Professional Comment

How Healthcare Workers Can Raise Concerns Without Fear of Reprisal

By Nicholas Hayes and Andrew Pepper-Parsons at Protect Whistleblowing charity (www.protect-advice.org.uk)

The NHS is currently facing unprecedented pressure because of staffing shortages and funding cuts. Healthcare workers are feeling overwhelmed, and patient health and safety is being put at risk. Consequently, staff from the health sector feel obligated to speak up, and Protect, the UK’s leading whistleblowing charity, advised 350 healthcare workers on how to blow the whistle safely last year alone.

It is vital that health care workers feel comfortable raising their concerns without fear of reprisal: they are the eyes and ears for organisations, regulators and the public. But it’s not always clear how to navigate the process.

Whistleblowing law
The Public Interest Disclosure Act 1998 (PIDA) gives workers protection against negative treatment from their employer after raising their concerns. The protection applies where a worker, including primary care professionals, has raised public interest concerns about specific types of wrongdoing.

What type of concerns are protected?

Any matters that may affect the health and safety of an individual or breach of the law may fall within whistleblowing concerns.

In the health sector, some of the examples we see include:
• Poor clinical practice
• Unsafe staffing levels
• Inadequate training
• Culture of bullying and harassment
• Safeguarding failures
• Fraud

It is important to note that you do not have to be certain that wrongdoing has occurred and hard evidence, although helpful, is not necessary to raise your concern. You simply need to have a reasonable belief that there is cause for concern and provide information, rather than just an allegation, about the wrongdoing.
Where can I raise my concerns?

Internally
Approaching a line manager or supervisor with concerns is often a sensible approach and the law protects this approach whether a disclosure is made to a line manager or the Chief Executive.

It is important to be able to raise concerns higher in the management chain. However, there will be times where the concerns are about the conduct of the line manager, or they have failed to deal with concerns in the past, so approaching this person would not be appropriate.

This is where an employer’s whistleblowing policy will be useful, as it often explains the best person outside of line management to approach. Following a policy is not a requirement though, it’s a guide on who to approach, there can be real value in approaching a manager or director you trust with concerns inside the organisation. Many health sector organisations have Freedom to Speak Up Guardians who can support those raising concerns.

Externally
Where the concerns have not been addressed, or if you have little faith the concerns will be addressed internally e.g. because you are aware of other whistleblowers being victimised or ignored, or maybe past concerns you’ve raised have been ignored, you can go outside of your employer.

The law protects whistleblowers who raise concerns with a regulator, an MP or – in some circumstances – even the media if they lose their job or are victimised for doing so.

https://www.gov.uk/government/publications/blowing-the-whistle-list-of-prescribed-people-and-bodies–2/whistleblowing-list-of-prescribed-people-and-bodies

If you blow the whistle to a regulator, you must reasonably believe that your concern falls within that regulator’s remit and that the information you disclose is substantially true.

An appropriate regulator in the health sector might be the Care Quality Commission or one of the professional health bodies- a full list of regulators can be found here.

Disclosure to the media may be protected but comes with the strictest legal tests and is usually a place of last resort for disclosure. You must either reasonably believe that you will be victimised by your employer, fear that evidence will be concealed by them or that your concern is exceptionally serious.

https://www.gov.uk/government/publications/blowing-the-whistle-list-of-prescribed-people-and-bodies–2/whistleblowing-list-of-prescribed-people-and-bodies

Where can I get advice?
Getting early advice, especially when you are considering those external disclosures, is important and there are places that provide such guidance. You can get support in raising your concerns from:
• Protect’s free and confidential Advice Line (020 3117 2520);
• Your trade union or professional body;
• Your local Freedom to Speak Up Guardian.
If you have already raised public interest concerns in the NHS, you may be eligible for the NHS Speaking Up support scheme.
If you are concerned about wrongdoing, it is important to know that there is legal protection and that you shouldn’t be treated badly or dismissed for doing so.

Nicky Hayes is a qualified solicitor and Legal Adviser at the whistleblowing charity, Protect. Prior to joining Protect, Nicky completed his training contract at an international law firm where he gained experience in Private Equity, Employment, Intellectual Property, Data and Technology and Pro Bono, which included a secondment to Protect.

Andrew Pepper-Parsons is Head of Policy at Protect, overseeing the charities lobbying and research functions. He’s been with the charity since 2007 and holds a law degree from Solent University, and MSc in Policy, Government and Politics from Birkbeck College, University of London.