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PATIENT SAFETY It is noted by Dr Graham,10


a blogger at the


NHS Confederation and Freedom to Speak up Guardian, that many independent sector providers of NHS care now have Guardians, and it is known that Primary Care will develop them soon.


There are many reasons why the development of the Guardian role has been very challenging in acute care in the current financial climate where collective leadership skills do not sit well alongside the demands of efficiency and increased productivity. Dr Graham comments that the current ‘lean’ leadership approaches include the reduction in number, visibility or presence of leaders; and indeed there are many vacancies, which may inadvertently affect the availability and time or support that is afforded to workers to discuss concerns.


Patient safety


Raising issue of concern in the area of patient safety or quality of care appears to be easier at a local level than other quality issues. It is largely because people know that it has a high profile, that patients will be harmed if they do not speak up and whilst some problems may seem to imply complicity with the reporter, it is easier to remain professional when raising these concerns.


Staff harassment and bullying


The issue of staff bullying, which can be seen from the data is sadly very common is very much more personal, hurtful and might


The issue of staffbullying, which can be seen from the data is sadly very common is very much more personal, hurtful and might signify weakness on the part of the reporter.


signify weakness on the part of the reporter. Bullying can have serious consequences for staff and affected individuals and those they work with, causing sickness rates to rise, psychological stress, reducing productivity and the risk of poor decision making and potentially poorer patient care.


Conclusion


The National Guardian’s Office collates the data and is rolling out the process of implementing the role of the Freedom to Speak Up (FTSU) Guardians throughout healthcare. Recently the arms length bodies have appointed their FTSU Guardians, this will be expanded to include more of the Independent Sector and Primary care in


the months to come. Positive working cultures have never


particularly been a feature of life in healthcare for its workforce, and many staff wonder enviously at those trusts that manage to provide such a positive place to work. October is the Freedom to Speak up month – ensure that you plan to attend an event or some training which may be featured locally.


It is crucial that the efforts by the National Guardian and all her acolytes are successful, to ensure that the culture becomes far less about blame and far more about supporting a caring, learning and open approach where staff and others can speak up without fear of recrimination.


References


1 Francis R 2015 Freedom to speak up Executive Summary http://webarchive.nationalarchives.gov.uk/20150218151131 /https://freedomtospeakup.org.uk/wpcontent/uploads/ 2014/07/F2SU_Executive-summary.pdf


2 NHS Staff Survey. March 2017 http://www.nhsstaffsurveys.com/Caches/Files/ 20170306_ST16_National%20Briefing_v6.0.pdf


3 Ibid 4 NHS Improvement & NHS England. Freedom to speak up : raising concerns (whistleblowing) policy April 2016 https://improvement.nhs.uk/documents/27/whistleblowing_ policy_final.pdf


5 Northern Ireland. The Regulation and Quality Improvement Authority Whistle Blowing Guidance https://www.rqia.org.uk/ contact/complaints-feedback/whistleblowing/


6 NHS Improvement. Guidance for boards on Freedom to Speak Up in NHS trusts and NHS foundation Trusts. May 2018


https://improvement.nhs.uk/documents/2468/ Freedom_to_speak_up_guidance_May2018.pdf


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7 The Kings Fund 2016 https://www.kingsfund.org.uk/ blog/2016/01/if-it%E2%80%99s-about-culture- it%E2%80%99s-about-leadership


8 Ibid 9 National Guardian’s Office. Speaking up data Q4 2017/18 https://www.cqc.org.uk/national-guardians- office/content/speaking-data


10 Dr Judith Graham. Having the Freedom to speak up July 2018. https://www.nhsconfed.org/blog/2018/07/ having-the-freedom-to-speak-up


18 I WWW.CLINICALSERVICESJOURNAL.COM SEPTEMBER 2018


CSJ


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