TITLES, BRIEF SUMMARIES AND LINKS TO ARTICLES & CORRESPONDENCE ARE PROVIDED. THE LIST STARTS WITH THE MOST RECENT ITEMS.
FPPR: CQC’s and University Hospitals Birmingham NHS Foundation Trust’s economy with the truth
Published 30 September 2019
CQC arbitrarily rejected an FPPR referral on a director of University Hospitals Birmingham NHS Foundation Trust on spurious grounds that a GMC referral had to be resolved first, despite having accepted a previous referral on the same individual under exactly the same circumstance, and despite the existence of a current, active FPPR process. Ian Trenholm CQC chief executive has been asked to examine this anomaly and to consider, if appropriate, whether there has been any collusion between CQC and the trust to exclude relevant evidence from the current FPPR review. Alongside this bizarre refusal by CQC to accept an FPPR referral, the trust issued a misleading FOI response to a third party, claiming that there had never been any FPPR referrals about trust directors. The trust changed its story after the CQC was informed of its misleading FOI response, but it only admitted to a single FPPR referral since 1 April 2016. CQC has been asked to disclose the true number of FPPR referrals on trust directors.
Super-gagged staff can’t even say that they’ve been silenced. Government still permits super-gags. NHS Improvement won’t audit new safeguards for super-gagged staff
Published 27 September 2019
A most pernicious aspect of the politicised management of the NHS is the use of super-gags to hide bad governance, such the silencing and victimisation of whistleblowers. Whistleblowers may not just be gagged to stop them revealing the contents of agreements reached with employers and details of what happened in the employment relationship, but they may be gagged from even revealing the existence of an agreement. This effectively renders them – and the employer’s misconduct – invisible. Despite past criticism by both Robert Francis and the National Guardian of super-gags respectively as “draconian” and “insidious”, the National Guardian and NHS Employers reviewed guidance to NHS bodies on compromise agreements this year but still permitted the use of super-gags. They made a minor change by suggesting that employers add a clause to allow super-gagged whistleblowers to communicate with the NHS whistleblower employment support scheme.
This small mercy is tainted by the continuing airbrushing of super-gagged whistleblowers from existence and implicit acceptance of blacklisting as business as usual. Nevertheless, Dido Harding Chair of NHS Improvement was asked if she would at least ensure audit of whether employers comply with new guidance by adding the suggested clause about the employment support scheme. Her head of whistleblowing has replied on her behalf to say that NHS Improvement will not do this, but that the regulator has plans to seek data from trusts. This will of course be subject to the same weakness as all self-reported information. NHS Improvement also offers ad hoc checks of cases that present to its whistleblower employment support scheme, but this will only give a very partial picture. Not all whistleblowers will present to NHS Improvement, and those who are super-gagged without the addition of the clause about the employment scheme would not be able to tell NHS Improvement that they are super-gagged.
Who would want a true picture, if it means stopping the silence and losing political grip?
The DHSC, Robert Francis and National Guardian Cabaret: Inconsistencies and obfuscation about whistleblowers’ concerns
Published 19 September 2019
The government’s Chief Medical Officer, Robert Francis and the National Guardian publicly rushed to defend a doctor in a high profile Brexit row, giving the impression that they value whistleblowing. The objective facts suggest otherwise. Importantly, Henrietta Hughes the National Guardian breached her own procedures by intervening in this manner, and she did so in a case which did not even clearly meet her official case criteria. This contrasted with repeated cases where she has questionably turned away and let down NHS whistleblowers in dire straits. Moreover, both she and the government continue to skirt around the central, vital issue of the proper handling and investigation of whistleblowers’ concerns. The government’s cabaret plays on. The encores will continue until UK whistleblowing law is properly reformed and power shifts to the public and the genuine protection of citizens.
Correspondence with parliament: The Department of Health and Social Care’s obfuscation about the investigation of whistleblowers’ concerns
Published 29 August 2019
The government continues to duck and dive when pressed to ensure that whistleblowers’ concerns are properly handled and investigated. It was scheduled to attend a CQC event which was originally billed as a consultation in part about CQC’s whistleblowing policy and processes. This was hastily redesigned and rebadged as rather odd event on first contact processes only, and a tiny handful of whistleblowers turned up. There was a no show by DHSC, who one assumes decided to take all possible precautions against being asked about the investigation of concerns. DHSC also failed to respond as promised ahead of the event to correspondence on this issue, necessitating a letter to Matt Hancock himself. See:
The Low Fact National Guardian’s Office
Published 25 August 2019
The NHS National Guardian’s Office could produce no robust evidence for a major recent claim that: “Patient’s lives have been saved and untold harm has been prevented because Freedom to Speak Up Guardians have supported workers”. The relevant correspondence and background is provided.
More consultation on the regulatory response to whistleblowing in Health and Social Care (But government is keeping shtum on investigation of whistleblowers’ concerns)
Published 22 August 2019
The CQC has issued short notice invitations to an unspecified number of whistleblowers to an event on 2 September 2019, which was being held partly to review how CQC’s whistleblowing processes could be improved:
“We are also reviewing our policies and procedures as they relate to how we manage information from people who work in the services we regulate and how we communicate and use the information shared. We have listened and heard that we have not always been successful at managing information shared with us. As a result of this, and in line with our commitment to consult on how we can make improvements, we are bringing together people who can help us to determine what good looks like.”
CQC sent out its current advice to its inspectors on handling whistleblowing as documentation relevant to the event.
Against advice, the CQC appeared not to have advertised the consulation or ensured open access at least by correspondence. After the consultation was made public, the CQC rowed back and claimed that the event would only look at first contact process, and “definitely not” look at other aspects of CQC process.
The DHSC, which will attend on 2 September, lurks silently in the background, refusing by its inaction to be clear on whether it will allow the CQC to investigate individual whistleblowers’ concerns.
Carl Beech, CQC inspector, convicted child sex and fraudster: Activities at the CQC
Published 21 August 2019
Carl Beech was jailed in July for eighteen years after conviction this year for perverting the course of justice and fraud. He had also been convicted for child sex offences in January. He was employed as an inspector by the Care Quality Commission. CQC has disclosed via FOI that he participated in 128 inspections. CQC denies that, based on a records review, that there is any evidence that his conduct during inspections was a matter of concern. It also does not believe there is a need to review its personnel processes. I have asked the CQC to clarify whether anybody raised concerns about Beech, whether or not related to his conduct during inspections.
Go Whistle: An Unaccountable APPG
Published 17 August 2019
The Whistleblowing APPG chaired by Lib Dem Baroness Susan Kramer, Tory Stephen Kerr, Vice Chaired by Lib Dem Norman Lamb, Tory Andrew Plebgate Mitchell and Labour Anneliese Dodds is sponsored by US bounty hunting lawyers Constantine Cannon. The APPG’s first report of July 2019 lays the ground for opening up the UK market for Constantine Cannon. It was poorly evidenced. Extremely seriously, the APPG told the press that it wishes to see an independent Office to protect whistleblowers, but buried in its report is a recommendation that this report should be under government control and located in two of the worst departments for suppression – either the Home Office or the Ministry of Justice. The APPG has blanked a request to produce evidence justifying some of its recommendations. It has also not provided information about the nature of support provided by another corporate sponsor, NAVEX Global. NAVEX Global’s contribution does not appear in the official APPG register. I have asked the parliamentary Registrar of Member’s Interests to establish whether the sponsorship by NAVEX Global meets the threshold for declaration. The relevant correspondence with the APPG and the Registrar are provided.
A portrait of ineffectiveness: Internal whistleblowing champions in their own words
Published 28 July 2019
The model of internal, nominated whistleblowing officers was spawned in the corridors of Whitehall by Sir Humphrey and enforced by Francis Urquhart. It is huge joke on unsuspecting plebs, who must of course be kept in their place.
It led to the English network of Freedom To Speak Up Guardians who were employed by NHS Trusts and the Scottish whistleblowing Champions, who were directors of Health Boards.
FOI data revealed that despite Robert Francis’ promises that Guardians would provide ‘independent’ advocacy for NHS whistleblowers, hardly any Freedom To Speak Up Champions were escalating matters to the National Guardian.
Similarly, FOI data reveals that Scottish Whistleblowing Champions are escalating very few matters to either the Scottish Health Minister or NHS Scotland.
Feedback from Scottish Whistleblowing Champions raises additional doubts about the effectiveness of the role.
There are examples from other sectors of failure of internal whistleblowing mechanisms, including the recent case of Kathryn Hopkins Ministry of Justice whistleblower. The MoJ denied in legal proceedings that the whistleblower had even made protected disclosures to the Department’s internal nominated officer. However, the Court made a finding of fact that she did.
CQC Whorlton Hall Cover Up: More CQC responses and culpability
Published 26 June 2019
The CQC suppressed a critical 2015 inspection report on Whorlton Hall which effectively described institutional abuse in the form of wide ranging, serious care failures.
CQC has now admitted via FOIA that it has a legal duty to publish an inspection report on every inspection, and that it has no policy which allows it to discard an entire inspection report. CQC has also admitted that where there is a concern about insufficient evidence to back up regulatory findings, normal procedure is for the same inspector to go back. In contrast, at Whorlton Hall the CQC sent a different team in several months later, which delivered an unrecognisably upbeat portrait of the service.
The CQC is suspiciously evading a question about whether CQC board members were involved in the decision not to publish the 2015 Whorlton Hall inspection report.
It also refused to disclose, on questionable grounds, the detailed evidence relied upon for the conclusion of the whitewash 2016 CQC inspection report that no unofficial seclusion was taking place at Whorlton Hall. A question arises about the sufficiency of this ‘evidence’.
Similarly, CQC refused to disclose on questionable grounds why its whitewash 2016 report was silent about the lack of an organisational rapid tranquillisation (forced medication) policy at Whorlton Hall, a serious failing, which was described in the suppressed 2015 inspection report but later conveniently omitted.
The stench grows stronger. The CQC is dangerous and needs to be abolished. In the meantime, parliament is duty bound to stop the DHSC/ CQC charade of an faux independent investigation controlled by the CQC. It should ensure a much more robust, wider investigation of whether the CQC is fit for purpose, as Barbara Keeley MP has called for.
The spreading CQC Whorlton Hall scandal. Emerging allegations at Newbus Grange: Another CQC deception?
Published 20 June 2019
Newbus Grange is another former Castlebeck-Danshell learning disability facility, which CQC inexplicably gave a pass despite staff convictions for abuse against patients and other matters.
The former deputy manager of Newbus became the manager of Whorlton Hall in 2017.
Following recent exposure of serious abuse against patients at Whorlton Hall by BBC Panorama, the police arrested ten members of staff.
A CQC cover up about Whorlton Hall has been exposed by Barry Stanley-Wilkinson, CQC whistleblower and former lead inspector.
According to Darlington, Hartlepool and Stockton on Tees CCGs minutes of May 2019 there is also emerging serious Safeguarding concern about alleged physical abuse at ‘Outstanding’ Newbus Grange.
The CQC is a dangerous organisation which needs to abolished. Barbara Keeley Shadow Minister for Mental Health and Social Care has called for a properly independent inquiry into whether it is fit for purpose.
Counting the cost of the CQC: Abuse, Whorlton Hall and CQC spin doctors
Published 14 June 2019
A dismal spectacle of self-preservation, sly deflection and scapegoating of subordinates unfolded when CQC directors, Paul Lelliott Deputy Chief Inspector and Ian Trenholm Chief Executive appeared in front of the Joint Human Rights Committee on 12 June 2019.
They had been hauled in to answer questions about CQC’s suppression of a 2015 inspection report. The report described wide ranging and serious care failings that effectively amounted to institutional abuse, serious risks and allegations of mistreatment at Whorlton Hall, where BBC Panorama recently exposed serious abuse by staff.
Although the CQC refused to hand over crucial documents, the Committee had in its possession internal CQC correspondence with Barry Stanley-Wilkinson CQC whistleblower. This put Lelliott in the thick of things in 2016, just before a whitewash alternative CQC report was published June 2016. The correspondence also revealed other allegations of bullying and suppression by CQC managers.
It was clear from the Committee hearing this week that the last thing that the CQC intends to do is to take responsibility. Instead, there is yet another disingenuous proposal to review inspection methodology, when the issue is not incompetence but cover up.
It takes time and money to service a denial machine.
A quick search reveals that CQC hires at least twenty seven comms and ‘engagement’ staff. This must be gratifying for its executive escape artists.
Of special note, it seems that CQC hired a PR bod to assist Andrea Sutcliffe former CQC Chief Inspector with managing the news on social care failings and BBC Panorama exposures.
Also noteworthy is the fact the former Department of Health’s chief spin doctor for the whitewash Freedom To Speak Up Review, on NHS whistleblowing, is now CQC’s Head of Provider Engagement.
The CQC is too riddled with years of misdeeds to be reformed. Only abolition and a clean slate will do now.
Did the Royal College of Psychiatrists award fake doctor Zholia Alemi the professional qualification of MRCPsych? A response from Mental Health Tribunal Scotland
Published 1 June 2019
The Royal College of Psychiatrists has so far refused to confirm if it awarded Zholia Alemi a qualification, the MRCPsych, which would have allowed her to masquerade across the UK as a consultant psychiatrist. Equally, the Mental Health Tribunal Scotland had answered a previous FOI request by a third party somewhat evasively, by failing to say if she was a medical member of the Tribunal. The Tribunal has now confirmed that Alemi was a medical member. It has also advised that Zholia Alemi would have needed to satisfy requirements of either membership (MRCPsych) or fellowship (FRCPsych) of the Royal College of Psychiatrists. However, it stopped short of answering a question about whether she had been verified to be MRCPsych qualified. The Tribunal pointed out that Scottish Ministers are responsible for this. UPDATE 10 JUNE 2019: The GMC has confirmed that the Royal College of Psychiatrists did award Alemi the MRCPsych.
A still unanswered questions to Department of Health and Social Care Department about whether CQC will investigate individual whistleblowers’ concerns
Published 25 May 2019
In recent correspondence the Department of Health and Social Care official responsible for whistleblowing policy seemed to believe that CQC should ‘urgently’ investigate whistleblowers’ patient safety concerns. He agreed to take the issue up with his Department but then stopped responding to enquiries. In the aftermath of yet more grave abuse revelations at Whorlton Hall, where CQC only conducted a superficial thematic review in response to whistleblower concerns, the question about specific investigation has now been redirected to the Minister for Care and Gosport MP, Caroline Dinenage. Relevant correspondence is provided below.
Spinning at Gosport II: DHSC FOI revelations & National Guardian’s fake independence
Published 31 March 2019
Shocking documents in the archives of the Gosport Independent Panel inquiry revealed the Department of Health driving improper, aggressive NHS spin in regards to the Gosport War Memorial Hospital inquests. The government is still spinning about Gosport through its Freedom To Speak Up project. The government appointed two unsuitable figureheads with no special expertise in whistleblowing to the post of National Freedom To Speak Up Guardian. The National Guardian’s Office makes unsupportable claims that it is having a substantial impact and that NHS whistleblowers will now be treated fairly. Department of Health and Social Care FOI data, albeit heavily redacted, shows how the National Guardian’s Office and the government have worked together to spin a ‘positive narrative’ about NHS whistleblowing, as part of the government’s response to the chilling Gosport deaths disaster. Two months ago the National Guardian claimed that she would put a report before parliament to hold the government to account. In fact this was orchestrated by the government. The DHSC repeatedly claims that the NGO is independent, but behind the scenes makes it clear that it prefers the NGO to ‘be on the same page’. Whilst this distasteful circus wastes more and more public money, the bereaved Gosport relatives remain in the cold with no justice to show for a distressing, twenty year search for answers. Whistleblowers continue to be ignored and harmed. Governments simply cannot be relied upon to hold themselves to account. We need real reforms including an overhaul of defective UK whistleblowing law. As part of this, we need a statutory agency to protect whistleblowers and the public interest, that is genuinely independent of government.
At the Royal Society of Medicine, without the Minister or the Judge
Published 29 March 2019
A brief account of an event on 26 March 2019 at the Royal Society of Medicine about NHS whistleblowing. Neither of the two main speakers, Caroline Dinenage Gosport MP and Minister for Care and Justice John O’Hara, turned up. Justice O’Hara last year recommended criminal sanctions for NHS whistleblower suppression. Remarkably, the National Guardian’s Office took no part in the event. Nevertheless, there were appearances by the Department of Health and Social Care and the government’s chosen lead researcher for an evaluation of its Freedom To Speak Up project. Echoes of Matt Hancock’s previous ‘egregious whistleblowers’ narrative were heard via the presentation on the government-sponsored evaluation research. Two whistleblower speakers, Peter Duffy surgeon ex-University Hospitals Morecambe Bay NHS Foundation Trust and Dr Peter Wilmshurst, laid bare false government promises of protection. The real risk has never been problematic whistleblowers. It is egregious government spin and failures of accountability.
Mr Hancock’s violence reduction plan, reportable injuries to NHS mental health staff & lack of consistent reporting by CQC.
Published 20 March 2019
In 2017 The government stopped central collection of data on assaults against NHS staff despite a rising trend and much criticism. A year later, it backtracked and announced a violence reduction strategy which included a promise that the CQC would scrutinise NHS trusts’ violence reduction plans. Three datasets show that NHS mental health services staff have suffered the highest rate of assaults. The Health and Safety Executive has supplied FOI data on statutory staff injury reports (RIDDOR) by NHS mental health trusts, which shows that since April 2015, 20 mental health trusts accounted for 67% of all the non-fatal RIDDOR injury reports. According to other FOI data, these 20 trust were mostly higher users of physical restraint, with very marked variation in the rates of resultant injury to staff and patients. However, the physical restraint data they supplied was incomplete and patchy. This raises questions about the governance and regulation of this area. The most recent CQC inspections on these 20 trusts do not report reliably on violence against or injuries sustained by staff.
Public sector gags: The Wilfully Blind Treasury
Published 12 March 2019
HM Treasury is responsible for scrutinising special, non-contractual severance payments and related gags in the public sector. Parliament asked the Treasury in 2014 to track the pattern of severance payments across the wider public sector. However, the government has resisted this. It gave the job to individual government Departments, which have a conflict of interest in reporting such data. A most cursory inspection of Department of Health and Social Care data on severance payments and minimal cross checking against other sources raises questions about its accuracy. The Treasury was asked if it kept its own data on special payments and gags, but in an FOI reply the Treasury frostily maintained that it does not track the settlement agreements and gags that it signs off. Plus ça change.
Spinning death at Gosport: The Department of Health and Social Care and the National Guardian
Published 11 March 2019
The NHS’ obsession with reputation management is well known and very unhealthy. It is rare to get a glimpse of its inner workings. The online Gosport Independent Panel archives of thousands documents, many of which were not cited by the Panel’s report, reveal some unsavoury secrets. For example, the intense spin by the NHS in the months prior to the 2009 inquest hearings into ten Gosport deaths. Although some officials expected a finding of unlawful killing, the inquests determined that all ten deaths were from natural causes, albeit with medication contributing to some. The instructions for spinning Gosport originated from the Department of Health, which asked to be kept informed of the NHS comms campaign: “….in the run up to, during and after the inquest”. The spin continues. The National Guardian ran a PR campaign about the (illusory) success of the Freedom To Speak Up project just before the government’s response to the Gosport inquiry was published last autumn. She is about to be deployed again this month, to lay good news about purported good practice before parliament. This is just before the police announce their decision on whether to pursue prosecutions over the Gosport deaths. The Department of Health has confirmed that it holds records of communications with the National Guardian about this good news plan, but it is trying to find a way not to disclose the data under FOIA. The institutional resistance to transparency only serves to underline that safe handling of the most serious whistleblowing matters needs to be overseen by a properly independent, statutory body that is not managed by any government department. It also raises questions about the usefulness of a new network of medical examiners that will be controlled by the NHS itself.
There’s still club culture at the heart of CQC
Published 9 March 2019
This piece shares further evidence sent to the Health and Social Care Committee for its hearing on 12 March 2019 about the Kark FPPR Review report, on the system response to poor NHS managers. In short, the CQC’s inspection arrangements are such that NHS trust directors STILL frequently rate each other on the “Well-Lead” domain, raising all sorts of questions about conflict of interest. An earlier analysis in 2016 on these matters can be found here.
Another turn of the Magic Roundabout: Jo Williams’ referees
Published 8 March 2019
Jo Williams resigned as CQC Chair in 2012 after a string of CQC scandals and repeated criticism of the CQC and of her personally. She was controversially recycled back to the NHS, as Alder Hey Children’s NHS Foundation Trust non executive director and then most recently Chair. An FOI disclosure by Alder Hey has revealed that references were provided by “a past DH official/ current chair of a health Think Tank…a past Minister…a university Vice Chancellor and a current NHS board Chair”.
Gosport deaths, UK government pork pies about whistleblower protection and failure to investigate concerns
Published 6 March 2019
The central issue in whistleblowing governance is whether concerns are properly investigated and addressed. The government is resisting the EU directive on whistleblowing, which seeks to compel proper handling of disclosures. The government falsely claimed to parliament that UK whistleblowing provision is “advanced” and maintained that it does not need to be replaced. It produced a misleading report to the European Scrutiny Committee. This sowed confusion by conflating the investigation of whistleblowers’ concerns with the production of activity statistics by Prescribed Persons. BEIS has disclosed that it has no plans to scrap the useless system of toothless, often unhelpful and even hostile Prescribed Persons, to whom UK whistleblowers are supposed to disclose under the Public Interest Disclosure Act.
Caroline Dinenage Department of Health and Social Care Minister and MP for Gosport, has written to a bereaved relative of a victim of Gosport War Memorial Hospital. She claimed that since the Gosport inquiry report was published, the National Guardian has stepped up activity on ensuring that the NHS deals better with staff‘s concerns. This is surprising because recent FOI data showed that the National Guardian does not bother to track whether NHS whistleblowers’ concerns are addressed. Caroline Dinenage has been asked to expand on her claims and for supporting evidence of increased National Guardian activity on whistleblowers’ concerns.
Questions about coaching of staff who gave evidence to the Gosport inquests and the Department of Health and Social Care’s role in promoting spin
Published 5 March 2019
The Gosport Independent Panel inquiry into hundreds of unnatural deaths at Gosport War Memorial Hospital dumped many thousands of documents on line. Many of the documents were not referenced in the Panel’s report, some containing important evidence. The government has abusively left bereaved Gosport families to search the archives themselves, a gargantuan task. Some documents relating to the 2009 inquests into ten suspicious Gosport deaths show an orchestrated strategy of spin, which extended to including a PCT media statement in a briefing pack given to staff who gave evidence at the inquests. Internal Department of Health correspondence just prior to the conclusion of the inquests reveals that the Chief Medical Officer’s team assumed the coroner would find Unlawful Killing. However, the PCT’s spin included denying any evidence of criminality. Additional internal correspondence of 2006 shows a Department of Health Official from the Ministerial Briefing Unit asking if the Strategic Health Authority was ‘on top’ of media coverage of Gosport, and instructing a colleague to “push them for a comms strategy”. A letter has been sent to Caroline Dinenage DHSC Minister of State for Care and Gosport MP, seeking assurance that the DHSC will not allow NHS staff witnesses to inquests to be unduly influenced in the future.
Number of NHS whistleblowing cases: A disagreement with Tom Kark QC
Published 1 March 2019
The Kark FPPR Review report, undertaken on behalf of the Department of Health and Social Care, states that there is a low number of NHS whistleblowing cases, and bases this on small figures of whistleblowing disclosures to Monitor (a predecessor body of NHS Improvement) over a three year period. This is spurious because it does not take into consideration much more numerous disclosures by NHS staff to the Care Quality Commission (1535 contacts over 2015/16 and 2016/17). Neither does it take account of the fact that there will be many more whistleblowing disclosures made internally to whistleblowers’ employers. Tom Kark has been asked if the facts can be corrected in his report.
Whistleblowing, the National Guardian and Defence Medical Services
Published 27 February 2019
The NHS Freedom To Speak Up project defines waste. It has committed millions in public money across the NHS to an un-evidenced vanity project. Not content with that, the government is trying to spread and embed the dubious model. Once embedded, it will be a bulwark against real whistleblowing reform. The National Guardian expends much energy on glad-handing and self-promotion instead of the day job of actually protecting patients and whistleblowers. The Defence Medical Forces have fallen to the Speak Up charm offensive, and has now adopted the model. Disclosed documents are provided.
An example of the investigation industry: Conflict Management Plus Limited AKA CMP Resolutions
Published 24 February 2019
Whistleblowers are always interested in private companies that employers may hire to undertake whistleblowing investigations. An example is CMP Resolutions, a company whose Business Development Manager wrote an article in the Health Service Journal on 21 February 2019 about how internal whistleblowing investigations come to “comfortable outcomes”. Some information about CMP Resolutions is collated in this piece.
How are CQC inspectors supposed to assess learning from deaths? Disclosed internal guidance for CQC inspectors
Published 23 February 2019
The CQC has reluctantly disclosed internal guidance to its inspectors on how to handle patient deaths and how to assess whether regulated organisations are responding effectively to deaths. Links to thee documents are provided.
The toothlessness of the National Guardian’s Office: Why it cannot be a model for protecting whistleblowers
Published 22 February 2019
Summary: This piece looks at what happens after the National Guardian has conducted an NHS whistleblowing case review. The answer so far is a long paper trail and much box ticking, but little of much substance. FOI data from NHS Improvement is not compelling evidence of Robert Francis’ contention that the powerless National Guardian would borrow power and authority from system regulators.
Whistleblowing in Whitehall: Civil Servants’ Complaints about Breaches of the Civil Service Code since 2014
Published 19 February 2019
Summary: Under the Civil Service Code, civil servants are required to observe values of integrity, honesty, objectivity and impartiality. They are required to whistleblow if they see evidence that the Code has been breached. Examination of published data by the Civil Service Commission, which is the final arbiter on complaints under the Code, reveals a picture of escalating complaints by civil servants in recent years but no proportionate increase in investigations by the Commission.
A total of 143 Code complaints have been examined by the Commission since April 2014, eleven (7.7%) of which were investigated and four (2.7%) of which resulted in findings of Code breaches. The most complained about Department was the DWP. The Commission has examined 30 complaints by civil servants about the DWP since 2014.
The Commission’s investigative procedure is variable. It appears reluctant to make findings of whistleblower reprisal. Even in a most egregious case of whistleblowing about suspected criminality in contract handling at the MoD, the Commission only criticised the poor whistleblowing governance but refrained from a finding of reprisal. It appears that whistleblowers in the civil service may get a promise of ‘better governance jam tomorrow’ but limited recognition of personal injustice, which can have a chilling effect on culture.
The Commission should in fact be more proactive and recognise that failures to protect and withholding of support are often a form of whistleblower victimisation.
The overall picture is of a clunky, slow, paternalistic and only partially effective and responsive mechanism for whistleblowing at the heart of the government. The public deserves better and a vital starting point is to reform UK whistleblowing law, to compel better minimum standards of practice.
The Dismissal of over Ten Thousand NHS Staff via ‘Some Other Substantial Reason’
Published 17 February 2019
An FOI disclosure by NHS Digital of 15 February 2019 is examined. Data on NHS sackings under the insidious category of ‘Some Other Substantial Reason’ is given for individual organisations, showing marked variation. National bodies which should be setting an example, and NHS Trusts rated as ‘Outstanding’, have contributed to the trail of SOSR destruction.
Public Health England’s response to the finding of Race discrimination and victimisation against Dr Femi Oshin: Discrepant Race and Grievance statistics
Published 13 February 2019
A damning Employment Tribunal determined that PHE racially discriminated against Dr Oshin, victiminsed him for raising concerns about the discrimination and unfairly dismissed him. PHE has been slow and reluctant in its response. It has published a report which is purportedly evidence of lessons learnt, but even the Race/ Grievance stats in the report do not match up with a later FOI disclosure on the same matters. Is PHE making things up as it goes along?
Jo Williams’ letter of 25 November 2011, to all CQC staff about two CQC whistleblowers who were about to give evidence at the Mid Staffordshire Public Inquiry
Published 10 February 2019
The government continues to protect poor senior managers and resists attempts to stop them from being recycled. Alongside Matt Hancock’s tepid response to the Kark FPPR review recommendations, NHS Improvement allowed the recycling of Jo Williams the controversial former Chair of CQC who stepped down after a string of regulatory scandals. Williams was appointed as a NED at Alder Hey NHS Foundation Trust in November 2016. Earlier this month it was revealed that she had been promoted to the chair of the trust. As a reminder of her past failures, a copy of a letter she sent to all CQC staff in November 2011 attacking two CQC whistleblowers is provided.
The unfair sacking of Andrew Smith, NHS whistleblower and trade union representative. A heady cocktail of tainted ingredients.
Or how CQC, NHS Improvement & Mid Essex Hospital Services NHS Trust worked together on FPPR
Published 7 February 2019
The government and its arms length bodies continue to protect poor senior NHS managers. The Kark FPPR Review report was published yesterday, but is a curate’s egg. Matt Hancock has wasted no time in undermining its findings and recommendations, and has astonishingly delegated the response to Kark’s report to one of the most heavily conflicted bodies, NHS Improvement. On the same day as Kark’s report was published, CQC shut down yet another FPPR referral about a case of proven serious whistleblower reprisal. This related to Mid Essex Health Services NHS Trust. One of the trust managers criticised by the Employment Tribunal in this case is employed as an NHS Improvement Director. CQC also issued a puff piece in July 2018 extolling this individual’s virtues, after the critical ET ruling of whistleblower reprisal in March 2018. Whatever propaganda gushes from the National Guardian’s Office, Covering Up, not Speaking Up, is business as usual.
Staff Surveys and FOI adventures with AAIB and HSIB
Published 27 January 2019
The Magnificent Men in their Flying machines at AAIB have repeatedly refused to disclose routine AAIB staff survey data. The Department of Transport has now appealed against a ruling by the ICO in favour of disclosure and the case is now with the First Tier Tribunal (Information Rights). A subject access request showed that behind the scenes, AAIB and HSIB have acted in concert, and that AAIB, the Department of Transport and the Cabinet Office conferred about the appeal against the ICO.
Whistleblowing APPG: Whistleblowers UK and questions about funding by Constantine Cannon LLP
Published 24 January 2019
A controversial whistleblowing All Party Parliamentary Group (APPG) was established last summer, with reported funding from Constantine Cannon a well-known US bounty hunting law firm. A subsequent denial about the funding by the APPG’s secretariat, the private company Whistleblowers UK (WBUK), has not been clarified or resolved. Responses are awaited from the parliamentary Registrar of Members’ Financial Interests and from the chair of Whistleblowers UK.
Mission Drift by the National Guardian: Further, proposed dilution of NHS whistleblower case reviews
Published 29 December 2018
The CQC and National Guardian have already watered down the National Guardian’s role, pulling it away from its original, core purpose to help whistleblowers in serious difficulties. The National Guardian is in the process of attempting to dilute her role even further, by dropping the term ‘case review’ and diverting focus from specific cases to reviewing themes. Her resistance continues to the original function of helping to ensure redress for whistleblowers and patients harmed by suppression.
Dissidentdaubs’ Boxing Day Cabaret
Published 26 December 2018
Some refreshing counter-culture seltzer for the dyspepsia caused by heavy government propaganda about whistleblowing. Avert your eyes if your taste runs to the delicate!
Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons
Published 19 December 2018
The PHSO has partially upheld a complaint about CQC’s handling of the FPPR referral on Paula Vasco-Knight and which allowed her to be promoted to CEO of St Georges despite nepotism and proven whistleblower reprisal. PHSO pulled its punches and only criticised CQC’s process, but claimed that it might have come to the same decision even if its process had been fair. This is another unacceptable trivialisation of whistleblower suppression and reprisal. Unanswered questions remain about how Vasco-Knight was protected by senior officials even after her wrongdoing was exposed. The futility of the exercise has been underlined by a non-apology to Clare Sardari the whistleblower concerned, who has written to the Secretary of State calling for real reforms that would make a difference: managerial regulation and reform of UK whistleblowing law.
Mr Tristan Reuser surgeon & GMC. Update on GMC, whistleblowing and implementation of the Hooper recommendations
Published 13 December 2018
The GMC has still not reported on the progress of its pilot of the Hooper recommendations, to improve protection for whistleblowers, which commenced in July 2016. The case of Tristan Reuser who was referred to the GMC after making a protected disclosure, and whose medical director wrongly claimed to the GMC that he was not a whistleblower, once again highlighted this important matter. Charlie Massey GMC CEO has provided an update and in doing so revealed that since March 2015, when GMC received Sir Anthony Hooper’s recommendations, GMC has examined only one possible case of whistleblower reprisal and suppression by a senior doctor, which it shut down. GMC has indicated that it would look further into the issues raised by the Employment Tribunal in Mr Reuser’s case.
CQC’s victimisation of whistleblowers: Failure to investigate concerns
Published 11 December 2018
The Employment Tribunal held that disgraced former NHS chief chief executive Paula Vasco-Knight’s trust was guilty of a “significant” act of reprisal because it failed to fairly investigated whistleblowers’ concerns about her nepotism. The CQC compounded the injustice by perversely shutting down the FPPR referral on Vasco-Knight. Details of the trust’s dishonest handling of the investigation into allegations about Vasco-Knight are set out. The CQC’s own failure to investigate whistleblowers’ concerns for the last nine years is examined. Robert Francis has previously advised that the CQC has the power to investigate, but has now fallen silent when asked to press the issue in the interests of patients. The Department of Health has given an initial indication that it believes CQC has the power to investigate. Further liaison continues.
The National Guardian’s Day Out with the PHSO: Claims and Rebuttals
Published 9 December 2018
The National Guardian has been assisted with her public relations programme by an interview broadcast by Rob Behrens the Parliamentary and Health Services Ombudsman. A transcript of the interview is in the appendix. Below I examine a few of her comments and claims, and I rebut them. The PHSO solicited interview questions for the National Guardian via Twitter, and put them all to her save for a question about reform of UK whistleblowing law.
The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project
Published 28 November 2018
Recent survey data shows that some Speak Up Guardians are bullied and obstructed when raising patient safety concerns. The National Guardian’s Office has admitted via FOI that it does not track how often such reprisal happens. The same FOI disclosure revealed that the National Guardian received only 18 qualifying disclosures from NHS trust Freedom To Speak Up Guardians in 2017/18, which suggests that not enough concerns are being escalated externally, even though this is the safety mechanism upon which the whole Freedom To Speak Up project hinges. Neither does the National Guardian measure Speak Up Guardians’ experience of whistleblowing to her Office. And yet the National Guardian is well aware of the importance of feedback, as evidenced by her repeated policy statements and demands that others should collect and learn from feedback. In addition to a previously reported failure by the National Guardian to track whether whistleblowers’ concerns are addressed, these are yet more mission-critical failures demonstrating what whistleblowers have known all along: the Office is a government firewall, was designed to be ineffective, and will never work. Real reform is needed.
Witness statements about concerns at Gosport War Memorial Hospital
Published 24 November 2018
The families of the Gosport victims are still seeking answers and justice. The Gosport Independent Panel investigation was not a statutory inquiry. It did not review all relevant evidence and although it found that there were at least 456 unnatural deaths related to the non-clinically indicated administration of opiates, there are still no prosecutions. Witness statements from Gosport hospital staff, relatives of the deceased and others who expressed concerns about events at Gosport are collated on this page.
A Serious Health Warning about the Freedom To Speak Up project: What all NHS Staff should know before they whistleblow
Published 17 November 2018
The spin by the Department of Health and Social Care and the National Guardian about NHS whistleblowing has escalated to dangerous proportions. It is misleading staff that change has occurred and that it is safer now to raise concerns. The evidence is that serious problems and risks for staff remain, and that the National Guardian’s Office is a key part of the problems. The evidence of collusion between bodies and continuing lack of protection for whistleblowers is briefly set out, with links to recent testimony from whistleblowers about failures of UK whistleblowing law, to illustrate common pitfalls. Staff need to fully inform themselves of these hazard before deciding whether to and how to whistleblow.
What Could a New Whistleblowing Law Look Like? A discussion document
Published 19 October 2018
As part of ongoing work to seek substantive reform of wholly unfit UK whistleblowing law, whistleblowers have drafted a proposal for new law in plain English, which would drive progressive public policy in the public interest. It draws on best practice from different jurisdictions and is also informed by the lived experience of whistleblowers on how institutions and governments evade accountability, transparency and loopholes whistleblowing law.
In brief the proposed law offers:
- Timely, mandatory investigation of concerns
- An active duty to protect whistleblowers from the outset
- A mechanism for early resolution of conflict
- A means of ordering remedy without the need for litigation
- A range of civil and criminal penalties against individuals
- A means of funding legal representation for whistleblowers through a mandatory insurance scheme for employers
- Expansion of protected groups – the example of patients and families who speak up is explored
Whistleblowers in Their Own Words. What’s Wrong with UK Whistleblowing Law and How it Needs To Change
Published 18 October 2018
Thirty one whistleblowers who have litigated under PIDA gave first-hand accounts of the problems with the law. Their individual accounts and ideas for change are listed individually below.
Whistleblowers were invited through an open process to submit brief testimony. The process did not include examination of individual cases and facts, but most individuals were known to the authors or to other whistleblowers.
The whistleblowers came from a range of sectors, public and private, including policing, education, industry, local government, health and social care.
Their accounts collectively reveal failures under PIDA to investigate whistleblowers’ concerns, protect them or hold wrongdoers to account. Whistleblowers’ feedback and suggestions amount to a call for replacement of the existing framework. A range of suggestions are made for levelling the playing field, which currently is hopelessly slanted against whistleblowers.
Prescribed Persons or the Pretence of PIDA. How UK whistleblowers are ignored
Published 14 October 2018
Under wholly ineffective UK whistleblowing law, PIDA, there is no meaningful enforcement of good practice and compliance with the law. A sprawling system of Prescribed Persons is installed by the UK government as window dressing but in reality these bodies do nothing useful. Many of them do not even know that they are Prescribed Persons nor understand even their limited abilities. The National Audit Office (NAO), itself a Prescribed Person, produced a particularly poor, superficial report on Prescribed Persons in 2015, coinciding with the publication of Robert Francis report of the Freedom To Speak Up Review on NHS whistleblowing. NAO’s report gave false assurance. Collated research about the failures of the Prescribed Person system and up to date FOI evidence which demonstrates continuing, serious failure is provided. Parliament has been informed.
Protect. The View from a Fence.
Published 8 October 2018
Protect, formerly known as Public Concern at Work (PCaW), is the dominant UK whistleblowing charity. It played a large part in introducing very ineffective UK whistleblowing legislation twenty years ago. Whilst this was probably done with good intentions, the charity has not redeemed the mistakes of the past by calling for replacement of the law or urgent correction of the law’s most serious deficits. For twenty years, UK whistleblowing law has not compelled anyone to investigate whistleblowers’ concerns.
Protect is an important reservoir of specialist knowledge because of its dominance of the market. It receives substantial income from the public purse but has declined to reveal full details of this income. It provides services to employees and employers. Some may be concerned about the potential for divided loyalties, priorities and the degree to which Protect challenges power. In any case, the charity has no official status and no powers to protect whistleblowers. The charity has not challenged the most obvious frailties of sham government whistleblowing policy. The Freedom To Speak Up project, which is arguably the biggest block to real reform, not only goes unchallenged but was this week endorsed by a Protect trustee. In the terrible shadow of the Gosport disaster, the public has a powerful need for a statutory, independent expert body with powers to protect whistleblowers and the public interest, and is subject to proper legal accountability.
Another Health Check on the Quality of the National Guardian’s Data
Published 27 September 2018
The National Guardian is relying on unverified Speaking Up data obtained by very variable methods and supplied by NHS trusts, and is drawing conclusions from too little evidence. The National Guardian inexplicably fails to collect or publish any data on whether whistleblowers’ concerns are addressed. Parliament has been alerted to this mission-critical failure and Health and Social Care Committee has indicated that it will follow up this issue.
CQC Concedes. Four years on from ‘Complaints Matter’ , CQC’s whistleblowing governance is still not right
Published 23 September 2018
After much spin, lengthy evasion and denial, the CQC has admitted that its approach to whistleblowing requires improvement. Time will tell if the CQC will take the necessary, serious action. An agreed record of a meeting with CQC Chief Inspector of Hospitals and his Deputy, who leads on whistleblowing at CQC, is provided.
Will the National Guardian come clean about why Freedom To Speak Up Guardians are leaving?
17 September 2018
The government and Robert Francis created more potential victims of employer reprisal when they introduced a model of Freedom To Speak Up Guardians employed by the very NHS trusts that they were supposed to challenge and hold to account. Some Speak Up Guardians have left in a short space of time. Some have resigned or retired and some have been off sick. Only partial information is available.
Corporate schmoozing at the National Guardian’s Office: National Guardian’s Pan Sector Party Planning
Published 15 September 2018
The National Guardian’s Office turns away NHS whistleblowers in serious trouble. It sat on a mass referral from Brighton and Sussex University Hospitals NHS Trus about an unsafe and failing organisation. It has not inspired enough confidence, such that staff at Shrewsbury and Telford Hospital NHS Trust turned instead to the Local Authority as a route for disclosure. The National Guardian is quick enough to cry limited resources when defending its very selective and minimal choice of cases for review. But it can find a fat slice of these limited resources to host grandiose schmoozing sessions with corporations that are notorious for harming whistleblowers. The output from these meetings does not suggest that there is any serious governance work being done in these sessions. Whose interests are being served?
Whistleblowing v Bounty hunting. A new whistleblowing APPG with sponsorship from bounty hunters.
Published 12 September 2018
UK whistleblowing is utterly ineffective and fails to protect the public, or indeed whistleblowers. It needs to be replaced and the campaign continues:
But whenever law change is mooted, some hear opportunity knocking in a different way. There has been increasing lobbying to import a US model of ‘whistleblowing’ bounties. This is a lucrative business but is a far departure from whistleblowing in its truest sense, and raises problems of ethics, fairness and the efficient use of public funds.
There is insufficient data in the public domain on the effectiveness of US bounty schemes in protecting whistleblowers to conclude that they merit replication by the UK. The data that is available raises serious questions.
The use of bounties would be particularly problematic in the public sector as the model conflicts with Nolan principles of selflessness and strict neutrality.
This piece examines some of the background on bounties and a new All Party Parliamentary Group on whistleblowing. This APPG was established with financial contributions from a US bounty hunting law firm. Whistleblowers UK, a private company which has advocated for whistleblower rewards, has been paid by Constantine Cannon to act as APPG secretariat.
CQC case study. Snooping. Briefing. Porkies. And vexatiously applied ‘vexatious’ protocols.
Published 5 September 2018
This is a piece to raise awareness amongst fellow campaigners about the importance of personal data as a tool when dealing with institutions that are seemingly opaque and unaccountable. I use an example of a ‘Subject Access Request’ for personal data that I made to the Care Quality Commission. This revealed institutional collusion and hostility, close surveillance of my online activity and revealed the reason for some critical failures to respond to some of my protected disclosures. Disclosed documents showed that this inaction was due to a deliberate, covert protocol of treating me as a ‘frequent correspondent’. CQC’s internal deliberations show a crazy ambivalence. The organisation will largely not engage meaningfully, preferring to demonise and denigrate, yet secretly monitors me like a stalker. Other whistleblowers have made similar discoveries.
A whistleblower’s feedback to the National Guardian
Published 18 August 2018
The National Guardian’s Office used to ask for feedback only from whistleblowers whose cases it had decided to review. After criticism, it recently began requesting feedback from those whom it had turned away. This is a quote from an example of the feedback that has been given:
“I have no energy left, finding myself in late middle age without a job, having lost my family and children, and soon to lose my home also.
The lack of humanity with which I have been treated has been appalling. I must question if you and your team have a real understanding of the human consequences of your actions and omissions, and the despair they cause.
Please spend some time thinking seriously about the health impact of your actions before claiming any further successes or spending any more public money on PR. The sight of it is very distressing to whistleblowers who know the real truth.
HSIB’s Sleight of Hand, CQC and the Care Programme Approach: Comments on HSIB investigation into the transition from child and adolescent mental health to adult mental health services 12017-18
Published 10 August 2018
The Healthcare Safety Investigation Branch looks to be just another, expensive go-faster stripe on the denial machine. Its selective report of an investigation on unsafe care planning in mental health services has omitted important information and failed to fully examine regulatory performance and failure of government policy. HSIB’s recommendations are more theatre than serious patient safety interventions and are not comprehensive or penetrating enough.
Replacing the Public Interest Disclosure Act (PIDA)
By Dr Minh Alexander, Martin Morton, Clare Sardari, published July 18 2018
This paper provides a digest of of why UK whistleblowing law is unfit for purpose and is so weak that it actually serves weapon with which employers persecute whistleblowers. The paper presents evidence on how badly UK whistleblowing law has fallen behind international best practice and gives examples of current best practice. We put forward principles for replacing PIDA with better law. Three key features are needed. New law should require that whistleblowers’ concerns are addressed, that there is pre-detriment protection and that there is personal liability for those who victimise whistleblowers in order to meaningfully deter reprisal. A parliamentary debate has taken place and further liaison and lobbying is intended.
National Guardian’s Hidden Bulletins and Disappearing Freedom To Speak Up Guardians
Published 17 July 2018
In 2017 the National Guardian hesitantly agreed to publish a newsletter for Speak Up Guardians, but shortly after this a parallel system of bulletins for Speak Up Guardians was established which were NOT published. The existence of these only came to light by chance through disclosures by trusts. A full set were obtained under FOIA from the National Guardian’s Office. They show some interesting and disturbing aspects such as an obsession with PR and little substance. Of significance, it has emerged that Speak Up Guardians have been leaving post but that the National Guardian has not reflected this in her official publications.
Whistleblowing isn’t fixed yet, and this leaves patients exposed. An overview of unfinished policy business
First published by the Centre for Health and the Public Interest, 26 June 2018
The publication of the Gosport inquiry report exposed yet again how vulnerable patients are when whistleblowers are ignored. The government has tried to draw a veil over repeated NHS whistleblowing scandals and in particular the grave governance failures exposed by the MidStaffs disaster by offering a sop in the form of the Freedom To Speak Up project. This overview paper summarises three years work tracking and analysing the official fallacies and fakery. Original supporting evidence is linked.
Gags still stop whistleblowers speaking out: Government claims about new safeguards are hollow
Published 24 June 2018
This piece reports on the chilling effect of the continuing use of secrecy and non-disparagement clauses in NHS settlement agreements despite the addition of tokenistic riders that staff may whistleblow. The legal territory is untested – who would test it? FOI data showing that some NHS employers might even consider suing whistleblowers who break gags is provided. A current call for evidence from gagged NHS whistleblowers by a journalist has resulted in silence, for understandable reasons. Although no absolute guarantees of safety are possible, if anyone is in a position to speak, please get in touch.
Inaction. Inefficiency. Indifference. The NHS whistleblower employment support scheme and NHS Improvement’s employer pool
Three years after Robert Francis urged the Department of Health to “urgently” ensure that an employment support scheme was set up to offer exiled whistleblowers trial employment and other help to return to the NHS, little real help has been provided. According to FOI data gathered so far, only three NHS trusts have confirmed that they have provided support to whistleblowers as part of the NHS employment support scheme. This does not mean there are no other examples, but it does suggest that there are very few in total. In one of the three cases so far, the support provided, after several months of an elaborate return to work assessment process, is reported to be merely library access. First hand reports by various whistleblowers reveal a considerable gap between the rhetoric and the reality.
Call for whistleblower evidence on flaws in UK whistleblowing law: The need for reform
Published 1 June 2018
This is a call for evidence from any UK whistleblower who has litigated under the Public Interest Disclosure Act and has experienced difficulties with the law. Details are provided.
Dr Kevin Beatt NHS Whistleblower and the Negligent GMC
Published 25 May 2018
Dr Beatt was vindicated by the Employment Tribunal in 2014 and ultimately by the Supreme Court but as many medical whistleblowers have found, his own professional regulator was hostile and treated him less favourably than the medical managers who treated him unfairly. The GMC continues to fail whistleblowers and there is little evidence that it has learnt the lessons from the Hooper review on its handling of whistleblowing cases.
Call on the BMA to come clean and to properly support whistleblowers
Published 16 May 2018
This is an update of long running correspondence with the BMA spanning four years which has sought to elucidate simple facts about services provided to whistleblower members. The BMA has repeatedly obfuscated and withheld information, but a few facts have slowly emerged and are summarised.
Masters of the Universe: CQC, NHS Improvement and Dame Glynis Breakwell
Published 11 May 2018
The un-fragrant connections between the CQC Chair, the former VC of Bath University with the enormous remuneration package and rapped knuckles and her astonishing current position as Chair of NHSI’s remuneration committee are noted.
The Greasy Freedom To Speak Up Review is Stuck: More Tales of Silence About Silence
Published 2 May 2018
This reports on a continuing failure at the heart of the Freedom To Speak Up project – the dilution of the National Guardian’s role and her Office’s refusal to help individual whistleblowers in difficulties, despite original plans that detriment should be remedied. FOI data is presented on the number of referrals that have been rejected by the National Guardian’s office. An update is provided on the case of Lloyd Armstrong who was sacked after the National Guardian declined to help him. He was accepted onto the NHSI whistleblower employment support scheme, which also failed him. NHSI officials failed to respond to repeated requests to help him secure a job interview and then dissembled when challenged.
A two year correspondence with NHS Improvement about the ET judgement from Dr Raj Mattu’s whistleblowing case
Published 29 April 2018
This correspondence illustrates how little the most senior NHS managers care about whistleblowers and their importance to patient safety. NHS Improvement has treated enquiries about its learning from the Mattu ET outcome with casual disdain. It is still taking its leisure in considering the matters.
A whistleblower led event on UK whistleblowing law reform: The Public Interest Disclosure Act needs to be replaced
Published 26 April 2018
After several difficult exchanges of correspondence, the National Guardian has agreed that whistleblowers may lead an event, with her Office’s support, on law reform. Preliminary details are provided.
Behind the performance: A postcard from the National Guardian’s conference of 6 March 2018
Published 22 April 2018
The National Guardian’s Office is intended to be a firewall for the Department of Health. A key part of its role is PR. A large part of its budget has been expended on glossy events and spin doctors. The claims and behaviour of the key speakers at the National Guardian’s conference on 6 March 2018 are unpacked. A serious breach by the Secretary of State and the National Guardian in citing an misleading, unpublished statistic and FOI disclosures from both the DH and NGO revealing the extent of the stage management behind the event are provided. NHS England’s tacit acknowledgment of the lack of real progress on national whistleblowing metrics is equally noted.
Jeremy Hunt et al’s re-branding of Morecambe Bay and a suppressed report on Race concerns
Published 21 April 2018
This piece gives an example of how the NHS re-brands failing organisations after scandals, whatever the real truth about their governance. The political interests of Ministers and egos of the various senior players responsible for ensuring improvement are such that a ‘spinaround’ is often more expedient than genuine, lasting turnaround.
Indeed, whilst the NHS is being savagely de-funded, spinarounds are sometimes the only means of achieving positive headlines. Morecambe Bay is a trust that has been recently favoured by Jeremy Hunt et al, despite continuing problems. Various disclosed data are provided.
Martin Morton social care whistleblower and Wirral Council
Published 19 April 2018
Martin Morton former social work manager’s whistleblowing case is serious and significant. His concerns about financial abuse of vulnerable adults were fully vindicated after a long fight and he successfully pursued his case using criminal harassment provisions. His case helps to highlight deficiencies in UK whistleblowing law, which does not hold individuals accountable for misconduct committed in the course of whistleblower reprisal. Morton is still seeking answers and has a hearing at an Upper Tribunal on 26 April in London, regarding further disclosure of information from a report held by Wirral Council about the treatment of whistleblowers.
Another call to the Chair of the parliamentary Health and Social Care Committee to examine the government’s lack of progress on whistleblowing
Published 16 April 2018
The Health and Social Care Committee in its former incarnation as the Health Committee asked the government in January 2015 to do more to protect NHS whistleblowers. It also called on the government to identify harmed whistleblowers and ensure that they received an ‘apology and practical redress’. The government has not delivered. The Committee has not chased. Indeed, the Committee has not acceded to requests to hold a follow up inquiry. The request has been renewed, supported with inevitable evidence of further failures.
Briefs, Whistleblowers and Jeremy Hunt’s Top Secret Evaluation
Published 10 April 2018
Jeremy Hunt’s whistleblowing policy is pants and has to be shored up by a small army of publicists to spin a specious tale of effectiveness, to the point of prohibited statistics practices which have now been confirmed as unsatisfactory by the UK Statistics Authority. The latest line in Department of Health and Social Care sneakiness is a quietly commissioned evaluation study on the introduction of the highly flawed system of Speak Up Guardians employed by the very trusts that they are supposed to hold to account. Key stakeholders have not been consulted, a copy of the research was provided but came with the request that it had to be kept secret for the time being, and the fundamental research questions seem skewed towards generating PR fodder for the DHSC as opposed to proper evaluation of the effectiveness of the model.
Race Discrimination by Public Health England
Published 7 April 2018
This piece covers Dr Femi Oshin, Public Health Consultant’s successful ET claim against PHE for unfair constructive dismissal and Race discrimination. The ET judgment of January 2017 determined that there had been institutional racism by senior PHE managers. It also revealed that PHE tried to stop Dr Oshin making a legitimate public interest disclosure to an MP about service cuts, and then deliberated (wrongly) on whether it could deprive him of a voluntary exit payment on grounds of a non-existent breach of contract. PHE has shown little sign of learning, and as a further indication of organisational hubris it has commissioned an internal review by a white male non executive director with no obvious expertise in Equality and Diversity, the terms of reference of which bizarrely omit any reference to Race, which has still not yet been conducted. The ET judgment and various documents disclosed by PHE under FOI are provided.
Published 6 April 2018
This is an update report on the Healthcare Safety Investigation Branch’s resistance to genuinely engaging with whistleblowers and creating effective processes through which its work can be supported by whistleblowers. As part of this, HSIB has failed to respond to enquiries about open consultation with whistleblowers that it agreed to consider. Instead, it has made a backdoor appointment to of a member of the organisation Patients First to its advisory panel, after the official appointments process had concluded. All this follows revelations that HSIB’s Chief has been ordered to repay some unusual expenses claims. Conradi’s former organisation the Air Accident Investigation Branch has also refused to disclose staff surveys, including those undertaken during his reign. Relevant correspondence is provided.
Gagged Whistlers, the Whistleblower Employment Support Scheme & Other NHS Silence
Published 5 April 2018
This is an update on NHS Improvement’s and the government’s refusal to make adequate provision for super-gagged whistleblowers to access the employment scheme. It also includes details of confidentiality clauses that NHS Improvement requires all workers to sign, restricting any contact with the press without the approval of NHSI’s comms managers. Whistleblowers who are serving on the employment support scheme panels have all been asked to sign. In one case, when a whistleblower asked for the confidentiality agreement to be amended to make it clear that public interest disclosures were not restricted, NHSI refused to do so.
A complaint regarding the National Guardian’s management of concerns about a spin doctor
Published 30 March 2018
The National Guardian re-appointed a spin doctor to her office, after being told of reportedly inappropriate behaviour by that individual towards a whistleblower, myself, and before the alleged conduct had been investigated. The investigation into this matter was mishandled and markedly delayed. The National Guardian’s Office initially exonerated itself. A subsequent investigation by NHSI recommended that a complaint be partially upheld on the basis that the original investigation was flawed. FOI data is given on the NGO’s spend on PR and conferences – a total of £261,000K since April 2016.
Regulation 5 Fit and Proper Persons: Dissecting CQC’s Dissembling
Published 27 March 2018
A summary of the CQC’s various techniques for avoiding the enforcement of FPPR is provided, tracing the regulation, CQC’s flawed arguments for not taking responsibility under the regulation and interesting stratagems for manipulating the system in favour of erring senior managers. Case examples are given.
National Guardian, Spin Doctors and Dodging Reform of Whistleblowing Law
Published 19 March 2018
The National Guardian agreed in principle to support a whistleblower-led event, but when it was proposed that such an event should be focused on the central issue of law reform with expert speakers, the response was much less willing. A spin doctor was repeatedly interposed and claimed that the the National Guardian’s Office could not fund such an event as law reform was not part of the National Guardian’s remit. Whistleblowers have declined to dilute the event, and advised that they would prefer not to lead an event at all if law reform is a banned topic. The relevant correspondence is provided.
Deaths? What deaths? The Rt Hon Steve Barclay and the denial machine
Published 11 March 2018
Steve Barclay a new Department of Health and Social Care minister who has previously been critical of NHS cover ups, failure to learn from deaths and whistleblower reprisal and gagging has been asked to address his department’s mishandling and suppression of coroners’ warnings about the NHS. This request was made in the context of the shocking recent deaths at East of England Ambulance Service NHS Foundation Trust. Barclay passed the request to his officials who have issued a characteristically snippy denial. Vroom Vroom.
National Guardian’s Stakeholder Advisory Group: Speaking Up Only When Permitted?
Published 27 February 2018
The National Guardian has established a tokenistic and unwieldy advisory group, which features whistleblowers, but she is not listening to the advice from this group. She has circulated uninformative meeting minutes, and did not include attendance or membership details as agreed and has not published the meeting records as requested. She agreed in principle to support a whistleblower led event, but when she was asked to support such an event focussed on reform of defective UK whistleblowing law, a key issue, she handed the matter to her comms manager, who refused.
Letter to Dido Harding Chair of NHS Improvement about un-gagging NHS whistleblowers
22 February 2018
The NHS is hoist on its own petard because whistleblowers who have been super-gagged whistleblower employment cannot access the NHS employment support scheme. The NHS has negligently failed to act on this issue despite it being first pointed out in November 2016. When it fully realised what a mess the situation was, the NHS floundered and came up with various flawed suggestions. The Chair of NHS Improvement has been asked to either indemnify whistleblowers who take the risk of break their gags in order to apply to the scheme, or to seek a government waiver
Concerns about Liverpool John Moores University’s evaluation of the NHS whistleblower employment support scheme
Published 21 February 2018
There are a number of concerns about the NHS’s handling of the evaluation and lack of robustness and challenge by the University, which may result in unfairness and a more positive evaluation of the employment support scheme than is merited. There has also been briefing to NHS Improvement, which has claimed that the evaluation is showing ‘positive’ results, without the basis for these claims being transparent to all legitimate stakeholders such as the Design and Monitoring Group for the scheme. Concerns have been raised with the University’s ethics unit and the full correspondence is provided.
‘Acceptable Hazard’? Lack of sprinklers and deliberately caused fires in mental health trusts
Estate Return Information Collection (ERIC) data published by NHS Digital shows a higher incidence of fires in mental health trusts. FOIs to mental health trusts show that a large proportion of these fires are caused deliberately, caused by patients and occur in inpatient areas. Despite this, these is almost no sprinkler coverage in mental health trusts, despite deaths and injuries. Neither NHS Improvement nor the Department of Health and Social Care were able to show that they were actively managing these risks and had good governance in place. of concern, current Government fire safety guidance for the NHS repeatedly states that where sprinklers are used, other fire safety measures may be cut back. A spreadsheet is shared, which summarises the FOI data obtained from mental health trusts and three acute trusts which also reported a high number of fires.
St. Andrews Healthcare, Whistleblowing, Safeguarding and Public Protection
Published 16 February 2018
A whistleblowing claim against St. Andrews Healthcare will be heard in private on 23 February 2018. Annual accounts show that St. Andrews’ annual income now exceeds £200m. Its services are mostly funded by the NHS. NHS England’s published spending transparency data, on purchases over £25K, shows that NHS England directly purchases almost £300m of services from St. Andrews between January 2014 and July 2017. Some background data on whistleblowing, Safeguarding and public protection matters relating to St. Andrews is presented.
Letter to David Behan CEO CQC, requesting review of previously rejected regulation 5 Fit and Proper Persons referrals
Published 12 February 2018
The CQC has royally botched FPPR in the service of its political masters. Implementing FPPR properly would risk rocking the boat as disgruntled NHS directors, who know where the political bodies are buried, and who have previously maintained omerta about Whitehall’s sharp practices, may obviously become a threat to power. However, the scandal of recycled poor NHS managers is hard to hide as the patterns keep recurring. Pressure on CQC has increased with the publication of Bill Kirkup’s review on events at Liverpool Community Health NHS Trust and his recommendation of another review of CQC’s implementation of FPPR. I have written to Behan to formally request review of all the FPPR referrals which CQC previously rejected out of hand. Examples are given of major service and governance failures that have occurred following CQC’s various refusals to act upon FPPR referrals.
What’s up at Wirral? NHS Improvement’s investigation of executive whistleblowing at Wirral University Teaching Hospitals NHS Foundation Trust
Published 10 February 2018
NHS Improvement has commissioned an investigation into mishandled whistleblowing disclosures by directors at Wirral University Hospital NHS Foundation Trust. The track record of regulators on such matters is described. The government’s response to the publication of Bill Kirkup’s review on Liverpool Community Health NHS Trust on 8 February 2018 is discussed. FOI data is provided on past NHS commissions undertaken by NHS Improvement’s chosen investigator for Wirral.
After the Bawa-Garba judgment. Some responses from the Court of Appeal, CPS, Criminal Cases Review Commission and GMC.
Published 8 February 2018
Institutional responses to enquiries have raised questions about gaps in the criminal justice system’s governance of Diversity and the handling of Gross Negligence Manslaughter, and about the GMC’s handling of offending by registrants. No Equalities analysis has been undertaken on the work of the Court of Appeal. The Criminal Case Review Commission stats suggest that BME applicants are over-represented. The outcomes by Race are not yet available. Neither the Crown Prosecution Service nor its specialist unit for Gross Negligence Manslaughter cases, the Special Crimes and Counter Terrorism Division, have kept central records of Gross Negligence Manslaughter cases against doctors. The GMC has implied that it is not tracking offending by registrants, through claims that it is unable to produce data on the number of registrants who have been convicted of offences in the last four years, or a ready breakdown of the types of offences in question.
Of Arbitrariness and Arbiters: The Freedom To Speak Up Project three years on
Published 7 February 2018
The National Guardian’s Office has been inconsistent in its approach to individual whistleblowers seeking help and protection. There is lack of clarity about which cases will be reviewed, with conflicting decisions and policies. A previous complaint about the NGO’s refusal to step in and review a case, which was followed by the whistleblower being sacked, was not upheld by NHS Improvement or Robert Francis. However, Francis and NHS Improvement recommended that the National Guardian should set out more clearly what sort of recommendations may be made following case review. Further events have raised continuing issues of fairness. There also appears to be no evidence that the National Guardian has acted on the recommendation to clarify the range of actions that may be made following case review. A further complaint has been made about the inconsistency, and Robert Francis has been asked to clarify his position on his original recommendation in the report of the Freedom To Speak Up Review that the NGO should facilitate redress for harmed whistleblowers.
The National Freedom To Speak Up Guardian’s Social Medial Policy
Published 31 January 2018
This most interesting document was disclosed after an enquiry and how reveals that the National Guardian and her team intend to with ‘negative’ comments on twitter, which includes muting, blocking and reporting those who fall into disfavour. The document shows little sign of reflection that criticism might be justified, and betrays complacency and a lack of fitness to perform its central function of facilitating healthy dissent. But that was never what the Department of Health and Social Care really wanted the Office to do.
Safe in their hands? Government’s response to coroner’s warnings about the NHS
Published 29 January 2018
This is a full update report to an analysis of August of four years data published by the Chief Coroner on reports on action to prevent future deaths. The update focuses on the NHS and the actions of central bodies from the Department of Health and Social Care downwards. There are troubling anomalies about missing PFDs and responses to PFDs from the Chief Coroner’s website, variance between what the Chief Coroner and some coroners say, and a lack of systematic response by the NHS to the intelligence from coroners. The DHSC was especially resistant. The DHSC, NHS England, CQC and NHS Improvement all refused to disclose their responses to key coroners’ warnings. All the supporting correspondence with these bodies and disclosed documents are uploaded and linked in the report.
UK Whistleblowing Law is an Ass: Helen Rochester and the Complicit CQC
Published 25 January 2018
This is an update on the case of Helen Rochester, doughty former nurse and care home whistleblower, who has embarrassed the gruesome CQC but also been twice shafted by the same. Rochester has added another example to the pile of UK whistleblowing law (PIDA) failures. The judgment is provided and discussed. The case for law reform continues to build. The CQC continues to sink further into its own stink and mess, and has not demonstrated one jot of learning.
BMA Says No to Whistleblowers
Published 23 January 2018
The British Medical Association fails many whistleblowers and often claims their cases aren’t worth backing. It has been secretive and reluctant to account for how it spends members’ fees. Over a period of years, it has reluctantly yielded small amounts of information, but cumulatively, the implied picture is one of an improbably low level of legal merits assessments passes. For good measure, the wealthy BMA likes to wine and dine its old boys and the great and the good in style, but refuses even to allow sacked whistleblowers near cost-neutral access to online medical journals. Glaswegians have bracing expression: “I wud nae gie ye the steam of my sh**”.
The Assimilation of Whistleblowers
Published 20 January 2018
Power seeks to contain and control dissent, and has an endless repertoire of dirty tricks, such as divide and rule, fielding controlled opposition and infiltrating and disrupting. Whistleblower campaigners are amongst the recipients. I tell the tale here of a Scottish whistleblower who was expelled from the whistleblowing organisation Patients First because he covertly recorded a Minister. Patients First took the position that only “leadership of PF in consultation with legal advisers” could take a decision to secretly record a politician, and that “It would never be the prerogative of a maverick individual to make such a decision”. Most importantly, Patients First demanded not only that the whistleblower should apologise to the Minister, but that he should destroy the audio recording despite his concerns that it was evidence of illegal actions by the Minister. Patients First insisted on the destruction of the recording despite admitting in writing that they did not actually know whether the recording was evidence of illegal activity. A whole contingent of Scottish whistleblowers broke away from Patients First as a result of this incident, and established a new campaign group, ASAP Scotland http://asapnhs.uk/
A critical consultation by the Scottish government starts on 30 January 2018 on whistleblowing policy and infrastructure. A prominent Patients First member from the English NHS has been recruited without to my knowledge sign of advertisement. What happens next will affect the future of Scottish patients and NHS staff for years.
The Flexible CQC, FPPR and Kettering General Hospital NHS Foundation Trust
Published 16 January 2018
An FOI to Kettering General Hospital NHS Foundation has revealed that CQC issued the trust with a warning notice which included concerns about the trust’s handling of Fit and Proper Person issue under Regulation 5. However, CQC failed to disclose this in the relevant inspection report, despite the context that this was a trust with a significant whistleblowing issue at the time. The whistleblowing matter, about an alleged waiting list fiddle, was exposed by the BBC a month after CQC published the report which failed to reveal the FPPR problems. Within two months of the BBC coverage, the trust CEO and Chair had resigned. These events add to existing concerns about CQC’s role in protecting senior NHS managers and covering up failings.
More loopholes in Jeremy Hunt’s ‘support’ scheme for whistleblowers
Published 21 December 2017
The NHS whistleblower employment scheme, run by NHS England and NHS Improvement has been sneakily re-named the ‘whistleblower support scheme’ and no provision has been made for super-gagged whistleblowers, who remain in the cold. Little due diligence seems to have been exercised in appointing panellists who will sit in judgment of whistleblowers. A list which I have seen but am not at liberty to disclose shows that just under half are Freedom to To Speak Up Guardians. Some panellists are managers from trusts that have admitted to super-gagging whistleblowers, or as evidenced by external review are from trusts that have harmed whistleblowers or covered up wrongdoing.
CQC’s asleep on the night shift
Published 16 December 2017
The dilatory CQC doesn’t like to discommode itself and shift from its soft armchair by the fireside. Disclosed FOI data obtained by care home whistleblower shows that nationally, over a three year period, only 1.5% of CQC inspections take place out of hours. Rochester reported insitutional abuses to the CQC, such as dragging vulnerable care home residents out of bed in the wee hours to suit the home’s purposes, but CQC did not inspect at an early enough hour to detect this and gave the home a good report. CQC has resisted calls from the Royal College of Nursing to inspect more at night, and resisted coroners’ calls for action on unsafe staffing at night. What a faithful watchdog. It does the DH proud.
Two years of national CQC whistleblowing data on health and social care services
Published 14 December 2017
CQC has reluctantly handed over national data on all whistleblowing by staff of service providers from all sectors for the years 2015/16 and 2016/17. It shows marked variations between providers, with some usual suspects but also some CQC pets attracting very high levels of whistleblowing by their own staff. Of a total of 16,457 whistleblowing contacts in 2015/16 and 2016/17, there were 9,760 outcomes which basically consisted of shoving whistleblowers’ disclosures in a drawer (no further action or information noted only for future inspection). CQC’s full spreadsheet of all the whistleblowing contacts is provided. Read it and weep.
WRES, CQC and more NHS hot air on Race
Published 28 November 2017
This is an update report on NHS England’s handling of NHS workforce Race issues and CQC’s role in ineffectual enforcement of the WRES programme. CQC revealed via an FOI disclosure that its inspection methodology omits to record the ethnicity of provider staff who are consulted during inspections. NHS England has not yet responded to an enquiry about whether its WRES team have vetted CQC inspection methodology. And to cap it all, it has been revealed that although CQC misleadingly reported in 2015 that an FPPR investigation into Race issues at Southport and Ormskirk Hospital NHS Trust was ‘thorough’, the FPPR investigators never actually spoke to BME whistleblowers who raised concerns. Relevant correspondence with NHS England is provided.
The long shadows cast by whistleblowing
Published 23 November 2017
This explains the gravity of the violence done to whistleblowers. It gives the current example of a whistleblower who has been failed by all, including the Secretary of State, who is now in end stage renal failure due to high blood pressure and will need a kidney transplant. The parliamentary health committee has failed in its duty to date to provide serious challenge to government failures on whistleblowing governance, refuses to hold a follow up hearing and has not even made efforts to find out if whistleblowers have received the ‘apology and practical redress’ that the committee recommended in January 2015. They haven’t.
Sir Robert Francis and Reform of Whistleblowing Law
Published 17 November 2017
Robert Francis seriously failed whistleblowers and the public interest in 2015 when he had the chance to recommend substantive reform of UK whistleblowing law, which he acknowledged was “weak”, but shrank from a confrontation with the Department of Health. Instead, he made a timid recommendation for an inconsequential adjustment, which the DH accepted and used for public relations. Francis made comments at a financial sector conference on 7 November 2017 – which were recorded – which clearly show that he is fully cognisant of the legislation’s flaws. He went as far as saying that it needed “looking at”, but when an NHS whistleblower in the audience asked if he thought reform of the law was needed, Francis seemed a little discombobulated and eventually replied that a review of how the NHS applies the law was needed. I have written to Francis to ask if he will act upon his serious criticisms of the law itself. In addition to the issues about the inadequacy of UK whistleblowing law, Francis revealed at the conference that he had expected the NHS to operate a whistleblower re-employment scheme, and was not best pleased with the tepid employment support scheme with which NHS England and NHS Improvement have been trying to fob whistleblowers off. The recordings of his comments at the conference, a transcript and the correspondence are provided.
Carry on smiling: National Guardian turns Helen Rochester away
Published 24 October 2017
The National Guardian is establishing a tokenistic advisory group as an afterthought, despite promising that this would be done at an early enough stage to influence the crucial determination of her case review process. She has refused an application from Helen Rochester a whistleblower who has been twice seriously harmed by her employer the CQC. The National Guardian’s proposed terms and conditions for her advisory group also have an unfortunate whiff of control and secrecy. Details are provided.
Who speaks for the dead? Ivy Atkin and the unaccountable CQC
Published 22 October 2017
The CQC has been attempting to evade proper accountability for its disastrous regulatory oversight – or lack of it – of Autumn Grange care home, which culminated in the horrific death of Ivy Atkin at 3St 13lb. CQC’s chief executive David Behan promised to publish a very belated internal review on the matter, but CQC later reneged on this. When I complained about CQC’s behaviour, the CQC simply deemed my complaint invalid. Yet despite claiming that my complaint had no legitimacy, the CQC suggested that it could be escalated to the PHSO. I have written to Peter Wyman CQC chair to rebut CQC’s claim that my complaint is invalid. The relevant correspondence and references are provided.
Waste Industry: The NHS Disciplinary Process & Dr John Bestley
Published 21 October 2017
This is an update paper about disciplinary action, suspensions and dismissals by the NHS. It illustrates typical NHS bad practice through the case of Dr John Bestley who was unfairly dismissed by Humber NHS Foundation Trust, which was criticised for suspending him long after there was any reason to do so, thereby causing serious damage to his health. Dr Bestley received compensation through both the Employment Tribunal process and via a subsequent claim for personal injury against the trust. There was a failure by the NHS, including by professional and system regulators, to learn lessons from the affair. Ongoing suspension statistics show that there has been little learning since the National Audit Office report of 2003 which showed very poor management of suspensions by the NHS. Central government and its arms lengths bodies need to take much more responsibility for ensuring good practice, and to stop relying on oppressive human resources practices for political ends.
Jeremy Hunt’s Secret Whistleblower (Non-Employment) Scheme
Published 14 October 2017
This is an update and digest of the shabby sham perpetrated by the Department of Health and its organs against sacked whistleblowers who are supposed to be helped back into employment. There has been refusal by NHS Improvement to share relevant records, and Liverpool John Moores University which has been contracted to evaluate NHS England’s pilot scheme has refused to answer questions about methodology despite NHS England promising that whistleblowers would have a say. Both NHS England and NHS Improvement have recently changed the names of their programmes from ‘Whistleblower Employment Support Scheme’ to just ‘Whistleblower Support Scheme’. Exile continues.
Will Simon Stevens uncork ALL the Race data?
The implementation of NHS England’s Race Equality programme, WRES, has been a disappointment to many. It still does not measure important parameters such as Race pay inequality and Race Employment Tribunal claims against the NHS. Challenges to the administration of the WRES programme have sometimes been ignored, resisted or deflected. It has now emerged that there is a raft of Race data gathered and held on behalf of NHS England, via the national staff survey, that has not been analysed and or reported. Uber tokenism or what? Simon Stevens has been asked to unlock the vaults.
Postscripts on Paula: NHS England’s apologia & regulatory reticence
Former ‘inspirational’ NHS trust chief executive Paula Vasco-Knight became notorious in relation to a nepotism and whistleblower reprisal scandal. Yet still the NHS establishment protected and recycled her whilst continuing to degrade and abuse whistleblowers. She eventually fell nevertheless after a grubby fraud of a paltry £11k came to light. NHS England has admitted that it knew about the fraud allegations all along and did nothing to stop her being recycled to NHS board positions. CQC and NHS Improvement have refused to shed full light on the relevant events. Disclosed correspondence from the unholy trinity is provided.
Ivy Atkin’s death and more CQC evasion
Published 6 October 2017
The CQC continues to avoid accountability for its failures in the Safeguarding catastrophe at Autumn Grange care home, which led to the haunting death of Ivy Atkin, weighing only 13 St 13 lb. Although CQC’s chief executive David Behan stated in November 2016 that CQC’s internal review of these failures would be published, CQC now seeks to conceal the full contents of this document. A copy of a detailed complaint to the CQC Chair about his organisation’s obfuscations is provided.
CQC, coroners’ warnings and the neglect of older people in hospital
Published 2 October 2017
The new CQC chief inspector Ted Baker has waved his stick at a beleaguered NHS that is highly stressed and reluctantly failing patients. The CQC has a birds-eye view of health and social care. It has been well aware of what has been happening for years. It has not advocated for patients as it should have. Analysis of published data by the Chief Coroner shows that there have been at least 200 coroners’ Section 28 warning reports on poor inpatient care of older people in the last four years. There is a pattern of unmet need that government repeatedly fails to rectify, which amounts to institutional neglect. I have referred the government’s failures to its latest PR device, the Healthcare Safety Investigation Branch.
Letter to BMA Chair of Council, President and Past Presidents
Published 27 September 2017
The BMA has not distinguished itself in the matter of Dr Chris Day or other whistleblowing cases, and many questions remain unanswered about its practices. I have asked the new BMA Chair of Council to review the state of play, to publish data about BMA member services, to provide better support for sacked whistleblowers and to lobby for whistleblowing law which the BMA itself acknowledged – three years ago – is inadequate. The letter to the BMA is provided.
National Guardian: Measuring Up?
Published 25 September 2017
The National Guardian has published her first tranche of data on staff whistleblowing to local Speak Up Guardians for. Almost one third of trusts failed to return any data. The National Guardian claims that staff’s experience of whistleblowing was ‘overwhelmingly’ positive without supplying proper data to substantiate her claim. Her data is seriously incomplete in any case given that one third of trusts failed to return any data. Other methodological flaws and issues are reported in this piece.
NEWSFLASH: CQC denies denial
Published 16 September 2017
The CQC Chair has denied that the CQC chief inspector denied the truth of allegations by the campaigning charity Compassion in Care that CQC has breached the confidentiality of 47 whistleblowers. The relevant correspondence is provided for readers to make up their own minds. CQC has been asked if it will audit whether it has complied with its policy of whistleblower confidentiality, and whether it will include whistleblowers in the design of the audit.
Helen Rochester v CQC, Act II : Wherein a Whistleblower Sues a Prescribed Person
Published 9 September 2017
Helen Rochester, an unrepresented, unemployed care home whistleblower has made a claim in the Employment Tribunal against the Care Quality Commission, a multi-million corporation. The CQC has mishandled her serious patient safety concerns on two occasions over four years. It now given her latest employer a clean bill of health and there are serious questions about the validity of CQC’s regulatory judgment. Rochester’s ET claim against a PIDA Prescribed Person is most unusual and one of several recent claims which challenge received wisdom on the types of cases that may be heard in the Employment Tribunal. Regardless of the legal merits of the claim, there are many questions to be answered about CQC’s conduct but CQC and the National Guardian, a CQC employee, have battened down the hatches and seem reluctant to account. Indeed, CQC denies any wrong doing.
National Guardian ‘Expects’
Published 3 September 2017
The National Guardian continues to demonstrate that her office presents little challenge to the system that repeatedly fails whistleblowers. Having been informed of CQC breach of whistleblower confidentiality and complicity in reprisal, she took over two months to respond and her response does not demonstrate that she has established the extent to which such CQC malpractice is widespread. This part of a pattern of resistiveness and reluctance by her office to offer NHS whistleblowers real protection.
Whatever happened to Jeremy Hunt’s Just Culture Task Force?
Published 30 August 2017
A sequel to the Whitehall farce ‘Call for Just Culture Task Force members to stand down’ published on 25 January 2017. In short, the DH appears to have battened down the hatches and doesn’t want to play…or answer awkward questions. It insists that the creature lives, even though it does not appear to breath.
Four years of published coroners’ Section 28 reports in England and Wales
Published 24 August 2017
This data was collated from reports published on the Chief Coroner’s website because although many coroners’ warnings are now published, which is positive, the data is presented in such a way that it is hard to search and track patterns. Patterns are also partly obscured by mislabelling of some deaths. There is missing data about what proportion of Section 28 reports have been published. There are no published responses to 62% of coroners’ warning reports and it is therefore unclear if the audit cycle is being reliably closed and the public is being effectively protected. At least 57% of Section 28 reports relate to the NHS and there are questions about whether the entire NHS all the way up to the Department of Health is learning enough from coroners’ reports. Notwithstanding reservations about the data’s limitations, such as incompleteness, there appears to be an escalation in serious safety concerns by coroners about ambulance services, which seems to partly reflect pressures on the rest of the NHS.
After Grenfell: Home Office FOI disclosure on prison fire safety
21 July 2017
Prisoners and prison staff are particularly vulnerable to risk of fire because of the locked environment, security restrictions around evacuation and added risks of arson. Questions had been raised in parliament about fire safety even prior to the Grenfell tower fire and all the related, subsequent concerns about public protection. The prison fire safety issues were set in the context of more general concerns about serious pressures on the prison estate and other safety issues. An FOI enquiry to the the Home Office Crown Premises Fire Inspection Group revealed that 11 prisons have received fire safety enforcement notices due to serious fire safety risks, most recently. The information has been passed to the Justice Committee.
Letter to the Health Service Journal’s Patient Safety Correspondent
Published 10 July 2017
This is an invitation to the Health Service Journal to devote more space and serious debate to whistleblowing policy issues in its annual patient safety conference. Ongoing failures and inadequacies of government policy are laid out and specific areas for discussion are suggested. A call is made for a level playing field between whistleblowing campaigners and senior government and health service officials at the next annual conference, so that power can be held properly to account.
The NHS in the Employment Tribunal: A 5 month sample
Published 6 July 2017
There has previously been little information available about ET claims against the NHS. Workers are at a disadvantage due to inequality of arms, the more so since the introduction of ET fees in 2013. Few cases succeed and the fate of claimants who withdraw cases is unclear. The government has started publishing ET decisions. Over 600 ET decisions about NHS bodies have been published since February 2017. Longer follow up is needed but preliminary examination shows that few claimants ‘win’ against the NHS, including whistleblowers. Supporting data is provided. Whistleblowing law reform is needed for a range of reasons but the National Guardian for NHS whistleblowing is refusing to actively pursue law reform.
Breach of confidentiality by CQC and complicity in referring a whistleblower to the Disclosure and Barring Service
Published 22 June 2017
CQC has been repeatedly criticised for failing to detect serious care failure and for failing to take warnings seriously. This article reports an important example of serious CQC failure towards whistleblowers. The regulator seriously breached a whistleblower’s confidentiality to their employer. The CQC compounded this failure by complicity with reprisal in a later incident, by suggesting that another employer should refer the whistleblower to the Disclosure and Barring Service. Far from being an honest broker, there are serious questions about CQC’s role in causing detriment to whistleblowers.
East Lancashire Hospitals NHS Trust: Triumph CQC style
Published 14 June 2017
The gruesome CQC as an important part of the denial machine has just fittingly published a good news offering called “Driving Improvement”. The report gives a glowing account of how a number of poorly performing trusts have improved, with CQC’s steady hand on the tiller. Amongst them is East Lancashire Hospitals NHS Trust, which persecuted surgeon whistleblower Aditya Agrawal, super-gagged 109 staff and helped recycle the notorious former NHS CEO Paula Vasco-Knight after an Employment Tribunal found that she had victimised whistleblowers. CQC doesn’t mention these awkward facts in its nice shiny report. So I have, with relevant documents and FOI disclosures.
Healthcare Safety Investigation Branch
Published 7 June 2017
HSIB’s establishment has been controversial, with little transparency and little apparent engagement with patients, families and staff. FOI data has been obtained about HSIB’s staffing and structure. The data shows amongst other matters that HSIB is exclusively or almost exclusively white. It will also have two full time comms staff, under the line management of a Department of Health Deputy Director who has been seconded to NHS Improvement as HSIB’s Director of Corporate Affairs.
Ian Paterson and failure by oversight bodies
Published 1 June 2017
Ian Paterson breast surgeon was sentenced to 15 years imprisonment on 31 May 2017 for criminal injuries due to unnecessary surgery that he carried out fraudulently, by deceiving patients and colleagues. He had also carried out a so-called cleavage sparing mastectomy procedure which was not accepted or evidence based, leaving patients at greater risk of cancer recurrence. His case represents a colossal failure of NHS governance, as despite serious concerns about his surgical practices since at least 2003, he was not suspended from medical practice until 2012. Whistleblowers who raised concerns about Paterson were repeatedly ignored. There are concerns that his employer Heart of England NHS Foundation trust has not really come clean. HEFT’s whistleblowing governance continues to be poor with 51 external whistleblowing disclosures to CQC since 2011. All the NHS oversight bodies involved have many questions to answer, and a public inquiry is clearly needed. Relevant documents and FOI disclosure data is collated and provided in this piece.
SSOTP: Robert Francis’ exemplar trust has feet of clay and Jeremy Hunt’s safety claims are un-evidenced
Francis based his Speak Up Guardian proposal on the prototype Cultural Ambassador at Staffordhire and Stoke on Trent Partnership NHS Trust (SSOTP), which he held to be a success in the absence of evidence other than an increased number of staff reports, and despite the fact that the experiment was never evaluated. There is evidence that the experiment has not succeeded and that both staff and patients have been harmed as a result of the trust’s failure to respond to escalating concerns about safe staffing. The Cultural Ambassador received 110 concerns about safe staffing and many questions remain about why staff concerns were not properly acted upon, and why staff were forced to disclose to the CQC and to the media. The CQC issued SSOTP with a formal warning which included a requirement to make improvements in Duty of Candour. The CQC also noted negative staff feedback about the Cultural Ambassador service. Far from being an exemplar, SSOTP serves to illustrate how misconceived the Freedom To Speak Up project is. The National Guardian has been asked to review SSOTP’s whistleblowing governance failures and to stop promoting SSOTP as an example of good practice. FOI material and correspondence are provided.
Steve Trenchard, NHS regulators and FPPR
Published 26 May 2017
This piece looks at an example of NHS recycling of senior managers after wrongdoing. Steve Trenchard former NHS trust chief executive at Derbyshire Healthcare was suspended and then resigned after an Employment Tribunal was severely critical of his conduct in the matter of sexual harassment against Helen Marks, a fellow director, by the trust chair. The ET found that Trenchard acted unfairly against Marks and helped to cover up the actions of the trust chair. Trenchard was hired by another NHS trust, five months after his resignation from Derbyshire Healthcare. FOI data reveals that the NMC and a CCG had a hand in his recycling and that the CQC took little action under FPPR when it examined matters at Derbyshire Healthcare.
FPPR: CQC has lost all moral authority, but what will the National Guardian do?
Published 23 May 2017
The CQC has thoroughly disgraced itself on its enforcement of the Fit and Proper Person Regulation (FPPR). It failed spectacularly in the case of former NHS CEO Paula Vasco Knight whom it secretly cleared shortly before she was charged with criminal fraud and eventually convicted. It secretly cleared her former Director of Workforce in November 2016 and again omitted to tell the referrer. The crowning ‘glory’ now is that CQC has cleared even David Loughton, NHS CEO, despite a repeatedly troubled history on whistleblowing and critical independent investigation findings. Of relevance, the National Guardian has maintained that she will refer findings of serious misconduct by those who victimise whistleblowers to regulators. She has now been asked what she will do if regulators subsequently fail to take appropriate action.
National Guardian complaints: Keeping it in the family
Published 20 May 2017
The National Guardian’s office is supposed to be free to hold any part of the system to account for failures of whistleblowing governance in the NHS. However, it is under CQC’s thumb because CQC part funds, employs and manages the National Guardian. Shockingly, the National Guardian’s funding bodies which the National Guardian should in theory hold to account, will also adjudicate complaints about the National Guardian, introducing an additional conflict of interest. The National Guardian has not yet published her complaints policy, but a very inadequate policy has been revealed when a whistleblower who made a complaint was given a copy. The document is provided.
National Guardian reprieves employers, but condemns whistleblowers and patients
Published 18 May 2017
The National Guardian has confirmed that she will not be accepting ‘live’ cases for review, at least initially. Greater clarification is needed about wether this applies only to employers’ internal processes or to external processes such as referrals to professional regulators and the Employment Tribunal claims. Critically, this is a very unsafe if the National Guardian will not act on whistleblowers’ reports that employers have not responded to patient safety matters, until lengthy employment processes have concluded. A concern has been formally raised about this and clarification has been sought the National Guardian’s precise definition of ‘live’ cases.
Speak up Guardians: A Whiter Shade of (Corporate) Pale
Published 16 May 2017
This is an early, quick and dirty look at the emerging characteristics of Speak Up Guardians. As part of the tokenistic nature of the government’s reforms on whistleblowing, the establishment of Guardians has been neglected. There has been almost no quality control and the situation is like the Wild West, but more disorganised. Published data is of questionable reliability but it is looking as if power appoints in its own image, with over-representation of white staff, plus and unhealthy sprinkling of corporate types. Robert Francis has effectively admitted that there is no evidence base for the Speak Up Guardian model. This correspondence is provided.
Whistleblowers Wanted: Dead or Not Live
Published 9 May 2017
Correspondence disclosed to a whistleblower has revealed internal correspondence by the National Guardian’s office which indicated that ‘live’ cases may not be accepted. This is absurd as Robert Francis recognised the importance of early intervention to prevent serious harm to whistleblowers. It is also quite ridiculous given that ‘historic’ cases have already been excluded from the National Guardian’s remit. Anyone would think that referrals are not welcome. Further clarification has been requested from the National Guardian.
CQC and National Guardian defend Fortress DH
Published 6 May 2017
The National Guardian, CQC and Department of Health closed ranks to wrongly claim that the National Guardian had no remit at all to intervene in individual whistleblower cases. David Behan CQC chief executive has now admitted that the National Guardian DOES have a responsibility to challenge employers to correct malpractice in individual cases. There are still unreasonable barriers in place by the National Guardian, which will disadvantage whistleblowers and deny them help.
4 years of CQC mental health whistleblowing data
Published 24 April 2017
The CQC is reluctant to part with any real information about whistleblowing, but has been forced progressively to collect and disclose more. However, it continues to record whistleblowing contacts in an unsatisfactory manner, that does not clearly reveal the number of whistleblowers and concerns involved. It also does not routinely publish national whistleblowing data beyond very cursory, global analyses. More detailed data has to be laboriously gathered by FOI. A recent CQC FOI disclosure on 4 years of mental health whistleblowing illustrates the vagaries that CQC relies on to keep a lid on things, and a total of over 700 so-called whistleblowing ‘enquiries’ between 2013 and 2017. These ‘enquiries’, as defined by CQC, may involve more than one whistleblower and or concern.
Health Education England hasn’t done its whistleblowing homework
21 April 2017
As another example of the tokenistic nature of the Freedom To Speak Up project, it is now apparent that Health Education England, notorious for reprisal against junior doctor whistleblower Dr Chris Day, has not provided guidance on the proper training for trust Speak Up Guardians. This is despite the government promising almost two years ago that HEE would do so. The relevant documents and background are provided.
National Guardian Newsletters: The Unexpurgated Version
Published 19 April 2017
The National Guardian agreed in February 2017 to publish her newsletters, for transparency, and to allow whistleblowers to track her office’s activities. Three newsletters were subsequently published but two have since been removed from the CQC website. All the newsletters released by the National Guardian will from now on be posted on this page, until and unless a full record is restored on the CQC website.
NHS bodies: 5 years of ICO decisions
Published 18 April 2017
This report looks at patterns in five years’ data of upheld complaints about NHS responses to FOI requests. The picture is one of a multi-billion corporation throwing its weight about and sometimes defying even the ICO. There have been over 500 ICO decision notices about NHS bodies, and almost 200 upheld complaints. Two NHS bodies emerge as behaving especially badly: NHS England and the Department of Health. There are signs suggestive of politicisation by public servants whose duty it is to be neutral, and various games are evident. At the Department of Health, repeated spurious claims have been made that disclosure of information would prejudice the effective conduct of public affairs or infringe on ministerial prerogative, which have been rejected by the ICO. The Department has absurdly even refused to provide data on grounds of national security, also rejected. The database extracted from published ICO decision notices is provided.
Jon Andrewes fraud: NHS Improvement responds
Published 11 April 2017
The NHS regulator NHS Improvement and its predecessor were hoodwinked by Jon Andrewes, fraudster, and appointed him to two NHS trust board positions on the basis of a faked CV. NHS Improvement says it is considering its approach to checking qualifications. NHS Improvement makes excuses for its past failure to undertake checks, and its account of events in the Andrewes affair contradicts information given by one of the affected trust. Importantly, Andrewes was for a period a Freedom To Speak Up Guardian, which only adds to concerns that the Department of Health is not taking whistleblower protections seriously.
Engineered failure to investigate NHS whistleblowers’ concerns
Published 8 April 2017
The whole system is currently designed so that there is no enforcement of reliable investigation of whistleblowers’ concerns. Very flawed UK whistleblowing law does not compel employers to investigate. Regulators tacitly allow employer failure to investigate and also controversially claim that they themselves cannot investigate individual whistleblowers’ concerns. The Department has also given us window dressing in the form of local Speak Guardians and a National Guardian who have been designed not to investigate. The newly launched Healthcare Safety Investigation Branch also looks set to be little more than window dressing and shows little interest in or expertise on whistleblowing. Real reform requires an enforceable legal duty upon employers to investigate whistleblowers’ concerns.
At the NHS Improvement Soup Kitchen
Published 26 March 2017
The NHS continues to drag its feet on welcoming back exiled whistleblowers, over two years after it promised to do so, and in contrast to the lightning speed at which duff senior managers are recycled. This is a report from a workshop by NHS Improvement on 24 March 2017, about how NHSI’s part of the whistleblower employment support scheme will operate. The level of allocated resource – up to £10k per whistleblower – is inadequate and may get worse. NHS Improvement is open to expressions of interest, either from potential applicants or any whistleblowers who would be willing to help with application panels or reviewing and advising on paper work. NHS Improvement’s draft protocol is provided.
Protest by Compassion in Care and supporters at CQC headquarters, Buckingham Palace Road, 22 March 2017
Published 23 March 2017
Compassion in Care supports whistleblowers from all sectors and seeks substantial reform of whistleblowing law. It also campaigns specifically on social care quality and abuse in care. It has amassed a mountain of evidence over almost a decade of work, including of regulatory failure and wilful blindness to both poor care and whistleblowers’ concerns. Very seriously, Compassion in Care reports that the Care Quality Commission has disclosed whistleblowers’ identities to employers and it will be publishing a report about this later this year. The charity has written to the Prime Minister copied to the CQC protesting CQC’s failures and David Behan CQC CEO’s knighthood. A protest was held outside CQC headquarters on 22 March 2017.
25 ‘Best’ and 25 ‘Worst’ NHS trusts on speaking up. Allegedly.
Published 22 March 2017
This post provides a database on the 2016 NHS staff survey data for all 2040 NHS trusts, set against the most recent CQC ratings. The data raises additional questions about the efficacy of Robert Francis’ non-evidence based model of local Guardians. Three trusts with established Guardians, in place for several years, returned mediocre results on the question about staff confidence and security in raising concerns about unsafe care. An analysis of the 25 ‘Best’ and 25 ‘Worst’ trusts is included, and also an analysis of the difference between doctors’ and managers’ reported experiences of speaking up: doctors seem less optimistic. NHS staff survey results on speaking up are also compared to recent results by a Royal College, which showed much lower medical staff confidence about speaking up.
Whistleblower Discrimination: Hunt’s Razzmatazz
Published 20 March 2017
Jeremy Hunt the ever spin-tastic Health Secretary is trying to grab more disingenuous “whistleblowers will be protected” headlines, with draft regulations about NHS whistleblower blacklisting. He’s only two years overdue and the proposals are in reality little help. He only proposes more waste through litigation, that most whistleblowers can ill afford both in terms of financial and health costs. There’s a lot of real action that he COULD take to manage whistleblower victimisation better, and to avoid whistleblowers being sacked and made unemployable in the firs place. It speaks volumes that he hasn’t.
How many NHS trust governors are disciplined and silenced?
Published 17 March 2017
The disempowerment of NHS foundation trust governors was identified by the Mid Staffs Public Inquiry as a contributory factor to safety failings. Little has changed, as illustrated by recent difficulties experienced by Southern Health NHS Foundation Trust governors. The Health Committee has indicated that it would welcome submissions providing evidence that trust governors are disciplined or silenced. The background and key correspondence is provided.
Just Culture: Sanctions for whistleblower suppression and reprisal
Published 15 March 2017
Fair and proportionate punishment for culpable behaviour is an accepted part of just culture, and creating a learning environment. A discussion paper put to the NHS whistleblowing organisation, Patients First, is provided. This lays out the arguments why sanctions for whistleblower suppression and reprisal are an essential component of culture change, and why impunity is harmful to safety culture.
National Guardian: Behan replies
Published 12 March 2017
David Behan CEO of the Care Quality Commission has replied to correspondence raising concerns about the National Freedom To Speak Up Guardian’s proposals and advice from her office to a current whistleblower, that it cannot intervene to help individuals. Behan’s reply is ambiguous and did not clarify whether the National Guardian will challenge employers to look again at badly handled cases. His reply was purportedly on behalf of all three CEOS of the CQC, NHS England and NHS Improvement. Clarification has been sought on the crucial issue of whether the National Guardian will implement Robert Francis’ recommendation that her core role will be to challenge others to look again at badly handled cases, where concerns have not been properly addressed or whistleblowers appear to have suffered detriment.
National Guardian: ‘Fantastic’….or airbrushed fantasy?
By Minh Alexander and Clare Sardari @SardariClare Published 9 March 2017
The Department of Health has often protected itself in recent years by claiming, in a fragment NHS, that regulators and other oversight bodies are independent. There is much scepticism about this. Presently, there is a concert of silence by the relevant NHS bodies about who knew what when about the Paula Vasco-Knight fraud, which may not be unrelated to a desire to minimise the embarassment of her sentencing on 10 March 2017. Whistleblowers are also being airbrushed out of the National Guardian’s picture, in favour of Good News. This will be under-pinned by the fact that she has restricted her annual caseload of whistleblower case reviews to just twenty, when there are probably hundreds who need help, judging from available data.
Freedom to Speak Up Guardian jailed
Published 7 March 2017
Jon Andrewes former NHS trust chair was jailed yesterday for fraud, by obtaining over £1 million salary for NHS director posts for which he was not qualified. He faked CVs in order to secure the senior jobs. Importantly, publicly available records also show that he was a non executive director at a neighbouring trust, when he was additionally appointed as that trust’s Freedom to Speak Up Guardian. This is another nail in the coffin of the discredited Freedom to Speak Up Review and its weak and ineffective proposals. The information on Jon Andrewes has been submitted to parliament and the relevant correspondence is provided.
Published 3 March 2017
The Healthcare Safety Investigation Branch was meant to be an independent body that would investigate serious NHS clinical failures and hold any part of the system to account if necessary. The government has done its best to neuter the recently established agency and a DH deputy director has been seconded to HSIB. HSIB is already doing its business in the dark. It also seems phobic of working with whistleblowers despite acknowledging that the right approach to whistleblowers is a key issue. Matters are still in play and the government’s response to Conradi’s request for statutory independence and more powers is awaited, but the body may end up as another NHS white elephant.
Published 28 February 2017
The shadow of the Department of Health falls across the National Guardian’s office for NHS whistleblowing. Signature messages are clear in what Henrietta Hughes the National Guardian, has been saying about the management of NHS whistleblowing. Accountability is minimised. Instead, ‘blame’, is framed as a dirty word. “Good news” is de rigeur.A transcript of a conference presentation and answers by Henrietta Hughes is provided.
If I was Secretary of State
Published 23 February 2017
A social media discussion on whether or not suppression in the NHS has a political root, I was asked what I would do to prevent whistleblower suppression if I was Secretary of State. I set out here examples of political punches being pulled, and the main things that the Secretary of State could do to redeem himself, and improve whistleblower protection and Safeguard patients – if he was serious.
National Guardian: Letter from Wonderland
Published 20 February 2017
Over a year after the National Freedom to Speak Up Guardian’s office was established, the latest National Guardian has finally unveiled draft proposals for how her office will conduct case reviews of whistleblower cases. Expectations were not high, but the draft proposals are particularly disappointing as they try to deviate from even the narrow, insufficient remit set out by Robert Francis, DH and CQC. Case reviews were intended to focus on failures in individual cases and to help address unresolved concerns and injustices to individual whistleblowers. However, loopholes and shifted goal posts abound in the National Guardian’s proposed protocol for case reviews, which serve to protect employers and dilute the focus on indivdual cases and divert to systems issues. A letter has been sent to the CEOs of the three funding bodies (CQC, NHS England and NHS Improvement about this disturbing turn in the development of the National Guardian’s office. The correspondence is provided.
Whistleblowers need more than hand-wringing headlines, Sir Robert
Published 10 February 2017
Robert Francis failed patients and whistleblowers by not reporting what sort of disclosures have been buried, by providing no effective measures to protect whistleblowers and by recommending that there should not be a proper inquiry into whistleblowing. He recently refused to meet to discuss the lack of progress since he published his report on NHS whistleblowing two years ago. Yet he now publicly bewails the fact that culture has not changed enough. He needs to take responsibility by retracting ineffective recommendations and putting right his omissions. Recent correspondence with Francis is provided.
Newspeak at the National Guardian’s office
Published 8 February 2017
There are continuing delays at the National Guardian’s office, which is still not yet accepting whistleblowers’ cases for review. Two recent meetings with the National Guardian only raise further, significant questions about the effectiveness of this office. The National Guardian says she feels independent, but she meets frequently with David Behan the Chief Executive of CQC, her chief paymaster. She shows reluctance to criticise CQC’s gross failures on whistleblowing, and her plans for the office are sketchy. The impression of a tokenism by the DH remains, and tellingly, the DH refused to be interviewed by the BBC about the lack of progress on NHS whistleblowing. The agreed records of the two meetings with the National Guardian are provided.
CQC: A Chief Inspector DOESN’T call
Published 27 January 2017
CQC gave Paula Vasco-Knight former NHS CEO the Fit and Proper Person (FPPR) rubber stamp in February 2016. She was sacked three months later and subject to criminal charges. Yesterday, she pleaded guilty to fraud at Crown Court. Fresh questions arise about what CQC knew when it shut down the FPPR in February 2016, because it is now evident that an investigation into the fraud was well underway before CQC did so. A complaint has been made about CQC’s handling of the FPPR referral on Vasco-Knight, but there are also concerns about how this complaint is being handled by CQC.
Call for Just Culture Taskforce core members to step down
Published 25 January 2017
An NHS Taskforce on Just Culture was a proposal by the Expert Advisory Group which helped with the establishment of the Healthcare Safety Investigation Branch. This was accepted by the government. However, there has been no public consultation and Jeremy Hunt has asked a small inner circle to kick off the Taskforce. This replicates club culture and is inimical to Just Culture. I have asked all of the Taskforce “core group” to support Just Culture by standing down and asking the Department of Health to consult properly on the establishment of the Taskforce. The relevant correspondence is provided
Ticket to ride
Published 19 January 2017
Alyson O’Connell is an NHS whistleblower, nurse and cancer patient who is making a long journey, by coach, from Wales to contribute to a National Freedom To Speak Up Guardian consultation event. The coach fare is the princely sum of £26. O’Connell has been unemployed for five years, sometimes doesn’t know if she can meet her mortgage payments and faces an uncertain future. So far, the National Guardian’s office has declined to reimburse O’Connell’s minimal travel expenses.
National Guardian independence: the CQC denies some more….
Published 19 January 2017
The majority of whistleblowers are unconvinced that the National Guardian’s office is independent as it has been located firmly within the NHS, at CQC. CQC has in various documents made it clear that there will be a relationship of oversight between CQC and the National Guardian. Curiously, CQC’s chief executive denied this at a CQC Board meeting on 18 January 2017. Notwithstanding CQC’s denial and inconsistencies, the office should be properly independent, and a test of the latest National Guardian’s mettle is whether she seek statutory independence.
SMILE, SHINE & SAG
Published 17 January 2017
This is a written submission to the National Guardian’s consultation on how her “Stakeholder Advisory Group” (SAG) should be established. In particular, questions are raised about the improbable plan devised by Robert Francis that she should “review” cases but not investigate them, and still produce recommendations for improvement although she is seemingly prevented from testing evidence.
The CQC denies….
Published 8 January 2017
A CQC press statement has been disclosed which shows that ludicrously, the CQC is spinning that gagging clauses were banned by the NHS in 2013. They weren’t, they were just tweaked, and they still have the effect of silencing staff. I have written to Mike Richards CQC Chief Inspector of Hospitals to point out CQC’s many failings on this important aspect of whistleblowing governance. The letter and supporting evidence are provided.
National Clinical Assessment Disservice
Published 6 January 2017
The little known but important quango the National Clinical Assessment Service (NCAS) is implicated in the mistreatment of NHS whistleblowers but despite agreeing in 2015 to reform its processes, appears to have resisted reform. Details are given of the background and the concerns that whistleblowers have expressed about NCAS. This is additional evidence of the Freedom To Speak Up Review’s ineffectiveness and the need for more robust reform of whistleblowing governance.
National Guardian: Tidings of comfort and joy
Published 26 December 2016
A letter to the National Guardian about her reported plans to seek good news stories about NHS whistleblowing. Good news culture has been identified as an obstacle to patient safety by the Mid Staffs Public Inquiry and other authorities. The National Guardian needs to engage with all, especially critics. She needs to show that she will robustly evaluate NHS whistleblowing governance, as opposed to relying upon employers’ superficial reports and selected cases brought to her attention.
Good News Culture at the National Guardian’s Office? or “Stop the tokenism used as cover”
Published 23 December 2016
Letter byRichard von Abendorff patient safety campaigner, and Patients Association Patient Safety Ambassador, to the Patients Association regarding concerns about the National Freedom to Speak Up Guardian’s office. The National Guardian has called for good news stories about NHS whistleblowing – but do we want anecdote and selected cases as opposed to real evaluation, robust evidence of effectiveness and genuine staff confidence?
New Employment Scheme (but not as you know it)
Published 19 December 2016
The much derided National Guardian’s office lurches from one mishap to another. With an absurd role specification, embarrassing resignations, stunningly silly comments to the press, and failure to actually process any cases after a long delay, it has singularly failed to command any credibility. The latest National Guardian seems to be keeping a wide berth of whistleblowers. A delegate list for a critically important consultation looks unimpressively corporate. The majority of whistleblowers are not invited to this bash, which will discuss how the machinery for choosing cases for review will be established.
Covering up cover ups: CQC’s revisionism
First published 15 December 2016
A critique of a damage limitation exercise by the CQC et al, the so called CQC Deaths Review. The review is a response to independent auditors, Mazars, letting the cat out of the bag about dismal NHS failure to investigate properly or in hundreds of cases, at all, deaths at Southern Health NHS Foundation Trust. The CQC has done its best to draw public attention away from deliberate NHS cover ups. It has also failed once more to defend the rights of people with learning disabilities and mental illness.
Tall Stories by the CQC
First published 9 December 2016
This is a response by four NHS whistleblowers to CQC’s evidence to a Health Committee accountability hearing on 6 December 2016. The CQC is in denial of its failures, especially in relation to whistleblowers. It hits out at critics and has not engaged with almost all the issues raised by campaigners in a letter to the Times. A letter to Peter Wyman the CQC’s chair is included. This questions the CQC’s evidence to parliament and invites the CQC to respond to a recent report on its serious whistleblowing failures.
Whistleblowers unheard by CQC
First published 2 December 2016
A report by four NHS whistleblowers summarising how the Care Quality Commission is part of the machinery of suppression through repeated acts of omission and commission. Importantly, the CQC has unparalleled national data on whistleblowing in health and social care but has revealed very little about this data. CQC has repeatedly failed to conduct central analyses or demonstrate proper learning. This has the added effect of preventing full access via Freedom of Information, because the CQC refuses FOI requests on grounds that it would exceed cost limits to collate data. Data that has been obtained reveals very disturbing inaction by CQC in response to even the most serious allegations of management fiddling and reckless endangerment of patients.
Is CQC’s handling of Regulation 5 “Fit and Proper”?
Published 21 November 2016
CQC has finally responded to an FPPR referral on controversial former NHS CEO Paula Vasco-Knight. It has conceded that St. George’s handling of FPPR is ineffective but questions remain about CQC’s prosecution of FPPR, and the basis upon which Mike Richards Chief Inspector gave St Georges and Vasco-Knight a pass in February 2016, which was not disclosed by CQC itself.
DH, Robert Francis’ National Guardian and the dark art of delay
Published 21 November 2016
The DH was asked in July 2016 how it would evaluate and track the effectiveness of the much scorned National Guardian’s office. The DH has taken four months to reply that, in short, it will have meetings with the CQC. Jeremy Hunt has been asked if he will ensure that specific performance metrics and a proper means of evaluating the office will be developed. A lack of evaluation would of course help the DH to use the National Guardian to further delay genuine whistleblowing reform.
The ever-anomalous CQC. Another soft-shoe shuffle around inconvenient data
Published 18 November 2016
As nine past Health Secretaries made an unprecedented attack Jeremy Hunt’s failures on mental health, a look at the CQC’s annual community survey of adults receiving specialist mental health care reveals that a persistently low response rate has been tolerated, and that the instrument does not distinguish well between trusts. Where there are outliers, the CQC does not seem to take much notice of this. Norfolk and Suffolk NHS Foundation has just been uprated by CQC and released from special measures, but the survey results support campaigners’ concerns that these are unjustified actions. Deaths continue to mount.
Morecambe: All that glisters…
Published 15 November 2016
Morecambe Bay is writ large in the the Secretary of State’s PR drive. It was praised for revealing a past, irregular compromise agreement that undertook not to investigate a senior midwife. However, when asked to disclose all such compromise agreements, the trust gave only a partial answer and avoided the years before 2011. Is the trust truly a miracle of transformation under Jeremy Hunt’s reign?
Coroners’ warnings: terminal inexactitude and CQC opacity
Published 11 November 2016
An analysis of coroners’ data which shows that 206 coroners’ warnings reports (Reports to Prevent Future Deaths, formerly known as Rule 43 reports) about serious failures by care providers have been sent to CQC since July 2013. There are only published CQC responses to nine of these warnings. It is not at all clear to what extent CQC has acted upon coroners’ warnings. Shocking case examples are given. CQC’s inspection reports do not reliably report on whether providers have been issued with warnings by coroners. CQC has given inconsistent accounts of when a memorandum of understanding with coroners was established and has not yet explained why it has done so. The data from which the analysis is derived is provided.
Does PHSO go easier on the big boys?
Published 4 November 2016
The Parliamentary and Health Service Ombudsman shies away from acknowledging that there is cover up in the NHS, or that it comes from the top. A quick and dirty look at FOI data on outcomes of complaints to PHSO about the Department of Health, NHS England and the Care Quality Commission against PHSO data on outcomes for all NHS organisations raises a question of whether rates of upheld complaints are lower for central bodies.
DH complaints handling
Published 2 November 2016
FOI data from the DH and PHSO, cross checked with DH publications, reveals that the DH has not followed its own guidance on good complaints governance. It has not been fully transparent about complaints made against it, it has not paid due attention to the narrative of complaints (Recommendation 40 Mid Staffs Inquiry) and it has not measured the experience of complainants. The PHSO received 914 complaints about the DH but only 0.5% were fully upheld and only 0.7% were partly upheld. According to the PHSO data, the majority of the complaints investigated related to inspection and regulation.
Letter to parliament: CQC’s inconsistent regulation of restraint in mental health
Published 31 October 2016
The use of physical restraint, inluding high risk prone (face down) restraint has increased as cuts to highly stressed mental health services have continued. The NHS has contended that this is due to better reporting but this is unlikely to be the whole explanation. The CQC accepts that the unwarranted, avoidable use of physical restraint is a Safeguarding issue, but it has been less than straightforward with the public. This letter submits evidence to parliament about these issues.
Northumberland Tyne and Weary
Published 29 October 2016
Debunking the CQC’s rating on 1 September 2016 of Northumberland Tyne and Wear NHS Foundation Trust as ‘Outstanding’, taking into account poor patient feedback, mediocre 2015 patient survey results, serious escalation of dangerous prone restraint in the face of government policy and safety alerts deterring this practice and repeatedly topping the national charts for violent incidents. But hey, it helps the Secretary of State spin against increasingly vociferous criticism of the government’s mental health cuts and failures.
FOI disclosure 26 October 2016 by PHSO on complaints made about NHS England
Published 26 October 2016
Notes on a disclosure which showed that less than 2% of complaints to the PHSO about NHS England had been fully or partly upheld. Discrepancies between PHSO & NHS England’s data are noted. Opacity in NHS England’s reporting of how it handles complaints against itself is also noted.
Jus’ like that, says Henrietta
Published 21 October 2016
The Ministry of Love has brazened it out and refused to acknowledge that it has mishandled the office of the National Guardian for NHS whistleblowing. The Ministry also refused to acknowledge dismay and offence caused by the latest National Guardian, due to some very revealing comments made in her first press interview.
Fit and Proper Mess
Published 19 October 2010
An update on evidence of the CQC’s, Jeremy Hunt’s and Department of Health’s failures to hold seriously erring NHS directors to account. An NHS chief executive who was found to be Fit and Proper last year, and who was recycled after major failures by his former trust, has led his present trust into special measures.
Morecambe and wise counsel
Published 17 October 2016
A little shot of antidote to Jeremy Hunt’s spin about Morecambe, maternity safety and his false claim to be the patients’ champion. Morecambe Bay’s continuing poor treatment of whistleblowers is summarised.
Letter. Unheeded deaths warnings. Neglect and care home owner with criminal convictions. Indefensible CQC.
Published 16 October 2016
Letter to parliament of 15 October 2016 about CQC’s long history of failure, a new analysis showing persisting unreliability in CQC response to coroners’ deaths warnings, and a shameful attitude by CQC in not reviewing its part in the profoundly shocking care home death of Ivy Atkin, who weighed 3 st and 13 lb. CQC’s value for money is discussed. A CQC FOI revealing the cost of an ineffective Southern Health inspection in 2014, which did not report on hundreds of un-investigated deaths, is provided.
CQC’s “better than ever”…or didn’t you know?
Published 14 October 2016
A post about the horrific death of Ivy Atkin, weighing 3 st 13lb, from gross neglect at Autumn Grange. CQC had issued an inspection report 20 days before the death, which gave the care home a clean bill of health. The CQC disclosed by FOI that it had not undertaken any internal review of its inspection activities at Autumn Grange, but insisted its processes were “better than ever”. A CQC Non Executive Director tweeted caringly, “Er, this was 4 years ago…..”
Published 12 October 2016
St. Robert of Richmond House, the NHS denial machine and the building of a brand by the Department of Health and Care Quality Commission.
A letter to the ever-listening Cat Quality Commission
Published 11 October 2016
Letter to Peter Wyman Chair of the CQC, to bring his attention to the strong negative reactions by whistleblowers, NHS staff and the public to comments by Henrietta Hughes National Guardian that NHS staff must be cheerful, so that no one is intimidated from whistleblowing. Questions are raised about CQC’s processes for appointing the current and previous National Guardian.
Published 10 October 2016
This is a response to comments made by the replacement National Guardian in her first press interview, in which she asserted NHS staff must be more cheerful, so that no one feels intimidated from speaking up: “she said that change could happen “just like that” if staff always acted as they would on a good day”. Henrietta Hughes’ introduction of a rule for her staff on smiling at a distance of 10 feet, in her previous role as an NHS England senior manager, is noted.
Care home deaths and more broken CQC promises
Published 8 October 2016
This is an analysis a year on from revelations by The Bureau of Investigative Journalism and the Independent that CQC had failed to act on serious coroners’ warnings about care home deaths. CQC promised in response to this scandal that it would make improvements. Cross checking between a total of 66 coroners’ Reports to Prevent Future Deaths (PFDs) since July 2013 and CQC inspection reports showed that there was no published evidence that 18 of the PFDs had yet been followed up with inspections. The CQC’s response to coroners’ warnings in terms of evidence of inspection is still slow and erratic.
Published 4 October 2016
An update on the cringeworthy saga of the Department of Health & CQC’s handling of the central plank of Robert Francis’ recommendations on NHS whistleblowing -the office of the National Guardian. Key issues of the National Guardian’s role and remit remain unresolved even at this late stage. A further letter to Dr Henrietta Hughes the latest appointee is included.
Do “Complaints Matter” to CQC?
2 October 2016
An analysis is provided of published information on CQC’s handling of complaints about itself. Concerns and questions are raised about transparency, learning and accountability, set in the context of CQC’s own expectations of best practice in complaints governance. Related correspondence to the Health Committee is attached.
Jim Reaper and gags up north
30 September 2016
Notes on an FOI disclosure by Northumbria Healthcare NHS Foundation trust on 15 February 2016, showing 62 compromise agreements, 61 of which contained non-disparagement clauses and 45 of which contained clauses preventing signatories from disclosing the existence of the compromise agreements.
PHSO FOI disclosure 21 September 2015 on handling of complaints: PHSO has CQC’s back
30 September 2016
This article briefly summarises the role that the PHSO has played in the NHS denial machine, the culture of “circular assurance” amongst NHS bodies – which listen to each other rather than complainants and whistleblowers – and provides FOI data which showed that since CQC’s inception, PHSO had not upheld a single complaint out of the 354 complaints that it had received about CQC.
Is the BMA worth £163? Are new socks better?
This article summarised the troubled history of the BMA’s handling of whistleblowing cases and its related governance of these activities. The BMA’s submission to the Freedom To Speak Up Review, an internal report of a review of BMA’s handling of whistleblowing matters and related correspondence are provided. New correspondence to Dr Mark Porter Chair of the BMA Council seeking information on whistleblowing cases is included.
Homerton maternity whistleblowers, FOI disclosure of the London Clinical Senate report on four maternal deaths and the National Guardian for whistleblowing
This article briefly updated the story of the Homerton maternity whistleblowers and provided a copy of the London Clinical Senate review of four maternal deaths. A past link between the recently appointed National Guardian for whistleblowing and the NHS’ handling of the Homerton whistleblowers’ concerns is noted. Links to a website about the Homerton whistleblowers’ disclosures and various other documents and audit trail are provided.
Sir Robert’s Flip Flops
Published 26 September 2016
This article tracked how Robert Francis u-turned on accountability for reprisal against NHS whistleblowers, even though he acknowledged that it constitutes serious misconduct. His original recommendations on criminal sanctions and sackings are collated and set against his later recommendations from the Freedom to Speak Up Review, which were considerably weaker. The contrasting advice of Francis’ lead researcher, Prof David Lewis, who supports criminal sanctions to deter whistleblower reprisal, is referenced.
Letter to Health Committee 23 September 2016
This correspondence raised serious concerns that the Care Quality Commission has made misleading claims about inspecting NHS compromise agreements, based on evidence from review almost 200 current CQC inspection reports.
NHS Gagging. How CQC sits on its hands
Published 23 September 2016
This article presented evidence that despite Jeremy Hunt’s claims in 2013 that he took action against NHS gagging, the Care Quality Commission and Department of Health have in fact turned a deliberate blind eye to continuing and widespread gagging. A new analysis was provided of 200 current CQC inspection reports, which showed that despite misleading claims by the CQC, there is in fact no evidence that CQC inspects NHS trust compromise agreements.
Letter to the Director of the National Clinical Assessment Service (NCAS) 22 September 2016
This letter questioned whether NCAS had taken action, that it said it would a year previously, to ensure better tracking of whistleblower cases and safeguards against abuse of process by NHS employers who refer whistleblowers vexatiously to NCAS in reprisal for whistleblowing. The letter also raised serious concerns about FOI data which showed that disproportionately more non-white doctors are referred to NCAS, and that NCAS is clearly not tracking Race detriment properly because it has no ethnicity data for almost half of the doctors who are referred. The FOI data is provided.
FOI disclosure 21 September 2016 by Health and Safety Executive on complaints received against NHS bodies and Priory Group since 1 April 2014
This FOI disclosure revealed that there have been 222 complaints against NHS bodies in the UK and 38 complaints against English mental health trusts since 1 April 2014. There have been four complaints against the Priory Group. The NHS bodies with the most number of complaints has been extracted and a table is given. Basildon and Thurrock have been the subject of 5 complaints despite claims by the CQC that the trust has improved, and is now ‘Good’.
Club culture at the heart of CQC
First published 9 September 2016
This article reported findings from a review of almost 200 current Care Quality Commission inspection reports, for patterns in CQC’s choice of inspector chairs. The choice of CQC inspection chairs were predominantly white, male and corporate and the majority of 103 inspection chairs appointed by CQC were current directors of NHS trusts.
Letter to 9 September 2016 to David Behan CQC Chief Executive on CQC under-reporting of coroners’ mental health deaths warnings
This letter asked CQC why it had cited only 3 coroners’ warning reports in a 2014/2015 report when there were in fact 92, five of which were marked as having been copied to CQC.
Hot air about Just Culture
First published 1 September 2016
This article argues that NHS cover ups are ultimately due to top down political pressure, and that whilst governments say they want to ensure NHS learning on safety issues, the NHS is managed in a bullying way by politicians, which encourages suppression and unfairness to patients and staff.
CQC Deaths Review: All fur coat…
First published 13 August 2016
This article reported evidence, from examining all current CQC inspection reports on English mental health trusts, which showed that CQC is reporting inconsistently and incompletely about mental health deaths and coroners’ Reports to Prevent Future Deaths.
Letter 8 August 2016 to Health Committee about lack of progress on NHS Improvement’s employment support scheme for whistleblowers
This letter raised concerns about lack of any apparent progress by NHS Improvement, refusal to further involve whistleblowers, to share documents or to give a clear and specific timetable for the work. An FOI response from NHS Improvement is included.
CQC’s Fit and Proper Parade
First published 29 July 2016
This article summarised the serious failure by the Care Quality Commission to hold any NHS directors to account under the new Fit and Proper Person Regulation (Regulation 5), and very questionable irregularities in CQC’s poor response to referrals, including misleading responses to a referral in the case of Paula Vasco-Knight, which were exposed by Freedom of Information disclosures.
No one believes Jeremy Hunt on patient safety and whistleblowers, not even his own appointees
First published 11 March 2016
This article examined the newly formed office of the National Guardian for NHS whistleblowing, and draws on information from a meeting with the first National Guardian, Eileen Sills (in post January – March 2016). A minute of the meeting is provided.
Safety campaigners’ letter to the Times 10 February 2016 about government inaction on whistleblowing, and measures required
This letter, by Professor Brian Jarman and others, was written on the anniversary of the Freedom To Speak Up Review to draw attention to lack of government inaction about NHS whistleblowing, despite promises to reform this major area of governance failure. A brief outline was given of the measures needed for genuine reform.
CQC FOI disclosure 15 January 2016 on Section 48 investigations conducted since inception in 2009
This FOI disclosure revealed that CQC had conducted six Section 48 investigations since 2009 (less than one a year) and that CQC had not investigated any mental health trusts despite immense service pressure and well publicised indicators of deteriorating mental health service safety.
Letter from whistleblowers 26 November 2015 : CQC a fraying rope
This letter from a group of experienced whistleblowers, to Mike Mire Acting CQC Chair, summarised how CQC has been failing to respond appropriately to whistleblowers’ concerns and supporting whistleblowers, and how CQC had failed to effectively regulate whistleblowing governance by provider organisations, or to hold senior managers to account for whistleblower reprisal.
Letter to Jeremy Hunt 16 October 2015 about his role regarding Homerton maternity whistleblowers
This letter asks questions about the Secretary of State’s and the Department of Health’s role in a major system failure to respond to black whistleblowers’ concerns about unsafe care and Race discrimination in the provision of maternity services, followed by a cluster of maternal deaths.
Critique of Francis’ model of trust-appointed Guardians
First published 21 June 2015
This is part of evidence submitted to the Department of Health on 4 June 2015, in response to its consultation on how the Freedom to Speak Up Review should be implemented.
It explains the lack of evidence base for Robert Francis’ proposals for a network of local Freedom to Speak Up Guardians, employed by NHS trusts.