Hooray Henrietta

A special bulletin from the Ministry of Love. 

It seems our replacement National Guardian for whistleblowing is a fan of peace and love, apparently by diktat if necessary. She’s even given an interview to the Times about her thoughts on how NHS staff must be cheerful, so that no one feels intimidated from speaking up.[1]


The NHS needed more of the “trust and joy and love” hormone oxytocin, Dr Hughes said, citing the happy embraces of reunited families at the start of the Hugh Grant film Love Actually….If you think about that scene in Love Actually where everybody is meeting at the airport, that’s the oxytocin feeling. So wouldn’t it be better if oxytocin was the predominant neurotransmitter in the NHS?…In her first interview as national guardian for speaking-up, Dr Hughes urged staff to “start living . . . the NHS that they want to work in…Dismissing concerns that her job had few formal powers, she said that change could happen “just like that” if staff always acted as they would on a good day”

Darn, why didn’t any of us think of that? Forget all those silly old professors who’ve been researching whistleblowing for years. Forget their daft evidence-based recommendations. Who needs dull stuff like Law reform and proper infrastructure for safeguarding whistleblowers [2] when you can have happy, happy, happy, happy talk. So, well done Sir Robert, Patients Association and CQC for another credible and serious appointment. [3]

Henrietta’s so big on happy, shiny people that according to a blog, she introduced a RULE about smiling for her staff: [4]

At the Olympics as I handed over my ticket and walked into the venue I noticed a small sign on the back of the booth – SHINE.  I saw the first 3 words but by then I had moved past so did some research and made a guess as to what the N and E meant:

S – smile

H- hello

I – eye contact

N- name

E- enthusiasm/ Empathy

While researching I came across the 10:5 rule – when someone comes within 10 feet – smile, within 5 feet – say hello.”

NHS managerial grotesquery, you may think.

Moreover, is it right and proportionate to disparage “grumpy” staff, without mentioning the KissUpKickDown senior management? Or the intolerable stresses to which the NHS frontline has been subjected? No, forget the lowest paid NHS staff being forced to rely on food bank handouts [5] whilst senior managers have repeatedly awarded themselves fat pay rises. Forget the anxiety of working in seriously under-staffed departments or the stress and exhaustion of servicing on call rotas with yawning gaps. Forget the institutional dishonesty that forces unhappy staff to become complicit in cover ups, or to risk all by dissenting. [6] Forget the message of intimidation inherent in seeing senior managers walk away unscathed after indulging in whistleblower reprisal. [7] [8] Just let those whining staff eat food bank cake.


Phil Morley, Robert Halfon MP, Jeremy Hunt Health Secretary and Douglas Smallwood Trust Chair, at Princess Alexandra Hospital Essex


The twitchy and highly controlling NHS establishment classically brands staff dissent as “disruptive” and “unmanageable”. Bogus disciplinaries are often concocted against truth tellers. If these don’t succeed, employers can still cry breakdown of relationships – which is a legal basis for dismissal no matter whose fault it is. [9] Compulsory smiling is surely part of the dysfunctional, choking miasma.

And is Henrietta in a position to share a valid evaluation of her “10 foot” smile rule, and whether it had a measurable effect on whistleblowing governance?

Or were her staff just grinning and bearing with the intrusive management….because they didn’t feel able to object?

On top of a non evidence-based Guardian model courtesy of Sir Robert [10], will there now be policy by caprice and movie references?

I would actually like to hear from Henrietta. Even at this very late stage no one knows what exactly she is going to do for desperate and distressed whistleblowers. I’m still waiting for an answer to questions that were first put to Sir Robert in May, which have been put to Henrietta twice since. [11] [12]

Whilst we’re all waiting for serious answers as opposed to CQC set pieces, here’s what Mr Orwell said about the Ministry of Love:

“The Ministtry of Love was the really frightening one. There were no windows in it at all. Winston had never been inside the Ministry of Love, nor within half a kilometer of it. It was a place impossible to enter except on official business, and then only by penetrating through a maze of barbed-wire entanglements, steel doors, and hidden machine-gun nests. Even the streets leading up to its outer barries were roamed by gorilla-faced guards in black uniforms, armed with jointed truncheons.”

Smile for the CCTV camera.

Related items

Clubadoodle-doo. An update on continuing lack of clarity about the National Guardian’s remit.


No one believes Jeremy Hunt on patient safety and whistleblowers, not even his own appointees. A summary about the development of the National Guardian office and information from a meeting with Eileen Sills the former National Guardian, who resigned.


Update 11 October 2016

Letter to Peter Wyman CQC Chair, bringing to his attention the strong, negative responses to Henrietta Hughes’ comments that staff must be more cheerful.




[1] Happiness is the best medicine, grumpy doctors and nurses told Chris Smyth, Times, 10 October 2016 happiness-is-the-best-medicine-henrietta-hughes

[2] Sir Robert’s Flip Flops. Minh Alexander, 26 September 2016


New National Guardian appointed to the lead the NHS in speaking up freely and safely. CQC press release about Henrietta Hughes’ appointment. 7 July 2016

[3] New National Guardian appointed to the lead the NHS in speaking up freely and safely. CQC press release about Henrietta Hughes’ appointment. 7 July 2016


[4] SHINE. Henrietta Hughes guest blog for NHS Mangers Network



Guest Editorial SHINE 28 Jul

SHINE Henrietta Hughes NHS England

It’s the first anniversary of the 2012 Olympic Games – what is the legacy for the NHS?


Cast your mind back to the warmth and friendliness of the volunteers at the London 2012 Olympic and Paralympic Games. Despite the crowds and the need to get all the visitors into the venues swiftly the volunteers were always smiling and friendly and made us feel really welcome.  The  friendliness continued outside the Olympic Park with commuters uncharacteristically chatting on the tubes and trains.  The NHS starred in the opening ceremony in such a moving way, in stark contrast to the daily stories we now read of widespread poor patient experience.

I wondered how we could harness the amazing warmth of the volunteers to improve not only the patient experience but also the staff experience within the NHS. At the Olympics as I handed over my ticket and walked into the venue I noticed a small sign on the back of the booth – SHINE.  I saw the first 3 words but by then I had moved past so did some research and made a guess as to what the N and E meant:

S – smile

H- hello

I – eye contact

N- name

E- enthusiasm/ Empathy

While researching I came across the 10:5 rule – when someone comes within 10 feet – smile, within 5 feet – say hello.

The 10:5 rule is widely employed by sales teams, at Universal Studios and the Georgia World Congress Center as well as several healthcare providers in the USA. At the Medical University of South Carolina (MUSC) Medical Center this is written into the job description of all staff. Individually employees, as well as applicants, must pledge to practice standards of behaviour for the benefit of colleagues and the betterment of the MUSC Medical Center.  A patient described a journey from the front door at MUSC to the time she was seen by the doctor.  By then she had received so many smiles and acknowledgements she described herself as grinning from ear to ear. The staff describe being happy and welcomed from day one.

I have started SHINE and the 10:5 rule within my team in London and shared it across the Directorate.  It has helped to create a kind and welcoming atmosphere across a large open plan office and to build relationships across different directorates. I would love to see this expanded across the NHS.  It is free, warm and friendly. Make this part of the training of GP receptionists and clinic staff and patients would feel better straight away. It needs to be role modeled by senior management, when you are walking the wards or around your own work environment you will be more approachable to patients, relatives and your junior staff.  As a GP I have always greeted patients by name from the waiting room rather than the impersonal dot matrix display.  A warm smile and greeting helps to evaporate the tension if I have started to run late and builds a great start to the consultation.

So let’s build on the inspiration of the Olympic and Paralympic games by helping staff to SHINE and making the NHS an inviting and friendly environment for both patients and staff. Smiling has been variously credited with improving mood, relieving stress and boosting the immune system, lowering blood pressure, releasing endorphins, improving attractiveness and making you look younger.  Whilst I cannot guarantee that you will look younger and more attractive smiling is contagious – I certainly get a lot of smiles around the office.

[5] Nurses turning to food banks and asking for debt advice because of NHS cuts.

Jane Kirby, Mikey Smith, Mirror 2 September 2015


[6] Hot air about Just Culture, Richard von Aberndorff and Minh Alexander


[7] Health Secretary. NHS boss Phil Morley’s appointment ‘Fit and Proper’


[8] CQC’s Fit and Proper Parade. Minh Alexander, 29 July 2016


[9] Important new guidance from the courts for employers on managing whistleblowing claims. Capsticks LLP

[10] Critique of Francis’ model of trust-appointed Guardians. Minh Alexander 4 June 2015


[11] Letter to Robert Francis 1 May 2016


[12] Clubadoodle-doo, 4 October 2016 Minh Alexander


2 thoughts on “Hooray Henrietta

  1. Oh yes, the answer to whistleblowing and the encouragement to raise concerns safely, lies with front-line NHS staff being happy and smiley! You want happy, smiley people then you need to find whistleblowers who have raised serious concerns and are still in their jobs being happy and smiley! What better role models could you ask for? So where are they? I’m an NHS whistleblower who won her case at ET but still ended up with no job. The trusts involved had every opportunity to make me a happy, smiley person but chose to support the transgressors (who they knew were in the wrong), who were all members of the executive team. Stop the patronising and start addressing the real issues of corruption, greed and cover-up inherent in senior management! Until then, we, the whistleblowers, are laughing at Henrietta’s naivety and crying at the loss of our professional careers.

    Liked by 2 people

  2. I do thank you for this and admire your self-discipline in dissecting the breath-taking stupidity of the issue without recourse to basic Anglo-Saxon.
    As soon as I read the first paragraph, George Orwell sprang to mind.
    The issues you describe defy satire and one is almost reduced to hyperbole. Re-arranging the napkins as the Titanic sank did at least enable focus in a terrible and inevitable disaster.
    But, the thermo-nuclear elephant in the room here is that things can be done. They should be done. And yet, it is as if we are left to watch as the patient haemorrhages to death whilst the politicos, management and medical professionals discuss the colour of the curtains.
    Can’t wait for Halloween. Perhaps Henrietta will dress up as a ghoulish vampire in order to bring cheer to her malnourished and neglected patients.
    Thanks you, Dr Alexander.

    Liked by 1 person

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