HEALTHCARE DELIVERY
manager and called for an amendment to the rules which would ensure that staff and volunteers have criminal record checks every three years. The current system is that hospitals’
recruitment processes for new volunteers include interviews and obtaining references, and in some cases occupational health checks. They undertake enhanced record checks via the Disclosure and Barring Service (DBS) but usually only at initial selection and not thereafter. Induction training was given which included safeguarding – but that it was not always of sufficient quality. The ‘Lessons learned’ report recommends regular updating on safeguarding processes and quality assurance for that training.
Safeguarding
In May 2011, the Government’s specified its policy on safeguarding adults to “prevent and reduce the risk of significant harm to vulnerable adults from abuse or other types of exploitation, while supporting individuals in maintaining control over their lives and in making informed choices without coercion.” It went on to state “safeguards against poor practice, harm and abuse need to be an integral part of care and support.”2 Earlier guidance3
had emphasised that
all staff should see adult safeguarding as ‘core business’ and to ensure that they were aware that everyone has a role to play in safeguarding vulnerable adults. It stated that all staff involved in planning or delivering care should be aware of the main elements of the safeguarding process, and should be equipped with the knowledge and skills necessary to enable the systems to work seamlessly. In the light of Savile’s horrific abuses,
we need to revisit policies for adult safeguarding and ensure that they are far more robust than they appear. It is known that Savile continued to abuse patients and staff from the 1960s until shortly before his death in 2011. The Lampard report made specific observations that not all safeguarding services were as well resourced as they might be and that this could affect the availability of specialist support and advice. They said: “Effective safeguarding requires organisations to encourage openness and listening when people,
Managers need to be trained to deal positively and appropriately when matters of concern are reported to them.
18 THE CLINICAL SERVICES JOURNAL
NHS hospital Trusts and their associated NHS charities should consider the adequacy of their policies and procedures in relation to the assessment and management of the risks to their brand and reputation, including as a result of their associations with celebrities and major donors, and whether their risk registers adequately reflect such risks.
including children, raise concerns. It also requires senior staff to be approachable and well informed about what is happening in their organisations: we heard of good examples of senior managers spending time on wards and how this allowed them to pick up on issues of concern.”
Internet and social media access Lampard also examined incidents relating to the use of the internet and social media on hospital premises that raised safeguarding concerns. They questioned whether NHS hospitals had adequate arrangements in place to protect people in their care, particularly children and young people, from the risks posed by modern information technology. The evidence gathered shows that some NHS hospitals do not have a clear and consistent policy on managing internet and social media access by patients and visitors. Hospital organisations need such a policy, to protect people on their premises from the consequences of inappropriate use of information technology, the internet and social media.4
Raising complaints and concerns Lampard states that both the Stoke Mandeville and the Leeds investigations show the difficulties that Savile’s victims had in reporting and escalating their complaints of abuse. Slater and Gordon, which represents 44 former staff and patients who say they were abused by Savile at Stoke Mandeville, said it ‘beggars belief’ that senior staff failed to intervene. Solicitor Liz Dux said: “The victims
are hopeful the (Lampard) review will establish a much greater level of accountability than the previous one did. Anything less will rightly be seen as a whitewash by those people still suffering from the awful crimes Savile committed all those years ago.”
Abigail, who was abused by Savile when she was an 11-year-old patient in the 1970s, said: “I want to see some accountability from the report into Stoke Mandeville. No one has properly said sorry. We must make sure this can never, ever happen again to anyone else in an
institution. No more lives must be ruined.” Dux told the BBC that many of her
clients had given evidence of how they reported abuse at the time, but they were told to keep quiet. “One of them has named the senior nursing sister to whom she told immediately after she had been assaulted in the children’s ward. She was told by the senior nursing sister: ‘Be quiet, you silly girl. Do you know what he does for the hospital?’” The senior nurse has since died, Dux said. “We do know that numerous people reported [Savile’s abuse] to senior members of staff. They will want answers today as to why people didn’t act. I hope the inquiry does try to name people and I hope those people who are still alive who did know what happened feel thoroughly ashamed of themselves.” She said nothing more could be done to punish those who knew. “Deliberately turning a blind eye is not a crime at the moment, which is why we are calling for a change in the law, supported by Labour and the Liberal [Democrats] so that if abuse happens in a regulated activity and a blind eye is turned, in future those people can be prosecuted.”5 Preventing abusive and inappropriate behaviour in hospital settings requires that victims, staff and others should feel able to make a complaint or raise their concerns and suspicions, and that those to whom they report those matters are sensitive to the possible implications of what is being reported to them and escalate matters to managers with authority to deal with them. Lampard identified a number of specific matters, that they believe will encourage staff, patients and others to raise the alarm about sexual abuse and other inappropriate behaviours.
Policies and the correct terminology A number of people interviewed during the Lampard investigations felt that the term ‘whistleblowing’ which is generically used to encourage staff to speak up about matters of concern, was not helpful or relevant to reporting possible abuse. It is suggested that a ‘raising concerns policy’ would be more effective.
APRIL 2015
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