By Dr Minh Alexander retired consultant psychiatrist 16 April 2022
The NHS Freedom To Speak Up project to promote culture change and safe whistleblowing is running out of road.
As the years pass, glib assurances by the government and by Robert Francis that it would deliver culture change look more and more unsound.
Seven years ago, Robert Francis rejected the option of calling for substantive reform of UK whistleblowing law – despite admitting the law was weak – because he claimed law reform would take too long:
“9.17 Although the existing legislation is weak, I have not recommended a wholesale review of the 1996 Act for two reasons. First, I do not think legislative change can be implemented quickly enough to make a difference to those working in the NHS today. What is needed is a change in the culture and mindset of the NHS so that concerns are welcomed and handled correctly. If this can be achieved, fewer staff will need recourse to the law.”
Instead, he proposed his go-faster option of Freedom To Speak Up Guardians, which he insisted would be effective despite inherent conflicts of interest in the model and an embarrassing lack of evidence:
If a doctor used an untested medical intervention on a wide scale without controls, they would be referred to the GMC for putting patients at risk and they would be in breach of clinical governance principles of ethical use of resources. And rightly so.
To pull his house of cards together, Francis proposed a national office. Thus, the National Guardian’s Office was established in 2016. It had no teeth. An official from the Department of Health was placed at the Office. Successive figureheads with no clear whistleblowing credentials have been appointed to head the Office.
Numbers One and Two
The first National Guardian was a high profile NHS trust director who was absurdly going to carry on with her day job and only put in a token two days a week as National Guardian. Eileen Sills was billed as the whistleblowing lead for her trust as part of the razzmatazz. But a meeting revealed that she did not know about the Public Interest Disclosure Act – the UK’s whistleblowing law. A later FOI request revealed that her trust had supergagged staff, including staff who had whistleblown:
| “2) How many of these compromise agreements require staff members not to disclose the existence of the compromise agreement itself? |
All of the compromise agreements contain standard wording regarding confidentiality…. …
4) How many of these compromise agreements were entered into by the Trust with staff who had previously made public interest disclosures, (whether or not these were raised by formally invoking the Trust’s whistleblowing policy)?
Two compromised [sic] agreements were entered into by the Trust with staff who had previously made public interest disclosures.”
A subject access request also later revealed that the “independent” National Guardian asked the CQC for a “briefing” about me prior to this meeting. Well, there ain’t nothin’ like a Dame!
Sills resigned before she even formally took up the National Guardian post, wasting huge head hunting fees, and with embarrassing headlines for the then Health Secretary:
The details were further explored here:
The second National Guardian was an NHS England Medical Director whom the Department of Health preferred to sell as a GP, based on limited part time practice.
|Hansard 13 July 2016 |
Dr Philippa Whitford MP: “…..what comes back from whistleblowers I meet is they are concerned that the person who has been appointed is an NHS manager. We have to have someone who is utterly outside the system.”
Ben Gummer, Parliamentary Under-Secretary of State for Health Services: “The hon. Lady is also wrong to say that the national guardian was an NHS manager. She is one of the leading chief nurses in the NHS, and I am sad that she felt unable to continue with that role. The hon. Lady will be pleased to know that her replacement, Dr Henrietta Hughes, is also a clinician—a practising general practitioner.”
In her previous role, Henrietta Hughes had introduced a rule which made it compulsory for staff to smile, and she wrote about it.
After appointment as National Guardian, she gave an interview to The Times in which she opined that culture in the NHS would be better if staff were more cheerful:
This led to a number of derisive headlines such as “Turn that frown upside down!”. Her movie references were also reported: NHS whistleblowing tsar tells staff to behave as if they’re in film Love Actually.
It was not an emotionally intelligent start to a role which is about the good governance of receiving bad news from distressed people.
Hughes also deleted her twitter account before taking up her post, obscuring her cosy past interactions as a very senior NHS manager with other very senior NHS managers. But some digital shadows remained nevertheless:
In her tenure, she paid for publicity, organised networking events which included questionable players from private industry & others and an FOI disclosure showed she did not always keep records of meetings with such players from private industry.
In 2018 she represented statistics favourably (used unpublished – against the UKSA code – by Jeremy Hunt for PR) in such a manner that the UK stats authority agreed she should be more precise:
UK Statistics Authority response 5 April 2018:
“We also note your concerns about the suggestion that some of the data are from the Freedom to Speak Up Guardian Survey Report. The presentation you referred to should have been clearer that the figures quoted on the same page as an image of the report where not in fact from this report. The report in question covers a different time period, and does not contain the information quoted.
We will write to the National Guardian’s Office to highlight areas that could be improved in their presentation and dissemination”
Hughes did not collect data on whether whistleblowers’ concerns were addressed, yet she later claimed without producing evidence that the project had prevented “untold harm” and saved patients’ lives. She declined to intervene where whistleblowers suffered detriment and did not run a tight enough ship to ensure whistleblower confidentiality. Very seriously, when a breach of whistleblower confidentiality was pointed out, no corrective action was taken and no apology was issued until this was forced. And that’s not all of it by any means. But she stayed the course long enough to pick up an OBE for her services to the NHS.
More importantly, she now has influence in the allocation of Health honours as a member of the relevant committee:
Completing the circle, Hughes is now once more an NHS executive. Since February 2022 she has been a NED at South Central Ambulance Service NHS Trust. Theoretically, she will be within the purview of a forthcoming review of ambulance trusts by her successor. The magic roundabout spins again.
The latest National Guardian’s appointment was announced in November 2021. Dr Jayne Chidgey-Clark took up post on 1 December 2021. Hewn once more from the NHS management mother lode, Chidgey-Clark was previously a non executive director of Somerset CCG and also one of the CCG’s Freedom To Speak Up Guardians.
The press release about her appointment as National Guardian made sure to shake on some ‘Robert Francis secret sauce’:
“Dr Chidgey-Clark’s selection for appointment was made by a panel consisting of representatives from CQC, NHS England and NHS Improvement, as co-sponsors for the National Guardian’s Office. The panel also included Sir Robert Francis QC, whose Freedom to Speak Up Review instigated the creation of the National Guardian role.” [my emphasis]
But it is a matter of concern, not cachet, that there is a conflict of interest in Robert Francis being allowed to oversee – as a member of the NGO’s oversight board – a venture he designed and clearly continues to shape.
Jayne Chidgey-Clark’s credentials in her own words can be found on her LinkedIn entry. This is a copy of the entry taken on 10 March 2022.
It contains reference to transformational and consultancy skills as follows:
| “Director THE JCC PARTNERSHIP LTD. · Self-employed THE JCC PARTNERSHIP LTD. · Self-employed Jul 2009 – Nov 2021 · 12 yrs 5 mos Jul 2009 – Nov 2021 · 12 yrs 5 mos Services: Transformational coaching, Interim management solutions, Health and Care Consultancy, Team development, End of Life Care Specialist|
Providing consultancy solutions and interim senior management support to health and social care organisations and leading projects across health and social care.
Providing exceptional executive transformational coaching and team development as well as organisational reviews.
A specialist advisor to the CQC. Able to help organisations to prepare for their CQC Inspection. [my emphasis]
Firewalk Instructor and Motivational Coach and Breath Work and Reiki practitioner.”
Of concern, it therefore appears Chidgey-Clark is one of those enterprising individuals who both offered services to the CQC as a specialist advisor for inspections and as advisor to organisations preparing to be inspected.
So how will she ensure that conflicts of interest are handled in a post that is centrally about probity?
And how many ex-CQC workers have now passed through the National Guardian’s Office?
Chidgey-Clark has written a first blog as National Guardian, which in 780 words does not say a great deal.
To find more specifics, I asked Somerset CCG for information about her previous role at the organisation.
The most startling fact which emerged from this is that Chidgey-Clark received a mere TWO whistleblowing disclosures as a Freedom To Speak Up Guardian.
This is the material disclosed by Somerset CCG via FOIA:
In fairness, CCGs are small operations – in 2020/21 Somerset CCG had 243 permanent employees.
But do just two cases represent suitable experience for a national role?
Nevertheless, Chidgey-Clark’s experience seemed to impress Andrew Morris, who represents NHS Improvement, one of the funders of her Office:
|“Sir Andrew Morris OBE Hon FRCP, Interim Chair of NHS Improvement said: “I welcome Jayne’s appointment to the National Guardian’s Office where her skills and experience will be invaluable in further developing the work of Freedom to Speak Up Guardians. On behalf of NHSE/I, we are looking forward to working in partnership with Jayne.”|
In previous rounds of recruitment, knowledge and expertise of whistleblowing were not featured in the person specification for the National Guardian post, which speaks volumes.
Knowledge and expertise were probably not required this time either.
I invited comments from both the CQC about who was the appointing officer, their due diligence in the appointment process, and I also invited comments from the National Guardian’s Office, but neither have so far commented.
I had also recently renewed my enquiry to Robert Francis, post Ockenden Report revelations about gross and ongoing NHS suppression, about whether he was ready yet to withdraw the Freedom To Speak Up project and support whistleblowing law reform. I pointed out that some are calling for yet another independent review of NHS whistleblowing, which does not reflect confidence in the success of his project. I also drew his attention to the fact that the numbers of NHS staff filing whistleblowing employment tribunal claims seems to be fairly stable, disproving his suggestions in 2015 that his model would reduce the need for recourse to the law. Again, there has not yet been a reply.
Silence seems a fitting epitaph for the Freedom To Speak Up project.
|Is Chidgey-Clark a master practitioner of Neuro-linguistic Programming? |
I recall seeing online reference to this but did not make a note of it. Others commented online. Some posted a link to Somerset CCG’s website. The website link is no longer functioning. I asked Somerset CCG about this, who simply said they removed Chidgey-Clark’s profile entry after she moved to the National Guardian’s Office, but did not deny that it featured an NLP qualification.
NLP is a controversial coaching/ therapeutic intervention. One rating exercise carried out with mental health professionals saw NLP rated below Angel Therapy and Past Lives Therapy:
Why should you be wary about NLP?
UPDATE 21 APRIL 2022
On 20 April 2022 the CQC made the following comments in response to question about Chidgey-Clark’s sum experience of two whistleblowing contacts as a CCG Freedom To Speak Up Guardian, who the CQC appointing officer was and what due diligence they took in the process:
“Hi Dr Alexander,
Please see our comment below as requested.
A CQC spokesperson said: “A multi-stage assessment process was conducted prior to the appointment of the National Guardian for Freedom to Speak Up in the NHS, to ensure the relevant knowledge, skills and experience were identified in the appointable candidate. Dr Chidgey-Clark’s appointment was made by a panel consisting of representatives from CQC, NHS England and NHS Improvement, as co-sponsors for the National Guardian’s Office. The panel also included Sir Robert Francis QC.”
On 19 April 2022, the National Guardian’s Office made the following comment about Chidgey-Clark’s sum experience of two whistleblowing contacts as a CCG Freedom To Speak Up Guardian:
“Dear Dr Alexander,
Thank you for your email.
Dr Chidgey-Clark was recruited through the process set out by the CQC. You can find details of her announcement as National Guardian on our website here.
Please click and add your signature to this petition to reform UK whistleblowing law – whistleblowers protect us all but weak UK law leaves them wholly exposed and it is a threat to public safety
In his 2013 Midstaffs recommendations Robert Francis recommended that whistleblower reprisal should be criminalised. In giving evidence to parliament in 2014 he opined that CEOs who victimised whistleblowers should be sacked to set an example and discourage others. By 2015, after he was knighted and on the board of the CQC, he faintly derided contributors to the Freedom To Speak Up Review who had asked him to consider criminal sanctions.