My Beautiful (Ministerial) Launderette: The National Guardian and Paula Vennells

In 2014, shortly after publication of the Midstaffs public inquiry, Jeremy Hunt came under mounting pressure to improve the NHS’ handling of whistleblowing.

He commissioned Robert Francis to conduct the Freedom To Speak Up Review, which made weak recommendations and was totally silent about the nature of the concerns which whistleblowers had reported to the Review.

Robert Francis later indicated through correspondence that most of the evidence submitted to the Review was destroyed.

Francis and the government devised a publicity tool called the Freedom To Speak Up model, which made it look as if something was being done, when nothing was done at all:

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

Henrietta Hughes, former Medical Director of NHS England London, the National Freedom To Speak Up Guardian sits at the head of the project. She has helped those proven to have harmed whistleblowers to launder reputation. For example, David Loughton CEO of Royal Wolverhampton NHS Trust, who has been found by an investigation to have harmed a whistleblower and has been criticised in several other whistleblower cases, tweeted this smiling image of a visit by Hughes:

David Loughton tweet Henrietta Hughes Selfie Oct 2019

Similarly, Henrietta Hughes visited West Suffolk NHS Foundation NHS Trust in January 2018 and praised their speaking up culture when in reality it was failing badly, and was criticised by the CQC. Just a few months after her visit, the trust launched a whistleblower witch hunt and demanded fingerprints and handwriting samples from its staff as part of the witch hunt:

Henrietta Hughes selfie with Steve Dunn 11.01.2018
Enter a caption

Henrietta Hughes posing with the West Suffolk NHS Foundation Trust Freedom To Speak Up Guardian and Chief Executive, on a visit to the trust in January 2018
Continue reading “My Beautiful (Ministerial) Launderette: The National Guardian and Paula Vennells”

Letter to Tom Lloyd WhistleblowersUK Chair: WhistleblowersUK’s financial arrangements, re-investment of surplus income, not for profit status, and declaration of interests

Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist, 20 February 2020

WhistleblowersUK is a private company which is seeking to exert major influence on how the UK deals with whistleblowers, but it has not been accountable.

On its website, its CEO Georgina Halford-Hall claims that she set up the company:

Screenshot 2020-02-20 at 08.39.39

https://www.wbuk.org/our-people

Companies House records state that WhistleblowersUK was set up in December 2014 by Ian Foxley, with Halford-Hall later appointed as a director on 8 April 2015:

Screenshot 2020-02-20 at 10.15.33

Screenshot 2020-02-20 at 08.42.10

WhistleblowersUK is paid by US Bounty hunting lawyers Constantine Cannon to act as secretariat for the controversial Whistleblowing All Party Parliamentary Group (APPG):

Whistleblowing v Bounty hunting. A new whistleblowing APPG with sponsorship from bounty hunters

Many troubling questions continue to swirl around Whistleblowers UK and the APPG.

Norman Lamb MP resigned from the APPG in October 2019 because of unanswered questions that he put on my behalf.

Norman Lamb resignation letter from APPG

Tom Lloyd WhistleblowersUK Chair declined to answer questions which I put to him personally last year, and I did not pursue them further with him.

But as some serious new matters have arisen, I have written to him again. My letter is provided below.

 

BY EMAIL

Tom Lloyd
Chair of WhistleblowersUK
20 February 2020
Dear Tom,
WhistleblowersUK’s financial arrangements, re-investment of surplus income, not for profit status, and declaration of interests
In August 2019 I asked you for information on clients to whom WhistleblowersUK had sold consultancy services, as advertised on your CEO’s LinkedIn page, at that point:
Screenshot 2020-02-20 at 05.54.12
I also asked you:
“I now see that there have been two payments of £7,500 respectively in February and June 2019, described as donations, from Constantine Cannon.


Please could you advise if these are the payments referred to in the whistleblowing APPG’s registered details, with respect to the statement: 
“WhistleblowersUK is paid by Constantine Cannon LLP to act as the group’s secretariat From : 10/07/2018 To : 09/07/2019”
or whether the two payments in February and June were separate, additional payments unrelated to Whistleblowers UK’s role as APPG secretariat.”

I did not receive specific answers to these questions.

Indeed, in your response to my enquiry you commented:

“You have made several requests for information that we are under no obligation to provide.”

However, Norman Lamb resigned from the Whistleblowing APPG on 24 October 2019 because he could not get answers from WhistleblowersUK to various questions that I had raised about finances and potential conflicts of interest, including my request for a list of organisations to which Whistleblowers has sold Non Executive Director services, as advertised by your CEO.

He commented in his resignation letter, addressed to your CEO:

“I do believe fundamentally in transparency and being accountable to members of the public who ask questions.”

I had not intended to write to you again. However, now that a document has emerged showing that WhistleblowersUK asks whistleblowers to pay £100/ hr for assistance, and 5% of any future award or settlement (the WhistleblowersUK “Statement of Cooperation and Agreement”), I feel it is all the more important to re-visit financial transparency.

This is particularly as in 2015, you prepared a speech in which you described WhistleblowersUK’s role as one of holding whistleblowers’ hands, and signposting them onwards to appropriate sources of support.

“We receive calls and emails and refer people to appropriate support and legal advice, in short we “hold hands” with whistleblowers as their story unfolds. Perhaps most importantly we believe them.”

https://tomclloyd.wordpress.com/2015/06/25/the-work-of-whistleblowersuk/comment-page-1/

£100/hr seems a lot to ask for signposting, particularly from vulnerable, distressed whistleblowers who are facing a lifetime of economic insecurity from crippling legal costs, loss of livelihood and blacklisting.

£100/hr also seems a great deal given that WhistleblowersUK has made repeated public statements that it can only help some whistleblowers, because it lacks funds and depends solely on volunteer staff.

On WhistleblowersUK’s website, you state that surplus income is re-invested to help whistleblowers in various ways:

“WhistleblowersUK is a not for profit organisation that reinvests its surplus income to provide help, support and information to whistleblowers.”

 

Screenshot 2020-02-20 at 05.48.58

The accounts submitted by WhistleblowersUK to Companies House provide only limited detail:

https://beta.companieshouse.gov.uk/company/09347927/filing-history

Accordingly, is it possible for WhistleblowersUK to provide a full account, by financial year since 1 April 2015, of:

1) Total Income gathered from direct payments by or percentage recovery on awards/ settlements from whistleblowers under your ’Statement of cooperation and agreement’

2) Total income from donations

3) The total number of whistleblowers helped by WhistleblowersUK

4) Total surplus income and how it has been used to help whistleblowers?

I am especially anxious for clarification of the numbers of whistleblowers who have been helped by Whistleblowers UK. This because WhistleblowersUK has made inconsistent statements about the numbers of people it has helped.

On social media, WhistleblowersUK stated on 14 January 2019 that it had helped “hundreds” of people:

Screenshot 2020-02-14 at 06.12.05

In contrast, on your website, your CEO states that WhistleblowersUK has helped “dozens” of people:

Screenshot 2020-02-20 at 07.08.40

https://www.wbuk.org/our-people

 

On 24 February 2019 WhistleblowersUK appeared to again contradict its social media statement of 14 January 2019 with another statement, that it received hundreds of requests but had only been able to help in a “small number of cases:
Screenshot 2020-02-14 at 06.12.25

 

I appreciate that WhistleblowersUK elected not to answer my previous questions about potential conflicts of interests such the identity of clients to whom it had sold any consultancy services, any remunerated services to the FCA and the identity of any clients to whom it had sold NED services, and as far as I can see your CEO has taken down her LinkedIn page

However, if WhistleblowersUK has changed its position on transparency about these matters, I would be glad of some answers.

If Whistleblowers no longer seeks to provide consultancy services or to place NEDs in organisations for remuneration, I would be grateful for that clarification.

As a former Chief Constable and senior public servant, I am sure you can appreciate the importance of accountability and transparency, and issues of trust when caring for vulnerable people in crises.

Lastly, please note if you have not already done so that the Whistleblowing APPG twitter account recently retweeted an extremely controversial figure who has been questioned by the police in regards to complaints about incitement of Race hatred. I hope that as Chair of the APPG secretariat, you will never tolerate this, and everything else that it implies.

Many thanks,

Dr Minh Alexander

NHS whistleblower and former consultant psychiatrist

Anneliese Dodds Labour MP Oxford East Whistleblowing APPG Vice Chair
Baroness Susan Kramer Liberal Chair of Whistleblowing APPG

 

RELATED ITEMS

WhistleblowersUK Company Number 09347927 is the secretariat for the controversial Whistleblowing All Party Parliamentary Group, which launched a Bill for an Office For the Whistleblower in January. It has the appearance of a marker to benefit whistleblowing industry middlemen, without specifying elements that are essential to the public interest.

The Whistleblowing APPG’s new Bill and unanswered questions about finances and potential conflicts of interest

WhistleblowersUK are collaborating with the whistleblowing charity Protect to get traction for UK whistleblowing law reform.

However, the combination of questionable players and an even more questionable authoritarian Johnson government means that adjustments to UK whistleblowing law carry extremely serious risk for UK whistleblowers, especially if WhistleblowersUK and the Whistleblowing APPG succeed in their proposal to place UK whistleblowing under the control of either the Ministry of Justice or the Home Office.

 

Unsung whistleblowers from NHS Nowheresville, betrayed by cynical UK government policy

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 18 February 2020

 

 

Summary: The National Guardian has been rewarded with an OBE after wasting public money on endless propaganda, encouraging NHS staff to speak up without reliable protection in place. After two successive years of month-long PR campaigns just before staff survey forms were completed, and five years since the Freedom to Speak Up Review on NHS whistleblowing, the overall NHS staff survey score on confidence in speaking up has moved from 70% to 71.7%.

But continuing horrendous victimisation and Orwellian whistleblower witch hunts make the shallow PR achievement somewhat meaningless.

Yet another example of NHS trust whistleblower victimisation is provided. Staff spoke up in a group, but still suffered detriment. This is despite Robert Francis’ highly speculative, non-evidence based claims that protection can be assured by just getting more folk to whistleblow.

Francis has the gall to claim that after five years, his Freedom To Speak Up model – which he originally recommended for purportedly speedy effect – needs time to work.  When people will stop listening to the Man with the Non Plan?

 

 

The annual national NHS staff survey has today been published. In the few years after Robert Francis’ Freedom To Speak Up Review, the measure of staff confidence in speaking up about unsafe clinical practice flatlined at approximately 70% of all NHS staff:

Last year it crept up to just 70.5% after a massive month of wet and windy PR campaign led by the National Guardian’s Office and supported by hundreds of Speak Up Guardians recruited in NHS trusts, to persuade more staff to speak up. This strategically took place just before NHS staff were due to fill in staff survey forms in the autumn of 2018.

The rationale behind persuading more staff to speak up, according to thin, speculative claims by Robert Francis, is that it is safer for staff when the majority speak up.

I would say that the government has just been irresponsibly duping staff into speaking up without ensuring reliable protection.

After another Speak Up Month campaign by the National Guardian last autumn, with even more trust Guardians recruited, this year’s measure of confidence in speaking up has inched up to 71.7% nationally.

 

NHS STAFF SURVEY OVER THE PERIOD IN WHICH THE NATIONAL GUARDIAN’S OFFICE HAS BEEN ESTABLISHED:

Year National average score on “I would feel secure raising concerns about unsafe clinical practice”

 

2016 70%
2017 70%
2018 70.5% (after a month long PR campaign by NGO)
2019 71.7% (after a month long PR campaign by NGO)

 

Coinciding with this bump, Henrietta Hughes got an OBE in the New Years’s honours for services to comms, sorry, the NHS.

But this surface gloss, of very slightly improved staff perception nudged by relentless comms, is far from proof of real improvement in how the system responds when staff raise concerns.

Matt Hancock still won’t answer me as to whether he will ensure by law that CQC will have a duty and power to investigate individual whistleblowers’ concerns. His permanent secretary is ignoring a complaint about this recalcitrance.

In real time, we have the slow motion car crash of the West Suffolk NHS Foundation Trust whistleblower witch hunt scandal, in which the role of a regulator – NHS Improvement – is highly suspect and is currently being covered up by NHS Improvement, with help from the DHSC.

There are other continuing active cases of whistleblower harm and suppression, some hidden, some in the public domain.

For example, unfairly sacked senior nurse Linda Fairhall has just decisively won  an ET claim for unfair dismissal due to whistleblowing, but is still facing more harm because her former employer has threatened to appeal. Her case is another important example of serious failure of government policy, partly because the HR Director at her trust was also the Freedom To Speak Up Guardian.

Yet another recent example of failure of the Freedom To Speak Up project, with disappointing conduct by an NHS Freedom To Speak Up Guardian, is provided below. It shows that despite Robert Francis’s desperate recent claims, there is no safety in numbers for whistleblowers when your employer is determined to be abusive.

The fact that this tale has to be highly anonymised says it all about the emptiness of the continuing government propaganda.

These ongoing failures are set in the context of UK whistleblowing law which is unfit for purpose and has no prospect of real reform under the Johnson government.

 

 

UK whistleblowing Law and internal champions

The UK government pretended to lead the world with the Public Interest Disclosure Act 1998, a badly written, weak whistleblowing law that:

 

–       Did not compel anyone to protect whistleblowers

–       Did not compel anyone to investigate concerns and rectify wrongdoing

–       Did not robustly deter reprisal or provide sanctions against individuals responsible for reprisal

It may have been well meant, and was unique in its time, but deliberate compromises against whistleblowers’ interests were made to assuage industry.

For the last twenty years, the UK government has had a symbiotic relationship with a charity, Protect (previously known as Public Concern at Work) which helped give birth to this bad law.

Both had evidence of the law’s serious failures but neither took radical action to put this right. The law has only been occasionally tweaked in the last twenty years, and Protect has recently put yet more tweaks on the table.

In 2015 a review of NHS whistleblowing by the government, the so called Freedom To Speak Review by Robert Francis had a chance to recommend substantive law reform but did not.

Instead, Francis made superficial and tokenistic recommendations for NHS organisations to have internal whistleblowing champions or “Freedom To Speak Up Champions”, who had no powers but would purportedly “oil the wheels”.

They were to be coordinated and supported by a National Guardian, who was equally powerless, and whose remit excluded the investigation of whistleblowers’ concerns. The handling of whistleblowers’ concerns remained wholly the responsibility of employers, and this left power in employers’ hands.

Such a model is of course riddled with conflict of interest, because it is hard for a Freedom To Speak Up Guardian, an employee, to truly hold an employer to account. Those who challenge a bad employer run the risk of being victimised, as has happened to some Freedom To Speak Up Guardians.

All such internal whistleblowing champion models are weak and doomed to fail:

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

Since the establishment of the Freedom To Speak Up project, the confidentiality of disclosures to some Freedom To Speak Up Guardians have reportedly been breached, for example, at West Suffolk.

Some Guardians have breached their duty of care to whistleblowers by sitting on their hands and not helping when asked to do so, and they have instead allowed abuse to take place unchallenged.

Some Freedom To Speak Up Guardians have been trust directors who were actually responsible for or party to reprisal. All whilst hypocritically churning out sickening publicity material about values and transparency, and encouraging staff to whistleblow.

Much like crocodiles inviting a wide eyed fawn into the water.

 

 

 

The NHS Nowheresville Freedom To Speak Up Guardian

Experienced NHS clinical staff at St. Nowheresville became concerned about serious risks to patients.

The concerns were widely shared amongst clinicians.

When these concerns were raised, the senior management response was hostile and provocative.

Staff were vilified.

The raising of concerns was not valued, but decried and criticised as trouble making.

Staff who were seen as the greatest threat to management were picked off, to decapitate the group.

Familiar, orchestrated tactics of isolation, trumped up charges and unfair processes were applied.

Staff appealed to the Freedom To Speak Up Guardian for support, but no response was forthcoming.

Staff suffered various kinds of detriment.

Serious issues with patient safety continue.

The injustice still angers and distresses the staff because it was never put right, and there is little prospect that it will be put right in the current system.

They still see the trust Freedom To Speak Up Guardian encouraging other staff to speak up, although they are aware that some staff have been deterred by their horrendous experience.

 

Robert Francis says give it more time

In 2015, Robert Francis dodged making a recommendation to substantively reform unfit UK whistleblowing law by claiming that this would take too long.

Instead, he maintained that his voluntary Freedom To Speak Up model, based on soft culture change, would deliver faster results.

These days, he bends the other way and claims that culture change takes time and that we must give his appalling Freedom To Speak Up model time to work.

 

For example, a good Samaritan sent me an exchange of correspondence with Robert Francis which included these comments by Francis on 14 January 2020:

“I fear we are not going to agree about the value of the Freedom to Speak Up National Guardian.  Her office and the network she leads is making a great deal of progress on promoting the freedom to speak up without legislative or regulatory powers.  The concept of guardians in this context is a new one and needs time to develop.”

 

That’s the contempt of the British ruling classes for you.

Remember all.

Resist.

 

Robert Francis on Mars Show 2045

 

RELATED ITEMS

Prescribed Persons or the Pretence of PIDA. How UK whistleblowers are ignored

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

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

National Guardian reprieves NHS employers, but condemns whistleblowers and patients

Henrietta Hughes selfie with Steve Dunn 11.01.2018
Henrietta Hughes posing for a characteristic selfie with the criticised Freedom To Speak Up Guardian and Chief Executive of West Suffolk NHS Foundation Trust, which launched a witch hunt for a whistleblower, demanding that staff provide fingerprints and handwriting samples. She wrote the trust a letter of praise about its culture shortly before the witch hunt. Her Office publicly thanked the CEO for his commitment to Freedom To Speak Up. The CQC reported that the Freedom To Speak Up Guardian emphasised the relationship with the Board, but was not sufficiently focussed on the needs of staff and did not provide appropriate quality reports, that showed due learning and thematic review.

Safe staffing and North Tees’ unfair sacking of ‘unblemished’ whistleblower nurse Linda Fairhall. HR Director was also the Freedom To Speak Up Guardian

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 17 February 2020

 

Linda Fairhall’s stark NHS whistleblowing case brings Robert Francis’s distasteful journey with the NHS and the MidStaffordshire disaster full circle.

Francis should have fought harder for whistleblowers but abandoned his original recommendations from the Mid Staffs public inquiry.

After Francis received a knighthood and seat on the CQC board in 2014, he chaired the Freedom To Speak Up Review into NHS whistleblowing for Jeremy Hunt.

hole2 (3)

Hunt  of course made great political capital out of Mid Staffs but did little to genuinely make the NHS safer.

Francis pulled punches on the Freedom To Speak Up review, eschewing substantive reform of unfit UK whistleblowing law and shedding his original recommendation to deter whistleblower reprisal with criminal sanctions.

An unpleasant touch in his review report was a faintly derisory tone towards contributors who urged criminal sanctions, as if to imply that he himself had never heard of such an extreme idea:

A small number even wanted to see criminal and custodial sentences.”

Francis came up with the ridiculous fudge of the Freedom To Speak Up model of internal trust Guardians and a toothless National Guardian whom he recommended should not investigate whistleblowers’ concerns. He left investigation of concerns under employers’ control, thus abandoning whistleblowers.

The model of internal trust Guardians was borrowed from Whitehall’s nominated whistleblowing Officers which had existed for some years with no evaluation.

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

The toothlessness of the National Guardian’s Office: Why it cannot be a model for protecting whistleblowers

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

 

Linda Fairhall and University Hospital of North Tees & Hartlepool NHS Foundation Trust

Linda Fairhall was a senior nurse with nearly 40 years “unblemished” NHS record.

This is her in August 2016, on the far left, supporting her staff:

Screenshot 2020-02-17 at 02.03.56

Classically, things only went wrong for her after she raised concerns about safe staffing and patient safety. at University Hospital of North Tees & Hartlepool NHS Foundation Trust.

The saga is detailed in the following Employment Tribunal judgment of 7 January 2020:

Ms Linda Fairhall v University Hospital of North Tees & Hartlepool NHS Foundation Trust

As well as the risk and harm caused to patients by lack of safe staffing, Linda Fairhall was very concerned about the severe strain on her staff and the harm to their well being.

Vague counter-allegations were made against her of bullying and harassment which were demonstrated to be insubstantial.

 

The ET was highly critical of the incompetent, trumped up nature of the trust’s allegations, disciplinary action and dismissal:

“119. The tribunal found the respondent’s investigation into the claimant’s alleged misconduct to be inadequate and unreasonable in all the circumstances of the case. No explanation was given for the unreasonable delay in interviewing the relevant witnesses, particularly those who are said to have expressed concerns about the claimant’’ behaviour. No explanation was given as to what was to be the remit of the investigation or of any instructions given to the investigating officer. No explanation was given as to why the investigating officer was not called to give evidence to the tribunal. The allegations of misconduct for which the respondent says it dismissed the claimant were never specifically put to the claimant, so that she was never given a fair opportunity to prepare her case or to respond to them. The respondent’s witnesses referred to little more than “themes” or “perceptions” by the staff, none of which contained a level of detail which would have enabled the claimant to respond. Many of the questions put to the staff contained what are commonly called “closed questions” which the tribunal found to be indicative of a requirement from the questioner that the interviewee would actively seek to identify any matters which may be detrimental to the claimant. When the investigation was completed and the report produced, it should have been sent to the claimant in accordance with the respondent’s policy. No explanation was given by the respondent as to why the report was not sent to the claimant until October. The tribunal found that no reasonable employer in all the circumstances of this case, would have conducted the investigation in this manner.

120. The tribunal found that the disciplinary hearing itself was unfair and unreasonable from the outset, in that it did not set out with any precision the allegations of misconduct which the claimant was expected to answer. The tribunal found it unreasonable for the respondent to say in these proceedings that the claimant could and should have been able to discover the nature of the allegations by reading the investigation report. Bearing in mind the size of the respondent’s administrative resources and in particular its dedicated HR resources, that was an unreasonable approach to adopt. The tribunal notes that, under cross examination, Ms Grieves conceded that there were a number of flaws and defects in the disciplinary hearing. Despite those concessions, Ms Grieves insisted that the disciplinary hearing had been fair and that those flaws did not adversely affect the fairness of the outcome. The tribunal found Ms Grieves to be an unpersuasive and unreliable witness. In assessing credibility, the tribunal took particular note of her sudden introduction of a finding by the disciplinary panel that the claimant had been dishonest in her handling of the charitable monies. Equally alarming was Ms Grieves evidence that it was this finding of dishonesty which led to the claimant being dismissed, as she would not have been dismissed solely in respect of the allegation relating to her professional behaviour. It was put to Ms Grieves in cross examination by Mr Rudd that this revelation was no more than an attempt by her to “beef-up” the respondent’s case, which she could now see to have been seriously eroded by the answers given in cross examination by earlier witnesses. Ms Grieves denied that she was so doing. In the absence of any meaningful explanation as to why there had never been any allegation of dishonesty made against the claimant and why that finding was not recorded anywhere in the dismissal letter, the tribunal found that Ms Grieves was indeed trying to “beef-up” the respondent’s case. The tribunal found that Ms Grieves was being less than candid with the tribunal.

121. The tribunal found that the decision of the disciplinary panel to dismiss the claimant for gross misconduct was not supported by the evidence before the panel. The reasoning behind the decision was systematically dismantled by Mr Rudd in his cross examination of Ms Grieves.

122. The tribunal found that the appeal process conducted by Lynne Taylor was similarly flawed. The tribunal found that no reasonable appeal officer could possibly have fairly and reasonably addressed all of the claimant’s grounds of appeal in the time taken to hear the appeal and particularly for the panel to undertake its deliberations. The defects in the investigation report were put to Ms Taylor who, albeit reluctantly, accepted that a number of the claimant’s grounds of appeal should have been upheld. Ms Taylor said in her evidence that she could recall Ms Grieves saying at the appeal hearing that the dismissing panel had taken into account the claimant’s “dishonesty” in coming to its decision to dismiss the claimant. Again, no mention is made of that in the minutes of the appeal hearing or in the letter dismissing the appeal. The tribunal found that the appeal process and the appeal hearing had not been conducted in a fair or reasonable manner.

123. In terms of the unfair dismissal claim, the tribunal was not satisfied that the respondent had established that its reason or its principal reason for dismissing the claimant was a reason related to her conduct. Those responsible for the claimant’s dismissal and the dismissal of her appeal did not “genuinely believe” that the claimant had committed any acts of misconduct which are now alleged. There could be no such genuine belief because there were no reasonable grounds for that belief. There could be no reasonable grounds because there had not been a reasonable investigation. The respondent’s decision to dismiss the claimant fell outside the range of reasonable responses open to an employer in all the circumstances of this case. This was an employee of thirty-eight years unblemished service who was suspended from her role in circumstances where that suspension was unjustified and unreasonable. The investigation which followed that suspension was inadequate and unreasonable. The investigation did not produce any qualitative evidence which could have led a reasonable employer to decide to dismiss the claimant in those circumstances, for reasons related to her conduct. The procedure followed by the respondent was unreasonable and unfair. For those reasons the claimant’s complaint of unfair dismissal is well-founded and succeeds.

124 Turning now to the claimant’s complaint of wrongful dismissal, the tribunal is not satisfied that the respondent has established that the claimant’s conduct amounted to gross misconduct which could possibly have justified summary dismissal. Nothing which the claimant was accused of doing could be described as seriously inconsistent or incompatible with her duty as a clinical care coordinator. On an evaluation of the primary facts, the tribunal was satisfied that nothing done by the claimant could be described as conduct of such a grave and weighty character as to amount to a breach of the confidential relationship between the claimant and the respondent such as would render the claimant unfit for continuance in the respondent’s employment and give the respondent the right to discharge her immediately. With regard to the allegations of professional conduct, inappropriate behaviour, bullying and harassment, there were simply no facts which could lead the respondent to come to that conclusion. With regard to the allegations relating to the charitable monies, the tribunal found that the claimant’s failure to deposit those monies with the respondent’s cashier was no more than an oversight and which did not involve any element of “dishonesty”, applying the objective standards of ordinary reasonable and honest people armed with all the relevant information. For those reasons the claimant’s complaint of wrongful dismissal is well-founded and succeeds.”

“126. In the claimant’s case before this tribunal, Ms Fairhall had made a number of protected disclosures to a number of different people within the respondent’s hierarchy. That hierarchy included Julie Lane (Director of Nursing), Julie Parks (Associate Director of Community Services) and Steve Pett (General Manager). It was those three senior managers who met immediately after the claimant expressed her intention to invoke the formal whistleblowing policy, and decided that the claimant should be suspended. From the date of that decision, the respondent’s substantial HR resources were engaged in the administration of the suspension, investigation, disciplinary process and appeal process. Those same HR resources were also engaged in the administration of the claimant’s grievance, the grievance hearing and the grievance appeal. The claimant made it known to Mary Grieves and Lynn Taylor that she believed the reason why she was suspended, investigated, disciplined and dismissed, was because she had made those protected disclosures. Ms Grieves and Ms Taylor both confirmed under cross examination that they were aware that the claimant had raised a grievance, but both denied that they were aware of the exact contents of the grievance. Both denied that their respective decisions to dismiss the claimant and dismiss her appeal against dismissal, were in any way influenced by the fact that she had made those protected disclosures. The tribunal did not accept their evidence in that regard. The original decision to suspend the claimant and to instigate a formal investigation was taken by the most senior member of the hierarchy, Julie Lane. The tribunal found it likely that thereafter, the task of investigating the claimant, instigating disciplinary proceedings and ultimately dismissing her, were influenced by that hierarchy to such an extent that it was appropriate to attribute their motivation to those carrying out the process which led to the dismissal. The respondent has failed to produce any evidence to explain the claimant`s treatment and provided unsatisfactory explanations for other matters.”

“128. In coming to that conclusion, the tribunal particularly takes into account the close proximity in time between the last of the claimant’s disclosures and the declared intention to formerly engage the respondent’s whistleblowing policy, and the decision to suspend the claimant. The tribunal also takes into account the unreasonable nature of the investigation, the delay in undertaking the investigation and the length of the suspension. The tribunal particularly takes into account lack of credible evidence from the respondent’s witnesses who gave evidence to the employment tribunal. The tribunal found that Ms Grieves in particular was disingenuous in attempting to “beef-up” the respondent’s case by stating that the dismissing panel had in fact found the claimant to have been dishonest with regard to the charitable monies and that it was this “dishonesty” which led to her dismissal. Lynn Taylor’s evidence was little better, when she stated under cross examination that she did recall Ms Grieves mentioning at the appeal hearing that they considered the claimant to have been dishonest, yet there was no mention of such dishonesty anywhere in the notes of the hearing, the outcome letter, anywhere in Ms Taylor’s witness statement or indeed in any part of the respondent’s pleaded case.”

 

A patient died despite Linda Fairhall’s meticulously documented warnings to senior trust managers, and after a poor system response to her concerns.

This death added urgency to the institutional imperative to cover up and manage her out of the organisation.

“21. (PID9). On 8th October 2016 at a meeting with Steve Pett, Emma Campbell (Head of Nursing) and Mel Cambidge (Senior Clinical Matron) the claimant informed those persons that, as a result of the decrease in staff levels, the nurses and staff were now unable to function in their roles. This meeting had been triggered by the death of a patient on 4th October 2016, which the claimant felt may have been preventable, had her earlier concerns been properly addressed.”

Linda Fairhall was suspended three weeks after the above meeting about the death and the factors related to the death.

Safe staffing is of course Robert Francis’ pivotal recommendation from the MidStaffs disaster, which the Tory government tossed away, after first making cynical political capital from the disaster.

As the cover up of Linda Fairhall’s concerns got into full swing, she was suspended for almost two years and then sacked on 16 April 2018, over three years after the Freedom To Speak Review reported:

“…the claimant had originally been suspended on 31st October 2016 and that her suspension thereafter continued for some 18 months until she was dismissed on 16th April 2018.”

The Employment Tribunal determined that her suspension and dismissal were unjustified, and represented victimisation for whistleblowing.

So after ten years, an independent inquiry, a public inquiry, a whistleblowing review and industrial quantities of hot air and platitudes by Francis, we still have conscientious, capable, experienced NHS staff being wastefully sacked for no reason other than doing their job, and raising concerns about basic staffing shortage.

The small print of Linda Fairhall’s case reveals even more embarrassment for Robert Francis.

The contents of a Care Quality Commission inspection evidence appendix from a November/ December 2017 inspectionon University Hospital of North Tees & Hartlepool NHS Foundation Trust indicated that around the time that Linda Fairhall was sacked, the trust Freedom To Speak Up Guardian was none other than the Trust Director of Human Resources.

The trust annual report for 2017/18 confirms that he was the Freedom to Speak Up Guardian at that point:

Screenshot 2020-02-17 at 00.00.11

Although he is not explicitly named in the ET judgment, it is hard to imagine that a trust Director of HR would be unaware of a serious whistleblower case, or the sacking of a whistleblower.

The CQC were uncomplimentary about the trust’s Freedom To Speak Up arrangements:

“There was a ‘raising concerns’ (whistleblowing) policy, although we found some barriers in the ‘Freedom to Speak Up’ processes. The Freedom to Speak Up Guardian was the interim director of workforce. They had not had any formal training to take on the role and did not have any dedicated time to carry out Guardian responsibilities. The Guardian did not network with other regional or national Guardians. There were no records to suggest people had been approaching the Guardian with concerns.”

Shamefully, the CQC failed to detect or report that the trust had incarcerated Linda Fairhall, a whistleblower, on long term suspension at the time of their 2017 inspection.

CQC just rated the trust ‘Good’ overall, and ‘Good’ on the Well Led domain. CQC gave the trust a clear pass on safe staffing:

“Staffing numbers allowed the trust to provide safe care to patients. The trust had robust systems in place to manage staffing shortfall as well as escalation processes to maintain safe patient care.”

According to the trust website, the interim Director of Workforce in November/December 2017, Alan Sheppard, remains at the trust and is now the substantive Director of Workforce:

Screenshot 2020-02-17 at 00.03.48

Another classic outcome to a whistleblower case.

Gloss slapped over the concerns, a P45 for some, and job security for others.

The Health Service Journal has today reported that, despicably, North Tees intends to appeal the ET decision: “NTH told HSJ it plans to appeal the tribunal’s decision.”

UPDATE 18 FEBRUARY 2020

A Nursing Times interview reports tragically that Linda’s partner died suddenly of a heart attack eight months into her unjustified suspension. Her son was also unwell and she herself was recovering from breast cancer at the time.

Of note, this interview notes that a Freedom To Speak Up Guardian was supportive.

There may be some anomaly over terminology. No doubt all will become clearer in time.

A North Tees FOI disclosure to me of 15 February 2019 Ref FOI1819(510) revealed that the trust had one main Freedom To Speak Up Guardian and several supporting Freedom to Speak Up ‘champions’ during the relevant period. At the time of the unfair dismissal, and of CQC’s critical findings about the trust’s Freedom to Speak Up arrangements, the Director of HR was the Freedom to Speak Up Guardian:

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I will not share the trust’s whole FOI disclosure because some of it may identify other whistleblowers, but reportedly only two cases were raised with the trust Freedom To Speak Up Guardian in 2016/17, one of which corresponded with Linda Fairhall’s case. The trust appeared dismissive of an experienced nurse’s carefully documented concerns and of a patient’s death:

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RELATED ITEMS

Linda Fairhall’s outrageously prolonged suspension for no good reason shows how successive governments have continued to keep the politically useful tool of arbitrary discipline in the NHS, because it assists with control and grip.

It is almost twenty years since the National Audit Office recommended measures for tracking and reducing inappropriate use of unjustified and wasteful suspension in the NHS, but these remain on a dusty shelf.

Waste Industry: Abuses of NHS disciplinary process

Weak and easily abused NHS disciplinary processes make it easier for whistleblowers to be silenced.

Combined in some trusts with ineffective or even abusive Freedom To Speak Up Guardians, these factors present continuing risk for whistleblowers.

Robert Francis’ denial and a major failure of the government’s Freedom To Speak Up model at West Suffolk NHS Foundation Trust

 

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Forget the unicorns. Protect’s proximity to WhistleblowersUK

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 14 February 2020

 

The UK political landscape has hardened immeasurably against whistleblowers.

Meaningful whistleblowing law reform is desperately needed, but vanishingly unlikely.

We now have an authoritarian, power-abusing government with links to other authoritarian governments.

Our government is attacking press freedom and judicial independence, and churning out disinformation as a matter of routine.

 

No 10 is trying to control the media, and everyone in our democracy should be afraid

‘PRE-FASCISM’ IS NOW Everywhere in Politics What Can be Done?

Suella Braverman: Boris Johnson appoints attorney general days after she attacked ‘unaccountable’ judges

“The prime minister acts as if judges were on the losing side of a culture war. This is a mistake for which democracy may pay a very heavy price.”

“Boris Johnson has lied his way through life and politics”

“The Conservative politician Chris Patten, who served as an EU commissioner, described Mr Johnson in Brussels as “one of the greatest exponents of fake journalism”.”

The lies, falsehoods and misrepresentations of Boris Johnson and his government

Our government has no limits when it comes to stoking nationalism and racism in order to win and cement power. The shameful Windrush deportations continue, as does the despicable war waged on EU citizens resident in the UK, some for decades.

We have a government that unashamedly makes and breaks promises in the same breath.

It lives and breathes cronyism and nepotism.

Because it taps into and deliberately cultivates the very worst of human nature, our government also engineers apathy to its misconduct, and callousness and indifference to the victims of its cruelty.

There is no chair reserved for whistleblowers in such a society.

Indeed, there is no room in the Cabinet for dissent, so why should plebs dare dream?

Importantly, the Johnson administration promised before the last election to honour EU standards for workers’ rights.

Predictably, a week after the general election, it published a new European Union (Withdrawal Agreement) Bill 2019-20 from which these clauses protecting workers’ rights had been excised:

House of Commons brief: Removal of workers’ rights in the new EU (Withdrawal Agreement) Bill

The rights excised were broadly as follows:

“workers’ rights” means rights of individuals, and classes of individuals, in the area of labour protection as regards—

(a) fundamental rights at work,

(b) fair working conditions and employment standards,

(c) information and consultation rights at company level,

(d) restructuring of undertakings, and

(e) health and safety at work.”

A great raft of relevant EU directives on matters such as Health and Safety, and prohibition against discrimination were expunged.

The UK government already resisted the EU whistleblowing directive two years ago:

“46. Before the publication of the Commission’s proposal, the Govemment [sic] expressed the view to the Commission that it would be better to use non-legislative means in the first instance to facilitate greater alignment between Member States in relation to legal protection of whistleblowers, partly on grounds of subsidiarity. This view was informed by the wide range of existing practices among Member States.”

Explanatory memorandum by Andrew Griffiths BEIS Minister 15 June 2018

It will hardly adopt the EU whistleblowing directive standards now.

It is not intended that workers will have a voice in the Johnson era UK.

Any claims that meaningful whistleblowing law reform will take place under the Johnson administration are at best misplaced, and more likely disingenuous.

The very best that can be hoped for is that an exemplar private Bill may be lodged with a view to the long term future, when better government returns.

However, the great danger with any venture  to reform whistleblowing law under present political conditions is that it will be hijacked, perverted and that things will be made even worse for future whistleblowers.

Any such bastardised law would be cynically paraded as a triumph by government, whilst whistleblowers are suppressed ever more viciously. The spin against whistleblowers is already deadly. Why hand government yet another publicity weapon?

On 11 February 2020 the policy advisor of Protect (formerly Public Concern at Work) started a petition calling for reform of UK whistleblowing law.

Of great concern, this was badged as a joint effort with the private company WhistleblowersUK and the controversial whistleblowing All Party Parliamentary Group (APPG), for which WhistleblowersUK acts as secretariat.

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WhistleblowersUK receives money from US bounty hunting lawyers Constantine Cannon to act as Whistleblowing APPG secretariat.

Ominously, the Whistleblowing APPG have suggested that UK whistleblowing should be placed under the repressive control of the Ministry of Justice or the Home Office:

“The new Office for the Whistleblower could be accommodated within the Home Office or the Ministry of Justice”

This is one of the most dangerous proposals by the Whistleblowing APPG. It is a bended knee to government, showing that there is no political threat in the APPG’s activities.

 

The MoJ and Home Office are notorious for victimising their own whistleblowers and for extremely poor culture:

Kathryn Hopkins MoJ whistleblower: Fears about ineffective national sex offender treatment programme were ignored

‘Toxic atmosphere’: the Home Office unit everybody wants to leave

28 April 2019

“Whistleblowers say bullying culture is causing chaos in department that handles asylum claims”

“Another spoke of a culture of fear and “immense bullying” where favouritism is rife and “you’re treated like an enemy by the management if you’re not in their clique”.

“One of the managers makes sexual boasts about the number of women he’s slept with, makes violent boasts about wanting to punch people in the face, and boasts about wanting to fire people – which he has done on at least one occasion without offering that person extra support before he forced them out,” the whistleblowers claimed.”

 

Rather, the APPG is driven by monetisation of whistleblowing and skimming profit from misery, but without really threatening the status quo.

Emphasising the unsavouriness and financial concerns, the APPG failed to answer questions that I put it about finances and conflicts of interest, resulting in the resignation of Norman Lamb  who had tried to no avail to pursue answers to these questions.

The financial harvesting of whistleblowers and whistleblowing is nakedly clear from the emergence of a document which WhistleblowersUK asks distressed whistleblowers  to sign, to agree payment at £100/ hour and 5% of any winnings or settlement.

Fees – We are a membership organisation but membership this is not a prerequisite to our working with you. We charge £100 per hour for the work that we undertake.”

“Should you be successful either at trial or by winning a settlement, we ask that you commit to making an agreed percentage donation to WBUK of 5%.”

WhistleblowersUK “Statement of Cooperation and Agreement”

 

The steep hourly rate of £100/hr is especially troubling given WhistleblowersUK’s claims that it is staffed by volunteers:

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However, WhistleblowersUK’s interest in getting a percentage of large US style whistleblowing awards has been evident for years. For example:

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(Ian Foxley was previously Chair of the original Whistleblowers UK Company Number 08112953 which he dissolved in April 2015 after some founding members left. He set up WhistleblowersUK Company Number 09347927 in December 2014 , later resigning as Chair but remaining as a member.)

Indeed, Constantine Cannon and other similar US bounty hunting law firms established offices in the UK as part of the gold rush discovery that US bounty hunting law could be used on foreign soil.

Law firm sees Britain as hunting ground for U.S. whistleblower cases

WhistleblowersUK’s website now sports the slogan “Winning for whistleblowers”: the language of litigation, percentages and vested financial interest in conflict instead of early resolution. All of which spells increased harm for whistleblowers.

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After I challenged Protect’s continuing collaboration with WhistleblowersUK via social media, Protect wrote to me yesterday with the stated aim of reassuring me.

Protect again stressed that it did not support bounty models. It justified its joint petition with WhistleblowersUK on grounds that it was better to present a united front but importantly, it said that it would not actually signpost whistleblowers to WhistleblowersUK.

I have no reason to believe that the individual who made this last assertion was other than sincere. However, I have observed more closeness and coordination between Protect and WhistleblowersUK than Protect had admitted.

Where power has been, or appeared to be, Protect has flocked. So it was with the Fair Business Banking and Finance APPG, and then the Whistleblowing APPG.

Fair Business Banking and Finance APPG update August 2018

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A study of Protect’s press releases, social media activity and reciprocal statements by WhistleblowersUK, their paymasters Constantine Cannon show a steady association.

The carousel of promotion does not stop spinning.

Everyone seems anxious to be seen at the right parties.

“Constantine Cannon Hosts Event with Author Tom Mueller, Whistleblowers, and Advocate Groups to Discuss Why Whistleblowers Act”

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And contrary to Protect’s denial,  there has in fact been signposting by Protect to WhistleblowersUK.

For example, Protect’s comms officer posted what appears to be an un-edited comms statement by Georgina Halford-Hall CEO of WhistleblowersUK on Protect’s website. The statement made various claims about WhistleblowersUK and the Whistleblowing APPG, directed whistleblowers to WhistleblowersUK and invited whistleblowers to provide WhistleblowersUK with personal data.

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Update on APPG for Whistleblowing

Posted on 27th March 2019 by Louise O’Neill

The APPG for Whistleblowing was set up on 10 July 2018 after a campaign by WhistleblowersUK to expose the positive benefits of making speaking up safe. We captured the imagination and support of our Politicians using cases that we had worked on to demonstrate not only the value to the economy but comprehensive value of this source of intelligence to society. Whistleblowers, or people who speak up, are valuable human capital. By engaging the imagination and the possibilities of reimagining the role of the whistleblower – as a vital element of a transparent society – we have been able to attract and engage a wide and influential cross party group of politicians. These Politicians have recognised that not only the UK but the world need to take advantage of this resource. 

The APPG has demonstrated its commitment to its principles by putting whistleblowers not only at the top of the agenda but at the heart of the APPG by appointing WhistleblowersUK as its secretariat. An organisation led by and largely run by whistleblowers across many sectors. The aim of the APPG is to develop world class, global standard whistleblowing legislation, because protection should not start and end at our borders and to succeed we all need universal cooperation.

The APPG has an ambitious work plan where phase one is coming to a close and will result in the publication of our first report in June. The data will represent the voice of the whistleblower as it originates from the call to evidence comprising the hundreds of whistleblowers who participated through our survey, group sessions, emails, social media and 1:1’s. The most prolific sector is health and social care comprising nearly 50% of the responses. The most widely expressed concerns are that the legislation does not work and that too many people are excluded leaving many people not only vulnerable but with no obvious place to seek protection. The biggest stated barrier to whistleblowing is fear of retaliation. The greatest concern is that the issue which led to the whistleblowing is not addressed. These issues are echoed across all sectors. The report will reveal all…

Not distracted by Brexit or the drafting of the report, we have already embarked upon the call to evidence for phase two of our report. The APPG are meeting regulators, professional bodies and trade unions in a series of calls to evidence. So far we are both impressed and challenged by the evidence that we are gathering. Every session, as with the whistleblowers is held in private and with those speaking guaranteed confidentiality. In setting up the sessions in this way we are able to ask and expect answers to challenging questions, and demonstrate the power of a learning not blaming environment. This report will be published in January 2020.

Phase three will be a call to evidence for Employers, Academics, the legal profession and judiciary and MP’s. This report is planned to be published in June 2020.

Take the survey

If anyone would like to assist or give evidence we welcome their support. Please support the work that we are doing via our secretariat www.wbuk.org

By CEO of WBUK Georgina Halford-Hall

https://protect-advice.org.uk/update-on-appg-for-whistleblowing/

 

I pointed this example of signposting out to the Protect worker who had told me that signposting to WhistleblowersUK did not take place.

I should have added that there have been multiple complaints to the ICO about the handling of whistleblowers’ personal data by WhistleblowersUK and the Whistleblowing APPG.

But if a charity concedes in principle that it draws the line at signposting to another organisation, what is the logic of entering into a joint publicity venture which helps legitimise that organisation?

Especially in the context that an APPG member resigned in protest at WhistleblowersUK and the APPG’s unaccountability.

In my view, that is Safeguarding thrown to the winds.

What else could go wrong?

Other missteps and mis-judgment could let in even more dangerous whistleblowing law than we already have.

Take a look at Liberty’s and Big Brother Watch’s websites for an idea of the constrictions ahead on our rights and freedoms.

What is in train at present with whistleblowing law reform is a play on decency. An appeal to people who want a better world to sign up, because they mistakenly think things can only get better.

Avoid that trap. Have the courage and realism to see things as they are, hard and bitter though it is. Clear sight is what whistleblowers do best and it is what is needed now.

Forget the unicorns. Now is absolutely not the time for misplaced optimism.

We may all need to self-medicate against the political misery of our times with some gesture that makes us feel better. But the safety of future whistleblowers and their families is paramount.

Protect put it to me, regarding their joint petition, that it is necessary to show a ground swell of support for change”.

My advice is do not support a petition that has WhistleblowersUK, its paymasters such as Constantine Cannon or their frontmen the whistleblowing APPG hitched onto its coat tails.

Instead, petition Protect to defer less to power, and to demonstrate a more coherent, internally logical Safeguarding position.

The onus is on Protect to prove its credentials and its loyalty to whistleblowers and the public interest, as opposed to governments and corporations.

Then it might be safe to unite.

 

RELATED ITEMS

The Whistleblowing APPG’s new Bill and unanswered questions about finances and potential conflicts of interest

Whistleblowing v Bounty hunting. A new whistleblowing APPG with sponsorship from bounty hunters

Protect. A View from the Fence.

In 2017, Protect’s then CEO told me that 43% of Protect’s business came from the public sector, but that Protect could not put a figure on it.

2017 correspondence with Cathy James CEO of Protect (Public Concern at Work) about income from the public sector

https://minhalexander.files.wordpress.com/2020/02/correspondence-2017-with-public-concern-at-work-protect-about-public-funding.pdf

A few fast facts about US bounty hunting schemes:

  • They tend to protect state financial assets, not people.

Overbill the State: Nemesis. Poor care: Mehhhh

 

  • They operate a jackpot model, with only a few financially high value whistleblowers being rewarded, sometimes with obscene amounts (hundreds of millions), based on percentage cut of the haul recovered. But overall, the house wins.

 

  • You can be a genuine whistleblower but not qualify for any financial award, despite suffering the usual life changing financial detriment

 

US bounty schemes are in short ruthless and focussed on the State’s interest.

The jackpots also support a lucrative industry of middlemen.

 

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The rapid review of West Suffolk’s whistleblower witch hunt: NHS Improvement takes us for a ride

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 11 February 2020

In the fine tradition of NHS cover ups, NHS Improvement is in the frame for the grotesque whistleblower witch hunt at West Suffolk NHS Foundation Trust, but it has refused to answer questions about its role. This is despite being fingered by the panicky National Guardian’s Office.

The Guardian newspaper yesterday specifically reported that Tom Grimes the head of whistleblowing for NHS England and NHS Improvement has not clarified the issues about NHSI’s role.

Worse still, the Department of Health and Social Care has allowed NHSI to control the investigation into events at West Suffolk, despite acknowledging that independence is important. Unsurprising perhaps given that Matt Hancock Health Secretary stands to be embarrassed by further probing and more detailed revelations of why he failed to help whistleblowers at West Suffolk.

Hancock won’t talk to us, say ‘bullied’ doctors at his local hospital in Suffolk

NHS Improvement has published terms of reference which do not explicitly include a clear examination of the role of oversight bodies and of the government, whether by action or omission.

Rather, there is merely a tangential reference to review of “any advice/interactions the Trust sought from other relevant bodies.”

This slippery wording potentially allows a complicit investigator to stop dead at the advice sought by the trust, and to avert eyes from the advice actually provided.

This is in contrast to NHSI’s previous terms of reference for the executive whistleblowing investigation at Wirral University Teaching Hospitals NHS Foundation Trust:

“The investigation will:

    1. investigate concerns raised by members of trust staff in late 2017 with NHS Improvement regarding cultural, behavioural and governance issues
    2. review the trust’s handling of a recent disciplinary case involving allegations of sexual misconduct; and
    3. consider NHS Improvements’ response to the concerns raised with it per above”

The lack of similar clear remit from the terms of reference for the West Suffolk rapid review point to a self serving NHSI cover up about the actions of its whistleblowing team.

This is extremely serious because NHSI’s whistleblowing team receives disclosures from desperate and vulnerable NHS whistleblowers who have exhausted internal whistleblowing routes with their employers. If they are jumping out of the frying pan into the malign fires of Hell, which whistleblowers already suspect from many bruising experiences with UK regulators, this should be clearly exposed.

And who has NHS Improvement chosen to undertake the investigation?

Christine Outram, an NHS insider and a peer of the directors of West Suffolk NHS Foundation.

Like Steve Dunn, West Suffolk CEO, Outram is a long served senior official with past tenure in central government as a DH Director General, now working at provider level as Chair of the Christie NHS Foundation Trust.

NHSI’s blurb emphasises that she is “respected”. And NHSI cites the fact that she got a gong recently:

“Christine was recognised for her service to the NHS last year in the Queen’s Birthday honours list.”

That’s alright then.

Screenshot 2020-02-10 at 22.33.20

The register of interests at the Christie NHS Foundation Trust reveals that Outram has a pecuniary interest as a member of the advisory board of the controversial private e-GP provider, Push Doctor (Push Dr Ltd Company Number 08624572). She reportedly joined the advisory board in March 2018. An astonishing contrast of roles, but alas no longer unusual in our rapidly degrading NHS.Christine Outram declaration of interest Christie

 

In April 2018 Push Doctor was criticised by the Advertising Standards Authority for misleading advertising material which failed to make clear that it was a private service which charged a fee.

ASA ruling

Online consultancy Push Doctor has adverts banned for implying links to the NHS

Push Doctor adverts condemned by the advertising watchdog

Perhaps more a case of Pushy than Push.

Screenshot 2020-02-11 at 03.21.19

The ASA additionally noted concerns that Push Doctor’s website featured five star Trustpilot graphics, but misleadingly omitted low star reviews. Push Doctor responded as follows:

“Push Doctor acknowledged that the box (provided through a Trustpilot widget) omitted reviews in which the customer had rated them with one, two or three stars, but said they were not aware of any requirements that they must feature negative reviews on their website. They said the Trustpilot widget included the feature and it therefore must be a widespread device on many websites.”

CQC inspection findings about Push Doctor in 2017 and 2018 were unfavourable, with findings of unsafe clinical practices.

However, after an advisory board of big names was established in 2018, “to support growth”, CQC upgraded Push Doctor last year to an overall ‘Good’ rating, and ‘Outstanding’ on the Well Led domain, with much gush.

Who else is on the advisory board of Push Doctor?

Why, the former Chair of NHS Improvement Ed Smith, a very busy person.

Screenshot 2020-02-11 at 02.12.55

And who else was on the advisory board of Push Doctor, until it caused a scandal?

Nicola Blackwood, DHSC minister for innovation, with responsibility for data, digital and technology, including cyber security.

Controversy over government’s ‘revolving door’ is reignited as it’s revealed new Health Minister worked for firm trying to win NHS contracts

The small print also shows that Outram attended an elite networking event in 2014, run by an outfit called The Chemistry Club, a sort of VIP tech industry dating agency.

According to Outram’s LinkedIn details, she was at the time NHS England Director of Intelligence and Strategy.

Her social media activity shows her carrying the torch for tech, the controversial care data initiative and tele-health:

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Outram’s declaration of interest at the Christie also reveals that she has a pecuniary interest in Yorkshire and Humber Academic Health Science Network:

“Yorkshire & Humber AHSN is one of 15 AHSNs set up by NHS England to operate as the key innovation arm of the NHS. Across the country AHSNs act as a bridge between health care providers, commissioners, academia and industry. By connecting these sectors, we help to build a pipeline of solutions for the NHS from research and product development through to implementation and commercialisation.”

Anti-NHS privatisation campaigners have been critical of AHSNs and of Outram for mixing public sector and corporate interests:

“Christine Audrey Outram is also Director of Foundation Trust Network , Manchester Academic Health Science Centre , Holgateside Consulting,  St Annes Community Services Leeds, which rents and operates Housing Association real estate, provides Residential nursing care facilities, Residential care activities for learning difficulties, mental health and substance abuse and Other non-residential social work activities”

Kirklees’ out-of-hospital integrated care system aims to change the relationship between patients and NHS

So, what’s the betting that Outram will feel a natural empathy for the little guy?

 

RELATED ITEMS

The National Guardian has demonstrated the usual lack of judgment in endorsing West Suffolk’s whistleblowing credentials without adequate evidence:

West Suffolk NHS Foundation Trust’s whistleblower witch hunt, National Guardian’s visit and an object lesson in superficiality

The public and whistleblowers will be cheated for as long as there is weak UK whistleblowing law and badly designed infrastructure. Things will be especially bad in the years  ahead now that we have a authoritarian government which runs on cronyism, and which will abuse power to embed itself and cut down any opposition and threats. But when conditions are better, what is needed is radical reform of the law and the means to enforce it.

Replacing the Public Interest Disclosure Act (PIDA)

Reforming UK whistleblowing law and infrastructure also requires radical reform of  corrupt bodies such as NHSI, which currently align with vested interests and which protect power against the public interest.

Prescribed Persons or the Pretence of PIDA. How UK whistleblowers are ignored

 

Spiv

West Suffolk NHS Foundation Trust’s whistleblower witch hunt, National Guardian’s visit and an object lesson in superficiality

Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 8 February 2020

For the last few months the Orwellian scandal of the NHS hunting down a whistleblower in the Health Secretary’s constituency, West Suffolk, has dripped out painfully.

We have heard of astonishing coercion against staff for fingerprints and handwriting samples.

And we are now approaching the heart of the grotesque heavy handedness – the cover up of widely held concerns about a trust doctor’s fitness to practice and an attempt to bury whistleblowers. 

There is very serious concern that behind the faux contrition after being rumbled, the trust continues to grind its whistleblowers into the dust, a classic scenario.

Under press scrutiny, Trust directors lost their head. They dared to claim that there was central approval for their witch hunt, and that the centre allegedly considered that the trust’s oppressive actions constituted “clear reasoning” and “good practice”.

The National Guardian lost her head and her Office fingered NHS Improvement by social media:

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NHS Improvement has been stony silent and appears to have enforced omerta, as the trust has now fallen silent too. The trust is well overdue on an FOI request about who at the centre approved the whistleblower witch hunt.

The CQC has dished out a punishment beating by stripping the trust of its ‘Outstanding’ rating and casting all manner of aspersions on the trust directors’ ability to engage staff and ensure quality. CQC also made findings about failure by the trust Freedom To Speak Up Guardian.

Winding back a bit, many had noted that the trust CEO Steve Dunn was fond of sporting a Freedom To Speak Up lanyard.

Steve Dunn selfie with Matt Hancock and Freedom To Speak Up lanyard

The National Guardian’s Office was moved to tweet thanks to him for “showing” his commitment to Freedom To Speak Up.

Steve Dunn National Guardian tweet thanks for commitment

 

An additional search now reveals that Henrietta Hughes the National Guardian in fact visited the trust in January 2018 and praised its culture.

The minutes of a trust board meeting 1 Dec 2017 noted the visit:

“Jan Bloomfield [then Director of HR] explained that the 5 o’clock club was where the organisation talked about leadership and quality improvement, and anyone with an interest was welcome to attend. The Trust was trying to cover a wide range of subjects and this was an opportunity for people across the organisation to connect. There were some excellent speakers for next year and the aim was to link the programme with what WSFT was trying to achieve as an organisation. Dr Henrietta Hughes would be speaking on 11 January”

Inevitable grinning selfies of Dunn and the trust Freedom To Speak Up Guardian with Henrietta Hughes were tweeted:

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The trust capitalised on the visit with the following report in its local newsletter:

“Following her visit, Dr Hughes kindly wrote to the trust to thank us for hosting her. Here are some key comments from her letter:

“Your focus on staff engagement for the benefit of patient care comes through at every level of the trust”

“It is striking that you adopted the vision of speak up for the purposes of quality improvement well before it was mandated and everyone I spoke with told me the same, that they felt valued and that they were encouraged and supported to speak up”.

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Other similarly dismal good news output by the trust, exploiting the Freedom To Speak Up branding, can be found below.

And that campers, is exactly what the Freedom To Speak Up project was devised for by the government. It is but a paltry confidence trick.

Accept no substitute for real law reform and genuinely effective enforcement infrastructure, and certainly not the synthetic air kissing road show that is the National Guardian’s Office.

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RELATED ITEMS

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

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

Prescribed Persons or the Pretence of PIDA. How UK whistleblowers are ignored

 

STFU not FTSU

 

Robert Francis’ denial and a major failure of the government’s Freedom To Speak Up model at West Suffolk NHS Foundation Trust

By Dr Minh Alexander, NHS whistleblower and consultant psychiatrist, 4 February 2020

Summary: CQC has released detailed supporting evidence from its inspection of West Suffolk NHS Foundation trust which shows stark failure of the Freedom To Speak Up model, with some criticism of the trust’s internal Freedom To Speak Up Guardian as well as the trust senior managers. There are concerns about actual breaches of whistleblower confidentiality in addition to the witch hunt to identify a whistleblower. Alongside this, Robert Francis continues to insist that the Freedom To Speak Up project is progressing well. Having five years ago recommended the voluntary Freedom To Speak Up scheme over substantive whistleblowing law reform, because he claimed the former was a speedier solution, Francis now falls back on claiming that the project “needs time to develop”.  Under pressure, the National Guardian appears to be conceding a little ground on responsibility for remedy of detriment, but it is very early days. She has so far failed to act on the West Suffolk scandal by announcing a case review. The ICO has accepted intelligence about West Suffolk’s processing of biometric (fingerprint) data. 

 

A Good Samaritan recently forwarded me a copy of their correspondence with Robert Francis, in which they tried to engage him about the lack of real change for NHS whistleblowers, and the behaviour of lawyers on behalf of the NHS towards whistleblowers. As the person put it, exhorting NHS workers to whistleblow can be like asking someone to volunteer for a Forlorn Hope mission.

As has become his wont, Francis responded by defending his work. He continued to tie himself up in logical knots, stonewalling with counter claims very similar to the daily output by the National Guardian’s Office. Francis maintained that there was safety in numbers and that if many whistleblew, that would solve the problem.

From email by Robert Francis 14 January 2020:

“In my view the best way of ensuring that staff who raise concerns feel safe to do so is to encourage all those who have concerns to do so.  One of the reasons this has been perceived as being risky is the isolation many who have tried to raise issues have experienced.

I fear we are not going to agree about the value of the Freedom to Speak Up National Guardian.  Her office and the network she leads is making a great deal of progress on promoting the freedom to speak up without legislative or regulatory powers.  The concept of guardians in this context is a new one and needs time to develop.   I believe that progress in this field is evidenced in her report, published today showing a dramatic increase in the level of concerns raised with local guardians.”

This is particularly surreal juxtaposed against the months of highly publicised scandal about West Suffolk NHS Foundation’s whistleblower witch hunt, where staff have been pitted against the trust executive. There is no sign there that any whistleblower found safety in numbers or that persecuted staff have declared that all is magically well now.

Doctors at West Suffolk hospital ‘too scared’ to report safety issues

Staff say hospital bosses misled them in hunt for whistleblower

In fact, documents released by the CQC in the last week provided more evidence of the failure of Francis’ useless Freedom To Speak Up model at West Suffolk.

CQC appear to have punished West Suffolk NHS Foundation Trust managers for committing the cardinal sin of claiming that they were following orders from the centre when they hunted a whistleblower, by releasing humiliating details of board failure.

Along with this, CQC have also revealed purported failures by the trust Freedom To Speak Up Guardian.

 

Alleged central approval for West Suffolk’s whistleblower witch hunt

The trust claimed to the Guardian newspaper that its approach was backed by “the NHS national head of whistleblowing”.

The National Guardian broke ranks after criticism and denied that it was she. Via social media, her Office fingered NHS Improvement:

Screenshot 2020-02-04 at 07.37.13

Alongside this, correspondence with Steve Dunn the trust CEO requesting information about the central backing has been met with evasion. There has also been silence from NHS Improvement to a request for information.

Most recently, NHS England press office has issued a slippery denial to BBC journalist Nikki Fox that it did not back the witch hunt. This may be a misleading way to avoid admitting that NHS Improvement was responsible.

A complaint has been made to the ICO about West Suffolk’s flat failure to answer several FOI questions.

 

Notably, a detailed, 396 page CQC evidence appendix, which was the supporting document to the main CQC inspection report, criticised the local trust Freedom To Speak Up Guardian for not focussing on their role to support staff, and criticised the reports produced by the Guardian. CQC also questioned the accuracy of some information provided by the trust Freedom To Speak Up Guardian.

Importantly, the forensic nature of CQC’s dissection on West Suffolk’s whistleblowing governance shows that CQC is perfectly capable of rigour when it pleases.

CQC claimed:

“During interview the FTSU guardian was extremely positive of the support provided by the executive directors. As well as direct support from the executive and non-executive leads for FTSU, they stated they could speak at any time to the CEO and chair and were confident that issues would be dealt with. They were proud of the role and stated they saw it as important and a privilege. They had monthly one-to-one meetings with the interim director of human resources and stated they met the nominated non-executive director (NED) every six months. They recognised that contact out in the community services needed to improve and stated they planned to work with the staff governor in the community to address this.

 However, during interview we were not assured that the guardian had full understanding of the role. Their focus was on the support they were receiving from the executive team rather than support they were providing to staff across the organisation. They also stated they caught up fairly frequently with the guardian of safe working hours (GOSW), however this was not confirmed by the GOSW. The GOSW had been in post since March 2019 and informed us that the FTSU guardian had not responded to their initial contact. Despite initial thoughts that contact between the two roles would be important, as time had passed this had lessened, however they confirmed that they knew who the FTSU guardian was.”

“There was no evidence of triangulation to other patient /staff experience data to identify potential emerging issues. There was no trend analysis of numbers, issues, type of worker speaking up or analysis of wider context such as potential risks, barriers and opportunities. Neither FTSU reports mentioned any analysis of the 2018 NHS staff survey results.”

Certainly, a previous review of the data published by the National Guardian showed that the West Suffolk NHS Foundation Trust Freedom To Speak Up Guardian rarely considered that there was any detriment to staff for speaking up.

Given what we now know about the West Suffolk witch hunt and deep staff unhappiness, this raises questions of whether the trust Freedom To Speak Up Guardian was assessing effectively or reporting accurately, or whether staff trusted the Guardian enough to report detriment.

There is an indication in CQC’s evidence appendix about a lack of trust in the local Freedom To Speak Up Guardian due to apparent breaches of confidentiality:

“We heard examples from staff that information they had provided in confidence, to various individuals including the FTSU guardian, had become known”

This is not to say that the Freedom To Speak Up Guardian breached whistleblower confidentiality. Whilst that is clearly a possibility, an alternative is that the trust may have spied electronically on staff by interrogating whistleblower case files. If a trust board are willing to hunt down whistleblowers with fingerprint evidence, why would they stop at other intrusive measures?

 

These are some other CQC findings about poor culture and whistleblowing governance, as detailed in CQC’s evidence appendix:

“Six of the 10 whistle-blower contacts we received between September 2018 and September 2019 raised concerns that there was an apparent reluctance by the senior executive team to hear and accept feedback of a negative nature. Overarching themes included: the trust does not welcome feedback, a lack of robust investigation into employee relation matters and human resource (HR) process, poor support for staff with mental health concerns, poor culture, lack of engagement with FTSU guardian, poor communication, distrust of being able to raise concerns without breach of confidence or fear of repercussion.”

“Staff did not feel listened to and saw others that had raised concerns be penalised. There was a focus on the individual raising concerns and response to issues were on occasion disproportionate. The executive leadership team failed to fully recognise the impact that this had on the safety culture within the organisation.

“we found that some staff felt the culture did not encourage openness and honesty. Not all staff felt supported, respected or valued and some feared reprisals if they raised concerns. This impacted negatively on the ability of staff to challenge and discuss options for mitigating risk.”

“the executive team appeared focused on the who, rather than the why and whether there were effective systems for staff to raise concerns to ensure patient safety.”

“There was a level of acceptance, by the executive team, that there were simply two sides of the incident which was not helpful. In one meeting, the medical director described that certain staff were in “separate camps” and alluded to a “them and us” situation. There were wider ripples of impact in that disengagement of the consultant body was a real risk, yet following the concerns raised there had been no separate medical staff survey undertaken to explore the extent of concerns.”

“We saw evidence that when staff had raised concerns they were not always taken seriously, appropriately supported or treated with respect. In some cases, responses to those raising concerns, were defensive in nature, individually focused rather than actively collaborating to seek solutions.”

“Several of the whistleblowing concerns included factors around poor engagement, communication and leadership. There was a growing disconnect between the executive team and several clinical specialties which had impacted on consultant involvement with the running of services. Communication with some members of medical staff had broken down. We were not assured that the significance of this had been fully acknowledged by the executive directors, or board, or responded to in an effective, timely manner.”

“The Pathology team stated they felt the executives had stopped listening and believed the matter resolved.”

“During interview it was evident that the board were aware of the areas of concern and there were strong opinions as to the reasons that certain groups were unhappy, however actions to address and repair leadership relationships were less apparent. We discussed with the executive team during feedback, that certain staff felt the executives listened but did not hear.”

“There was recognition that the board were aware of a degree of unhappiness among the consultants, and a feeling that concerns were not being recognised. It was noted that the increasing distance felt between the consultant body and the executive team had begun to impact on individuals withdrawing involvement in the running of the trust.”

“We reviewed the board meeting minutes for April 2019 and whilst the agenda stated the FTSU report was submitted for the board to accept there was no documented comment in the minutes that this had taken place or evidence of any questions or challenge to the FTSU guardian. Therefore, we were not assured that there was sufficient data or content presented within the reports to provide any assurance to board.”

 

 

I have raised a concern with the Information Commissioner about West Suffolk NHS Foundation Trust processing staff biometric data without valid consent, and I am now passing on a concern about covert breaches of whistleblower confidentiality.

 

Biometric data and GDPR

The General Data Protection Regulation deems that biometric data used for the purposes of identification constitutes “Special category data”,  which requires more rigorous processing and safeguards.

One of the requirements is that employers need to gain explicit consent before processing special category data.

This raises issues of lawfulness if West Suffolk covertly processed any fingerprint data or processed fingerprint data through duress and coercion, which may negate valid consent.

The ICO has passed the matter to its intelligence team.

 

 

Breaches of whistleblower confidentiality by the NHS are nothing new. Even regulators have been implicated in such breaches. The CQC has in the past admitted breaching the confidentiality of at least three whistleblowers: Helen Rochester, Shiban Ahmed and a third unnamed person.

In the case of Shiban Ahmed, it very much appeared that CQC outed him to his employer in reprisal for criticising some of CQC’s regulatory failures of child protection.

Thus, CQC’s current scapegoating of the West Suffolk board, which it previously and dubiously elevated to a ‘Outstanding’ rating, looks more like politicised and hypocritical abuse of power than dedication to the public interest.

 

No honour amongst thieves

One particularly hypocritical attack by the CQC on West Suffolk’s leadership deserves special mention.

CQC previously told providers that they had to sell themselves as ‘Outstanding’:

“Professor Field responded that if a practice was outstanding ‘this is up to the practice to tell us’.”

Field: Presentation skills necessary to receive CQC outstanding rating

But in its evidence appendix, CQC insinuated that West Suffolk’s leadership should be censured for doing so:

“Some staff told us that they felt that the executive team were so focused on maintaining outstanding status this impacted on the response received when concerns were raised and they “only wanted to hear the good”. We explored during the inspection whether there was added pressure on staff internally that was arising from the rating of outstanding. We noted that the theme of outstanding was used in various communications and formats. For example, the summer leadership summit had taken place on 19 June 2019 with outlined objectives and sessions based on creating a more inclusive culture and quality. There was an intense focus on understanding, developing and maintaining outstanding care and 70 staff attended. Session one focused on addressing and responding to priorities for improvement agreed from the 2018 national staff survey results. Session two focused on quality “keep calm and carry on being outstanding.” Minutes from the trust executive group on 2 September 2019 included a section on the CQC inspection and included text “the CQC don’t know we are outstanding, so we need to ensure we tell them”. This message was reiterated by several staff throughout the core service and well led inspections”.

The theatrical thoroughness of CQC’s public flogging of West Suffolk’s leadership does emphasise that the centre probably has unsavoury truths from which it wishes to deflect.

 

 

One of the great concerns about the government’s Freedom To Speak Up scam has been that it spins a false line about progress. This encourages thousands more NHS staff to break cover and make themselves vulnerable to being picked off whenever it suits power. Not unlike Mao’s campaign to “Let a hundred flowers blossom”:

The Silence that Preceded China’s Great Leap into Famine. Mao Zedong encouraged critics of his government—and then betrayed them just when their advice might have prevented a calamity

At present, we wait to see how far up the West Suffolk whistleblower witch hunt went. West Suffolk NHS Foundation Trust staff had the misfortune of whistleblowing in a Secretary of State’s constituency, which increases jeopardy because of the increased political sensitivity.

Matt Hancock Health Secretary initially claimed to the Bury Free Press that he had been told by the NHS that whistleblowing matters at West Suffolk had been handled “entirely appropriately”.

It is essential that this claim is further clarified. I have asked Hancock to disclose from whom he received advice. I expect prolonged resistance by DHSC to my request.

In the meantime the National Guardian has reluctantly, in principle, agreed to stand by a 2017 promise to  help reinstate unfairly sacked NHS whistleblowers. Correspondence continues on whether she will logically help NHS whistleblowers with remedy of other forms of detriment, even though she has tried to date to avoid this. I will report on the outcome of the correspondence in due course.

The National Guardian has so far stood by passively on West Suffolk scandal. Her Office previously even congratulated the trust’s CEO for “commitment” to Freedom To Speak Up.

She should of course proactively review West Suffolk NHS Foundation Trust and help ensure that the detriment suffered by whistleblowers is rectified.

But just as the West Suffolk Freedom To Speak Up Guardian is beholden to their employer, she has no powers and is beholden to the CQC, NHSI/E and DHSC.

The main, damning sections of CQC’s evidence document about the lack of Freedom of To Speak Up at West Suffolk are provided in the appendix. I have formally brought them to Robert Francis’ attention. The letter to Francis is also provided.

 

RELATED ITEMS

The sham of model of internal whistleblowing champions is spread across UK government departments and satellite bodies, with a policy intention to spread it further. It is wasteful and risky both to the workforce and the public. It is particularly risky now that we have an authoritarian government that has little regard for basic rights or press freedom, and seeks to strengthen its links with other similarly minded governments, such as the pariah administration in Hungary.

Real reform is needed with much better UK whistleblowing law and supporting structure:

Replacing the Public Interest Disclosure Act (PIDA)

In the meantime, we will be stuck for some time with the government’s charade of wholly flawed UK whistleblowing governance, which fails to protect the public.

Prescribed Persons or the Pretence of PIDA. How UK whistleblowers are ignored

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

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

National Guardian reprieves NHS employers, but condemns whistleblowers and patients

 

By day Henrietta, by night Lanyard Woman

 

APPENDIX

(1) Letter to Robert Francis:

 

Sir Robert Francis

Chair of Healthwatch England

Care Quality Commission

4 February 2020

Dear Sir Robert,

Further evidence of serious failure of the Freedom To Speak Up model

I am aware from correspondence shared by others that you remain firm in your views that yours and the government’s Freedom To Speak Up model is sound.

I am also mindful that your disclosed correspondence to the National Guardian of 3 February 2017 revealed that you apparently decided not to meet with me as I requested, because you believed you could not change my mind on my concerns about the Freedom To Speak Up project:

“We can have no expectation that Dr A will agree with anything you do or say and I have little doubt that any meeting with me is not going to change that. I do not propose to accede to her request.”

May I posit that it is open to you to change your mind.

To that end, I copy below relevant excerpts from CQC’s evidence appendix for its latest inspection report on the scandal-hit West Suffolk NHS Foundation Trust, where the trust board tried to hunt down a whistleblower with biometric data.

As you will see, the Freedom To Speak Up Guardian is criticised, and staff concerns about the confidentiality of disclosures to the Freedom To Speak Up Guardian are noted.

From the outset, this type of risk to staff and patients was the central and very obvious flaw of the Freedom To Speak Up project.

I would be grateful if you could comment on whether you will act to put right this serious risk and call for better cross sector, UK whistleblowing law and enforcement structure, to drive genuine improvement in culture and practice.

With best wishes,

Minh

Dr Minh Alexander

 

(2) This is the supporting evidence document for CQC’s latest inspection report on West Suffolk NHS Foundation Trust:

West Suffolk NHS Foundation Trust Evidence appendix

Below is the section from this document on the trust’s culture and whistleblowing governance failures. For convenience, I have highlighted the section on the trust Freedom To Speak Up Guardian in bold.

Culture

Not all staff felt respected, supported and valued or felt that they could raise concerns without fear. Communication and collaboration to seek solutions had not always been effectively undertaken. An open culture was not always demonstrated. However, staff were focused on the needs of patients receiving care. Equality and diversity and opportunities for career development were promoted.

Throughout the core service inspections, we found that the culture was centred on the needs and experience of people who used the service. Staff across the services were proud of the care they provided. Within the divisions staff were positive about the culture and felt supported by their colleagues and immediate line managers.

The trust felt that they promoted an open culture and had policies, procedure and processes in place to support staff, patients and relatives to raise concerns. The trust took assurance from the following mechanisms incident reporting, PALS, freedom to speak up (FTSU) guardian, trusted partners (volunteer members of staff), and guardian of safe working hours. To support staff directly there was an employee assist programme in place and the chaplaincy department was available to all. However, this did not align to the inspection findings. Staff did not feel listened to and saw others that had raised concerns be penalised. There was a focus on the individual raising concerns and response to issues were on occasion disproportionate. The executive leadership team failed to fully recognise the impact that this had on the safety culture within the organisation.

The trust was clear that behaviour inconsistent with the vision and values would be addressed and there were processes in place to manage behaviour and performance. In October 2018 the trust outlined via the green sheet that the trust executive group (TEG) was actively sponsoring action to make sure that anyone who believed they were being / or had been bullied or harassed or discriminated against had the confidence to report it formally and knew how to do this and that access to confidential support was available.

Despite these identified processes we found that some staff felt the culture did not encourage openness and honesty. Not all staff felt supported, respected or valued and some feared reprisals if they raised concerns. This impacted negatively on the ability of staff to challenge and discuss options for mitigating risk. Detail in the provider information request (PIR) was that, between April 2018 and March 2019, the trust had recorded one whistle blowing incidence. Incidences of whistleblowing were recorded in three main categories; patient care and patient safety, fraud, and workforce issues (including bullying culture). Additional PIR narrative then stated there had been six workforce incidents raised, no incidents of fraud and two patient care / patient safety incidents, thus giving a total of eight whistleblowing incidences, not one, within the same timeframe. The trust’s own analysis of theses noted that allegations of bullying and harassment, including lack of consideration and kindness to colleagues were key factors in a number of incidents. Other issues were around professional registration and staffing issues. These correlated to some of the results in the 2018 NHS staff survey and to our findings during inspection.

Six of the 10 whistle-blower contacts we received between September 2018 and September 2019 raised concerns that there was an apparent reluctance by the senior executive team to hear and accept feedback of a negative nature. Overarching themes included: the trust does not welcome feedback, a lack of robust investigation into employee relation matters and human resource (HR) process, poor support for staff with mental health concerns, poor culture, lack of engagement with FTSU guardian, poor communication, distrust of being able to raise concerns without breach of confidence or fear of repercussion. We heard examples from staff that information they had provided in confidence, to various individuals including the FTSU guardian, had become known. Across a number of specialties, including paediatrics, pathology, anaesthetics and vascular services, genuine concerns relating to clinical risk and safety had been raised. Staff directly involved felt communication and collaboration to seek solutions had not been effectively undertaken. Some staff, during interview, stated they felt this had resulted in specific areas and groups of staff being seen, by the executive team, as dysfunctional rather than believing that issues needed to be addressed and worked through with staff to improve services for patients. Some senior staff we spoke with felt that they had not been personally supported by the executive team when they had sought help and advice.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20 Duty of candour, is a regulatory duty that relates to openness and transparency and requires providers of health and social care services to notify patients (or other relevant persons) of certain ‘notifiable safety incidents’ and provide reasonable support to that person. When we requested information around a serious incident in the vascular services, we were informed that duty of candour had not been undertaken as the level of harm was still unknown.

Whilst the duty of candour component 20(2) refers to notifiable incidents (death of a service user, severe harm, moderate harm or prolonged psychological harm), component 20(1) states that registered persons must act in an open and transparent way with relevant persons in relation to care and treatment provided to service users in carrying on a regulated activity. Providers must promote culture that encourages candour, openness and honesty at all levels. This should be an integral part of a culture of safety that supports organisational and personal learning. There should also be a commitment to being open and transparent at board level or its equivalent, such as a governing body. We reviewed the trust local policy “Being open – The Duty of Candour” January 2018 where it was stated in the summary that the board set out a commitment to transparency and being open.

We requested copies of communication that were sent to vascular patients that required follow up and received only a draft letter for duty of candour. We were not provided with evidence of what communication had been made with the patients that had been affected by the incident, to be assured that the trust was openly communicating that there had been a failing in internal systems. It was also evident that this had not been acted upon or communicated in a timely manner. Therefore, we were not assured that the trust had acted in line with its own policy or taken reasonable steps to ensure duty of candour had been appropriately applied by being fully open and transparent.

There was a complex serious incident investigation ongoing at the time of inspection that encompassed aspects of alleged patient safety, incident reporting, risk management, breach of confidentiality and both personal and professional conduct. We found that the process of this investigation had far reaching effects across a number of staff, and the executive team, impacting on health and wellbeing, culture and morale of those involved. Whilst internal HR processes were being adhered to, some staff felt that the actions undertaken by the trust were questionable in purpose. Communications sent during the investigation were corporately worded, with direct legal reference, which meant that they lacked any personal element, and were seen by some as quite threatening in nature with a focus for apportioning blame.

On the 10 September 2019 the medical staffing committee (MSC) wrote a collective statement of concern to the chair. This stated that concerns had been raised by multiple departments in regard to the culture and behaviours of the executive body, on multiple occasions, that had not endorsed the trust values of freedom to speak up. The CEO and the chair attended the next meeting of the MSC in October 2019 to discuss and listen to the concerns being raised and reassure the consultant body that the executive directors lived the values. Whilst the meeting itself had been an attempt to address some of the concerns raised, we found that the subsequent response letter to the MSC chair, dated 14 October 2019, could be considered intimidating, and confirmed to us the continued disconnect around communication. The letter outlined that discussions were held around how matters of speaking up were dealt with and how the board sought to ensure balance and objectivity in their decision making. However, it also included a schematic, developed by trust lawyers, to set out the process followed when concerns were made about a professional’s practice and stated that this was “assiduously followed”.

During the well led interviews, we found that the ongoing serious investigation was in the forefront of several of the executive directors’ minds. There was an understandable desire to bring the investigation to a closure as soon as possible however, we were concerned that the route the investigation had taken, and the commitment of the board of non-tolerance to poor behaviour, was potentially limiting their objectivity. CQC have no regulatory remit to investigate or intervene with individual complaints or incidents. Having looked at the process however, we were concerned that the incident focus had potentially impacted on the wider root cause analysis. Irrespective of the incident itself there was learning to be gained from understanding why established channels of raising concerns had not been taken, however the executive team appeared focused on the who, rather than the why and whether there were effective systems for staff to raise concerns to ensure patient safety. There was a level of acceptance, by the executive team, that there were simply two sides of the incident which was not helpful. In one meeting, the medical director described that certain staff were in “separate camps” and alluded to a “them and us” situation. There were wider ripples of impact in that disengagement of the consultant body was a real risk, yet following the concerns raised there had been no separate medical staff survey undertaken to explore the extent of concerns. We fed this back to the executive directors and there was an element of recognition that communication and engagement needed to improve.

The senior executive team did reflect and recognise that communication and handling of certain aspects of this incident, and others, could have been better. They also stressed that other incidents had been handled sensitively and had not been brought to the attention of others by those involved. They provided a separate example where wording around a question in relation to pay and annual leave for doctors had caused huge discontent and recognised that often language used can escalate an appropriate question out of proportion, that then takes a long time to repair. The trust had implemented a “lessons learned” process following a grievance or disciplinary to help to ensure any issues identified were not repeated going forward, but we were not provided with evidence that this had been implemented.

There was a better working lives group in place. We reviewed the minutes of the meeting on the 23 September 2019. Under agenda point 7, there was a discussion held in relation to improved support for staff in stressful situations such as coroner’s court, serious incident investigation, a never event, a complaint or after maternity or any long-term sickness absence. Included in this discussion were suggestions from the MSC. Options included ‘opt out’ rather than ‘opt in’ for support required. There was agreement that an exact process for support would be beneficial for all staff, not just doctors. It was noted that this would be a great quality improvement project but would be a huge piece of work. An action was identified that the deputy medical director would arrange a meeting with the head of patient safety and human resources to help take this forward.

Some staff told us that they felt that the executive team were so focused on maintaining outstanding status this impacted on the response received when concerns were raised and they “only wanted to hear the good”. We explored during the inspection whether there was added pressure on staff internally that was arising from the rating of outstanding. We noted that the theme of outstanding was used in various communications and formats. For example, the summer leadership summit had taken place on 19 June 2019 with outlined objectives and sessions based on creating a more inclusive culture and quality. There was an intense focus on understanding, developing and maintaining outstanding care and 70 staff attended. Session one focused on addressing and responding to priorities for improvement agreed from the 2018 national staff survey results. Session two focused on quality “keep calm and carry on being outstanding.” Minutes from the trust executive group on 2 September 2019 included a section on the CQC inspection and included text “the CQC don’t know we are outstanding, so we need to ensure we tell them”. This message was reiterated by several staff throughout the core service and well led inspections.

 

NHS Staff Survey 2018 results – Summary scores

The following illustration shows how this provider compares with other similar providers on ten key themes from the survey. Possible scores range from one to ten – a higher score indicates a better result.

Screenshot 2020-02-04 at 06.21.38

There were no themes where the trust’s scores were significantly higher (better) or significantly lower (worse) when compared to the 2017 staff survey. (Source: NHS Staff Survey 2018) The 2018 NHS staff survey was completed by staff during the period September 2018 to December 2018. A sample of 1250 staff was randomly selected, of which 601 responded. This meant a 48% response rate which was better than the average of 44%. The 2018 national staff survey results showed that staff felt more supported than in the previous year. Ratings improved for staff getting support from their immediate manager (up 2.5%); getting clear feedback on their work (up 2.1%); being asked for their opinion before changes are made (up 2.9%); and for feeling like their manager values their work (up 1.4%). The percentage of staff that felt their role made a difference to patients had decreased from

92.7% in 2017 to 91% but remained above the national average 89%. The percentage of staff satisfied with the quality of care they give was 84% against a national average of 80%, and 78% staff felt enthusiastic about their job (national average 74%). The overview theme results, scored out of 10, for health and wellbeing, morale, safe environment (bullying and harassment) and safe environment (violence) were all above average at 6.4, 6.4, 8.1 and 9.4 respectively. Whilst the trust had a fairly consistent result between 2015 and 2018 in relation to safe environment (bullying and harassment and violence) there had been decline in several of the detailed results: Q13b: In the last 12 months, how many times have you personally experienced bullying and harassment from managers: had increased from 9.1% in 2017 to 11.9% in 2018 (2.8% increase). Q13c: In the last 12 months, how many times have you personally bullying and harassment from other colleagues: had increased from 14.9% in 2017 to 19.3% in 2018 (4.4% increase). Q13d: The last time you experienced harassment, bullying or abuse at work, did you or a colleague report it: reporting had dropped significantly from 51.2% to 37.9% which was in line with the worst rate for acute trusts.

A summary paper on the staff survey results went to board on 1st March 2019 and highlighted reporting, creating a compassionate and inclusive culture, being kind to each other and visible leadership as the top three priorities. We reviewed the trust action plan in response to the 2018 staff survey. Actions to address these results included further analysis to identify any ‘hot spots’ and reasons why staff may not be reporting. Additional actions included communication of the reporting process and importance of reporting via several means (core brief, Green sheet, and medical directors bulletin) alongside the re-promotion of staff support available, alongside setting of agreed behavioural standards and staff training on positive performance management and dealing with unacceptable behaviour. The introduction of an anonymous telephone reporting line had seen two contacts, one of which was to explore what the line was for. The lack of any high immediate response was seen by the executive directors we spoke with is as a positive sign.

The freedom to speak up (FTSU) guardian had been in post since 2017 and was directly employed by the trust. Prior to the role they had been a staff governor for nine years and had been approached by the director of HR to consider the role as there had been no expressions of interest. The FTSU guardian stated that they averaged approximately four hours a week but would flex this dependent on need. They could be contacted either directly by telephone or via email. The guardian had received initial training from the National Guardian Office (NGO) and they were involved in the Eastern Counties freedom to speak up network. The trust had hosted the network meeting on site on 26 June 2019.

During interview the FTSU guardian was extremely positive of the support provided by the executive directors. As well as direct support from the executive and non-executive leads for FTSU, they stated they could speak at any time to the CEO and chair and were confident that issues would be dealt with. They were proud of the role and stated they saw it as important and a privilege. They had monthly one-to-one meetings with the interim director of human resources and stated they met the nominated non-executive director (NED) every six months. They recognised that contact out in the community services needed to improve and stated they planned to work with the staff governor in the community to address this.

However, during interview we were not assured that the guardian had full understanding of the role. Their focus was on the support they were receiving from the executive team rather than support they were providing to staff across the organisation. They also stated they caught up fairly frequently with the guardian of safe working hours (GOSW), however this was not confirmed by the GOSW. The GOSW had been in post since March 2019 and informed us that the FTSU guardian had not responded to their initial contact. Despite initial thoughts that contact between the two roles would be important, as time had passed this had lessened, however they confirmed that they knew who the FTSU guardian was.

The FTSU guardian produced two reports a year to board. We reviewed the FTSU reports to board, dated 26 April 2019 and 1 November 2019. We found that these reports lacked substance and were extremely limited in content. Both reports outlined the role of the guardian and ongoing engagement at staff events to promote role. There was no evidence of triangulation to other patient /staff experience data to identify potential emerging issues. There was no trend analysis of numbers, issues, type of worker speaking up or analysis of wider context such as potential risks, barriers and opportunities. Neither FTSU reports mentioned any analysis of the 2018 NHS staff survey results.

Data was submitted quarterly to the NGO as per the “Recording Cases and Reporting Data guidance”, July 2018. Data entry format was the total number of cases, number raised anonymously, number with a patient safety / quality element, number with a bullying or harassment element and number where people report they are suffering detriment. The FTSU report for board categorised the data into behaviour / attitude, trust procedure / practice, capacity / workload and miscellaneous. It was difficult to compare reported data to the NGO with the data reported to the trust board as timeframes and categories differed.

In the data submitted to the NGO for quarter four 2018/19 eight cases were reported, two under the patient safety element and six under bullying and harassment. The same total number overall was reported in the April 2019 board report, with time frame stated as “over the last six months”. Four were recorded under behaviour / attitude, with the status reported as zero resolved and four outstanding. We noted that the additional text did not correlate with the figures presented as it stated “these are two cases where I am either working with staff and HR or where I have been asked to support staff. To date one has been resolved and the other is outstanding with the member of staff awaiting closure”. One was recorded under trust procedure / practice (status outstanding), and three recorded as miscellaneous (all resolved). In the November 2019 report six concerns were documented as being reported in the five months prior to the report. Four as behaviour / attitude (status three resolved, one outstanding), and two as miscellaneous (both resolved). There was no update on any of the previous reports concerns that had remained outstanding in the November report. This limited the board’s ability to track and monitor progress. We reviewed the board meeting minutes for April 2019 and whilst the agenda stated the FTSU report was submitted for the board to accept there was no documented comment in the minutes that this had taken place or evidence of any questions or challenge to the FTSU guardian. Therefore, we were not assured that there was sufficient data or content presented within the reports to provide any assurance to board. We noted that in an additional report to board in November 2019, in response to national FTSU guidance in NHS trusts it was documented that the trust would review the FTSU guardian report to ensure that the board received assurance through this reporting mechanism. In the same document was the commitment to produce a FTSU strategy to be presented to the board in January 2020.”

 

“Is this organisation well-led?

Leadership

The trust had an established, stable executive leadership team. Whilst priorities and issues were known and understood these were not always managed in a consistent way. The style of executive leadership did not represent or demonstrate an open and empowering culture. There was an evident disconnect between the executive team and several consultant specialties. Poor communication and fractured engagement of some of the consultant body had begun to impact on medical managers playing a full and effective role within the organisation.

The trust has an established experienced executive leadership team with only one executive being an interim appointment. The trust board consisted of six executive directors, chair and five nonexecutive directors. The team had remained stable since the previous inspection in 2017, with the only substantive change being the appointment of a new chair on 01 January 2018.

At the time of the inspection, there was an interim executive director of human resources (HR). The previous substantive director of HR, had accepted the interim position on 01 May 2019, on a part time basis following their retirement, until the next appointed director took up the position. Recruitment, and appointment, had taken place and the new director of HR was due to take up position with the trust on 04 November 2019. The chief executive officer (CEO) had been in post since 03 November 2014. The longest established member of the executive team was the director of resources, and deputy CEO, who had been in post since 01 December 2011.

The five non-executive directors (NED) were appointed between September 2013 and September 2018. There had been two changes of NED since we last inspected in 2017 due to previous individuals reaching the end of their tenure. Of the two most recent appointments, one NED held the responsibility as the audit committee chair, link to director of resources and health and wellbeing programme. The other held responsibilities for safeguarding adults, security and emergency preparedness, resilience and response (EPRR).

We found that the executive leadership team did not always support the delivery of high-quality person-centred care. The style of leadership amongst the executive directors did not represent or demonstrate an open and empowering culture. There was a failure by the executive team to step back from specific clinical safety concerns and consider organisational impact. We saw evidence that when staff had raised concerns they were not always taken seriously, appropriately supported or treated with respect. In some cases, responses to those raising concerns, were defensive in nature, individually focused rather than actively collaborating to seek solutions.

CQC received 10 whistleblowing concerns between September 2018 and September 2019, five of which were received in the three months leading up to inspection. Several of the whistleblowing concerns included factors around poor engagement, communication and leadership. There was a growing disconnect between the executive team and several clinical specialties which had impacted on consultant involvement with the running of services. Communication with some members of medical staff had broken down. We were not assured that the significance of this had been fully acknowledged by the executive directors, or board, or responded to in an effective, timely manner.

The medical staffing committee had been reinvigorated in June 2019, by the consultants, as an opportunity for clinicians to increase engagement collectively with the executive directors. We reviewed the minutes of the first two meetings. In the initial meeting the structure, format and frequency of the MSC were outlined, with the CEO to have a regular 15 minute slot at each meeting. It was agreed that the medical director would attend but that the chair of the MSC could ask the medical director to leave should this be appropriate if discussions directly related to them. Matters arising were minuted, with actions, and it was agreed at that initial meeting the MSC would be held quarterly, with the next meeting set for September 2019.

The 10 September 2019 meeting minutes demonstrated that there had been discussion between the trust chair and the secretary of the MSC, around the morale and concerns of the consultant body. There was recognition that the board were aware of a degree of unhappiness among the consultants, and a feeling that concerns were not being recognised. It was noted that the increasing distance felt between the consultant body and the executive team had begun to impact on individuals withdrawing involvement in the running of the trust. As a result, it was agreed that one of the non-executive directors should be regularly invited to attend the MSC to update the consultants on the issues and concerns that the board was addressing and to gain an understanding of the consultants’ views and concerns. It was agreed at this meeting that the MSC would meet monthly rather than quarterly.

During interview it was evident that the board were aware of the areas of concern and there were strong opinions as to the reasons that certain groups were unhappy, however actions to address and repair leadership relationships were less apparent. We discussed with the executive team during feedback, that certain staff felt the executives listened but did not hear. One example was Paediatrics where the trust and the consultants shared similar concerns but the communication between parties had not identified they were on the same page. Another example was Pathology, where there was an apparent disconnect between the view of the executive team and that of the consultants. The executive view was that staff at the trust were reluctant to work within the North East Essex and Suffolk Pathology Services (NEESPS) network however, we were informed by the consultants, and operations manager, that this was not the case. Their frustrations came from a lack of ability to provide the service they wanted to, due to ageing equipment and no control over the day to day management of the service they provided. Whilst the board had met with the senior team at the lead acute trust that host the NEESPS and received a commitment to deliver the required improvements, the consultants felt that this focused on the longer term and did nothing to address immediate concerns. They remained sceptical about the timeframe for change as NEESPS had been in place for two years with no significant improvement or responses to continued concerns. The Pathology team stated they felt the executives had stopped listening and believed the matter resolved.

There was a process for individual contribution, check and challenge through the internal governance framework, HR processes and various committees. Whilst there was an appropriate level of challenge seen in the various committee meetings we reviewed, we found that there was a potential risk that the board had become so driven behind a united decision there was a reluctance, perceived or actual, to take on board other perspectives and alternatives. For example, there was an ongoing complex, serious incident investigation at the time of inspection. The way this had been managed had impacted on the leadership, governance and culture across the organisation. We reviewed the approach taken by the executive leaders in regard to the investigation process that had occurred, alongside relevant information provided. Actions undertaken were unprecedented and concerning, such as the requirement for fingerprinting and handwriting analysis. These actions had not been disclosed to us until after the trust had undertaken them. Whilst there had been attempts to ensure impartiality, such as external independent reviews and legal advice, we found that certain aspects of the process lent towards individual bias with potentially questionable conclusions and judgements made. We were not assured that, having made the decision to follow the course of action agreed by the board, that any subsequent information had been appropriately considered. We voiced this concern with the CEO and chair during the inspection.”

 

STFU not FTSU

 

 

The Whistleblowing APPG’s new Bill and unanswered questions about finances and potential conflicts of interest

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist, 30 January 2020

The controversial whistleblowing APPG,  funded by US bounty hunting lawyers Constantine Cannon, brought out its Bill for an Office of the Whistleblower on 28 January 2020.

The Bill was proposed by Baroness Susan Kramer, one of the APPG’s Co Chairs.

The Bill is very short and leaves it wide open for the functions of the Office to be further defined at a later point.

The powers given to the Office of the Whistleblower are described in rather opaque terms by the Bill, for example:

“(a) give direction to and monitor activities of relevant bodies prescribed by the regulations under section 1, including but not limited to confidentiality and the use of disclosed information;”

 This lack of detail as to how the Office will operate is troubling. This is particularly so because the APPG previously proposed that the Office of the Whistleblower should be under the control of either the Home Office or the Ministry of Justice, two of the most authoritarian and suppression-prone government departments.

There was also a proposal  by the APPG that all members of the public should be designated as whistleblowers. This would set up the conditions for deputising them as bounty hunters, replicating US models.

The lack of detail in Kramer’s Bill is also a concern given a number of allegations that have been made about WhistleblowersUK the APPG’s secretariat, regarding its treatment of whistleblowers, and financial arrangements.

Moreover, a document recently came to light which revealed that WhistleblowersUK asks whistleblowers to pay for help – “We charge £100 per hour for the work that we undertake.” – and to pay WhistleblowersUK 5% of any award or settlement.

WhistleblowersUK Statement of cooperation and agreement

The Financial Conduct Authority advised on 19 December 2019 that WhistleblowersUK is not a registered claims management firm.

Screenshot 2020-01-30 at 14.19.38

Moreover, enquiries to parliament have revealed that there are no meaningful controls on APPG secretariats, with respect to the Safeguarding of any vulnerable people with whom they may interact.

A concern amongst many whistleblowers is that the whistleblowing APPG is compromised by the nature of its funding from Constantine Cannon. There are questions about whether the APPG is acting in the public interest, or the interests of whistleblowing industry players, who profit from whistleblower litigation and the sale of whistleblowing compliance services.

My impression is that the Susan Kramer’s Bill does little to assuage these concerns.

There is no explicit commitment in the Bill to:

  • Prevention of harm to whistleblowers and the public, and proper follow up on whistleblowers’ concerns
  • Minimising expense to the public purse through early intervention mechanisms, to prevent entrenchment, conflict and wasteful litigation
  • Non-financial redress of harm, for example, erasing unfair appraisals or unjust disciplinary records, reinstatement after dismissal or restoration of lost promotion and seniority.
  • Deterrence of whistleblower reprisal and meaningful penalties for reprisal

 

Instead, Kramer’s Bill specifies items that would benefit the whistleblowing and compliance industry:

  • Opportunities for industry middlemen:

“(c) form and maintain a panel of accredited legal firms and advisory bodies to advise and support whistleblowers;”

  • Financial redress for whistleblowers, of which a percentage may of course be skimmed off by middlemen

“(e) provide financial redress to individuals whose disclosure is deemed by the Office to have harmed their employment, reputation or career;”

 

The organisation Protect formerly known as Public Concern at Work, which is currently the dominant UK industry middleman, has “welcomed” the Bill.

But it is very risky for whistleblowers if any Office is created which does not give primacy to whistleblowers’ interests and the public interest, and instead focuses on conflict and detriment, for profit.

Of additional concern is the APPG’s reluctance to answer questions about finances and potential conflicts of interest.

Norman Lamb former MP and APPG vice chair resigned from the Whistleblowing APPG last year because the WhistleblowersUK, the APPG’s secretariat, failed to answer questions which I had asked of the APPG:

Norman Lamb MP has resigned from the Whistleblowing All Party Parliamentary Group

 

A subject access request to the APPG for my personal data revealed that not only was the APPG’s secretariat reluctant to address my questions, but Susan Kramer suggested that a “simple” response should be given to my questions:

Susan kramer email about simple answer

In fact, I have never received a response from any APPG member to my questions about finances and probity.

I am also not sure that the APPG has made full disclosure in response to my subject access request. This is because disclosed documents refer to other correspondence that has not been disclosed.

The subject access request was handled respectively by Stephen Kerr APPG Co Chair and former MP, and then by Susan Kramer. The process has been a prolonged saga, with delays and an extra document being provided only after a query.

After I raised a second query about the completeness of disclosure of correspondence between Norman Lamb and the CEO of WhistleblowersUK about my questions on finances and probity, Susan Kramer maintained that disclosure by the APPG was complete and she commented:

“I have nothing more to add”.

Accordingly, the matter of whether all relevant documents have been disclosed is now being passed to the ICO.

It is hard to feel confidence in an APPG which calls for better governance but does not answer questions about its own conduct and interests, or in a Bill that does not clearly have public protection as its prime objective.

 

RELATED ITEMS

For real reform, ineffective UK whistleblowing law needs to be replaced with law that proactively protects whistleblowers and the public, ensures that whistleblowers’ concerns are acted upon, and sanctions those who cover up and harm whistleblowers.

Replacing the Public Interest Disclosure Act (PIDA)

Industry middlemen who profit from conflict and governance failure should not shape policy about the public interest.

 

Bounties Unwanted

 

NHS CV fraud, Peter Knight & CQC’s failure to safely implement Regulation 5 Fit and Proper Persons at Oxford University Hospitals NHS Foundation Trust

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist 25 January 2020

 

 

Summary: The NHS continues to appoint senior officials without robust checks and the CQC continues to fail in its regulation of the Fit and Proper Person requirement. A glance at the small print in the case of convicted fraudster and former Department of Health Deputy Director Peter Knight reveals that CQC failed to detect or report failure by his employing NHS trust to check his primary qualifications. CQC then later glossed over the scandal of Knight’s fraud in another inspection report. There is little sign that the government and NHS Improvement intend to meaningfully reform Fit and Proper Persons practice in the NHS.

 

This week, Peter Knight former Department of Health Deputy Director and latterly a director of Oxford University Hospitals NHS Foundation Trust (Chief Information and Digital Officer) received a two year suspended prison sentence for CV fraud. He had claimed a Classics degree which he did not possess, to land a job which paid £130K.

A past list of Department of Health National Information Board members gives his summarised CV as follows:

Peter Knight – Deputy Director and Head of Information Intelligence

 Biography

Peter Knight is Deputy Director for Research Contracting, Information Intelligence and Stakeholder Engagement in the Research and Development Directorate at the Department of Health. Peter joined the Department in April 2010 having established the Research Capability Programme in 2008 that established a secure research data service now operated by the MHRA call the Clinical Practice Research Datalink. Prior to his these roles Peter was a Managing Director and interim Chief Executive at Winchester and Eastleigh Health NHS Trust.”

Oxford University Hospitals NHS Foundation Trust, its board stuffed full of illustrious big names, had apparently not seen fit to check Knight’s primary qualifications since his appointment at the trust in 2016:

“Additionally, in November 2017, the trust updated the files of its executive and non-executive staff as part of its duties under the fit and proper persons check, but when checked during the investigation Knight’s HR file did not contain a copy of the degree he claimed to have, according to the NHS Counter Fraud Authority.”

But why would chaps check up on other chaps? T’would be the height of rudeness under Club etiquette.

Oxford University Hospitals NHS Foundation Trust’s crown, as one of the powerful Shelford Group trusts, has slipped latterly. CQC downgraded its overall rating to ‘Requires Improvement’   in June 2019, and ‘Requires Improvement’ on the well led domain.

However, worryingly I found no mention of any Fit and Proper Persons issues in CQC’s June 2019 inspection report. This was despite the fact that the allegation about Knight’s CV fraud was raised anonymously with the trust in May 2018, and passed on to local counter-fraud, with Knight reportedly admitting in August 2018 that he did not have a Classics degree as claimed.

Did the CQC fail in its pre-inspection due diligence to liaise with NHS Counter-fraud services? Did the CQC know, but deliberately gloss over the scandal in its report?

Perhaps CQC did not wish to look foolish, because in an earlier inspection report of March 2018 it had declared the trust compliant with the Fit and Proper Persons regulation:

“Fit and Proper Person checks were in place. The trust was satisfied that staff with director level responsibilities, including the NEDs, were fit and proper persons in accordance with Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.”

The unenthusiastic CQC, in that earlier inspection, had checked only three of the trust’s director files:

“We reviewed a random sample of three board level director’s personnel files and found all the necessary fit and proper person checks had been undertaken. Throughout our inspection, we had no concerns about the fitness of the board to undertake their individual roles”

Instead of thorough checks on the basics, CQC’s 2018 report threw in some guff:

“In April 2017 an independent review of divisional Leadership arrangements at the trust was undertaken. The review focused on leadership and governance within individual divisions and corporate oversight and support for divisions. The report was positive about the Divisional Directors (DDs) high levels of personal and clinical credibility as well as the strong leadership capability of Divisional General Manager (DGM) and Divisional Nurses (DND’s) or equivalent. The report was positive about multi-disciplinary teams working in a cohesive manner with high levels of personal and collective accountability across the Divisional Leadership Teams (DLTs).”

 In its marshalling of evidence of effective leadership at Oxford, CQC emphasised the trust’s digital initiatives:

“‘Go Digital’: To achieve digital transformation, to support excellent care and enable care to be delivered closer to home.”

which of course was flattering to the government’s digital ambitions.

And what of the Department of Health and Social Care? I cannot find any report of the Department’s HR practice in the Knight case. Yet it is likely the fact that Knight came to the trust from the Department contributed to the trust’s complacency in not checking his credentials properly.

According to the BBC, the trust’s chief executive Bruno Holtof (who since February 2019 has also been a non executive director and then Chair of Tristel, a business which supplies infection control products) had praised Knight’s expertise:

“Chief executive Dr Bruno Holthof said in the release that Knight brought a “wealth of experience and expertise” to the role.”

Moreover, in 2016 after Knight’s appointment, Jeremy Hunt the then Health Secretary bunged Oxford University Hospitals NHS Foundation Trust £10m to be a NHS “Global Digital Exemplar” and: “…to champion the use of digital technology to drive radical improvements in the care of patients.”

It remains to be seen if calls for certification of senior NHS IT leaders, which followed exposure of Knight’s CV fraud, will be heeded:

“Some 59% of NHS IT leaders say that top digital leadership roles should require certification.”

Just a few years ago, NHS Improvement  was painfully embarrassed when it emerged that the regulator had appointed Jon Andrewes a fraudster, to the Chair of the Royal Cornwall Hospital NHS Trust.

Andrewes had spectacularly defrauded the NHS over a long executive career in the NHS with a fraudulent CV, which contained obvious anomalies. He was even the Freedom To Speak Up Guardian at Devon Partnership NHS Trust, where he had been appointed as a non-executive director by NHS Improvement.

I asked NHS Improvement what it had learned from the Jon Andrewes shambles, and what it would do differently in future. The response was unimpressive and not at all reassuring:

Jon Andrewes fraud: NHS Improvement responds

Senior NHS managers can do immense damage, and cause much more harm to patients than individual frontline clinicians, because they control whole systems of care.

Recurring NHS scandals such as MidStaffs, Gosport , Liverpool Community Health NHS Trust and Shrewsbury and Telford Hospital NHS Trust have shown what can go gravely wrong when health services are mismanaged.

Yet there appears little intention by the government, and its proxy NHS Improvement, to robustly ensure that Fit and Proper Persons are appointed to key positions.

NHS Improvement has dragged its feet on implementation of Tom Kark QC’s review of FPP in the NHS.

And for good measure, NHSI last year also appointed Paula Vennells the disgraced former CEO of Post Office Ltd to the Chair of Imperial College Healthcare NHS Trust.

 

Paula Vennells, Post Office Ltd CEO from 2012-2019

This is a profile by Nick Wallis the journalist who has covered the trial about the Post Office Horizon computer system controversy:

The Ballad of Paula Vennells

During Paula Vennells’ tenure, Post Office Ltd continued to unsafely accuse and prosecute subpostmasters for financial shortfalls, despite the organisation’s knowledge of numerous computer glitches which could have caused phantom shortfalls.

The subpostmasters were vindicated after they brought a legal action against Post Office Ltd.

The Post Office Horizon IT trial also revealed some thoroughly oppressive workforce practices by Post Office Ltd, which were described by one of the judges as behaviour akin to that of a “Mid-Victorian factory owner”.

Post Office Ltd’s prolonged denial, dishonesty and “extremely aggressive” and “attritional” legal tactics meant that only a fifth of the settlement reached  will be left for the badly harmed subpostmasters, after costs have been met.

There are currently calls for Vennells to stand down from her public roles at Imperial and the Cabinet Office, for her ministry as an ordained Church of England priest to cease, for the board of Post Office Ltd to be cleared out and for a public inquiry into the mass miscarriage of justice.

FPPR referrals have been made to CQC about Vennells’ appointment as Chair of Imperial.

One of the subpostmaster claimants in the trial has set up a petition for a judge led inquiry, which if you wish, you can support here:

Post Office Horizon Scandal Judicial Enquiry

 

 

Vennell’s appointment to the Imperial Chair was made despite the Kark FPPR review recommendations, and thus represents a pretty clear snub to any hopes that the government would implement FPPR more effectively in the NHS.

CV fraud in the NHS, including by managers, is a longstanding phenomenon. A list of some additional examples is provided in the appendix.

However, as the stealth privatisation of the NHS advances, and the whiff of loot intensifies, attitudes of entitlement, cronyism, backscratching, instances of unearned privilege, meritless appointments, and self-serving cover ups are likely to worsen. And the revolving door to private industry will likely spin faster.

 

RELATED ITEMS

Employers ‘aren’t bothering to verify candidates’ CV claims’

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

Crony Capitalism Babylon’s burning cash. Solomon Hughes reports on the healthcare privateers Babylon, their failed doctor-replacing app and their cosy relationship with Health Secretary Matt Hancock

Paul Bate – CQC strategy director to join Ali Parsa tech start up

Juliet Bauer to leave NHS England and move to online GP consultation provider

Malte Gerhold – Senior Care Quality Commission executive joins AgeTech startup Birdie

 

APPENDIX

Some past reports on CV frauds by NHS managers and clinical leaders:

 

Kerrine Devine

NHS HR manager who lied on CV ordered to pay £9,600 in costs

 

Lee Whitehead

NHS director jailed for lying about professional qualifications

NHS manager jailed for CV lies lands new NHS job   

 

Neil Taylor

  Hospital boss’ fake CV exposed 

NHS chief faked his CV to land £115,000-a-year job

Ex-NHS trust chief escapes jail

 

Hasan Tahsin

Suspended sentence for NHS manager who lied on his CV

 

Rhiannon Mackay

Woman who lied on CV that she had A-Levels to get NHS job is jailed for six months

 

Luis Conrad De Souza

‘Fake’ doctor given 18-month jail sentence

Bogus doctor: Conrad de Souza jailed for lying again

 

Philip Hufton

Nurse stole £350,000 from NHS by lying on CV and claiming fake expenses   

Man who lied on his CV to swindle nearly £350,000 out of the NHS to fund his ‘lavish lifestyle’ – all whilst pretending to have cancer – has been jailed for five years

Fraudster stole almost £350k from NHS and pretended to have cancer

Deborah Hancox

NHS manager locked up for £1m scam went back to work for health service after release from prison

 

fppr-copy