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New guidance recommends primary care providers appoint a whistleblowing guardian

4 April 2016

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Every primary care provider should appoint a whistleblowing guardian to make it easier for staff to raise their concerns, as part of a new guidance issued by NHS England.

The Freedom to Speak Up Guardians should be independent of management and will have the power to hear concerns as well as offering them support.

The guidance follows Sir Robert Francis’s recommendations that his Freedom to Speak Up report should be adapted for workers in primary care.

He pointed out that workplaces with few employees can present challenges over anonymity and conflicts with employers.

Primary care providers should also take a proactive role to prevent bullying or harassment or discrimination of staff who raise concerns.

They will also have to review and update their policies and procedures by March 2017.

NHS England’s director for patient experience Neil Churchill who drew up the guidance said: “The best providers seek to ensure there are opportunities for their staff to raise any concern they may have routinely and early. Managing concerns early means there is little opportunity for them to escalate to bigger problems, which risk directly impacting patients and the public.”

Issues in primary care could include a failure to safeguard patients, maladministration of medicines, poor clinical practice or other malpractice, which could harm patients and the use of untrained or poorly trained staff, the report said.

The report said would-be whistleblowers may feel isolated and anxious about raising concerns if they work in small teams about raising their concerns confidentially and anonymously.

Primary care employees may be concerned about their jobs if they raise issues about their direct employers and anxiliary workers and nonclinical staff may not have access to a professional body or union to offer them support.

Churchill said staff should have the confidence to speak up and that their concerns will be investigated.

Primary care providers should also make sure people know that it is safe to speak up and they will not suffer if they do raise concerns.

There should also be a culture where speaking out makes a difference, Churchill said.

The proposals also said staff concerns should be investigated. They should be thanked for making them and feel that they would be confident to speak out again.

The consultation on the proposals ends in May.

From 1 April NHS England became a ‘prescribed person’ under the Public Interest Disclosure Act 1999, which means whistleblowers in primary care can also contact it about inappropriate activity.

They can call 0300 311 223, email [email protected] or write to NHS England, PO Box 16738, Redditch, B97 9PT. British Sign Language interpreters are available via NHS England’s BSL Service.


The guidance can be found here.