Dr Minh Alexander retired consultant psychiatrist 14 July 2023
I raised concerns in a post earlier this week about NHS England’s refusal to heed concerns from bereaved families and whistleblowers about the suitability of a Jeremy Hunt favourite, Marianne Griffiths former Sussex NHS trust CEO, to investigate the North East Ambulance Service (NEAS) deaths scandal.
I also pointed out that she gave sketchy details about her investigation team, which seemed to lack clear credentials for handling complex legal issues thrown up by the matters at NEAS.
A concerned party has now contacted me to say that they believe that Griffiths’ investigation team at NEAS were in fact former trust colleagues from her days at Sussex.
I have written to Amanda Pritchard, CEO of NHS England, copied to parliament and others, seeking clarification.
The correspondence is shared below and is hopefully self-explanatory:
BY EMAIL
Amanda Pritchard
CEO NHS England
14 July 2023
Dear Amanda,
Concerns about the selection of Marianne Griffiths’ investigation team at North East Ambulance Service
I write to enquire about the composition of the team which, led by Marianne Griffiths former CEO of Sussex University Hospitals NHS Foundation Trust, which conducted NHS England’s investigation into the deaths scandal at North East Ambulance Service (NEAS).
As you can see, the credentials of the investigation team members were not clearly and fully provided.
It did not seem clear to me that there was sufficient expertise within the team to determine complex issues of whistleblowing, employment, coronial and criminal law which arose from the matters at NEAS.
It was not obvious that there were any practising lawyers on the team.
A concerned party has now contacted me to say that they believe all members of the Griffiths NEAS deaths investigation team were former colleagues of Marianne Griffiths at Sussex.
The person believes these are the relevant employment details of the NEAS investigation team members:
“Marianne Griffiths – CEO, Western Sussex Hospitals/Brighton and Sussex Hospitals/University Hospitals Sussex – 2010 – 2022
Denise Farmer – Director of Organisational Development and Leadership, Western Sussex Hospitals/Brighton and Sussex Hospitals/University Hospitals Sussex – 2010 – 2022
Lynn Woolley – Head of Midwifery and Gynaecology, Brighton and Sussex Hospitals/Western Sussex Hospitals – 2012 – 2021, Director of Maternity Services, Portsmouth Hospitals – 2021 to current (also CQC adviser on maternity)
Sian Finlay – Executive assistant to the CEO (Marianne Griffiths) and the Chair (Alan McCarthy) at University Hospitals Sussex 2017-2022”
Could NHS England kindly confirm if the individuals in the Griffiths investigation team have been correctly identified.
Concerns arise if so.
The impression of a handpicked team of Marianne Griffiths’ former Sussex NHS trust colleagues is troubling, especially from a trust which is now under police investigation into whistleblowers’ disclosures about deaths, which may amount to allegations of gross negligence manslaughter.
Dr Minh Alexander retired consultant psychiatrist 12 July 2023
Summary: NHS England resisted concerns from several parties about the fact that it had appointed Marianne Griffiths former CEO of Sussex University Hospitals NHS Foundation Trust to investigate the deaths scandal at North East Ambulance Service (NEAS). It officially stood by her AFTER the police investigation into deaths at her former trust in Sussex became public in early June, stating that it was “content” with her. Her report today has been understandably dismissed by bereaved families as a whitewash. There are other concerns about the report. The credentials and suitability of Griffiths’ investigating team are not clear, especially with regards to the complex legal matters involved at NEAS. There is also still no sign of a persistently withheld report on bullying and whistleblowing governance at NEAS, only scant summary of findings of opinion without facts. As bereaved families have commented, “This is the NHS investigating the NHS”.
NHS England’s investigation into North East Ambulance NHS trust has been published today:
It was led by Marianne Griffiths former NHS CEO despite multiple objections from bereaved families and several whistleblowers, including those who reported she failed them. I objected over a year ago, based on concerns about governance at her former trust in Sussex where she was CEO, and received the usual stonewalling from NHS England.
After fits and starts of correspondence and long silences, NHS England eventually spat out its reluctant response on 20 June 2023:
“In brief, NHS England is content with Dame Marianne Griffiths’ suitability to lead this review and expect it to conclude soon.”
This was remarkable as it came AFTER revelations about the police investigation at Griffiths’ former trust in early June.
There was nothing in NHSE’s response to address the governance issues I raised about her former trust at Sussex. Or any sign that NHSE had investigated the ongoing issues at Sussex, some of which were seeded during Griffiths’ tenure.
Importantly, NHS England confirmed in its response to me that Griffiths had received a copy of a review about bullying and poor whistleblowing governance at North East Ambulance Service, as part of her investigation into the trust.
Email from NHS England 20 June 2023:
“Hi Minh
Apologies for the delay in responding to your email. NHS England take all whistleblowing-related issues seriously and as such I have taken the time to review your concerns.
In brief, NHS England is content with Dame Marianne Griffiths’ suitability to lead this review and expect it to conclude soon.
With regards to the Stanley/Boylin report, it was shared confidentially with Dame Marianne Griffiths. NHS England does not intend to request investigation documents, nor to commence a review of the investigation contents. We await the findings of Dame Marianne’s review, and will then consider whether any action needs to be taken in response to that review.
I note you have also emailed recently about the ‘implications of governance failings at Sussex’ and I hope this response addresses the point you raise there too.
I am sorry again for the delay in responding to you. I know there is another matter I have yet to respond to you on, and will aim to do so next week.
With best wishes
Tom”
[My emphasis]
The review about bullying and whistleblowing failures at NEAS took place in 2020, and it was carried out by Jennie Stanley (née Fecitt) and Tracy Boylin.
The report has been suppressed by NEAS ever since.
Affected trust staff were only given superficial feedback about the outcome of the investigation, that concerns were partly upheld.
The trust has refused to disclose it under FOI, whether in full or as summary findings and recommendations.
Griffiths’ report on NEAS, unveiled today, is a woeful affair. It refuses, on a test of the balance of probabilities, to find that repeatedly altering original documents and withholding documents from the coroner was deliberate concealment.
Tracey Beadle, Quinn’s mother, told HSJ that the report was a “complete whitewash” due to issues including its limited scope and key details being omitted from previous investigations, and that the review failed to examine why the Care Quality Commission did not take action when concerns were raised with them. She also questioned the suitability of Dame Marianne to lead the review, given cultural problems previously highlighted at her former trusts.
“This is the NHS investigating the NHS,” she said. “Therefore no impartiality exists.”
She added NEAS “have [been] afforded protection from [CQC and NHSE], putting their reputations before the safety and wellbeing of patients”.
Griffiths’ conclusions reduce NEAS’ use of illegal and unenforceable clauses in settlement agreements, which prevented whistleblowers from pursuing public interest concerns further (applied in one case and rejected in another), to a matter of “misinterpretation” and “perception”:
“In those two cases, the circumstances were sufficiently sensitive and contentious as to make any form of proposed settlement open to potential misinterpretation. NEAS accept that there were perception issues with that, and its processes have been strengthened.”
It is unclear what specialist expertise informed Griffiths’ investigation. The full credentials of the investigation team are not supplied:
What credentials did the Griffiths investigation team have to make determinations on issues of whistleblowing, employment, coronial law and criminal law? It is not obvious that there were any practising lawyers on the team.
Griffiths’ analysis of NEAS’ general whistleblowing governance is staggeringly superficial and brief. The report’s section on Freedom To Speak Up was less than two pages long (see pages 62 and 63) and totalled 641 words. The specific section on the coronial whistleblowers tries to paint a “can of worms” type picture. This can be a technique that is sometimes used for misdirecting attention in whistleblowing matters.
I cannot find explicit mention of the Stanley/Boylin report’s outcome in Griffiths’ report.
I found this passage:
“6.34 Between 2019-20 there was a significant change in executive leadership; a new Chief Executive (CEO) (following a gap of 4 months), new Director of Quality and Safety, new Finance Director and new (and the organisation’s first substantive) Director of HR (HRD). The incoming CEO put the new executive team together including investing in Board development work. She also actioned the outcome of reports relating to behaviours and culture including meeting staff who had raised concerns.”
There were also these passages about an unspecified external Freedom To Speak Up commissioned by NEAS concluded in 2020, which would fit:
“7.38 The findings made clear that the functioning and leadership of HR, and relationships between senior staff, had been difficult for some time and had not been addressed effectively up to 2020.
7.39 Senior leaders had allowed dissent and factions to interfere with proper processes and therefore added to serious risk for HR and professional matters, and to the support given to the organisation, including to the staff raising concerns and grievances.
7.40 There was clear evidence of a lack of professional respect, and a lack of acknowledgement of professional duties and responsibilities and the consequent need to co-design processes.
7.41 There was a lack of transparency and consistency between the operational management of services and professional leadership.”
The facts supporting these opinions are not provided.
Opaquely, Griffiths gives no bibliography of the documents examined by her investigation.
A search of her report for the words “bully” and “bullying” yield zero hits, although she was tasked with examining culture.
Why has there been so much secrecy about the Stanley/Boylin report outcome?
Why has over £35K public money not been properly accounted for?
Why do private contractors undertake these types of reports without a clear condition that such reports will be openly published?
Is it because there would be no repeat customers if NHS organisations cannot cherry pick what is reputationally advantageous to publish?
Why are NHS bodies allowed to misuse public funds in the support of managerial self interest and against patients’, families’ and the workforce’s rights to transparency?
The bad, bad smell that still hangs over NEAS will likely intensify as the scandal at Sussex unfolds.
Perhaps NHS England will invite Helen Ray the NEAS CEO to review Sussex at some point. Only once CQC has confirmed improvement at NEAS and upgraded the trust to “Good” or “Outstanding”, of course.
But unaccountable senior NHS managers are bulletproof for now.
But this serves to emphasise how perfectly unfit the NHS’ governance is when things go wrong, and how only hard law reform will suffice to protect whistleblowers.
RELATED ITEMS
I have written to the Secretary of State about the missing Stanley/Boylin report.
08.07
BY EMAIL
Steve Barclay
Secretary of State for Health and Social Care
12 July 2023
Dear Mr Barclay,
Suppressed report on bullying and poor whistleblowing governance at North East Ambulance Service
Marianne Griffiths’ investigation on North East Ambulance Service for NHS England was published today and references your predecessor’s announcement last year about this investigation.
One of the NEAS whistleblowers understandably declined to cooperate with this flawed exercise. The investigation was also criticised by the bereaved families.
I write to draw your attention to the fact that NEAS paid over £35K for a 2020 report on bullying and poor whistleblowing governance at the trust, which it has suppressed ever since. This was the so-called Stanley/ Boylin report. Its findings appear to be absent also from today’s Griffiths report.
NHS England confirmed in a note to me last month that Marianne Griffiths had been provided with a copy of this report.
However, I can find no clear mention of its findings in her report today. I could find only this paragraph:
“6.34 Between 2019-20 there was a significant change in executive leadership; a new Chief Executive (CEO) (following a gap of 4 months), new Director of Quality and Safety, new Finance Director and new (and the organisation’s first substantive) Director of HR (HRD). The incoming CEO put the new executive team together including investing in Board development work. She also actioned the outcome of reports relating to behaviours and culture including meeting staff who had raised concerns.”
Marianne Griffiths also provides no bibliography at the end of her report to transparently list the documents examined by her investigation. A search of her report for the words “bully” and “bullying” brings up zero hits.
The section of her report on Freedom To Speak Up is less than two pages long and comprises of 641 words.
The report claimed it could not say that the repeated alteration of original documents and withholding of documents from the coroner, which the trust had previously been warned were potential crimes, was a deliberate act of concealment.
I really do not think that the public interest has been served by this report. It is in my opinion a sample of what we should expect if the NHS is permitted to conduct its own “exit Fit and Proper Person tests”, as currently proposed by NHS England.
I forward below the correspondence from NHS England which informed me that Marianne Griffiths had been provided with the Stanley/Boylin report.
This brief response was the culmination of over a year of my raising concerns with NHS England about Marianne Griffiths’ suitability to lead the NEAS investigation given the previous concerns about whistleblowing governance at her former NHS trust in Sussex.
Additional concerns arose over the course of that year. You will see that none of this swayed NHS England.
With best wishes,
Minh
Dr Minh Alexander
NHS whistleblower and retired consultant psychiatrist
Cc Tom Kark KC
08.54
BY EMAIL
Steve Barclay
Secretary of State for Health and Social Care
12 July 2023
Dear Mr Barclay,
My apologies.
I need to correct my earlier letter today of 08.07.
I have found a further passage in Marianne Griffiths report which seems to give a brief outcome of the 2020 Stanley/Boylin report, although the report is not explicitly identified.
It is stated that an external report commissioned by NEAS concluded in 2020 with the following:
“7.38 The findings made clear that the functioning and leadership of HR, and relationships between senior staff, had been difficult for some time and had not been addressed effectively up to 2020.
7.39 Senior leaders had allowed dissent and factions to interfere with proper processes and therefore added to serious risk for HR and professional matters, and to the support given to the organisation, including to the staff raising concerns and grievances.
7.40 There was clear evidence of a lack of professional respect, and a lack of acknowledgement of professional duties and responsibilities and the consequent need to co-design processes.
7.41 There was a lack of transparency and consistency between the operational management of services and professional leadership.”
My understanding is that affected staff were advised that their concerns were partly upheld by the Stanley/Boylin investigation, but that they were given no other information. I have seen some of the feedback correspondence from the trust.
In Marianne Grittith’s above summary, opinions are given but the specific facts supporting them are not.
She provides little comment on the issues of whistleblowing governance examined.
Information relevant to mounting an effective Fit and Proper Person challenge remains largely withheld from affected parties.
Dr Minh Alexander retired consultant psychiatrist 11 July 2023
Steve Barclay Secretary of State waffled before Health and Social Care Committee on 20 June 2023, in response to questions about the failure of the government’s Freedom To Speak Up project to protect NHS whistleblowers, after eight long and miserable years.
In consequence, I asked him some questions under FOI:
In brief, the Department says it has accepted the following four recommendations from the Kark review on Fit and Proper Persons in the NHS, but hasn’t a clue when they will be implemented, because it’s been palmed off onto NHS England:
“With regard to recommendations 1 to 4, DHSC does not hold the information you have requested. However, you may wish to contact NHS England, which may be able to provide an update on the timetable for recommendations 1 to 4.”
“Recommendation One
All directors (executive, non-executive and interim) should meet specified standards of competence to sit on the board of any health providing organisation. Where necessary, training should be available.
Recommendation Two
That a central database of directors should be created holding relevant information about qualifications and history.
Recommendation Three
The creation of a mandatory reference requirement for each Director
Recommendation Four
The FPPT [Fit and Proper Person Test] should be extended to all Commissioners and other appropriate Arms-Length Bodies (including NHSI and NHSE).“
Disbarment has been dumped
Importantly, it is also confirmed that Barclay has ditched Kark’s fifth recommendation, for a mechanism to disbar NHS managers for serious misconduct:
“The power to disbar directors for serious misconduct”
This is blamed on NHS England:
“The Government agrees with NHS England that effective safeguards are currently in place by ensuring an exit fit and proper person test is completed when directors leave employment and that any conduct issues which arise after their employment remain on the national register. These safeguards, together with a robust referencing process, will prevent unsuitable leaders being re-employed in the NHS and also act as a deterrent to misconduct itself.”
So, “an exit Fit and Proper test” has been secretly mooted but kept hidden even after publication of the NHS Workforce plan on 3 July 2023.
It sounds like a ludicrous fig leaf, that everyone knows is a ludicrous fig leaf.
Interestingly, NHS England previously blamed ministers for disbarment being dumped, telling me there was no “ministerial support” for this Kark recommendation.
How they all twist and turn.
It is worth remembering that Kark’s review reserved disbarment for matters such as criminal convictions leading to a custodial sentence, victimisation of whistleblowers or knowingly allowing the victimisation of whistleblowers, “Causing, facilitating, colluding in, or requiring any staff member to fail to comply with the duty of candour including by means of a settlement or confidentiality agreement” and “Falsification, concealment or suppression of records, data or other information which is required to be provided to any other person or organisation”.
And the disbarment mechanism also fell short of full regulation. The latter is rightly expected of hundreds of thousands of NHS staff who are responsible for patients’ lives. But so are NHS managers, who have been dodging regulation since it was recommended by the Bristol heart public inquiry over twenty years ago.
“Now Stephen Barclay, a health minister, has told The Independent he wants the “fit and proper” person test for NHS directors – introduced in 2014 – to be widened to require action on harassment and discrimination.
Mr Barclay said: “That one in four NHS staff have experienced bullying, harassment or abuse – and that more than twice as many BAME [black, Asian and minority ethnic] staff have suffered discrimination from their manager or colleagues than white staff – is deeply alarming and should be a call to arms for urgent action across the NHS.
“I am determined to put an end to this, which is why the NHS is already working to close the equality gaps and tackle bullying.”
It is also worth remembering that Barclay recently wondered out loud at Committee on 20 June 2023:
“What accountability is there for senior managers when wrong doing is established? Are they just rotated through the system? Or are people held to account?”
Really Mr B!!!!
UPDATE 23 AUGUST 2023
The Telegraph yesterday asserted that the ministerial fashion for dumping disbarrment originated with Matt Hancock:
RELATED ITEMS
NHS England’s “exit Fit and Proper Person test”
I have written to the Chief Workforce Officer at NHS England to ask for details of the “exit Fit and Proper Person test” mentioned in the Department’s FOI response:
“The Government agrees with NHS England that effective safeguards are currently in place by ensuring an exit fit and proper person test is completed when directors leave employment and that any conduct issues which arise after their employment remain on the national register. These safeguards, together with a robust referencing process, will prevent unsuitable leaders being re-employed in the NHS and also act as a deterrent to misconduct itself.”
I would be grateful if in your reply to my enquiry of 4 July 2023 you could additionally include the details of the “exit Fit and Proper Person test” that is envisaged by NHS England, and by whom it will be applied.
If no such exit test has yet been devised, please indicate the timescale within which the test will be developed and ready for use.
Would the exit test will be applied by a local employer with possible vested interest, as opposed to an independent central body, as disbarring mechanism would be?
I must say I cannot see how for example, University Hospitals Birmingham NHS Foundation Trust would have applied an exit test reliably to David Rosser, its former CEO who was criticised by the Employment Tribunal for his behaviour towards a whistleblower. He also received a warning from the General Medical Council. The trust board has still not published a flawed FPPR investigation review on David Rosser, conducted by a subordinate trust employee which it claimed cleared him. The trust board also misled the public in a bizarre fiction, claiming that Rosser stepped down as CEO and moved to a regional role, when he remained a trust employee as revealed by an FOI request. As the trust board continues to deny that its FPPR investigation found cause for concern, if left in control of an exit FPP test, I imagine it would allow him to recirculate in the NHS.
Many thanks and best wishes,
Minh
Dr Minh Alexander
NHS whistleblower and retired consultant psychiatrist
Cc Tom Kark KC
Health and Social Care Committee
Secretary of State for Health and Social Care
Is the Patient Safety Commissioner a Prescribed Person under PIDA?
Under this law, there are a number of designated bodies and individuals to whom whistleblowers may make so-called “protected disclosures”.
This too is a useless system as the Prescribed Persons sometimes are clueless about their responsibilities, and are legally obliged to do little more than to log the concerns received and to publish a superficial annual report about the numbers of concerns. No one is legally obliged to protect the whistleblower or act upon their concerns.
Barclay implied to Committee on 20 June 2023 that the Patient Safety Commissioner (for Medicines and Devices only) might be a Prescribed Person for whistleblowers’ disclosures. She is not currently listed as one. I asked him if the Department intended to give her this legal status. It did not reply.
The Patient Safety Commissioner was of course the second and particularly objectionable NHS National Freedom To Speak Up Guardian who expended most of her and her Office’s energies on PR, self-promotion and supporting an establishment narrative. Not to mention instances of failure to apologise and learn when her Office actually harmed whistleblowers:
Dr Minh Alexander retired consultant psychiatrist 6 July 2023
Disappointing BBC News coverage featured Robert Francis and the latest NHS Freedom To Speak Up Guardian Jayne Chidgey Clark on 3 July 2023.
The piece helped to legitimise the National Guardian’s Office, when it is in fact a threat to NHS whistleblowers.
The BBC team who produced the material did not balance claims by the National Guardian with evidence of her Office’s failures or with criticisms of her Office by whistleblowers.
They also chose not to include whistleblowers with the strongest cases which exposed the serious failings of the National Guardian’s Office. Whistleblowers from whom they had agreed to take this evidence were ignored.
Below is a letter to the relevant BBC team, placing my concerns about the coverage on record:
The thrust of the BBC reportage was on airing a defunct and empty argument that culture change alone is needed.
Robert Francis commented disingenuously that NHS boards need to “buy into” and “understand” about whistleblowing. He knows full well that many boards understand, but simply choose self interest and suppression. He used to advocate dismissal for abusive NHS CEOs.
Culture change is of course needed but it is not going to happen without enforcement. Road safety laws on safety belts and drink driving are an example of law changing behaviour and culture.
Power, however, naturally fears enforcement of whistleblowers’ rights to protection and action upon their disclosures.
The BBC News coverage appeared the day after The Guardian ran an item featuring the BMA’s call for reform of UK whistleblowing law:
Moreover, BBC News featured the National Guardian’s claims to purportedly support accountability for whistleblower reprisal:
“Dr Chidgey-Clark says the main healthcare regulator – the Care Quality Commission (CQC) – and NHS England itself could do more to protect individual whistleblowers and rein in rogue managers.
“I do call on them to do everything they can within their power to ensure there is accountability and these serious issues are looked into,” she says, “because without that, more high-profile cases will happen and, potentially, more patient harm and worker harm will happen. And in our society, in our healthcare system, we don’t want to see that.”
It is hypocritical of the National Guardian and her Office to call for others to ensure accountability for whistleblower reprisal and detriment, when they have done the opposite.
And why the distasteful focus on “high profile” cases? Every whistleblowing case matters, because every patient matters.
The National Guardian’s Office was primarily set up to provide independent reviews of poorly handled NHS whistleblowing cases, but has conducted a shockingly low number of case reviews since the Office was established in 2016.
Case reviews by the National Guardian since 2016:
Southport and Ormskirk NHS Trust 2017
Northern Lincolnshire and Goole NHS Foundation Trust 2017
Derbyshire Community Health Services Foundation Trust 2018
Nottinghamshire Healthcare NHS Foundation Trust 2018
Royal Cornwall Hospitals NHS Trust 2018
Brighton and Sussex University Hospitals NHS Trust 2019
Northwest Ambulance Service NHS Trust 2019
Whittington Health NHS Trust 2020
Blackpool Teaching Hospitals NHS Foundation Trust 2021
Thematic review of ambulance trusts 2023
The case reviews turned into toothless systems reviews and are now not even called case reviews anymore. They have been renamed “speak up reviews”, hiding their original purpose.
The NGO’s case reviews have avoided criticising any senior manager for harming whistleblowers.
… 1.12 Communicate that detriment for speaking up will not be tolerated, act to prevent detriment occurring, and put in place procedures that would enable cases of detriment to be looked into effectively when they are reported.”
That is hardly accountability for serious wrongdoing. It glossed over serious harm already done to the trust whistleblowers.
At North Lincolnshire and Goole, where the trust Chair publicly and notoriously attacked a whistleblower, the National Guardian made no reference to this incident in its case review report other than to say that the Chair expressed “regret” and made no recommendation for regulatory action to be taken against the trust Chair.
“We carried out this review because we had received information that the trust’s support for its workers to speak up did not always meet with good practice.”
Whitewash Central in other words.
In the latest case review by the current National Guardian, which was a thematic review of ambulance trusts, the resultant review report listed grievous examples of detriment (pages 43 and 44).
But the National Guardian did not criticise any managers responsible and kicked the can down the road by only suggesting that the Kark review recommendations should be implemented:
“One of the Kark Review recommendations called for processes to ensure greater accountability for leaders, including a focus upon behaviour which suppresses the ability of people to speak up about serious issues in the health service. This recommendation must be implemented as a matter of urgency.”
It was in fact within the National Guardian’s gift, and indeed arguably one of her duties, to request that the CQC review trust directors under Fit and Proper Persons regulation, and that NHS England should take related action. But she did not report that she did so.
Compounding these failures to hold abusive managers to account and to set the right tone, successive National Guardians have also refused to facilitate access to redress for harmed whistleblowers. This is despite the fact that this was recommended in the 2015 Freedom To Speak Up Review:
They have repeatedly taken the indefensible line that it is not part of their job.
Unsurprisingly, the National Guardian and her Office are not trusted by the NHS workforce and regularly receive only a tiny number of qualifying disclosures as a Prescribed Person under UK whistleblowing law, from an NHS workforce of 1.4 million.
BBC News reported quite wrongly that the National Guardian’s Office received over 25K contacts last year. This was actually the contacts received by local NHS trust Freedom to Speak Up Guardians and others.
Appallingly, the NGO sent 13 of these 30 staff back to their trusts:
“Signposted a worker to the Freedom to Speak Up Guardian at their organisation, so that the worker could contact them for support to raise matters relating to their disclosure”
When NHS staff contact the NGO (and some of them will be NHS trust Freedom To Speak Up Guardians who have been blocked or victimised for helping whistleblowers), they will have lost confidence in their employers.
It is unsafe and abusive to give such staff the runaround and make them go back to their employers.
Yet the NGO tried this approach in the whistleblowing case of Mr Shyam Kumar surgeon from University Hospitals Morecambe Bay NHS Foundation Trust (UHMBT), despite the fact that this trust was already notorious for several serious whistleblowing failures. This included a trust cover up of breast screening failures.
I am aware of at least seven whistleblowing cases from UHMBT, and yet the NGO has studiously avoided any case review of this organisation.
That must surely be a serious failure in the NGO’s duty of care to trust staff, and another example of the political nature of the NGO in how it sidesteps matters that are inconvenient to power.
That is hardly holding erring senior trust managers to account.
I asked Ian Trenholm CQC CEO to investigate the failure of the NGO at Sussex since the police investigation became public knowledge. He passed it to the CQC complaints team, who replied on 5 July 2023:
“After considering your email, we will not be considering this as a corporate complaint, as it goes beyond the time limit of what we would consider under our policy.”
So no accountability.
In the case of whistleblower Dr Jasna Macanovic who asked for help, the National Guardian’s Office told her to come back after her Employment Tribunal had concluded. This meant there would be no help for her or for patients for years. This too has happened to other NHS whistleblowers.
It was left to the whistleblower community to refer Dr Macanovic’s dismissing Medical Director to the CQC (the National Guardian’s employer) under Regulation 5 Fit and Proper Persons, who as usual refused to find any breach of the regulation.
I have seen correspondence supplied by an NHS whistleblower with a very serious case who was dismissed despite seeking help from their local trust Freedom To Speak Up Guardian.
They contacted the National Guardian’s Office for help. They gave the NGO a detailed account of what had happened to them, including their attempts to seek help through the local trust Guardian.
The National Guardian’s Office, under Jayne Chidgey Clark, wrote back last year suggesting:
“We understand that you were a worker at REDACTED and have attempted to speak up about a number of issues, including those around patient safety. We understand that you do not feel able to speak to the Guardian at the Trust as they are employed by them. However, we would encourage you to contact them if you have not already done so.”
The NGO correspondence continued in this incompetent and insensitive vein, such that the whistleblower questioned whether the NGO had actually read their original request for help.
This is a typical example of how the NGO operates.
The Office resists requests for help, and its first response is to try to send NHS whistleblowers back to the organisations in which they have lost confidence.
Sending victims back to abusers is not a recognised method of safeguarding.
I hope that BBC News will at some point acknowledge that the NGO’s actions smack more of collusion than accountability.
As does the disgracefully low number of case reviews conducted by the NGO.
The National Guardian’s Office simply does not protect whistleblowers.
RELATED ITEMS
The lack of evidence base for the Freedom To Speak Up project
It was reported that the prototype Cultural Ambassador role had disappointed some staff:
“The Staffordshire and Stoke on Trent Partnership NHS Trust created a role of ‘Ambassador for Cultural Change’. This innovative role was designed to allow the staff voice to be heard and concerns from staff to surface in a way that focused on the topic rather than the individual, protecting the identity of any staff member wanting to remain anonymous. This initiative received significant national attention. We saw that not all staff were happy with this role. They were often guarded and concerned they might not have the full protection promised. While some staff engaged with the Ambassador for Cultural Change many felt that the actions from this did not follow on as expected.”
And the trust was rated “Inadequate” on the Well Led domain partly because trust executives had not addressed staff concerns:
Francis et al did not put these salient facts in the glossy Freedom To Speak Up promotional material.
The truth, as ever, struggled to lace its boots whilst its counterpart had already been widely disseminated by government spin doctors.
Dr Minh Alexander NHS whistleblower and retired consultant psychiatrist 2 July 2023
Summary: This is a brief post to share documentation which shows that the private company WhistleblowersUK’s business model continues to be based partly on charging whistleblowers for help, and that it has linked with another company which sells services to barristers.
WhistleblowersUK also asks people for money if they wish to become “associate members”.
A statement of interests to Somerset Council by WhistleblowersUK’s Chair wrongly indicates that WhistleblowersUK is a public authority, and does not disclose that Whistleblowers seeks to influence public opinion and policy.
Background
WhistleblowersUK acts as the external secretariat of the Whistleblowing APPG. Leading members of the APPG and WhistleblowersUK seek to introduce a US model of bounty hunting.
WhistleblowersUK recently co-produced a lengthy document singing the praises of whistleblower rewards, with two major US bounty hunting law firms. However, the document omitted to mention serious drawbacks of the US bounty hunting model, such as its exploitative nature and the fact that the majority of whistleblowers are left with nothing, even if they suffer reprisal and loss. The model also siphons money into lawyers’ coffers. Bounty hunting is a billion dollar US industry led by lawyers. Lucrative cases from the financial sector generate huge bounties.
WhistleblowersUK’s document on rewards for informers also claimed that historically, the model worked well in England. Historical studies reveal that the model generated scams and corrupt practices, as has been the case with its modern successor.
I have since been contacted by someone who approached WhistleblowersUK for help and who obtained the following documents, which they have shared with me:
A revised, updated version of WhistleblowersUK’s “Statement of cooperation”
I have previously published an earlier version of this document.
Changes include the fact that this appears to be a joint document produced with another private company, the “Barrister Consultancy Services”.
The Barrister Consultancy Services’ logo also appears on this document, and the document reads:
“If appropriate we will introduce you to our trusted partner Barrister Consultancy Services (BCS), who will provide you with legal project management services enabling us to work together on your case from start to finish.” [my emphasis]
The document also indicates that WhistleblowersUK may arrange initial pro bono assistance by barristers that is not legal advice. It appears to imply that BCS may be involved in arranging access to barristers:
“We help you retain full control at all times because you know your case best.
Our specialist panel of barristers usually provide initial pro bono assistance (not legal advice) based on the chronology and supporting information that you supply. All barristers on our panel are regulated by the Bar Standards Board in England & Wales and/or Faculty of Advocates in Scotland, be assured that separate letters of agreement will be sent to you before any official legal advice is provided. You will not incur any legal costs without your agreement. WBUK & BCS does not accept responsibility or liability for any independent legal advice provided.”
The statement of cooperation links to the website of the BCS to a page about the BCS’ privacy policy.
The BCS website suggests that this company primarily provides specialist administrative support to barristers:
“Barristers in the UK often work independently in Chambers and are mostly self-employed. Therefore, they are responsible for managing their own practices and developing their business. However, managing a legal practice can be complex and time-consuming, which is why many barristers and their clerks turn to Barrister Consultancy Services for assistance.”
The “About” page of the BCS states:
“As former Barrister Clerks and Practice Managers, our primary objective is to enhance and refine internal practice management processes and procedures within barrister’s chambers.”
At the bottom of the pages of the BCS website, it is stated:
“Barrister Consultancy Services is the trading name of David Wright a self-employed consultant at DW Business Consultancy, a Company Registered at 23 Franmil Road, Hornchurch, Essex, RM12 4TR No: 10431011”
The Companies House entry for DW Business Consultancy lists Linda Wright as company secretary and David Wright as director. The nature of the business is stated to be: “70229 – Management consultancy activities other than financial management”.
According to Companies House, BCS was incorporated on 17 October 2016, and it last filed accounts last year, with “Accounts for a dormant company made up to 31 December 2021”.
These accounts state that the company was dormant in the reporting period, received no income and incurred no expenditure.
BCS also has a post on Facebook as follows:
An examination of the metadata of the revised Statement of Cooperation by WhistleblowersUK reveals that it was last edited by David Wright:
In comparing the new “statement of cooperation” with the previous version that I published, the section “What we will do for you” has been expanded, with insertion of an additional service:
“We will help you identify and instruct specialist legal advisors.”
The latest statement of cooperation indicates that WhistleblowersUK still charges whistleblowers £100 per hour for its services, albeit it now states that it will provide initial assistance without charge for up to two hours.
The latest statement of cooperation indicates that WhistleblowersUK also asks for a “percentage” of any financial award that a whistleblower may receive. It differs from the previous version of the document in that where five percent was previously specified, there is now no numerical value given, and no clear limit on what share of financial awards WhistleblowersUK propose to take.
WhistleblowersUK’s application form for associate membership
WhistleblowersUK states in the application form that it does not charge fees for membership.
However, it asks any individuals wishing to join as an associate member for a minimum donation of £120 per annum.
There is a section at the end of the document which states:
“Financial hardship is not a barrier to becoming an Associate Member. The Directors will consider applications to waive the requirement for a regular donation. Please advise WBUK in Section 2, Question 3 if you wish to apply for a waiver.”
This is the clause in the application form which asks applicants to commit to the payment of £120 and to abide by the company’s by-laws:
I could find no company by-laws on the WhistleblowerUK’s website or recorded in documents filed at Companies House.
But the application form indicates in bold text that WhistleblowersUK’s directors can terminate membership at any time:
“Associate Memberships are approved by the directors and can be terminated without notice at any time.”
WhistleblowersUK states that its objectives include expanding its associate membership:
“We Grow our community through our associate membership promoting engagement, collaboration, and sharing of ideas and perspectives among our members.”
The company publicises dates for meetings of associate members, the most recent being 26 June 2023:
However, I could find no record of the current or past number of associate members, or of the level of income generated by associate members’ required donations of a minimum £120 per annum.
I asked WhistleblowersUK through its Chair Tessa Munt former Liberal Democrat MP, now local councillor, if the organisation wished to comment on matters arising from the above two WhistleblowersUK documents, but I have not yet received a reply.
“Tessa Munt
Chair of WhistleblowersUK
29 June 2023
Dear Ms Munt,
I write to ask if WhistleblowersUK would like to comment on and/or elaborate on reports that:
i) WhistleblowersUK asks whistleblowers for £120 minimum donation per annum to be associate members
ii) WhistleblowersUK offers pro bono assistance from lawyers which is not legal advice, from a panel of specialist barristers
iii) WhistleblowersUK now works in partnership with Barrister Consultancy Services
I note in Munt’s declaration of interests to Somerset Council that she is described as “interim” chair of WhistleblowersUK, and has declared that WhistleblowersUK is a public authority when it is a private company.
I have written today to the CEO of Somerset Council and the Leader of the Council about this factual inaccuracy, and also raised an issue of whether Munt should have declared the fact that Whistleblowers is an organisation which seeks to influence public opinion and policy.
BY EMAIL
Duncan Sharkey
CEO Somerset Council
2 July 2023
Dear Mr Sharkey,
Declaration of Interests by Councillor Tessa Munt: error and omission
I am sure it is a mistake but the council currently publishes inaccurate information about Councillor Munt’s interests.
Ms Munt’s declaration of interests states under Question 9 “Do you hold membership of other Public Authorities?” that she is “director and interim chair” of WhistleblowersUK.
WhistleblowersUK is not a public authority but a private company (09347927) which had £3,905 assets by end 2022, according to documents filed at Companies House. By the end of the previous year, WhistleblowersUK only reportedly had £736 assets.
WhistleblowersUK is seeking to introduce a controversial and exploitative US model of bounty hunting, which if ever adopted as the UK national model would disadvantage the majority of UK whistleblowers and lead to only a tiny handful receiving vast rewards. The model primarily benefits bounty hunting law firms and is a billion dollar US industry, which has been trying to the break into the UK market for some years now. This model primarily targets the financial sector, where bounties from recovered monies can be huge.
Under question 11 of Ms Munt’s declaration of interests, “11. Do you hold membership of bodies influencing Public Opinion or Policy (including any political party)?”, Miss Munt has only declared membership of the Liberal Democrats.
The company states on its website that it explicitly seeks to influence public opinion and policy. It seeks to introduce an Office Of The Whistleblower, which mirrors the US Securities and Exchange Commission’s Office of the Whistleblower which handles a high profile whistleblower reward programme.
For example, WhistleblowersUK state on their website:
“We Transform the way everyone thinks about whistleblowing, educate the public, and demonstrate the importance of whistleblowers in a fair and transparent society.
We Campaign for the Office of the Whistleblower now a Bill going through Parliament that will revolutionise the treatment of concerns and the people who raise them.”
Of note, WhistleblowersUK has since 2018 acted as the external secretariat to a Whistleblowing All Party Parliamentary Group, which explicitly campaigns for the law change which would open the door to the US style whistleblowing rewards. When the Whistleblowing APPG was first established in 2018, its declarations showed that it accepted money from Constantine Cannon, a major US bounty hunting law firm. This funding was badged as payment for WhistleblowersUK’s services as external secretariat.
Sir Norman Lamb former Liberal Democrat MP was a member of the Whistleblowing APPG but resigned after the CEO of WhistleblowersUK refused to answer questions about conflicts of interest and finances which I put to the APPG:
I copy below correspondence to Councillor Munt in her capacity as WhistleblowersUK Chair, seeking greater transparency about WhistleblowersUK’s financial arrangements and the handling of whistleblowers’ highly sensitive personal data. I have received no reply to my letter of 4 May 2023, and I await a reply to my letter of 29 June 2023.
Please confirm receipt of this letter and advise what action Somerset Council will take to ensure that Councillor Munt’s declaration of interests is accurate.
Many thanks.
Yours sincerely,
Dr Minh Alexander
NHS whistleblower and retired consultant psychiatrist
Cc Bill Revans Liberal Democrat councillor North Petherton, Leader of Somerset Council and Lead Member for Governance & Communications
A Tory MP who is a pro bounty, former member of the Whistleblowing APPG secured a junior ministerial post this year and launched a review of UK whistleblowing law:
Dr Minh Alexander retired consultant psychiatrist 29 June 2023
Summary: The Department of Health and Social Care has confirmed that its plans to set up a Special Health Authority to investigate maternity failures in the NHS are dead and buried, with no plans to resurrect. This is despite an abortive attempt to recruit a Chair for the Special Health Authority which concluded with fourteen applicants being turned away. It refuses to disclose its justification for transferring the maternity investigation programme to the Care Quality Commission or the legislation drafted for the now binned Maternity and Newborn Safety Investigation Authority.
Background
Jeremy Hunt former Health Secretary’s unwieldy vanity project the national maternity investigation programme was foisted on the Healthcare Safety Investigation Branch against advice.
It unravelled in secrecy as whistleblowers spoke out against poor management and inherent systemic problems, such as designed-in conflicts of interest from seconded staff feeling pressured to keep on good terms with the regional teams they investigated, for the sake of their long term career prospects.
Keith Conradi the head of HSIB’s retirement was announced after the King’s Fund’s conclusions were shared with HSIB staff.
On 21 January 2022 the Health Service Journal reported the findings of the leaked King’s Fund report, which was the first time the report’s existence was revealed:
On 26 January 2022 Sajid Javid made a statement in parliament announcing that the government would create a short life Special Health Authority to take over the maternity investigation function from HSIB. The idea was to eventually hand maternity investigations back to NHS trusts once an example of good practice had been purportedly modelled:
“Special Health Authority will be established for up to five years from 2022-23 to enable maximum learning to be achieved and to equip NHS Trusts with the expertise, resources, and capacity to take on maternity safety incident investigations in the future.”
The post of Chair for the special health authority was advertised in autumn 2022:
“On 26 January 2022, Official Report, 25WS, by way of a written ministerial statement, the Department of Health and Social Care announced that a separate Special Health Authority would be established to continue the independent maternity investigation programme, which is currently overseen by the Healthcare Safety Investigation Branch.
The Department is committed to ensuring the continuation of independent, standardised maternity investigations that provide learning to the system and contribute to the Government’s ambition to halve the 2010 rates of stillbirths, neonatal and maternal deaths and brain injuries in babies occurring during or soon after birth by 2025.
Following careful consideration, the Department has determined that the most appropriate and streamlined mechanism for delivering the valued and independent maternity investigations is for the function to be hosted within the Care Quality Commission. The purposes of the maternity investigation programme remain as set out last January: to provide independent, standardised and family-focusedinvestigations of maternity cases for families: to provide learning to the health system via reports at local, regional and national level; analyse data to identify key trends and provide system wide learning; be a system expert in standards formaternity investigations; and collaborate with system partners to escalate safety concerns.
We will now work with the CQC and the HSIB to complete the transition of the maternity investigation programme to the CQC by October 2023.
As announced in the written ministerial statement of 9 February 2023, Official Report, 40WS, the establishment of the new HSSIB will take place in October 2023, to enable all the necessary work to be completed to ensure a smooth transition of these investigation programmes.”
The Department of Health and Social Care’s termination of the Maternity and Newborn Safety Investigation Authority
To confirm whether this was a permanent arrangement and to find out more about the justification for locating maternity investigations within the notoriously politicised and none too competent CQC, I made an FOI request to the Department of Health and Social Care. This is the response:
The Department confirmed that it went ahead with its appointment process for a chair to the Special Health Authority, for which it received fourteen applicants:
“DHSC received 14 applications for the post of Chair/Chair designate to the Maternity and Newborn Safety Investigation Special Health Authority (MNSI).”
The government claims no appointment was made because:
“An appointment was not made, as a final decision on the appointment had not been reached before the announcementon the future of the MNSI [Maternity and Newborn Safety Investigation Authority] via a Written Ministerial Statement (WMS) on 30 March 2023.”
Well that’s a good way to do business. Advertise a job and then tell everyone “Hard cheese chaps, the job’s gone”.
The government also confirms that the Special Health Authority was never legally established.
It stands by its claims that the best option is hosting by CQC rather than a standalone Special Health Authority reporting directly to the Department of Health and Social Care:
“….following careful consideration, DHSC has determined that the most appropriate and streamlined mechanism for delivering the valued and independent maternity investigations is for the function to sit within and be hosted by the CQC.”
However, the government refuses to disclose its justification for this opinion on grounds that it might be embarrassed. Sorry, I mean on grounds of Section 35 FOIA formulation of government policy, because the transition period is not yet complete and policy is still being formulated.
The government has no plans to revisit the idea of a Special Health Authority.
This implies that the maternity investigation division will likely be allowed to wither on the vine for some as yet undetermined period until it all reverts to NHS trusts. This will do nothing for the independence of maternity investigations.
The government also refuses to disclose legislation drafted for the Special Health Authority on purported grounds that this is legally privileged.
One is left wondering what sort of governmental hissy fit led to such a major change of direction, and the bizarre Heath Robinson arrangement of the Care Quality but We Don’t Investigate Complaints Commission hosting a specialised incident investigation function.
It is left only to commiserate with the unfortunate maternity investigation staff who have been so badly managed and supported from the outset of a political misadventure.
RELATED ITEMS
Hunt’s chutzpah
Hunt skilfully dined politically off the Midstaffs and Morecambe Bay disasters whilst simultaneously wrecking the NHS, fashioning a narrative of hero crusader against the wicked NHS and recruiting a number of families to insulate himself.
He dined off Midstaffs whilst reneging on core recommendations from the public inquiry such as mandatory safe staffing and real whistleblower protection, which would have helped to prevent further maternity tragedies and any need for his disastrous national maternity investigation gimmick.
Even in 2020, Hunt was still trying to politically capitalise from maternity tragedies:
His handiwork on the NHS is now all around us as emergency care has collapsed, regularly causing deaths, cancer care is teetering and 7.4 million people await treatment.
And at the UK COVID public inquiry it has just been revealed that Hunt wanted to cut Public Health England’s funding by half:
Public health is one of the most crucial, effective and super-efficient medical specialties with profound effects on improving the health of the populace. Why would anyone except the utterly incompetent or those with malign intentions wish to cut it?
I leave readers who are less familiar with CQC’s ways with this FOI revelation about how CQC senior managers huddled and deliberated on the best way to manipulate public into thinking that they had written a “hard hitting” inspection report, but with as few facts as possible:
The whistleblowing APPG and its external secretariat WhistleblowersUK are becoming more and more explicit in their pursuit of a model of financial rewards (bounties) for whistleblowing in the UK.
For a while, they toned down references to rewards in most of their written material. For example, WhistleblowersUK referred to “compensation” in contexts which made it clear that they were talking about rewards. Equally, although leading members of the APPG called for rewards and financial incentives, documents by the APPG coyly suggested that it was a matter for the government to decide if rewards were appropriate.
But last month, WhistleblowersUK produced this document with two major US bounty hunting law firms, Constantine Cannon and Kohn, Kohn, and Colapinto LLP, singing the praises of financial rewards:
Any wisps of veil are gone.This long report claimed to set out the strengths and weaknesses of whistleblowing rewards, but in reality it only knocked down straw men and it ignored elephants.
The report also makes surprising claims, such as an assertion that “qui tam” prosecutions (legal claims in the name of the King, with a share of the proceeds going to the claimant as well as the crown) “worked well for many centuries” in England.
This claim by WhistleblowersUK et al appears to be unsupported. Qui tam suits were very rough justice introduced in the 13th century only because of a lack of governance infrastructure and law enforcement resources. Citizens were effectively deputised.
“Early in Henry VII’s reign, it had become apparent that qui tam enforcement of penal statutes had created serious problems….”
False, malicious suits were sometimes pursued for personal gain. Corrupt officials “extorted” fines by imprisoning people until they “confessed” to wrongdoing. Trials without jury were held. Informers sometimes perjured themselves. Suits might be tactically and abusively filed hundreds of miles away from the accused’s home, making it nigh impossible to defend a suit.
A class of “professional informers” called “promoters” arose who made a living out of qui tam suits, and who were despised and distrusted:
“Informers were widely perceived as self-interested at best and malevolent at worst. The charge of self-interest was a natural inference from the bounty provision of a qui tam statute.”
“They were described variously as “varlets, “lewde” and “evil”…”viperous vermin”
“Indeed, informers harassed and impoverished citizens, particularly those in the lower classes, “for malice or private ends, [but] never for love of Justice.”
Some informers settled quietly and unofficially with their marks, in order to pocket more money and deprive the crown of its share, without bringing matters to the court’s attention:
“This collection of payments in return for a promise not to prosecute was, in essence, a form of blackmail or extortion.”
Informers were sometimes jailed for such scams. The worst offenders were occasionally executed.
Where justice is monetised, it is hardly surprising if the perverse incentives lead to corrupt practices. In the same way that the SEC Office of the Whistleblower became corrupted, its ancient predecessors were also sometimes corrupt.
Such was the level of abuse sometimes endured by the populace under qui tam law, that assaults and riots against informers were occasionally recorded in ye in Olde England.
Additional laws were repeatedly passed in attempts to manage the misconduct of informers.
So, hardly a picture of success as claimed by WhistleblowersUK et al.
And it is not reassuring that a claim of success was made.
Nevertheless, WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP gamely argue in their report that publicity about large financial rewards increase public awareness of whistleblowers. They leap to a conclusion that this increased awareness must improve public opinion of whistleblowers, without providing the evidence to confirm this theory. (Page 20).
Notoriety for excessive whistleblower rewards, especially in scandals where victims are uncompensated, is of course an alternative explanation.
Yesterday, I observed most of a webinar by WhistleblowersUK and the Whistleblowing APPG yesterday, bar the first twenty minutes which I had to miss due to a clashing commitment. The speakers were Rory Field barrister with a specialism in organised crime and who has spoken on organised economic crime, standing in for Iain Mitchell barrister, Richard Pike of Constantine Cannon, Susan Kramer former Whistleblowing APPG Chair but still active pro-bounty politician, Folashade Adeyemo Lecturer in Banking and Company Law Reading University and a specialist in Nigerian banking regulations, a whistleblower whose full name I did not catch and Georgina Halford Hall CEO WhistleblowersUK.
The theme of the event was “restitution”.
In reality, this proved to be about financial incentivisation.
Richard Pike of US bounty hunting law firm Constantine Cannon explained the US model of bounty hunting to the audience.
He took a similar approach to that of his colleague Mary Inman in 2018 at the Bylines festival, explaining that the concept came from the “mother country”, England, when ancient custom was to take action in the name of the King, qui tam.
Pike argued that a prime benefit of bounties was to ensure legal representation for whistleblowers, because if lawyers knew that they could get a large pay out, they would be more willing to work contingently (or in plain English, on a no win, no fee basis).
Importantly, Pike did not explain to the audience the vagaries of the bounty system and the minimum financial recovery thresholds that whistleblowers have to fulfil to qualify for a reward, which in reality means that only a tiny minority are rewarded.
This leaves many genuine whistleblowers with no redress. It is possible under the US bounty system to be a bona fide whistleblower who suffers severe reprisal, who loses their livelihood and suffers longterm economic insecurity, but be left with zero redress.
Despite this reality, Pike described the model as “phenomenally successful”. This is possibly more of a comment from the point of view of the bounty hunting industry, and to an extent, the State.
Pike stated that the model is designed to recover money for the State, and indicated that it is therefore a problem when whistleblowers raise concerns about the State itself. His commented that federal whistleblowers might find themselves in prison.
He did not inform the audience of the existence of the the US Office of Special Counsel which looks after federal whistleblowers, who whistleblow about the State. This agency would be of less interest to bounty hunting law firms because it does not financially incentivise whistleblowing and operates a lean public sector model of restitution. It restores whistleblowers to the position that they would have occupied but for the whistleblowing, and no more, and it can ensure non-financial redress.
The whistleblower on the WhistleblowersUK panel suggested that bounties could perhaps be capped.
This reminded me of a past quote from Mary Inman who upon discovering Brits’ “visceral” dislike of the idea of paying whistleblowers, suggested that the bounty model could be made more culturally acceptable by capping rewards:
And will this proffer of capped rewards survive the implied intention to pursue large and eye-catching bounties, mentioned in the above joint document published only last month by WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP?
Alongside Pike, Folashade Adeyemo also spoke about restitution and by this she appeared to mean financial reward. She also used the words “recognition” and “acknowledgment”.
Mostly, Adeyemo’s contribution consisted of different ways of talking about financial transaction. For example:
“Compensation, not payment for informing, but recognising the value of that information”.
There was no clear discussion of non-financial redress.
Susan Kramer former APPG chair, who employs WhistleblowersUK’s CEO as a researcher at the House of Lords spoke on how the APPG and she have garnered interest from members of parliament. She anticipated that the Bill would fall again but made it clear that the campaign would continue.
Of note, Kramer appeared not to be familiar with the details of her own Bill and initially stated that people could have their claims dealt with by either the proposed Office of the Whistleblower, or by the Employment Tribunal if they preferred.
This would actually not be possible under Kramer’s private member’s Bill, which repeals PIDA and provides no alternative path to litigate whistleblowing cases in the Employment Tribunal.
Georgina Halford Hall WhistleblowersUK CEO stepped in to state that the whistleblowing element would be dealt with by the proposed Office of the Whistleblower but other heads of claim such as discrimination would need to be presented to the Employment Tribunal.
An important question from the audience about public sector employees did not receive a satisfactory answer. The panel was asked how their Bill would benefit public sector whistleblowers and if public servants would effectively be paid for information.
Either panel members did not appreciate that or did not wish to address it, because the response did not address this principle.
Folashade Adeyemo instead replied:
“Why do we need to incentivise? Valuable information that will save lives, by our very nature as humans, if there’s no incentive, people won’t come forward”
All the talk I heard was about recovering money from frauds and SEC’s 10 to 30% bounties from recovered money.
I heard almost nothing about protecting the public from harmful health and social care, excepting a very few broad comments about saving lives, with no particularisation.
My impression was that the APPG and WhistleblowersUK wish to throw as many nice words as they can at the concept of monetising information and bounty hunting.
As in the words of WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP :
“The real sticking point remains the idea of rewarding people for doing the right thing. The UK remains publicly queasy when it hears the word “reward” in the same sentence as “whistleblowing”. However, when we change “reward” to “compensate” or “restitution” attitudes change. No one can dispute the importance of fairness and that whistleblowers should not suffer for doing the right thing.”
So when you hear “restitution”, do not forget that the Whistleblowing APPG, WhistleblowersUK and the substantial corporate power behind them, are talking about financial rewards and the billion dollar bounty hunting industry led by lawyers.
Any financial reward that exceeds fair compensation for loss, and is calculated on a percentage is still bounty, capped or not.
Dr Minh Alexander retired consultant psychiatrist 22 June 2023
The letter below, sent today to the parliamentary Justice Committee, is hopefully self-explanatory.
BY EMAIL
Sir Robert Neill MP and colleagues
Justice Select Committee
22 June 2023
Dear Sir Robert and colleagues,
Processes for reviewing and assuring the fitness of senior officers of the Criminal Cases Review Commission
I write to raise a concern about procedures for reviewing the fitness of senior officers of the Criminal Cases Review Commission (CCRC).
I raised a concern with Helen Pitcher Chair of CCRC about the suitability of the CCRC CEO arising from actions and omissions in her ongoing capacity as a non executive board member of University Hospitals Birmingham NHS Foundation Trust (UHB).
The trust has been undergoing multiple investigations following concerns of poor governance, whistleblower victimisation, a “toxic” culture with reported “cronyism” and patient safety failings.
In particular, I was concerned about the UHB trust board’s actions in ratifying an internal Fit and Proper Person investigation of the former UHB trust Chief Executive. The investigation was launched after he was criticised by the Employment Tribunal for conduct towards a senior medical whistleblower, and related referrals were made to the Care Quality Commission by several external parties, myself included, under CQC Regulation 5 Fit and Proper Persons.
The Employment Tribunal’s criticism included the fact that the former UHB CEO made a misleading referral to the General Medical Council in which he omitted to declare as required, that the whistleblower was a whistleblower. For this he later received a formal warning from the General Medical Council, as a registered medical practitioner himself.
The subsequent UHB trust internal Fit and Proper Person investigation which reportedly exonerated the trust CEO (it has never been published or even shared with the whistleblower) was undertaken by a subordinate trust manager who was not a board member, assisted by a lawyer from a firm retained by the trust, which had been paid £497K for other services in the three previous years. It could not be described as an independent investigation and a probity issue arises from the fact that a subordinate employee was put in this position.
This was compounded by the fact that UHB misled the whistleblower and informed him wrongly in correspondence that the assisting law firm was independent and without current or previous links to the trust.
There were a number of procedural irregularities in the manner in which the whistleblower had been disciplined, suspended and dismissed by the trust, which were criticised by the Employment Tribunal. These breached a principle that NHS doctors should be disciplined with regards to Article 6 rights.
Documents were repeatedly withheld from the whistleblower and from the Employment Tribunal, which had the effect of concealing the fact that he was suspended on a false premise, which the Employment Tribunal determined the former UHB CEO should have known was false. The Employment Tribunal judge indicated in a costs judgment against the trust that he could not rule out “deliberate dishonesty” by the trust and key players, or that there would not be future serious governance failures of this sort.
The CRCC CEO had sight of the trust’s internal Fit and Proper Person Investigation report exonerating the former UHB CEO. She is on record as having reassured the trust governors that the investigation was sound. The minutes state at a UHB Council of Governors’ meeting on 29 July 2021:
“Karen Kneller also wished to provide reassurance to the Governors that the NEDs are particularly enquiring and have examined the situation thoroughly to their satisfaction and all are happy with the review.”
Although I am informed by an individual who actually witnessed the meeting that their recollection is that she stated there was “no smoking gun”.
The former CEO of UHB announced his retirement on the day that the first investigation report on the trust was published, on 28 March 2023.
Helen Pitcher also received information about the understandably serious impact of events on the whistleblower.
The issue I wish to raise with Justice Select Committee is this:
Helen Pitcher initially informed me via her Office on 14 April 2023 that she would consider my concerns and respond within twenty eight days.
On 18 May 2023 Ms Pitcher’s Office informed me that enquiries continued and that there was no date for completion.
On 2 June 2023, after an enquiry, the same message was given again.
There was no date set for review/ update.
I understand that serious matters take time to consider, but I am concerned by this open-ended approach to a serious matter, by an agency that is supposed to be all about fairness and accountability and should be above reproach.
It does not seem to me to be a sufficiently accountable approach.
I ask Justice Committee to note it for any future consideration of the effectiveness of the CCRC and CCRC’s governance.
I should note that parallel to this matter, NHS England’s “Well Led” investigation of UHB is expected to conclude early next month. There is reason to have modest expectations of this given that NHS regulators have repeatedly protected and helped to recycle erring NHS senior managers, which was a trigger for the NHS Kark review on the Fit and Proper Test in the NHS. The report of this review by Tom Kark KC was published over four years ago, but reflecting the recalcitrant nature of NHS senior management culture, its implementation was entrusted to NHS England and it has not yet been implemented.
I copy below the relevant correspondence from the CCRC showing its initial response and later responses with no identified timescale for completion or even review and update.
Yours sincerely,
Dr Minh Alexander
NHS whistleblower and retired consultant psychiatrist
Cc Health and Social Care Committee
From: REDACTED
Subject: FW: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO
Date: 14 April 2023 at 14:50:04 BST
To: REDACTED
Dear Dr Alexander
I confirm that your correspondence of 13 April 2023 has been passed to Helen Pitcher.
Ms Pitcher will consider the contents and respond to you within 28 days.
Please could I also ask that you direct any further correspondence on this matter to this address rather than the Commission’s general mailbox.
Yours sincerely
Kind regards,
REDACTED
Executive Assistant to the Chairman | CCRC
From: REDACTED
Subject: FW: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO
Date: 18 May 2023 at 15:51:04 BST
To: REDACTED
Dear Dr Alexander
Further to recent correspondence, Ms Pitcher has asked me to confirm that matters remain under consideration and inquiries are underway.
At this stage, we do not have a date for completion, but we will inform you of the outcome in due course.
Yours sincerely,
REDACTED
From: REDACTED
Subject: RE: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO
Date: 9 June 2023 at 10:49:39 BST
To: REDACTED
Dear Dr Alexander,
Thank you for your recent email.
Our inquiries remain underway. We do not have a specific completion date but will inform you of the outcome as soon as we can.
Yours sincerely,
REDACTED
Executive Assistant to the Chairman | CCRC
RELATED ITEMS
There is a difference in Karen Kneller’s declaration of interests at UHB and her declaration of interests at CCRC, which are more extensive.
This is her declaration of interests at UHB taken from a published trust document of 2020 (the most recent I could find):
By Dr Minh Alexander retired consultant psychiatrist 21 June 2023
The parliamentary Health and Social Care Committee sat on 20 June 2023 and took evidence from Steve Barclay Secretary of State.
Mr Barclay appeared to start waffling when asked about failure of the Freedom To Speak Up project.
In his verbal perambulations he wondered out loud if bad NHS managers are recycled.
He knows the answer to this, of course, having commissioned the Kark review on this topic in 2018.
But to provide cognitive support, I have reminded him of his previous commission, of two recent unanswered letters on the topic and of a topical example of an NHS exec who resigned after being criticised for poor governance, who then sold governance services to the NHS and is now back in the NHS as a Director of – you guessed it – Governance.
But it is positive that MPs are now starting to speak openly about the failure of the Freedom To Speak Up project.
The danger is that it will be replaced with something equally ineffective that will be again be used for another eight to ten years for PR and to block real change.
Actors new to the whistleblowing landscape, who are not whistleblowers, have recently been clamouring for a central route of NHS disclosure, such as at DHSC or NHS England. I have advised against that notion but it has popped up again through a Committee member. I have warned the Committee against it.
These are the relevant exchanges at Committee on 20 June 2023:
Rachael Maskell MP: If I may Chair. I’d just like to turn to the complaints system. I’m really concerned about the reports coming out of University Hospitals Birmingham. We’ve seen the reports that have come out of a number of mental health trusts. These trusts are clearly not safe for patients as the data is showing, but also not safe for many of the staff who are raising concerns.
After the Robert Francis report we thought that this would come to an end. Duty of Candour very much [inaudible] the front, whistleblowing being accepted as part of the NHS culture, however we haven’t seen the culture move on, and risk still prevails. Even looking at the PHSO insufficiency in being able to have leverage over what’s happening and in their reporting, back of what’s happening at many of these trusts, I’m really concerned that we do not have a robust complaint system.
What steps are you taking to look into that and what measures have you taken to date to move that forward?
Steve Barclay MP and Secretary of State for Health and Social Care: I think it’s a hugely important issue and I think colleagues across the house when I was on the Public Accounts Committee as a member for four years, one of the things I particularly focussed on, which is on record, was gagging of whistleblowers, particularly in the NHS. And how we have more transparency and a culture of learning where things go wrong, you know. In a Department which is allocating over £180 billion and employing as many people as the NHS does, there will be issues that go wrong. The key is how we identify them quickly and how we learn from that.
And so I know the Committee will share my concern when we heard the reports of some of the sexual abuse data that was coming out. And that was something I very urgently met with NHS leaders to discuss to ensure that was being gripped. You allude to the issues of mental health and I hope to have more to say very shortly on that specifically, particularly in the context of the Essex issues. And I know that a number of members of parliament [inaudible] have discussions with them on that, not just in Essex, but there’s been concerns more widely so I think the point you raise is a very valid one. It’s one I take extremely seriously. It’s one that colleagues can see throughout my time as an elected representative I’ve taken very seriously and it is something that I have discussed with Amanda Pritchard the chief executive of the NHS and with senior leaders such as Ruth May the lead nurse, and others, to ensure that we are learning the lessons from these issues and ensuring that where an issue is raised whether that’s by patients, whether it’s by members of staff, whether it’s by others in the community, that we’re addressing it.
Rachael Maskell MP: Just my final question. Because of what has been described as quite a bullying culture in many of these organisations and bullying being very prevalent across the whole economy (27% of workers experience bullying) but when it comes into the Health context it clearly puts the system at risk and patients at risk as well. Not to mention the impact on staff and staff retention.
Will you look at a central place where people can raise concern independently, in order to be able to whistleblow safely and to be able to raise those those concerns so that they are properly investigated? And a top down approach can be put on trusts to deal with these issues, because without it, as hard as the Robert Francis report tried to address these issues, it hasn’t delivered.
Steve Barclay MP andSteve Barclay Secretary of State for Health and Social Care: I’m keen to understand where, if there are areas where the complaints system are not working, why that is and how we learn from it. I think it is an area that has already had lots of focus so one of the issues we’ve got to understand, we have a Patient Safety Commissioner, we have er Guardians, we’ve had a number of other initiatives over many years, in this space. You touched on cases such as Birmingham which still generates significant concern. So for me it’s about understanding why when issues are known about locally, too often they’re not addressed. And how where, we’re learning from that. So that includes things like the trust Board and what visibility, what line of sight does the Board have? What accountability is there for senior managers when wrong doing is established? Are they just rotated through the system? Or are people held to account? So I think there are a number of issues. It’s an issue sadly that’s been with us for quite a while, because I’ve spent a fair bit of time on it in a previous role. But I share your absolute desire to tackle it. I think you touched on it in the context of the wider duty we have to NHS staff and things like staff absence which is why these things then often manifest themselves in falling retention, because people vote with their feet and leave. It’s a hugely important issue. It’s one that we have a number of people involved in the NHS to tackle. It is also a role for the Royal Colleges and others in the wider NHS family and I’m extremely keen to work with them on it.
This is my letter to Steve Barclay which includes a formal request for information about the DHSC’s approach to the Kark review on Fit and Proper Persons in the NHS:
“BY EMAIL
Steve Barclay
Secretary of State for Health and Social Care
21 June 2023
Dear Mr Barclay,
Kark review implementation and disbarring unfit NHS senior managers
I watched your oral evidence to Health and Social Care Committee yesterday, and in particular your answers to concerns that the government’s Freedom To Speak Up model has failed to deliver.
Your response on being asked about the failure of the DHSC’s and Robert Francis’ 2015 Freedom To Speak Up project was thus:
“Steve Barclay MP and Steve Barclay Secretary of State for Health and Social Care: I’m keen to understand where, if there are areas where the complaints system are not working, why that is and how we learn from it. I think it is an area that has already had lots of focus so one of the issues we’ve got to understand. We have a Patient Safety Commissioner, we have er Guardians, we’ve had a number of other initiatives over many years, in this space. You touched on cases such as Birmingham which still generates significant concern. So for me it’s about understanding why when issues are known about locally, too often they’re not addressed. And how where, we’re learning from that. So that includes things like the trust Board and what visibility, what line of sight does the Board have? What accountability is there for senior managers when wrong doing is established? Are they just rotated through the system? Or are people held to account? So I think there are a number of issues. It’s an issue sadly that’s been with us for quite a while, because I’ve spent a fair bit of time on it in a previous role. But I share your absolute desire to tackle it. I think you touched on it in the context of the wider duty we have to NHS staff and things like staff absence which is why these things then often manifest themselves in falling retention, because people vote with their feet and leave. It’s a hugely important issue. It’s one that we have a number of people involved in the NHS to tackle. It is also a role for the Royal Colleges and others in the wider NHS family and I’m extremely keen to work with them on it.”
A number of points arise from your comments to Committee:
1. The Patient Safety Commissioner’s role
The Patient Safety Commissioner’s remit is restricted to medicines and medical devices.
She is not currently listed as a Prescribed Person to whom whistleblowers can make protected disclosures.
But if she is to be a Prescribed Person under UK whistleblowing law, within these narrow confines, I would be grateful if you could confirm that this is so.
2. Local NHS Freedom To Speak Up Guardians
Local FTSU guardians are toothless and importantly, defenceless. They themselves may become victims of abusive NHS organisations which employ them, and that has happened in some cases. Alternatively, some Guardians are appointed because they are willing to abuse whistleblowers. The model is a logically flawed and wasteful. It contributes very little. Testimony from two whistleblowers who have been failed by NHS trust Guardians can be found here:
Oversight by NHS Boards is not the issue. It is abusive NHS Boards that are the issue, whether by actively and directly abusing whistleblowers or knowingly soliciting and/or permitting abuse.
4. Accountability for senior management wrongdoing
In your evidence to Committee you wondered out loud about whether there is accountability for erring senior NHS managers, or whether such individuals are recycled.
You personally commissioned the Kark review in 2018 on identifying unfit NHS managers and preventing their recirculation.
You will recall the immediate catalyst was the debacle in which failed trust managers were protected by NHS regulators after Mid Staffs style failures at Liverpool Community Health NHS Trust.
However, the implementation of the Kark review recommendations was entrusted to NHS England, an NHS regulator which has been responsible for much of the executive recycling and setting a culture of impunity.
There has been no sign yet of implementation of the Kark review.
Indeed, NHS England has claimed to me that there is no ministerial support for Tom Kark’s crucial recommendation of a disbarring mechanism for the worst and most unfit NHS managers.
I have written to you twice about this (7 February and 29 May 2023, forwarded below), asking you to reconsider this reported decision, but I received no reply.
A current example of NHS executive recycling
But to answer your question on whether erring senior managers are rotated through the system, the answer is ‘yes’. This is a current and topical example:
Darren Grayson resigned from a post as NHS trust CEO in 2015 after an extremely critical CQC report and allegations of management bullying and other governance failures. Mr Grayson went on to sell consultancy services to the NHS through a private company, the Good Governance Institute. This included work for a predecessor body of University Hospitals Sussex NHS Foundation trust, during Marianne Griffiths’ tenure as CEO. Partly on the basis of material produced by the Good Governance Institute, the CQC took the trust out of special measures and rated it “Good” in 2019. Last year Mr Grayson took up a substantive post at this same trust as Director of Governance. Staff whistleblowing to the CQC continued and the police are now making enquiries into concerns about patient deaths 2015-2020 that may amount to gross negligence manslaughter.
The longer the implementation of the Kark review is delayed, the more examples of such recycling will accumulate.
The Kark review stopped short of recommending managerial regulation, but reserved it as an option for the future. Please note that the delay in regulating NHS managers now spans decades.
The 2002 Bristol Heart inquiry recommended regulation for NHS managers:
I would be very grateful if under FOIA the DHSC could advise me of the following:
1. As of now, which of the Kark review recommendations does the DHSC accept and which does the DHSC reject?
2. Is it correct that there is no ministerial support for Tom Kark’s recommendation of a disbarring mechanism for unfit NHS managers?
3. Why did the DHSC decide not to pursue a disbarring mechanism? What directions/ instructions has the DHSC given to NHS England on this matter?
4. What is the DHSC’s timetable, if any, for implementating any of the Kark review recommendations that it has accepted?
Many thanks and best wishes,
Minh
Dr Minh Alexander”
This is my letter to the Health and Social Care Committee to register concern about the proposal for another NHS and government controlled whistleblowing body, and to ask that the Committee instead focuses on implementation of the Kark review.
By Dr Minh Alexander retired consultant psychiatrist 13 June 2023
Background
The private company the Good Governance Institute (GGI) sells consultancy services and has many links with the NHS. It lists a large group of current and former NHS managers and NHS regulatory staff amongst what it calls its “people”.
What this designation signifies seems vague.
Jacqui Smith the controversial former Home Secretary, former Chair of University Hospitals Birmingham NHS Foundation Trust (UHB) and current chair of Barts Healthcare NHS Trust and Barking Havering and Redbridge University Hospitals NHS Trust is listed amongst the Institute’s “people”.
Upon a FOI request to Barts, Smith denied that this amounted to any specific role: “Rt Hon Jacqui Smith has no formal board or management title or any ongoing role with GGI” but nonetheless Smith is listed as one of the GGI’s “people”.
Several other UHB managers are listed as GGI “people”.
The GGI carried out a “Well Led” review on UHB in 2019, but more on that another time.
What I cover here is a link between the GGI and University Hospitals Sussex NHS Foundation Trust, where it was revealed at the Employment Tribunal on 5 June 2023 that the police are investigating allegations that may amount to gross negligence manslaughter.
The Guardian reported that Mr Krish Singh, surgeon, one of the Sussex whistleblowers had raised concerns about corporate actions which resulted in deaths:
“Singh claimed the trust had promoted insufficiently competent surgeons and overused insufficiently skilled locums.”
“…he claimed that cost-saving changes at the hospital “were driven through that were grossly unsafe and ultimately drove up complication rates and patient mortality”.
Another senior trust whistleblower Mr Mansoor Foroughi, surgeon, raised similar concerns.
University Hospitals Sussex NHS Foundation Trust was formed by the 2021 merger of Western Sussex Hospitals NHS Foundation Trust, a regulatory and political favourite run by Marianne Griffiths CEO and George Findlay Medical Director, with the struggling trust Brighton and Sussex University Hospitals NHS Trust.
In the CQC’s evidence appendix for the related inspection report, CQC stated that the trust had hired the Good Governance Institute and ensured a “golden thread” of quality throughout its improvement strategy:
“Governance
The chief medical officer explained that when the current executive management team had taken over the management contract for the trust, they felt concerned about the governance and assurance arrangements in place and felt they did not have assurance about the quality of treatment and care being provided for patients. They found examples of good clinical governance and reporting in place at a service level, but this information was not being reported up to the board. The trust had therefore commissioned an external review of the governance arrangements from the Good Governance Institute.
Because of this review, a structure of five divisions was put in place where previously there had been 13 directorates. The divisional structure led by a triumvirate of a clinical director, general manager and head of nursing had provided the building blocks for the revised governance arrangements. The Good Governance Institute provided training in governance for these leaders. the non-executive directors and executive directors described the journey for the triumvirate leaders moving from a concern that more reporting was going to be required of them, to understanding governance and how the data and reporting would enable them to drive quality improvement.
The board invited the Good Governance Institute to carry out a review of the trust’s quality governance structures, which resulted in 31 separate recommendations being made. The trust acted to address these issues and the Good Governance institute carried out a further review reporting on progress against these actions. A focus of this work has been to strengthen quality governance arrangements at divisional level.
The trust had effective structures, systems and processes in place to support the delivery of its strategy including sub-board committees, divisional committees, team meetings and senior managers. Leaders regularly reviewed these structures. The trust reported regularly through its governance arrangements on progress against delivery of its strategy to the board, trust executive committee and to other relevant committees. However, the structure needed more time to become fully embedded.
In interviews with the chair of the Quality Assurance Committee, the chair of audit and the chief medical officer (the executive officer responsible for governance), all non-executive and executive directors were able to describe the governance structure and how it functioned.
The effectiveness of the governance arrangements was observed on inspection at Strategy Deployment Review meetings. Each of the three leaders of each division owned and presented the data for their breakthrough objectives. They had interrogated the data to find root causes where the objectives were behind plan and had devised action plans based on this knowledge to bring the objective back on track.
The Chair of the Audit Committee explained that under the previous administration, assurance was not provided through reporting and they were not getting the information they needed. The new structures provided a joined-up approach that provided assurance on quality and delivery against the Patient First Strategy and breakthrough objectives and delivered quality improvement.
Quality was a ‘golden thread’ running through the trust Patient First Strategy. In all the interviews undertaken on inspection the golden thread of quality was evident in the use of data both quantitative and qualitative and how this was triangulated and reported through the Quality Steering Group to the Quality Assurance Committee and the trust board.
Non-executive and executive directors were clear about their areas of responsibility. Performance against the trust’s patient first strategy, true north and breakthrough objectives was focused and reinforced through the trust’s strategic deployment review approach. There was clear ward to board line of sight through daily performance huddles, weekly driver meetings, Divisional Strategy Deployment Review, executive level Strategy Deployment Review and the board.
The Chair of the Quality Assurance Committee gave an example of challenge and holding the executive directors to account when an action plan did not evidence sufficient learning to drive improvement and required further work to be undertaken.
The quality dashboard was aligned to the quality priorities along with the quality improvement plan with actions being taken and monitored at divisional, corporate and board level through the quality governance system, Quality Assurance Committee and board. The Audit Committee evaluated the effectiveness of the trust’s structures and processes in relation to the management of risk, the management of performance and financial management and the management of quality and quality improvement.”
Well, if your quality dashboard looks good, what could possibly go wrong?
And who led the CQC inspection team that concluded BSUH should be taken out of special measures? The inspection team was led by Cath Campbell now CQC Deputy Director of Operations and a David Melbourne.
Would that be the David Melbourne who was then deputy chief executive of Deputy Chief Executive of Birmingham Women’s and Children’s NHS Foundation Trust and is now the much-criticised CEO of Birmingham and Solihull ICB, a body that has helped to protect failing UHB executives and to obfuscate the reality at UHB?
Darren Grayson formerly of the Good Governance Institute, now a University Hospitals Sussex NHS Foundation Trust director
I am informed that the Good Governance Institute’s review of BSUH in 2018 was led by Darren Grayson, executive director and partner at the Good Governance Institute 2016-2022.
The Good Governance Institute later celebrated its work at Sussex with a little blog:
In March 2022 Griffiths appointed Darren Grayson, executive director and partner of the Good Governance Institute, on to the board of the newly formed University Hospitals Sussex NHS Foundation Trust as Chief Governance Officer.
This is Grayson’s LinkedIn entry, which gives some of his CV in terms of past NHS posts prior to becoming an executive partner at the GGI. He was a local NHS executive, previously working as CEO of NHS Brighton and Hove, and then CEO of East Sussex Healthcare NHS Trust.
The CQC found evidence of managerial bullying and other signs of poor culture. For example:
“The themes identified related to the quality of staff engagement, low morale, and a bullying and harassment culture from senior management.”
“The trust board continues to state they recognise that staff engagement is an area of concern but the evidence we found suggests there is a void between the Board perception and the reality of working at the trust. At senior management and executive level the trust managers spoke entirely positively and said the majority of staff were ‘on board’, blaming just a few dissenters for the negative comments that we received.
We found the widespread disconnect between the trust board and its staff persisted. This is reflected in the national NHS Staff survey.
….The trust told us they were disappointed by the results; but we saw no direct programme to address this or to change the position. There remained a poor relationship between the board and some key community stakeholders. We found the board lacked a credible strategy for effective engagement to improve relationships.
….Within the trust, we did not see a cycle of improvement and learning based on the outcome of either risk or incidents.
• Staff remained unconvinced of the benefit of incident reporting, and were therefore not reporting incidents or near misses to the trust. the trust was not able to benefit from any learning from these. this position had not improved.
• The risk register was not capturing risks in a robust way.
• We saw a redesign of the governance structure, but were unable to yet see any significant benefits or improvements from this.”
A special meeting of the local Joint Health Scrutiny and Overview committee reached a unanimous vote of no confidence in him:
The Chair of the Committee commented: “You are the captain of the ship which has hit rocks, and it is starting to sink and I think the biggest morale boost you can give to staff is to say sorry and then offer your resignation.”
Grayson reportedly refused to resign initially but later stepped down:
“The CEO did not listen to his own staff, public opinion or GMB. Instead he openly criticised and blamed those, including GMB, for challenging him and his management style.”
This is Grayson’s biography from the University Hospitals Sussex NHS Foundation Trust’s website, which adds political detail in terms of his work at the New Labour hub, the No 10 delivery unit which ran 2001-2005.
Importantly, Darren Grayson’s partner is Jenny Procter, another director at University Hospitals Sussex NHS Foundation Trust, as revealed by trust declarations of interest:
According to her LinkedIn entry, Procter has been the trust’s Director of Improvement & Delivery since April 2021, and before that she was Director of Efficiency & Delivery from 2017 to 2021 for both its predecessor trusts.
Matters arising
So, what does it say about Marianne Griffiths’ leadership of University Hospitals Sussex NHS Foundation Trust that she hired someone like Darren Grayson to review trust governance and then later gave him an executive job, after such a disaster at East Sussex Healthcare NHS Trust?
Ironically for Griffiths et al, their enterprise with the Good Governance Institute may well tip the balance in any consideration of corporate failures in the deaths scandal. In the
“At a corporate level, we are working with Good Governance Institute to ensure clear lines of sight from the front line of service delivery through to board level on quality and safety. This means that we can identify – and resolve – issues much earlier, contributing to the improvements in patient care.”
As above, the CQC later reported that the “clear line of sight” by the trust board was in place in its January 2019 inspection report. This appears to be additional evidence supporting staff disclosures to Health Education England that the board, through Griffiths, knew about the deaths, staff concerns and lack of governance in the surgical division.
I am requesting copies of all Good Governance Institute reports undertaken for the trust under FOIA.
I will also ask CQC to confirm that David Melbourne was an employee of the CQC as an inspection chair/ executive reviewer, to disclose whether this continues and to disclose whether any other executives from UHB and Birmingham and Solihull ICB are CQC executive reviewers.
CQC’s unseemly habit of employing part time/ bank staff from regulated bodies, especially at director level, has long been a source of conflicted interests and incestuousness which has undermined the authority and legitimacy of its inspections.
Importantly, it has now been made public that shockingly, Grayson is the trust’s police liaison for Sussex police with respect to the polic investigation into police deaths.
This is despite the fact that there are questions of conflict of interest from his review of trust services in his previous capacity as a consultant for the so-called Good Governance Institute. The GGI was investigated by BBC Newsnight.
RELATED ITEMS
This is a published CIPFA profile of David Melbourne in question and answer format, from when he was CFO at Birmingham Women and Childrens, in which Melbourne sympathises with the poor and emphasises the importance of staying true to your values.
This is Birmingham and Solihull ICB’s biography of Melbourne:
Melbourne took part in a charade in which the ICB and UHB misled the public and partner agencies by claiming that David Rosser the former CEO of UHB stepped down, when he in fact remained employed by UHB:
The Kark review, commissioned by Steve Barclay five years ago made a string of recommendations for preventing the recycling of unfit managers in the NHS. The task of implementation was given to NHS England, which is notorious for running the so-called “donkey sanctuary” for failed senior NHS managers. There has been no sign yet of any implementation, and NHS England claims that Steve Barclay himself dropped Kark’s recommendation for a disbarring mechanism. Correspondence to Mr Barclay about the failure to implement Kark’s recommendations has so far gone unanswered.
The NHS National Freedom To Speak Up Guardian helped Griffiths and co by disadvantaging trust whistleblowers in 2018, when she delayed a review of whistleblowing governance. This aspect of the saga can be found here:
Alexander's Excavations 