Raising concerns (whistleblowing)

Speak Up offers free, independent, confidential advice on the speaking up process for employers and employees in the NHS and adult social care. You can find more information on their website.

Every NHS trust and foundation trust should have a freedom to speak up guardian. Their role is to work with the board and the executive team to support an organisation be an open and transparent place to work. They should act in an independent and impartial capacity, listening to staff and supporting them to raise concerns.

Find your freedom to speak up guardian on the National Guardian website. 

The National Guardian and Health Education England have developed training for everyone in healthcare which sets out what speaking up is and its importance in creating an environment in which people are supported to deliver their best. To access the training see the e-Learning for Healthcare website.

In April 2016, NHS England and NHS Improvement launched a national, integrated whistleblowing policy to help standardise the way NHS organisations support staff who raise concerns. The policy sets out:

• who can raise a concern
• the process for raising a concern
• advice and support when raising a concern
• how the concern will be investigated
• what will be done with the findings of the investigation.

In February 2015, Sir Robert Francis QC published his report on the Freedom to speak up review. The review was set up in response to continuing disquiet about the way NHS organisations deal with concerns raised by NHS staff and the treatment of some of those who have spoken up.

The report sets out 20 principles and actions which aim to create the right conditions for NHS staff to speak up, share what works right across the NHS and get all organisations up to the standard of the best and provide redress when things go wrong in future. These are designed to:

• promote a culture in the NHS where staff feel safe and encouraged to speak up 
• make sure all concerns are heard, investigated properly and the right support is on hand for staff
• protect vulnerable groups, such as student nurses and medical trainees, from intimidation 
• prevent discrimination against people who have been brave enough to speak up and help them get back into work.

Raising concerns at work: whistleblowing guidance for workers and employers in health and social care, published in 2014, set a standard for whistleblowing/raising concerns policies in health and social care organisations. Key messages in the guidance include:

• the importance of encouraging staff to raise concerns as part of normal day-to-day practice and how this can help employers identify poor practice and improve the quality and safety of care
• an outline of the legislation – the Public Interest Disclosure Act 1998
• a flowchart of the whistleblowing process
• top tips for workers who wish to raise concerns and sources of advice and support
• top tips for operational managers to respond positively when staff raise concerns
• at corporate level, the guidance sets national standards for whistleblowing policies for employers, together with a summary of their responsibilities
• case studies of good practice, frequently asked questions, and further information and link.