The Low Fact National Guardian’s Office

 By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 25 August 2019

 

Summary: The NHS National Guardian’s Office could produce no robust evidence for a major recent claim that: “Patient’s lives have been saved and untold harm has been prevented because Freedom to Speak Up Guardians have supported workers”

 

 The Freedom To Speak Up project is based on government duplicity, spin and half truths.

It had no evidence base.

Robert Francis, the government’s frontman, later spun this as heroic pioneering, but even this was not true:

In fact the model is a hand-me-down from the corridors of Whitehall.

It is clear the National Guardian is keen to generate Good News stories, as her newsletters are full of smiling photos.

Her compact with local trust Speak Up Guardians includes promoting their purported successes, although the evidence so far suggests that caution is needed in accepting the National Guardian’s examples of success.

One of her latest projects is to collect a 100 stories of self-reported success. The instructions for submission encourage NHS Trust Guardians to recruit the help of local trust spin doctors:

“Involve your communications team before you make a submission to discuss how you can develop these case studies. They can help you tell these stories by filming short videos; commissioning animated GIFs for social media; shooting high-quality photos; or drafting media releases for the local and regional press. The National Guardian’s Office may get in touch about adapting the case studies for short social media videos, annual reports, news stories and other communications.”

 

Of course, the message communicated in seeking Good News stories is that Bad News is not welcome. Surreal coming from a whistleblowing agency

The government’s smoke and mirrors also continue in a lack of rigourous monitoring and evaluation.

The National Guardian does not even collect data on whether NHS whistleblowers’ concerns are addressed.

And yet the National Guardian, a senior doctor trained in the proper evaluation of evidence, makes extraordinary claims of success in the absence of clear evidence.

On 16 July 2019 her office tweeted a claim by her that the Freedom To Speak Up project had prevented untold harm and saved lives:

 

Customarily, to reach such conclusions about healthcare interventions and to promulgate them, doctors conduct scientifically rigourous research and have their work peer reviewed prior to publication.

Indeed, the GMC expects all doctors to work in an evidence-based manner:

“provide effective treatments based on the best available evidence”

(Good Medical Practice, Professionalism in Action, 16.b)

To my knowledge, the National Guardian has not produced any evidence that the establishment of the Freedom To Speak Up project, as opposed to other factors, has been specifically responsible for reducing harm and deaths in the NHS.

The evaluation research on the Freedom To Speak Up project commissioned so far by the government avoids core questions such as this. It is designed to faff around at inconsequential edges.

The National Guardian maintains it is a success that staff are raising concerns through Speak Up Guardians, but this is not necessarily a good sign. It can indicate in some cases that there is a difficulty with the line of management and perhaps with the management culture generally.

The tweeted claim of 16 July about lives saved was queried and supporting evidence was requested.

This request was ignored twice. Accordingly, a request for substantiating evidence was formally made by correspondence.

After a chaser, this was the reply from the National Guardian’s Office on 9 August 2019:

“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”

This was also extraordinary, but upon checking, it was confirmed to be the ‘evidence’ for the claim about lives saved.

So it appears the National Guardian, a senior doctor, has claimed from self-reported data by NHS trusts that patient safety concerns are raised with Speak Up Guardians, that “untold harm” and deaths have been prevented.

The full correspondence is provided in the appendix below.

It is tragi-comical that this is the level of evidence relied upon to make claims that lives are being saved.

But it does go to the political nature of the National Guardian’s Office.

It is a very expensive firewall, that will pump out cheery messages whilst core NHS services crumble around us.

 

RELATED ITEMS

 Replacing the Public Interest Disclosure Act (PIDA)

 What is needed is a serious, professional whistleblowing agency established under an umbrella of strong, safe whistleblowing law and direct supervision by parliament, not governments.

The first essential step is the urgent replacement of seriously inadequate UK whistleblowing law.

A portrait of ineffectiveness: Internal whistleblowing champions in their own words

 

 

 APPENDIX

 Correspondence with the National Guardian about the claim that Freedom To Speak Up Guardians have prevented untold harm and saved lives

 On Fri, 9 Aug 2019 at 16:25, National Guardian’s Office <REDACTED> wrote:

Dear Mr Alexander,

I can confirm that the email below is in response to your original email of 23^rd July.

Kind regards,

Ellie Staite

Correspondence Officer

National Guardian’s Office

151 Buckingham Palace Road

London

SW1W 9SZ

 From: Ian Alexander <REDACTED>

Subject: Re:

Date: 9 August 2019 at 16:21:30 BST

To: National Guardian’s Office <REDACTED>

Dear Ms Staite,

In the interests of clarity, can you advise if your letter of today’s date is in response to, and therefore the answer to, my query of 23rd July addressed to Dr Hughes.

Many thanks,

Ian Alexander

 

On Fri, 9 Aug 2019 at 15:37, National Guardian’s Office <REDACTED> wrote:

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

SW1W 9SZ

From: Ian Alexander <REDACTED>

Subject: Re:

Date: 2 August 2019 at 11:18:55 BST

To: Henrietta Hughes <REDACTED>

Dear Dr Hughes,

I refer to my letter of 23td July copied below for your convenience.

I received a reply by return from your office advising me that I would receive a substantive response within twenty working days.

Given the importance of this issue, and your overarching responsibility to your public office, I was surprised to receive such a casual brush off and indeed made a further, as yet unanswered, enquiry regarding civil service response targets.

As I have still not received any meaningful explanation for your extraordinarily important claim, I confess to being a little uneasy that such a claim, made over two weeks ago still lies on the public record unevidenced.

I would be glad if you could correct that, and publish the evidence on which you made such an important claim without further delay.

Thank you,

Ian Alexander

To: Henrietta Hughes <REDACTED>
Sent: Tue, 23 Jul 2019 11:56

Dear Dr Hughes,

Attached is a screen shot quoting your response to the APPG report. It also shows my request that this claim be evidenced. To date there has been no response. Accordingly I now bring it to your attention in case your comms team have not done so.

Thank you,

ID Alexander