Expert Reaction – Sir Robert Francis QC's Freedom to Speak Up Review
Published 11 February 2015
Today (11 February) saw the publication of the much-anticipated 'Freedom to Speak Up' Review by Sir Robert Francis QC into whistleblowing in the NHS. The review concludes that there is a culture within many parts of the NHS that deters staff from raising concerns and, as a result, has negative consequences for those who raise issues.
Sir Robert's review outlines recommendations grouped around five themes. These are:
- Culture change
- Improved handling of cases
- Measures to support good practice
- Particular measures for vulnerable groups
- Extending the legal protection
International law firm DAC Beachcroft was a contributor to the inquiry and Udara Ranasinghe, Head of its Health Employment and Pensions team, welcomed the report. Reacting to its publication, he said:
"Sir Robert has clearly tried to strike a balance between the views he heard. He identifies that some "whistleblowers" may raise concerns for personal reasons but the emphasis for NHS bodies is that all concerns must be considered and addressed regardless of the suspected motivations of a whistleblower, which should be irrelevant.
"It is also to be welcomed that Sir Robert has recognised the focus must be on culture change within the NHS rather than implementing wholesale legislative change. The key enforcement measures are designed to be regulatory – both at organisational and individual level."
Key recommended actions arising from the report include:
- The creation of independent Freedom to Speak Up Guardians as well as empowering a variety of personnel (from frontline managers to Directors) who can support staff who raise concerns;
- Regulators should regard any departure from principles of good practice set out in the report as relevant to whether an organisation is safe and well-led and to the measure of whether someone is a "fit and proper" person to hold a director-level position within an NHS body;
- Trust Boards should ensure that progress in creating and maintaining a safe culture is measured, monitored and published on a regular basis;
- All NHS organisations should have a clear process for recording all formal reports of incidents and concerns and for sharing that record with the person who reported that matter;
- Trust CEOs personally reviewing all Settlement Agreements containing a confidentiality clause should ensure these are in public interest;
- Any Settlement Agreement containing a confidentiality clause to be made available to the CQC for inspection.
- The creation of a support scheme for NHS workers who have "blown the whistle" to help them find employment within the NHS;
- NHS England, NHS TDA and Monitor to issue joint guidance setting out the support required for staff who have raised a concern;
- The creation of an Independent National Officer whose duties will include reviewing the handling of concerns raised by NHS workers where this has not been in accordance with good practice and to provide guidance on good practice in handling concerns;
- Legal protection should be extended to cover all students working towards a career in healthcare.