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Annual appraisals, revalidation, whistle-blowers and staff forums are driving safety and engagement

Published 13 December 2017

More than 80% of respondents are using revalidation, staff forums, annual appraisals and Freedom to Speak Up Guardians to drive safety improvements.

"We carry out a monthly review of incidents and the clinicians associated with them to identify trends and flag the people more commonly coming up." - NHS director of nursing

The survey revealed that the most effective methods of capturing staff feedback about patient safety is annual appraisals or the revalidation process, as 88% rate it either a four or five out of five where five is 'very effective', staff forums at 87%, incident reports at 83% and whistle-blowing or raising concerns with Freedom to Speak Up Guardians at 80%.

Staff seem to be more engaged in the whole culture of patient safety than board members, as 49% feel staff are truly engaged compared with just 37% saying board members are truly engaged.

Apart from the formal complaints process, when asked an open question about how patients could raise issues or safety concerns there is a wide range of responses. Many respondents are happy for the management team to be contacted directly, while others are keen to pass responsibility to regulators or other agencies.

An NHS chief executive comments: "Patients can contact the head of nursing or the board directly to resolve their issues or concerns." Other NHS chief executives and patient experience leads explain that their organisations have systems in place so that patients or relatives can contact board members or departmental or ward leads. Respondents from the NHS and the independent sectors variously advised contacting the Care Quality Commission, or their local Healthwatch branch or a professional regulatory body.

DAC Beachcroft partner Udara Ranasinghe, who is an employment specialist, is concerned at the reliance organisations put on annual appraisal and revalidation as an alert to patient safety issues. “These are once-a-year events – although useful – what happens in the meantime? Where is the ongoing dialogue with staff? Many organisations are using staff fora and suggestion boxes, but the frequency of staff meetings should be monthly to gauge a real-time picture.”

However, it feels that a shift in safety culture is taking place. “Some 49% of staff feel more engaged in patient safety than the leadership and 87% of NHS trusts say they draw effective patient safety improvements from feedback from whistle-blowing and Freedom To Speak Up Guardians, so it is obvious trusts are taking account of the Freedom to Speak Up Inquiry recommendations and that is really positive.”

Download the full report here.


Udara Ranasinghe

Udara Ranasinghe

London - Walbrook

+44 (0)20 7894 6727

Corinne Slingo

Corinne Slingo


+44 (0)117 918 2152

Heather Durston-Hillyer

Heather Durston-Hillyer


+44 (0)1962 705513

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