will be implemented and how. Incomplete information has been publicly shared to date, but some more information has been obtained and the relevant documents are provided below. The documents shared so far show an attempt by NHS Improvement to water things down with an emphasis on “light touch”.

NHS Improvement and other bodies have a history of not consulting openly enough with whistleblowers or making adequate use of their extensive knowledge of system failure. Certain voices may be selected without transparent, sufficient justification, and some may also be paid. Some FOI data giving a past example of the latter is provided.

There is also a tendency to rely on intermediaries such as the National Guardian’s Office, about which many whistleblowers have significant reservations, adding to reduced representativeness and further lack of whistleblower confidence.

Documents and other information provided by NHS Improvement show that many of the organisation and players that have been part of the problem have the most seats at NHSI’s Kark implementation table. Links to the documents follow.

I encourage whistleblowers, patients or families who have not been invited to contribute to the Kark implementation process to do so and to ensure that NHS Improvement listens to all voices, even if they do not say what it wants to hear.

 

 

 

Background

There have been very serious, repeated failures by the CQC to fulfil its responsibilities under Regulation 5 Fit and Proper Persons, and to ensure that the public is Safeguarded from managers guilty of serious misconduct.

In response to mounting criticism of CQC’s blatant FPPR failures, the government eventually conceded and commissioned the Kark FPPR Review which took place last year.

Kark’s review report was published in February and largely let CQC off the hook for its misconduct and mishandling of FPPR, but it did criticise the present FPPR provisions and made a range of recommendations.

The government handed final decisions about implementation of the Kark recommendations to NHS Improvement.

NHSI fell silent in the subsequent months despite occasional whistleblowers’ enquiries as to progress.

 

NHS Improvement’s behaviour regarding Kark implementation

I wrote on 6 September 2019 to Dido Harding NHSI Chair cc parliament with an example of continuing, characteristic CQC failure on FPPR – including failures to feedback to the referrer, excessive delay and refusal to share adequate information.

A reply of 25 September 2019 Dido Harding gave the following update:

As you know, the Department of Health and Social Care accepted the first two recommendations of the Kark Review and asked that NHS England and NHS Improvement engage with a wide range of stakeholders to consider the remaining five. We have subsequently agreed with the department that we should also implement the third recommendation (to introduce a mandatory reference requirement for NHS directors) and that the department would consider the final recommendation (which concerns the application of the FPPR in social care).  

We intend to write to the department, setting out our implementation approach to the entire Kark Review alongside publication of the People Plan later this year. My team is currently speaking to a range of people to inform the best approach to implementation and I have passed your contact details on to a colleague, who will be in touch with you separately so that you have an opportunity to inform on our next steps.”

This colleague, a policy adviser, proved to be an DHSC employee, previously attached to the Freedom To Speak Up review and currently seconded to NHSI.

Upon request for relevant NHSI Kark consultation documents, the policy adviser shared the following document, which are the slides from an NHS Leadership Academy event that took place in Leeds on 4 October 2019:

‘Transforming Leadership Culture: Implementing the Kark Review’ NHS Improvement 4 October 2019

Some whistleblowers had been notified in early September of this event, but it was not clearly badged as an official NHS Improvement event. There was the usual, rather patronising invitation to contribute experiences:

 

Session

Facilitator

11:00am – 12:30pm

As part of wider Speak Up Month activities, we invite you to a Lessons Learnt/Shared Experiences session – TBC by Bernie

Bernie Rochford, Russ Parkinson (TBC)

12:30pm – 1:15pm

Lunch – (supplied by the Academy)

N/A

1:15pm – 3:15pm

Focussed Kark session, exploring the themes of your experiences regarding Directors in whistle-blowing incidents

Karl Roberts, Bernie Rochford, Sally Scales (TBC)”

 

Seeing the involvement of the National Guardian’s Office and not having been advised that this was an official NHSI event on policy, I had decided not to attend.

I questioned NHSI about the fact that whistleblowers were just invited to contribute ‘experience’, and NHSI has clarified that it will accept submissions about policy.

In terms of publicising the 4 October event, NHSI said it asked the National Guardian’s Office and NHS Leadership to send out invitations. Only some whistleblowers received an invitation. Some of those who were not invited had in fact been participants in the Kark FPPR review.

NHS Improvement advised me that about 14 whistleblowers attended the Leeds Kark session on 4th October.

I noticed that the 4 October 2019 event slides mentioned a Reference group.

The DHSC/ NHSI contact explained that this group was set up to help steer NHSI’s Kark implementation.

The Reference group appears to the real business end of NHSI’s consultation process and the key point at which influence is on the process is exerted.

Further enquiry NHSI revealed there was a single whistleblower on this NHSI Kark Reference group. This person was previously a PCT manager, who unsuccessfully claimed for constructive dismissal and whistleblower detriment, against Southwark PCT and currently works as a Freedom to Speak Up Guardian for Mersey Care NHS Foundation Trust including covering the now defunct Liverpool Community Health NHS Trust which was absorbed by Mersey Care.

The presence of a solitary whistleblower took the gloss off a recent expansive claim by Chris Hopson CEO of NHS Providers that the consultation was robust:

“More happily, there is a strong and effective consultation process on the other Kark Review recommendations as part of the work on the NHS People Plan. NHS Providers, frontline trust leaders and a broader group of stakeholders, including whistleblowers are contributing to this exercise and we are having a quality discussion on some highly complex issues. That is how to create the right decisions that can be implemented successfully to deliver the desired outcome.”

https://www.hsj.co.uk/policy-and-regulation/new-rule-to-stop-nhs-directors-revolving-door/7026055.article

Upon enquiry about how the single whistleblower member of the Kark Reference Group was selected, the NHSI response was one of initial uncertainty followed by the following explanation:

“I have also been through my records and confirm that the whistleblower member of the Kark reference group was drawn from the wider membership of the Improving Leadership Culture reference group.”

I have challenged the lack of transparency and equality of opportunity in NHSI’s selection of a whistleblower representative for the Kark Reference group, and pointed out that NHSI previously acted in a similar manner during the establishment of its much criticised NHS whistleblower employment support scheme. 

 

NHS Improvement’s anointed figurehead for the whistleblower employment support scheme

Without any transparency or equality of opportunity, an individual who was previously an NHS trust HR manager who as far as I am aware had not established in law that they had a whistleblowing case, and who was the subject of conflicting medical evidence about possible factitious illness, was selected as an adviser for the much criticised NHSI whistleblower employment support scheme.

Moreover, NHS England had originally approached two individuals at the (now defunct) organisation Patients First, regarding establishment of the NHS whistleblower employment support scheme:

Screenshot 2019-10-22 at 14.44.43

FOI enquiries later revealed that

1.      NHS England made payments totalling in excess of £18K to one of these individuals, the person selected as an adviser by NHSI, through their company:

Payments totalling £18,536.64 were made to TAB HR Limited between September 2016 and June 2017. These payments were for a range of contractor/consultancy services.”

NHS England FOI disclosure 23 February 2018 Ref 055603

2.     NHS Trust Development Authority, one of NHSI’s constituent bodies, paid the same individual £4,893 for their part in development of NHSI’s whistleblower employment support scheme:

“The NHS TDA spent £4,893.85 on the services of TAB HR Limited which covered services for up to 16 days between February and April 2017. This was to provide support for the development of the Employment Support service.”

NHS Improvement FOI disclosure 7 February 2018

 

 

But the failures to be transparent and to ensure equality of access for all are not new on the whistleblowing scene.

It is a cycle that repeats ad nauseam. Power typically seeks out that with which it feels comfortable, finds familiar and or believes it can exploit or mould to its own purpose, providing trouble-free public relations and photo ops, without the nuisance of dissent and robust scrutiny.

Power may deny that it does so, and sometimes this denial may be sincere and the selectivity is based on subconscious bias, but the actions have the same effect.

Controlling tokenism undervalues dissent as a healthy part of normal governance.

 

The usual suspects

I asked for the terms of reference and minutes of the meetings of NHSI’s Kark Reference group.

Minutes of the first Kark Reference group meeting, and Terms of Reference for the overarching ‘Improving Leadership Culture’ Reference group have been provided:

Minutes of NHSI Kark Reference group meeting 21 August 2019`

NHSI Improving Leadership Culture Reference group terms of reference

Minutes of a second meeting have also been promised and will be posted here when available.

A glance at the list of attendees at the Kark Reference group’s first meeting on 21 August 2019 [redacted by NHSI of junior officials’ names] shows many familiar faces, representing organisations that have firmly been a part of the problem:

NHSI Kark reference group meeting attendees 21.08.2019

 

The principles put forward by the Kark Reference group after two meetings convey inertia and low expectations:

NHSI Kark Reference group principles

Upon questioning, NHSI admitted that the above assertion that “the vast majority of managers do a good job” was not based on any evidence whatsoever, but merely a wish to avoid negativity.

I contended that the assertion was improper and provocative in the absence of evidence, especially given the history of recurring avoidable deaths, and that such attitudes were the reason the Kark Review was necessary in the first place.

On that theme, NHSI is trying its best to nudge the Kark implementation process in the direction of doing as little as possible – the words ‘light touch’ stand out:

NHSI preliminary thinking on Kark implementation slide 4 oct 2019

Granted, NHSI has yet to update its slide based on the outcome of the 4th October 2019 event.

NHSI admitted that whistleblowers who attended on 4th October pushed back on the light touch gambit. I have now added my opposition.

This is the agreed record of two telephone meetings with the DHSC policy adviser seconded to NHSI, who is handling the Kark review implementation:

Agreed records of telephone meetings 10 & 11 Oct 2019 with NHS Improvement about Kark Review implementation

My formal written submission to NHSI on implementing the Kark review is also provided below in the appendix.

Any whistleblowers or patients and families who wish to challenge NHSI and DHSC’s attempt to water down what were already compromise solutions by Kark should also add their voices as a matter of urgency, because NHSI plans to finalise a draft of its plans by early November:

 

Screenshot 2019-10-22 at 15.57.19

The Kark review came after years of serious government failure following Jeremy Hunt’s glib and insincere promises of culture change following MidStaffs.

The issues are at their heart simple and are about decency and honesty. Everybody is qualified to comment. If you feel strongly, just write in however briefly and simply, FAO Joseph Smith Policy Adviser, NHS England and NHS Improvement.

 

RELATED ITEMS

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

Twiddling at the edges will not be safe substitute for much needed reform of unfit UK whistleblowing law:

Replacing the Public Interest Disclosure Act (PIDA)

 

APPENDIX

SUBMISSION TO NHS IMPROVEMENT’S KARK IMPLEMENTATION PROCESS

22 October 2019

Dear Joe,

 

Thanks for your help, all the information provided and the documents shared.

As promised, this is my formal submission to NHSI’s Kark implementation process.

  1. Firstly, I should say that I do not believe that the mistreatment of whistleblowers In the NHS or any other UK sector will reduce until there is substantial reform of UK whistleblowing law, which should include meaningful deterrence of whistleblower reprisal in the form of sanctions for individuals, civil and criminal, as opposed to sanctions for organisations.

 

  1. The government said it might consider changes to UK whistleblowing law after the publication of the Gosport inquiry report, and meetings between DHSC and BEIS have been held, but little has update has been provided. I doubt that there are present government plans to make the necessary degree of change for safe governance.

 

  1. At present, some senior NHS managers corruptly squander public money on legal services to intimidate, settle and gag whistleblowers because they know there is almost zero chance that they will suffer any personal consequence.

 

  1. The fact that regulators such as NHSI rubber stamp some of these payments, help shelter and redeploy senior abusers and avoid taking action in even the most egregious cases is permissiveness of a scale that is tantamount to encouragement of the misconduct. Similar arguments apply regarding the DHSC, the ultimate culture carrier and pace setter.

 

  1. At present, the DHSC resists even the proper investigation of whistleblower’s concerns, so the Kark implementation exercise is somewhat hollow, no disrespect to you personally.

 

  1. I also note from the Kark review report that there is understandable fear by managers that any system of managerial regulation will be abused by the centre to unfairly dismiss individuals who are unwanted, as opposed to wrongdoers. Also that there are reports that not only FPPR has been blind to some misconduct but has been improperly weaponised against managers who are not in favour.

 

  1. Nevertheless, those caveats apart, I make the following summarised points and address some issues that you asked me to.

 

  1. As I understand it, the government has so far accepted the following recommendations from the Kark review:

 

  • The introduction of a national competency framework for NHS board roles
  • The creation of a central database about NHS managers’ training and employment history, including upheld grievance and disciplinary issues

 

  1. NHSI has informed me that it accepted a third recommendation:

 

  • The introduction of standardised, mandatory references

 

I understand this should be along the lines of a sample reference form provided by the Kark review report, and a recommendation that mandatory references are signed off by directors who are subject to FPPR (and thus can be held accountable for any false references).

 

Please let me know if the government and NHSI are not fully implementing any of the above three Kark recommendations as I have understood them.

 

  1. This leaves much a number of other recommendations to be decided, including:

 

  • Extension of FPPR to commissioners and ALBS

 

  • A power to disbar directors for serious misconduct, with a disbarring service located within NHSI

 

  • Removal of the clause which makes being ‘privy’ to misconduct a criterion under FPPR

 

  • The application of FPPR in social care provision.

 

 

  1. Overall, I believe that there needs to be a step change in the quality of NHS management, commensurate with the gravity of the task in hand. Professionalisation is needed, with clear, explicit, regulated standards, as for all other health professions.

 

  1. I reject any attempts to lower standards based on concerns that barriers should be lowered for access, as implied by the guiding principles generated by the Reference group steering NHSI’s Kark implementation. It is low expectations, poor controls which have allowed unchecked managerialism and unsuitable senior managers appointing in their own image that have got us to this state.

 

  1. Patients and the wider public deserve a high standard of management in a vital, safety-critical public service. That should be the core expectation, with no compromise on quality, the latter being short termism which stacks up disproportionate trouble for the future.

 

  1. It is essential that DHSC and NHSI face up to the need to remove corrupt senior managers from the DHSC, ALBS and provider bodies. Until this is done, there will be little change because these individuals will not change behaviour. They will operate corrupt cultures where meritocracy, safe governance and patients cannot flourish.

 

  1. Beyond that, I agree with the need for a supportive, proactive system of talent development and supportive remediation where things go wrong due to issues of competency.

 

  1. However, I also suggest that much more emphasis is given to recruitment of the right individuals, with the right values and character. This is less wasteful than appointing unsuccessfully and throwing resource at managing failure.

 

  1. The Kark review emphasised competency and proposed that NHS directors should have understanding of the importance of the following:

 

  • Board governance;
  • Clinical governance;
  • Financial governance;
  • Patient safety and medical management;
  • Recognising the importance of information on clinical outcomes;
  • Responding to serious clinical incidents and learning from errors;
  • The importance of learning from whistleblowing and ‘speaking up’;
  • Empowering staff to make autonomous decisions and to raise concerns;
  • Ethical duties towards patients, relatives and staff;
  • Complying and encouraging compliance with the duty of candour;
  • The protection, security and use of data;
  • Current information systems relevant for health services;
  • The importance of issues of equality and diversity both within the hospital in workforce issues and in relation to appointments to the Board; and
  • The importance of complying on a personal basis with the Nolan principles

 

Whilst understanding of these matters is obviously necessary, the issues in the worst breaches have been deliberate non-compliance, collusion and conspiracy to misconduct, not inadvertent blunders.

 

  1. You asked me to comment on NHSI’s competency frameworks.

 

  1. Regarding “Developing People – Improving Care A national framework for action on improvement and leadership development in NHS-funded services”

 

https://improvement.nhs.uk/documents/542/Developing_People-Improving_Care-010216.pdf

 

  1. Page 20 gives the following as the action plan for ensuring “Compassionate, inclusive and effective leaders at all levels”:

 

“A variety of frameworks are used across the NHS to develop, assess, select, promote and regulate leaders and leadership, and they are often incongruent. People across the system need to agree on ‘what good leadership looks like’ at different levels and develop consistent descriptions, using language common to all organisations and systems.”

 

  1. Page 23 gives a little more detail:

 

Screenshot 2019-10-22 at 07.28.07

 

  1. The emphasis here is on development and training. Whilst these interventions may augment, they cannot substitute for wise, kind, honest character. If the NHS fails to recruit managers with sound character, the rest falls. As cited in the Kark review report, the PSA has observed that: “Technical competence to serve on a Board is as nothing without personal commitment to the public interest”

 

  1. Looking at NHS Improvement’s resources for “Creating a culture of compassionate and inclusive leadership”

https://improvement.nhs.uk/resources/culture-leadership/

This leads to sample documents from several trusts, some of which briefly nod to “recruiting for values” but give little detail on definitions and methodology.

 

  1. The Kark review noted huge variation in how NHS directors are recruited:

“The variation in how executives are recruited is huge. At one end of the scale, there is a ‘full service’: full stake holder discussions are held with each candidate, applicants are filmed in order to test media training etc. At the other end of the scale, there is just an interview panel for between 45 and 60 minutes with little other than CVs and references.”

 

  1. If the NHS does not have sufficient expertise on this subject of recruiting for the right values, it has the options of buying in suitable expertise and of commissioning research to inform future policy decisions. The Kark Review directed the government to the Institute of Directors’ Director Competency Framework which emphasises the importance of evidence of suitable “attitude and disposition that shapes a director’s responses and behaviour”.

 

  1. Regarding models of regulation, I have looked at the regulation of teachers as you suggested:

https://www.gov.uk/government/collections/teacher-misconduct

 

  1. I do not think this model offers adequate protection to patients because it only deals with misconduct so serious that it is wholly incompatible with the role and may require a life ban. The model leaves any misconduct short of this extreme level to employers to deal with:

“They [the regulations] cover cases of serious misconduct. This is when a teacher’s behaviour:

  • is fundamentally incompatible with being a teacher
  • uld lead to them being prohibited from teaching

 The regulations don’t cover the cases of less serious misconduct, incompetence or under-performance. A teacher’s employer should deal with these cases.”

 

  1. I think it would be unacceptable for employers to be left wholly in the control of NHS managers’ misconduct that merits serious but lesser sanctions. There is a conflict of interest for employers to cover up failure, and that conflict of interest becomes acute and unmanageable when it is the directors of the organisation who are the accused.

 

29. The full model of professional regulation as operated by health and social care professional regulators is preferable and safer, partly because it is in principle proactive and preventative through the basic requirements of standardised qualification, accreditation and registration. It is required for the proper professionalisation of NHS management as a discipline. I believe the additional expense of full regulation is justified to keep patients safe.

 

  1. Therefore, I would prefer full professional regulation of NHS managers to give parity with the way clinicians are managed, not least to stem the abuses of unchecked managerialism against patients’ interests which have resulted in horrors such as MidStaffs, Gosport and Liverpool Community Health NHS Trust.

 

  1. I appreciate that the Kark recommendation is only for a disbarring council broadly similar to that which operates for teacher, but with less formality. I do not feel this goes far enough. I also do not agree that a disbarring service should be under NHSI’s control, given political conflicts of interest and the potential for abuses. As I write I am mindful that NHSI currently employs as a director a trust manager who had been personally criticised for causing serious detriment to a whistleblower.

 

  1. Needless to say, I think this preliminary suggestion by NHSI is wholly unacceptable and I reject it:

“A light touch approach is probably desirable – this might include a voluntary register to help raise standards and professionalise management, and standardised references.”

 

  1. It is hopeless to expect that the worst offenders who have cheated, lied, fabricated false allegations against staff, referred staff vexatiously to regulators and misled regulators, dismissed honest investigators, committed fraud, perjured themselves, covered up, and knowingly endangered patients out of self-interest would comply reliably with, and act in the spirit of, voluntary arrangements.

 

  1. The current failure of FPPR and the farce of self-declaration under FPPR are I believe sufficient evidence to show that NHSI’s hopes of a light touch, voluntary system are doomed.
  2. I agree with the proposal to extend FPPR to commissioners, regulators and other ALBs. I also think the DHSC should be included.

 

  1. NHSI has characterised Kark recommendation 7 as: “That the FPPT be extend [sic – extended] to cover social care provision”

 

  1. As discussed, I believe from my reading of Regulation 5 and CQC’s supporting material that FPPR already applies to social care (and at the time of writing it occurred to me that I made an FPPR referral to CQC on a director of social care some time ago, about which I had forgotten). On checking the wording of the Kark review report, it says: “We recommend that further work is done to examine how the test works in the context of the provision of social care and whether any amendments are needed to make the test effective.

I would support this.

 

  1. You asked about definitions of misconduct and red lines – or as NHSI puts it: “what constitutes someone crossing a moral line”.

I think there should be clear definitions of types of serious misconduct that would result in disbarment from senior office. I agree with the suggested red lines set out in the Kark review report, and I would particularly emphasise:

  • Covering up safety issues
  • Suppressing whistleblower concerns
  • Reprisal against whistleblowers or complainants
  • Misuse of public funds in the pursuit of any of the above, including aggressive, meritless appeals by NHS organisations that been the subject of successful claims, and respond by punishing and ruining whistleblowers through vexatiously prolonging the legal process

 

The Kark review emphasised “deliberate” bullying:

“Deliberate bullying, particularly victimising those who raise concerns should in our view be regarded as ’red line’ behaviour and serious misconduct.”

I am concerned that this might provide a loophole.

I suggest that any bullying of whistleblowers is a red line, whether proven to be deliberate or not, but that if deliberate bullying is found, this should be viewed as an aggravating factor when sanctions are decided.

 

  1. The Kark review suggests removing the clause which makes being privy to serious misconduct a criterion for consideration under FPPR:

“Amending the Fit and Proper Person Test to remove the reference to directors ‘being privy to’ mismanagement which we do not think promotes clarity”

 

  1. I am concerned that this will remove proper liability for executive negligence in the form by-standing. Whistleblowers very commonly encounter a wall of silence when after being blocked they anxiously explore more and more avenues to resolving concerns or seek protection from reprisal. It is often concerted failure to respond, to act and to protect that sinks whistleblowers as much as active victimisation. Indeed, in a rare glimpse, it became evident that officials planned to warn a DH minister not to respond to a whistleblower.

 

  1. I think that if the clause about being ‘privy’ is removed, it must for clarity be replaced with a clause that makes it clear that offences of omission are just as serious, and that failing to act appropriately upon knowledge that fellow directors are guilty of serious misconduct is itself classed as serious misconduct.

 

  1. There is a note along these lines on page 132 of the Kark review report about red lines: Victimisation or knowingly allowing the victimisation of whistleblowers”

 I think the principle of “knowingly allowing” other forms of serious misconduct should also apply.

 

  1. The Kark review sets out to prevent unfit managers from moving around the NHS:

“Our recommendation in relation to mandatory references and an independent disbarring service are intended to prevent those proved to have been guilty of misconduct moving around the NHS system.”

 

  1. I think NHSI should give consideration to wider Safeguarding issues, and set out how it would ensure that other agencies are apprised of risks posed managers who are barred from the NHS and who may seek employment in other areas where they may also pose a risk to the public, especially vulnerable people.

 

  1. With regard to proposed exceptions in the public interest from a five year statutory time limitation for serious misconduct, I think the principles by which exceptions are made should be explicitly provided in guidance, to avoid arbitrary and widely varying responses.

 

  1. I recommend that NHSI takes note of resources on the organisational management of seriously sociopathic behaviour. This is one example, which describes how psychopathic individuals may impact on institutions, and what institutions can do to manage this risk:

 

Tackling psychopathy: a necessary competency in leadership development?

As the author comments, psychopathic individuals excel at kissing up and kicking down, and may manage upwards in a manipulative way, to please regulators such as NHSI:

“The problem for leadership development16 is that psychopathic individuals can achieve most of the key competencies including getting others to follow them, being politically astute, relating to senior colleagues with charm, and possessing excellent communication skills. If the person can muster sufficient ‘charisma’ and achieve set targets (for example, in cost cutting), affective instability and the tendency to damage others could be overlooked by organisations”

 

  1. Accordingly, as my last word to NHSI, I would stress the importance of valuing voices that the regulator finds less comfortable, whether it is trust executives who honestly say they cannot do the impossible, frontline staff who report the consequences of provider organisations being asked to the impossible or whistleblowers who are more challenging and less complaisant regarding NHSI’s policies. In terms of future policy consultations that may involve whistleblowers, I advise open calls for contributions and publication of consultation papers at an early stage, without reliance on intermediaries such as the National Guardians Office who have any control of the communication.

 

With best wishes,

 

Minh

 

Dr Minh Alexander

 

Cc Tom Kark QC

Dido Harding NHS Improvement Chair

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Letter to the Whistleblowing APPG about the Duke of York Royal Military School whistleblowing matter

The following correspondence is hopefully self explanatory.

 

BY EMAIL

Whistleblowing APPG

Stephen Kerr MP Vice Chair and Registered Contact

Baroness Susan Kramer Vice Chair

Norman Lamb MP

Anneliese Dodds MP

Andrew Mitchell MP

9 October 2019

 

Dear APPG members,

Correspondence from the Crown Prosecution Service about whether the CEO of Whistleblowers UK “stood trial”

Please find below the correspondence with the CPS about whether or not the CEO of Whistleblowers UK, the private company which currently acts as the APPG’s secretariat, “stood trial” regarding matters at the Duke of York Military School.

As you may be aware, Whistleblowers UK tweeted on 9 March 2019: “Our CEO was arrested for protecting whistleblowers, exposing CSA and stood trial”.

This is the screenshot of the tweet:

WBUK tweet claim Our CEO was arrested for protecting whistleblowers, exposing CSA and stood trial

Tracy Austin a former teacher at the Duke of York school, who raised concerns, has disputed that a trial took place.

I attach a photograph of an article of 15 October 2015 which noted that the CPS offered no evidence against Tracy Austin with respect to allegations of unlawfully disclosing personal data, and that the CPS had also decided not to proceed with a case against the parent of a child at the school:

Tracy Austin newspaper clipping no evidence offered by police

 

As other media had reported that the case against Whistleblowers UK’s CEO for handling stolen goods and unlawfully [sic – breaching data protection] came before Canterbury Crown Court, I asked the CPS to clarify if a trial had actually started into these matters.

https://www.telegraph.co.uk/news/uknews/law-and-order/11702655/My-fear-of-jail-for-being-a-whistle-blower.html

https://www.lawgazette.co.uk/lawyer-in-the-news/alleged-school-abuse-whistleblower-arrested/5049933.article

The CPS has advised that: “no trial appears on the CPS database for anyone of this name in Kent, Surrey or Sussex”.

I have invited Whistleblowers UK to offer some sort of explanation and comment on these apparently anomalous facts.

The only response that I have received so far is to be blocked by the Whistleblowers UK twitter account.

Ms Austin also reports that she has now been blocked.

I trust that the APPG may wish to establish on what basis Whistleblowers UK made the claim of 9 March 2019 that: “Our CEO was arrested for protecting whistleblowers, exposing CSA and stood trial”.

I also trust that the APPG may wish to ensure that any sensitive personal data entrusted to the APPG by whistleblowers, some likely to be vulnerable, via Whistleblowers UK in its capacity as APPG secretariat, is properly handled and safeguarded.

Yours,

Dr Minh Alexander

Cc Committee for Standards in Public Life

Lord Jonathan Evans Chair of CSPL

 

From: South East VRR and Complaints <REDACTED>

Subject: FW: FOI request FAO Crown Prosecution Service South West

Date: 7 October 2019 at 15:24:21 BST

To: Minh Alexander <REDACTED>

Cc: South East VRR and Complaints <REDACTED>

 

Dear Dr Alexander

Thank you for your email which has been passed to this department.

I can confirm that no trial appears on the CPS database for anyone of this name in Kent, Surrey or Sussex.

Kind regards

South East VRR & Complaints Team

 

From: Minh Alexander [REDACTED]
Sent: 06 October 2019 15:14
To: Freedom of Information Unit
Cc: Enquiries
Subject: FOI request FAO Crown Prosecution Service South West

FOI request FAO Crown Prosecution Service South West

6 October 2019

Dear Sir,

It was reported in 2015 that the case against Georgina Halford Hall for handling stolen goods and breach of the Data Protection Act came before Canterbury Crown Court but that the case was dropped by the Crown Prosecution Service.

https://www.telegraph.co.uk/news/uknews/law-and-order/11702655/My-fear-of-jail-for-being-a-whistle-blower.html

https://www.lawgazette.co.uk/lawyer-in-the-news/alleged-school-abuse-whistleblower-arrested/5049933.article

Please can you advise if a trial ever actually commenced into the allegations, and if so, on what dates did the trial take place?

Dr Minh Alexander

 

UPDATE 23 OCTOBER 2019

On 10 October 2019 Ref. 8734 the CPS offered further clarification in which they stated definitively that no trial took place:

“In response to the above, the Crown Prosecution Service can confirm that the case was discontinued and therefore a trial did not commence.”

 

UPDATE 8 NOVEMBER 2019

On the 5 November 2019 Georgina Halford Hall the CEO of WhistleblowersUK tweeted from her personal account that a trial took place, and claimed that the article in the Dover Express of 15 October 2015 was “fake news”:

Screenshot 2019-11-05 at 18.17.38

The whistleblower mentioned in the tweet challenged Georgina Halford Hall’s claim that she had been charged with theft.

The CEO of WhistleblowersUK made this further statement, but did not withdraw her claim that a trial took place:

WBUK Georgina Halford Hall partial retraction of theft claim against Tracy Austin

 

RELATED ITEMS

Whistleblowing v Bounty hunting. A new whistleblowing APPG with sponsorship from bounty hunters

Replacing the Public Interest Disclosure Act (PIDA)

Whistleblowers in Their Own Words: What’s wrong with UK whistleblowing law and how it needs to change

UK Whistleblowing Law is an Ass: Helen Rochester v Ingham House Ltd and the Complicit CQC

Whistleblowers UK has been paid by well-known US bounty hunting lawyers Constantine Cannon to act as the secretariat of the Whistleblowing APPG

Mary Inman of Constantine Cannon speaking about the bounty hunting model at the Byline festival in 2018:

“37.24 “…It’s exactly what you do in law enforcement…we pay informants”

https://www.youtube.com/watch?time_continue=1&v=QoY6FEEeTNI

Screenshot 2019-10-09 at 10.58.10

FPPR: CQC’s & University Hospitals Birmingham NHS Foundation Trust’s economy with the truth

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 30 September 2019

 

Summary: CQC arbitrarily rejected an FPPR referral on a director of University Hospitals Birmingham NHS Foundation Trust on spurious grounds that a GMC referral had to be resolved first, despite having accepted a previous referral on the same individual under exactly the same circumstance, and despite the existence of a current, active FPPR process. Ian Trenholm CQC chief executive has been asked to examine this anomaly and to consider, if appropriate, whether there has been any collusion between CQC and the trust to exclude relevant evidence from the current FPPR review. Alongside this bizarre refusal by CQC to accept an FPPR referral, the trust issued a misleading FOI response to a third party, claiming that there had never been any FPPR referrals about trust directors. The trust changed its story after the CQC was informed of its misleading FOI response, but it only admitted to a single FPPR referral since 1 April 2016. CQC has been asked to disclose the true number of FPPR referrals on trust directors.

 

 

Background

CQC was excoriated for a string of very serious FPPR governance failures.

The government eventually caved in and arranged a formal review of FPPR by Tom Kark QC after Bill Kirkup added his voice to the chorus, through his investigation of major regulatory failures at the now defunct Liverpool Community Health NHS Trust (LCH).

LCH was Jeremy Hunt’s MidStaffs: Staff horrendously bullied and their safety concerns ground into the dust in the pursuit of foundation Trust status. Regulators were asleep at the wheel. They later helped orchestrate the recycling of incompetent trust directors who covered up serious safety issues, and frittered money on even a ‘life-sized elephant’ whilst stripping away essential patient care.

 

Rosie Cooper MP, whose father suffered poor care at Liverpool Community Health NHS Trust, led a parliamentary debate on the scandal and made these observations:

We might think that an executive team that slashed £20 million from front-line services, causing patient and staff harm, would guard every penny. We would be wrong. They spent more than £350,000 on drumming up support for their application for foundation trust status. They spent more than £1 million on a programme management office of external consultants to tell them how to save money. At the trust’s annual meeting in 2013, the same year the board slashed £7 million from front-line services, its leadership team still managed to find enough money to hire jugglers, unicyclists, stilt-walkers and a life-sized elephant to greet guests—I am not kidding. In the same period, the chief executive’s pay increased by nearly a third, from £95,000 to around £130,000 a year.

… The Trust Development Authority in the end removed the chief executive, the executive nurse and the human resources director from their posts following a review by Sir Ian Carruthers. I was led to believe that because of the information that I had provided and the Carruthers review, those individuals had been sacked. That was untrue. The TDA also left the failing non-exec directors in place on the board, and that hindered the trust’s recovery. If the board was failing and the executives had to go, why leave half the board there to hinder the people brought in to make it better?

I am still astounded that I was told that the chief exec had been fired when the truth, elicited by freedom of information, says that she was given a reference and that Manchester mental health trust was asked to mentor her without being told about the full circumstances. Effectively, she had been moved from one job—because she was doing badly—to be mentored at Manchester mental health trust. Currently, she remains safely holed-up in a senior executive role at Betsi Cadwaladr University Health Board, still earning about £106,000. I am told by the Care Quality Commission that her flight across the borders within the United Kingdom prevents it from taking any action.

Gary Andrews, the former director of finance and a non-clinical clinical governance lead, has been given a senior managerial role in NHS England’s vanguard programme. Craig Gradden, LCH’s former medical director, is employed as a medical consultant in Sefton. Helen Lockett, Liverpool Community Health’s former director of nursing, who I was told had been sacked, got a £25,000 pay-off and a reference. Only the 18-month interim order issued by the NMC while she is under investigation stops her practising. Who referred her to the NMC? Was it the system? No, it was me.

Michelle Porteous, the HR director, was allowed to leave unchallenged and was seen to spend her last days at the shredding machine—no one stopped her. Although outside the remit of the NHS and its regulators, the former chair of the trust continues to work with the health service through her management of a charitable company called Health@Work, which sells health and safety advice, training in emotional intelligence, spotting signs and symptoms of poor mental health in staff members and techniques to manage stress. I will say no more.”

 

 

Kark’s FPPR Review report, published in February 2019, was a curate’s egg.

The key recommendations of his Review were as follows:

(a) Requiring the design of a set of specific core elements of competence, which all directors should be able to meet and against which they can be assessed when considering whether they meet the FPPT in terms of qualifications, competence, skills and experience.

(b) Setting up a central database so that information about directors is consistently retained and a history is built up in relation to each individual Board level director within the health service.

(c) Requiring that a mandatory reference form be designed, which must be completed by the employer and signed off by a Board level director, when a director moves from health Trust to health Trust.

(d) Extending the concept of the FPPT to Board level directors of commissioners and appropriate NHS Arms’ Length Bodies (ALBs).

(e) Setting up a body which has the power to bar directors where serious misconduct is proved to have occurred.

(f) Requiring the identification and definition of what is regarded as ‘serious misconduct’ justifying barring.

(g) Providing that ‘normal’ disciplinary and performance issues are still dealt with at Trust level.

(h) Amending the appointment rules for commissioners of health services and appropriate ALBs so that they are prevented from appointing somebody who has been disbarred as a director.

(i) Aligning the test of serious misconduct to be considered by the HDSC with the same definition of misconduct under the Fit and Proper Person Regulations

(j) Amending the Fit and Proper Person Test to remove the reference to directors ‘being privy to’ mismanagement which we do not think promotes clarity.

 

The government accepted the first two recommendations. Of concern, Matt Hancock the Secretary of State for Health and Social Care delegated the decision on which of the remaining recommendations should be adopted to NHS Improvement.

Regulators like NHSI have in fact been a key part of the problem. NHS Improvement is notorious not just for recycling erring NHS trust directors like Paula Vasco-Knight,  but also for providing shelter in its recesses for those overcome by the rigours of running provider services.

NHSI has been slow and opaque in its response to the Kark Review. The most information so far was provided in an email of 25 September 2019 from Dido Harding, NHSI Chair:

“As you know, the Department of Health and Social Care accepted the first two recommendations of the Kark Review and asked that NHS England and NHS Improvement engage with a wide range of stakeholders to consider the remaining five. We have subsequently agreed with the department that we should also implement the third recommendation (to introduce a mandatory reference requirement for NHS directors) and that the department would consider the final recommendation (which concerns the application of the FPPR in social care). 

We intend to write to the department, setting out our implementation approach to the entire Kark Review alongside publication of the People Plan later this year. My team is currently speaking to a range of people to inform the best approach to implementation and I have passed your contact details on to a colleague, who will be in touch with you separately so that you have an opportunity to inform on our next steps.”

I imagine that if others are interested in contributing to NHSI’s process, they could contact NHSI and ask to be involved.

In the meantime, it seems clear that CQC’s handling of FPPR remains very patchy.

I have had one experience of prompt and appropriate response from CQC recently, which is the first of its kind, but this is set against the seriously questionable handling of another referral.

 

CQC’s funny FPPR footwork

In October 2018 I referred a director of University Hospitals Birmingham NHS Foundation Trust to the General Medical Council, and then forwarded the GMC referral to CQC, to ask also for an examination under FPPR.

In August this year, after enquiries, Nigel Acheson CQC Deputy Chief Inspector of Hospitals informed me that the FPPR had been accepted but was still ongoing. He indicated that University Hospitals Birmingham NHS Foundation Trust was in the middle of an external FPRR process:

“The Trust are involved in an external process which may take some time to conclude.”

Another person referred the same University Hospitals Birmingham NHS Foundation Trust director to the GMC and also sent an FPPR referral to the CQC. This related to similar but different matters.

Unexpectedly, the same CQC Deputy Chief Inspector of Hospitals refused to consider this additional FPPR referral until the GMC process was completed:

Screenshot 2019-09-29 at 23.46.22.png

I am not aware of any CQC policy, any law or government guidance which allowed CQC to refuse the further FPPR referral on such a basis.

It was mystifying that CQC advised the second referrer that their FPPR could not be accepted before the GMC process was complete, when CQC had accepted my referral under exactly the same circumstances and CQC knew that there was an active FPPR review underway on the same individual, as a result of my referral.

I have asked Ian Trenholm CQC Chief Executive to account for the apparently arbitrary difference in the way the two FPPR referrals were handled. I have asked him, if appropriate, to investigate if there was collusion between the CQC and University Hospitals Birmingham NHS Foundation Trust to exclude relevant evidence by the second referrer from the current FPPR review.

 

truth false buttons

 

An untrustworthy trust

In addition to the irregularity in CQC’s response in refusing the second referrer’s FPPR referral, University Hospitals Birmingham NHS Foundation Trust itself appears to have acted in a misleading way.

Martin Morton a social care whistleblower asked University Hospitals Birmingham NHS Foundation Trust for the number of FPPR referrals on its directors over the period 1 April 2016 to the present day. He received the following reply on 23 September 2019, which was of course false:

https://www.whatdotheyknow.com/request/fit_and_proper_persons?nocache=incoming-1439262#incoming-1439262

UHBT FOI response to Martin Morton FPPR

 

The CQC was informed that the trust had issued a misleading FOI response.

Shortly after this, on 26 September 2019, the trust corrected its FOI response and admitted that there had been a single FPPR referral on a trust director, which was the subject of an external review.

The trust claimed that its original, misleading FOI response was due to miscommunication and administrative error.

“It has come to my attention that the information provided to you within our reply to your FOIA request was incorrect. I have conducted a brief investigation into how this may have occurred and it would appear that there may have been a miscommunication between the relevant members of our Corporate Affairs department. My sincere apologies for this error.”

Even then, it seems surprising that the trust has purportedly received only one FPPR referral, given that one of its predecessor bodies was the troubled Heart of England NHS Foundation Trust, the home of several scandals including the Ian Paterson rogue breast cancer surgeon affair.

I have asked Ian Trenholm to disclose how many FPPR referrals CQC has received about University Hospitals Birmingham NHS Foundation Trust, including its predecessor bodies.

The trouble with our post Truth society and the deterioration of standards in public life is that trust is badly eroded, and little can be taken for granted. Deception and doubt are a self-replenishing toxin, concentrated by every additional casual lie and half truth. One hopes an antidote will come, but it is likely to take many years.

UPDATE 26 OCTOBER 2019

The CQC was asked to disclose the true number of FPPR referrals that it had (1) received (2) passed onto the trust.

CQC’s reply revealed another layer of deception:

More Fit and Proper Person lies: CQC & University Hospitals of Birmingham NHS Foundation Trust

 

RELATED ITEMS

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

FPPR is a poor sop for a genuinely enforced system of accountability. In particular, it has failed to ensure that those responsible for whistleblower reprisal are held to account.

FPPR’s failure and the government’s reluctance to provide real alternatives only serve to emphasise the need for proper reform of UK whistleblowing law:

Replacing the Public Interest Disclosure Act (PIDA)

Whistleblowers in Their Own Words: What’s wrong with UK whistleblowing law and how it needs to change

funeral