NHS Improvement declines to remove Andrew Morris from the National Guardian’s Accountability and Liaison Board, which he chairs.

By Dr Minh Alexander NHS whistleblower and retired consultant psychiatrist, 11 March 2021

Summary: NHS Improvement has decided that Andrew Morris NHS Improvement non executive director will continue in his role as chair of the National Guardian’s Accountability and Liaison Board despite an instance of proven whistleblower reprisal by Frimley Health NHS Foundation Trust, when he was trust CEO and line manager to a director criticised for their part in the whistleblower detriment. The whistleblower harmed was Donna Simmonds, an administrator who raised patient safety concerns. Moreover, the trust’s litigation in the case was signed off by another of Morris’ direct reports, the director of Human Resources. Is there sufficient clear blue water between Morris and the proven whistleblower detriment? CQC missed the whistleblower detriment at the time and instead praised Frimley’s whistleblowing governance. Most recently, CQC asked Frimley for evidence of learning from the Simmonds whistleblowing case, but the trust response was grudging and thin. Frimley Health NHS Foundation Trust serves former health secretary Jeremy Hunt’s constituency. Frimley featured prominently in Hunt’s patient safety crusader narrative and also in the National Guardian’s propaganda. However, the well known twenty year cover up of baby Lizzie Dixon death under Frimley’s care took place on Andrew Morris’ watch.

The NHS National Guardian for whistleblowing is funded and supervised by those whom she is supposed to hold to account, namely the Care Quality Commission and NHS England/Improvement.

This is not reassuring.

The supervising structure is the National Guardian’s Accountability and Liaison Board and comprises Robert Francis and Andrew Morris and Henrietta Hughes. Morris and Francis are non executive directors of CQC and NHSI respectively, and Henrietta Hughes holds the office of the National Guardian for whistleblowing in the NHS.

Francis previously chaired the Accountability and Liaison Board, and so was scrutinising a flawed project which he designed.

Francis refused to meet with me to discuss concerns about the Freedom To Speak Up project. Francis’ correspondence to the National Guardian disclosed via subject access request revealed that this refusal was based on his belief that he could not change my mind, raising questions about his objectivity about his brainchild and ability to process challenge.

Francis was replaced by Andrew Morris as chair of the Accountability and Liaison Board.

I raised concerns with NHS Improvement about this role because of knowledge of victimisation whistleblowers by of Frimley Health NHS Foundation Trust, when Morris was trust CEO.

NHS Improvement declined to act.

On 26 October 2020 I raised questions again about Morris’ role as chair of the National Guardian’s Accountability and Liaison Board, after the publication of an Employment Tribunal judgment on proven whistleblower reprisal against Donna Simmonds NHS administrator, by Frimley Health NHS Foundation Trust. Donna Simmonds raised patient safety concerns.

This whistleblower reprisal occurred during Morris’ tenure as CEO.

I wrote to Dido Harding, NHS Improvement chair:

Letter 26 October 2020 to Dido Harding NHS Chair about Andrew Morris’ role as Chair of National Guardian’s Accountability and Liaison Board

After five months, NHS Improvement responded thus on behalf of Dido Harding on 9 March 2021:

“Hi Minh

Thank you for your email and apologies for taking so wrong [sic] to reply directly to this.

We have considered the tribunal findings and can understand why you have raised it. I have liaised with Dido, Sir Andrew Morris and Henrietta Hughes on this matter.

Having discussed with Sir Andrew, it seems that he was not directly involved in this matter. Nonetheless, NHSE/I will consider whether we might incorporate learning from this into our broader work to improve people practices in the NHS.

Sir Andrew will remain in his role on the NGO’s ALB.

Thank you again for bringing this to our attention.

With best wishes”

But the ET found that Helen Coe the then Frimley Director of Operations and Sarah Casemore Deputy Director of Operations were responsible for detriment to Donna Simmonds in terms of not allowing her to return to her original role:

“We have considered the reasons why Ms Casemore and Ms Coe reached the decisions that they did that the claimant’s working relationships had broken down so that the claimant could not return to her original role. The respondent said that the problems with the team were not limited to the claimant. It was accepted that the team as a whole was dysfunctional. We did not hear any evidence about why the respondent decided that, despite there being a problem across the whole department, it was the claimant who had to move. As set out above, there was evidence before us that the claimant was regarded by her managers as difficult and a troublemaker and we have inferred that her first two protected disclosures materially influenced that perception. We also infer that the perception of the claimant as a troublemaker by her line managers played a material part in the decisions by Ms Casemore and Ms Coe that there had been a breakdown in the working relationships between the claimant and her managers in the department and the decision that it was the claimant who had to move.”

It is hard to understand how Andrew Morris could not know about the case given that Helen Coe was his direct report. It would surely be a failure of oversight if he did not.

But NHS Improvement’s response gives comfort to NHS trust chief executives, who can heave a sigh of relief that they will not be held accountable for serious wrongdoing so long as they are not “directly involved”.

In between my letter of 26 October 2020 to Dido Harding and NHS Improvement’s reply of 9 March 2021 Andrew Morris signed off an NHS Improvement complaint investigation about the National Guardian and her Office, which interviewed only two of four key witnesses.

Morris reportedly stuck to his guns after a query. He was overruled after I appealed to Dido Harding.

Alongside querying Morris’ role as chair of the Accountability and Liaison Board, I also asked Frimley Health NHS Foundation Trust about executive responsibility for the handling of the Donna Simmonds whistleblowing case.

The trust’s reply indicated that another of Morris’s direct reports, the Director of Human Resources was ultimately responsible for signing off the trust response to Donna Simmonds’ ET claim:

Frimley Health NHS Foundation Trust FOI disclosure on senior responsibility for the trust’s response to Donna Simmonds whistleblowing case

I leave it with readers to judge if there is sufficient clear blue water between Morris and the victimisation of a whistleblower, to justify his continuing role in shaping the work of an agency that is supposed to help NHS whistleblowers.

For completeness, in October 2020 I also sent the Simmonds ET judgment to Ted Baker CQC Chief Inspector of Hospitals who kindly took the matter up with the local CQC inspection team. At the material time CQC had failed to either pick up or report the Simmonds case. In fact, CQC praised Frimley’s whistleblowing governance:

“Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. The trust had a well-publicised and embedded values system developed in conjunction with its staff. Staff described and open and positive culture at the organisation. Staff demonstrated a sense of belonging and frequently talked about a “family feel” at the organisation. The trust supported effective employee relations and staff could formally raise concerns through effective human resources procedures”.

The local CQC team told me that they would ask Frimley for evidence of learning from the Simmonds case.

I asked Frimley what evidence of learning the trust gave to CQC. This is the document disclosed by the trust in response:

Frimley Health NHS Foundation Trust disclosed evidence document sent to CQC November 2020

There are some process improvements but alas, the specific trust response to causing a whistleblower detriment is very flimsy. It consists of waffle on defining “detriment” as opposed to any action to robustly deter it.

Importantly, Frimley’s response to CQC implied that the trust did not seek to learn from the Simmonds case until approached by the CQC.

Overall, Frimley’s response to CQC reads as a reluctant document, which shows little empathy and makes little if any acknowledgment of the injustice and harm to the whistleblower.

An important contextual factor is that Frimley’s reputation has been a political issue. In June 2014 Jeremy Hunt announced that he had hired recently knighted Robert Francis to undertake the Freedom To Speak Up review on whistleblowing in the NHS as a response to pressure over scandals. Hunt also brandished a list of twelve NHS trusts which he claimed had signed up to his grandiose campaign to make “the NHS the safest healthcare system in the world.” Frimley was amongst those who were obligingly helping with Hunt’s tinselly narrative.

Letter by Jeremy Hunt 24 June 2014 on whistleblowing and national patient safety campaign

Frimley was endlessly wheeled out as an exemplar.

Andrew Morris was knighted for services to the NHS in 2015.

Frimley has also featured prominently in the National Guardian’s propaganda:

However, it is also important to note the infamous twenty year cover up of baby Lizzie Dixon’s death took place on Morris’ watch as Frimley CEO.

The cover up of baby Lizzie Dixon’s death

Andrew Morris became Frimley’s chief executive in 1991. His tenure as chief executive spanned the death of baby Lizzie Dixon under Frimley’s care on 4 December 2001, and a subsequent twenty year multiagency cover up.

An investigation by Bill Kirkup, published by the government on 25 November 2020, focussed on dishonesty by frontline clinicians but said almost nothing about the governance of their employer, Frimley Park Hospital.

The life and death of Elizabeth Dixon, a catalyst for change

The then Chief Executive of the Strategic Health Authority was interviewed but oddly, Andrew Morris was not listed amongst individuals interviewed by Kirkup’s investigation.

Buried in the investigation report appendices is the sentence:

“Allegations about the fitness to practise of medical staff involved in her death were considered by the General Medical Council, and complaints were considered by Frimley Park Hospital and Great Ormond Street Hospital”.

Kirkup made no specific recommendations for Frimley, but there is a comment that community care should be properly planned and should not discriminate against disabled people through the application of lower standards:

“Community care for patients with complex conditions or conditions requiring complex care must be properly planned, taking into account and specifying safety, effectiveness and patient experience. The presence of mental or physical disability must not be used to justify or excuse different standards of care.”

We will limp on with cover ups, subpar whistleblowing governance, conflicts of interest and ramshackle sham ‘protections’ systems for as long as there is no political will to do it properly.

If you have not already done so, please help drive change by signing and sharing this petition to parliament for law reform.

Petition: Replace weak UK whistleblowing law and protect whistleblowers and the public

Many thanks