By Dr Minh Alexander retired consultant psychiatrist 26 June 2022
The story of a serious NHS cover up at North East Ambulance Service NHS Trust (NEAS) was reported by the Sunday Times on 21 May 2022:
This was helpful reportage, apart from a bum note of someone slipping in a misleading and inaccurate claim of Jeremy Hunt being an anti-gagging NHS hero, when he was no such thing.
Paul Calvert, a former police officer, latterly a coroner’s officer and one of the whistleblowers who revealed the failings at NEAS, has continued to talk to the media.
He has now revealed more details of a typical NHS whistleblower’s journey, and the often futile attempts to escalate through successive layers of indifferent, incompetent and or malign management.
Calvert, like so many other NHS whistleblowers who have been failed, attests to the ineffectiveness and in his case the harmfulness, of NHS whistleblowing arrangements.
He has criticised a wasteful, non-evidence based central plank of NHS whistleblowing policy since 2015: the use of internal Freedom To Speak Up Guardians.
This is a model where a trust employee is appointed by senior trust managers to act as a purported reporting point for whistleblowers. This individual is supposed to challenge senior trust managers if necessary, and to make referrals outside of their organisations to regulators. In good trusts it is unnecessary, in corrupt trusts it is a conflicted, compromised non-starter.
Paul Calvert has shown the Northern Echo his disclosure correspondence, including his disclosures to to the central whistleblowing team at NHS England, in which he whistleblew about harmful internal Freedom To Speak Up arrangements at his trust:
“In his first approach to a “Freedom to Speak Up” casework manager at NHS England, Mr Calvert wrote: “I have a reasonably held belief that the North East Ambulance Service have caused harm, to members of the general public, by concealing, altering and destroying relevant information that should have been supplied to HM Coroner.
“The trust’s patient safety department does not have the necessary policies and processes in place, in order to ensure the trust meets its statutory obligations as prescribed by law.
“For the past year, myself and colleagues have continued to raise our concerns, with the relevant individuals.
“We are aware that these concerns not only failed to be addressed, but are constantly ‘pushed under the carpet’.”
Mr Calvert, who is from Peterlee, told the case worker he had already raised his concerns with his MP, Grahame Morris, who represents Easington and subsequently discussed the matter in Parliament.
Mr Calvert has said is he aware of 90 cases where changes have been made to medical reports at inquests to hide mistakes by ambulance crews where someone has died.
They include the case of 17-year-old Quinn Beadle, from Shildon, who died by suicide in 2018.
Key details omitted from the report to coroner in the hearing the establish the circumstances surrounding her death.
In his email last July, Mr Calvert said: “The North East Ambulance Service are continuing to fail members of the public and putting lives at risk by failing to address these very issues.
“I am of the opinion that these matters require urgent attention to prevent the public suffering any further harm.”
Mr Calvert, who claims he has been the victim of bullying and is unable to work due to ill health, said NHS England did “little to nothing” regarding his concerns and merely passed his information to the Care Quality Commission.
He said: “The trust continues to ignore that there is a problem and is unwilling to listen or consider the concerns being raised or acknowledge the supporting evidence regarding this.
“The trust also continues to bully and harass the members of staff who are attempting to raise the concerns, taking punitive action against the people speaking up, whilst the parties responsible for the failings are afforded complete impunity.
“However, the mechanisms for raising concerns within the trust are entirely ineffective, being used to cover up and delay matters, rather than investigate and address the concerns raised.” [My emphasis]
It seems unclear from the Northern Echo report whether NHS England did anything about this extremely serious allegation, even though it would have been well within its power to take action. I have sought clarification from the NHSE/I Head of whistleblowing.
|Corporate Freedom To Speak Up Guardians at North East Ambulance Service |
According to trust board papers Jennifer Boyle former Trust Secretary was previously trust Freedom To Speak Up Guardian.
Her LinkedIn entry shows she was NEAS trust secretary between May 2015 to June 2021.
She has since moved to Gateshead Health NHS Foundation Trust where she is also Trust Secretary, working under Yvonne Ormston CEO, who was NEAS CEO until 2019.
According to NEAS trust board papers, the role of NEAS Freedom To Speak Up Guardian has since been taken over by another person from trust corporate services, Paula Gent, whose LinkedIn entry describes her as “Executive Personal Assistant to Director of Strategy, Transformation and Workforce at North East Ambulance Service”, but makes no reference to the Freedom To Speak Up role.
Hard to see how corporate appointments would make whistleblowing frontline staff feel very comfortable, or understood.
Shockingly, NEAS’ whistleblowing policy tells trust staff that there is no guarantee that their highly sensitive disclosure emails will only be opened by the Freedom To Speak Up Guardian. It does NOT say who else might open their emails:
So does life imitate caricature?
The NHS National Freedom To Speak Up Guardian
Sitting at the head of the failed NHS Freedom To Speak Up project is a propaganda outpost of the Department of Health and Social Care, known as the Office of the National Freedom To Speak Up Guardian. It came embedded with DHSC personnel from the outset.
In a totally conflicted and compromised arrangement, the National Guardian is funded and overseen by NHS England/ Improvement and the Care Quality Commission (CQC), but is also supposed to hold these bodies to account.
| The National Guardian’s compromised governance |
The role of the NGO and how it sits within the NHS is set out in the position specification for the post.
The National Guardian is appointed by the CQC, with participation from NHSE/I. She reports to the CQC chief executive. She also reports to the government via the Department of Health and Social Care.
Her funding comes from CQC and NHSE/I. She produces annual reports for CQC and NHSE/I boards.
CQC and NHSE/I oversee her work through a board which consists of a representative from CQC, NHSE/I and the National Guardian.
This committee used to be called the “Accountability and Liaison Board”. Latterly the name has been softened by the NGO to the “Advisory and Liaison Board”.
Farcically, despite all the above, we are expected to believe that the National Guardian is “independent”:
“the role is independent”
“The NGO will set its own priorities, have its own budget and identity and speak independently of its sponsor bodies.”
AND that the NGO will hold the whole system including CQC, NHSE/I and DHSC to account:
“Make recommendations to individual and national organisations (NHS trusts and foundation trusts, NHS England, NHS improvement, CQC and the Secretary of State for Health) on trends, common issues and interventions to drive and support culture change across the NHS”
Yes, and pigs can fly.
And where are the National Guardian’s reviews on NHS England/Improvement, CQC and DHSC’s whistleblowing failures?
Oh yes, of course, there aren’t any.
The National Guardian is not in the business of giving NHS staff truthful information about the real risks of whistleblowing. She and her Office pump out rose-tinted claims about how staff will be supported by Freedom To Speak Up Guardians, when the evidence shows that this does not reliably happen.
I have challenged misinformation by the National Guardian’s Office on several occasions. There is a current complaint about the latest National Guardian lodged with the Chair of the CQC about such a matter.
The latest concerns by Paul Calvert represent another hole in the jerry-built Freedom To Speak Up wall.
National Guardian’s planned review of speaking up in ambulance services
The National Guardian’s Office started THINKING about a thematic review of speaking up culture of ambulance trusts in June 2020, after the staff suicides at East of England Ambulance Service NHS Trust made national headlines.
The NGO continued thinking about it until this spring, when I started asking about progress.
The NGO FOI response to my enquiry stated that the work was “in the early stages”:
“We are in the early stages of this review process, and therefore have not agreed
final parameters yet”.
The NGO refused to disclose relevant correspondence, claiming exemption on grounds of Section 22 FOIA documents intended for publication. Nonsense of course, as such documents would not be published. Importantly however, they would show the dates on which work had actually commenced.
Overall, the NGO has displayed little sense of urgency, despite the obvious distress and strain on ambulance services:
By the point that I started asking questions, other ambulance staff suicides, at West Midlands Ambulance Service, had been publicised.
Even the Director of Nursing at WMAS has repeatedly been in recent news, making dire predictions of unsustainable service pressure, inevitable patient deaths and looming service collapse:
It is unsurprising that the National Guardian’s Office is so little trusted by frontline NHS staff that it receives very few whistleblowing disclosures. This includes NHS ambulance staff.
The April FOI response revealed that the National Guardian had received a mere twelve whistleblowing disclosures from NHS ambulance staff in the period 1st April 2017 to 31st March 2021
This week, the National Guardian finally published terms of reference for her thematic review:
Only five of the 10 ambulance trusts will receive in depth scrutiny. It is not revealed which five trusts have been selected. I have asked the NGO to specify which trusts have been chosen and why.
Former ambulance staff can contribute to the thematic review.
BUT individual whistleblowers’ cases will NOT be investigated.
No embarrassing details wanted, just a demonstration that “something” has been done.
This perfectly complements Sajid Javid’s announced review of NEAS, which has not satisfied relatives or whistleblowers, who want a public inquiry:
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, lets abusers off the hook and it is a threat to public safety.