COMMENT


Editor LOUISE FRAMPTON louiseframpton@stepcomms.com


Contributing Editor SUZANNE CALLANDER


Technical Editor KATE WOODHEAD


Business Manager Online CHRIS VINCENT chrisvincent@stepcomms.com


Publisher GEOFF KING geoffking@stepcomms.com


Publishing Director JOSH TAYLOR joshtaylor@stepcomms.com


Journal Administration KATE PHILLIPS katephillips@stepcomms.com


Design RAY ECCLESTONE DAVE WOODALL


THE CLINICAL SERVICES JOURNAL is published in January, February, March, April, May, June, August, September, October and November by Step Communications Ltd, Step House, North Farm Road, Tunbridge Wells, Kent TN2 3DR, UK. Tel: +44 (0)1892 779999 Fax: +44 (0)1892 616177 Email: csj@stepcomms.com Web: www.clinicalservicesjournal.com


Speaking up in difficult times


A new“speaking up charter” has been launched in a bid to encourage healthcare professionals to raise concerns over care quality and safety. The key purpose of the charter is to recognise that, in order to enable a cultural shift in the NHS, it is vital that leadership comes from national organisations to promote a culture in theNHS where staff can report concerns with confidence. Twenty-eight organisations have signed the newcharter – including the Royal


College of Nursing, the British Medical Association,NHSEmployers and theCare QualityCommission – to name just a few. Among the key principles are:


• Safety should be at the heart of all care and is the responsibility of everyone involved in the provision of health and social care services.


• Ensuring all individuals are treated in a service which is open to feedback, and encourages, as well as supports, its staff to raise concerns.


• Staff engagement in the development and delivery of healthcare services is fundamental.


• Individuals should always feel free to raise concerns through local processes and be supported to do so.


• Compromise agreements containing clauses seeking to prevent disclosures protected under the PIDA 1998 are not acceptable.


• Adequate training and support is provided for managers so that they understand their role and responsibilities in handling concerns raised with themand are able to respond appropriately.


The charter has emerged at a time of heightened awareness of the importance of creating a culture where poor care and safety failures are challenged, as the country awaits the impending conclusion of the Francis Inquiry into the failures at Mid Staffs. The inability of staff to speak up was identified as a key issue at the Trust. At a recent


conference in Birmingham, organised by the Association for Perioperative Practice, Sir Stephen Moss warned that Mid Staffs could happen in any healthcare setting. The previous chairman of Mid Staffs (appointed in 2009 to drive improvement at


the Trust), Sir Stephen Moss commented: “At Mid Staffs, mediocre practice and not striving for the best care became a part of the culture. It became acceptable for poor behaviours to be demonstrated as it became ingrained into the culture of the organisation. Nobody tried to challenge it or put it right, and staff were fearful of speaking up. “We are now facing the biggest change in the way that healthcare is provided, in


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this country, since the inception of the NHS. At times like this, staff worry about whether they will have a job; whether their operating room, their ward or even their hospital will be needed in the future. This creates a situation where it is easy for people to take their eye off the ball. “This is what happened at Mid Staffs – in 2012, we are now reliving the financial


challenges that occurred at the Trust in 2006. If there was ever a time when another Mid Staff could emerge, it is now.” If we are to prevent another Mid Staffs from occurring, organisations need to


foster an open culture in which patient safety is paramount.Creating a culture, in which staff feel empowered to speak up will continue to pose a challenge, but the charter signals a welcome commitment to work together, across professions and healthcare settings, to achieve this goal.


LOUISE FRAMPTON Editor


NOVEMBER 2012 THE CLINICAL SERVICES JOURNAL 5


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