Whistleblowing: improving organisational practice
A film to encourage organisations to create a safe environment for staff to raise concerns openly as part of normal day-to-day practice.
Messages for practice
- Raising concerns at work should be seen as part of normal day -to- day good working
- Managers and staff should listen to what the whistleblower is saying and make sure the concerns raised are managed well
- Whistleblowing isn’t always easy. However, if seen as part of routine practice, organisations have a better chance of making quality improvements for staff and the people who use their services
- An open culture where concerns can be raised helps to build a safe working environment and effective learning organisation.
Who will find this useful?
Managers, health and social care staff, housing staff, social workers, care providers, care staff, people who use services.
Video transcript Open
10:00:19:00 The importance of raising concerns at work in the public interest, (known as “whistleblowing”), is beginning to be seen in a more positive light for the improvements this can trigger in Health and Social Care organisations.
10:00:34:00 It can lead to better practice and outcomes when the concerns of staff, the people who use services and carers are listened to and acted upon.
David Behan Chief Executive, Care Quality Commission
10:00:44:12 There’s an important discussion going on about whistleblowing. If I look over my career in the late 90’s I think there was very little discussion about whistleblowing. But since Robert Francis’ Inquiry in relation to Mid Staffordshire these issues have quite properly received much work on focus and discussion.
Rosemary Crockett, Policy Manager, Mencap
10:00:42:19 The public know that they themselves may well end up in a care home needing social care or their relatives. They want staff to raise concerns (if they have them so things can be put right at an early stage.) So I think we’re actually in the middle of quite a big sea change really in terms of attitudes to whistleblowers (and recognising the value of what they do).
10:01:29:07 I think the key issue for this is I think whistleblowing is a symbol, a signal of an organisation that’s failed to listen to the concerns of its staff. And therefore I think the thing that we need to get right in health and social care is how do organisations listen to the concerns that their staff are raising around quality and safety?
10:01:54:19 Another indication of the changes taking place, is the Department of Health’s 2014 national guidance for people who work in the sector, produced by the Whistleblowing Helpline.
10:02:07:16 I think the key message is that raising concerns should be seen as part of normal day to day working practice. There’s different sections in the guidance. One section is for workers, how they can raise concerns properly. There’s also a section for managers, in helping managers to respond appropriately which would involve thanking the whistleblower for raising the concerns even if they think they’re mistaken. To take their concerns seriously, listen to them and to do a proper investigation. They shouldn’t shoot the messenger; they should look at the information.
10:02:44:08 Many organisations will have procedures in place and good practice is to first raise concerns internally.
10:02:52:13 I would advise staff to locate their organisation’s whistleblowing policy and that will normally set out the process of who they should disclose information to. It will typically be their own line manager unless there’s a very strong reason why they feel they can’t do that. May be they feel if the manager is implicated in the wrong doing then they can go to their manager’s manager.
10:03:18:15 But there will come a point when internal procedures are exhausted or if their concern is exceptionally serious and they feel that even the top senior managers are aware of the wrong doing and choose to ignore it. Then they can go beyond to a regulator. The principle regulator in social care is the Care Quality Commission
10:03:39:16 The 1998 Public Interest Disclosure Act, has also been strengthened to protect whistleblowers from harassment and bullying, and they can now report concerns to their MP, but whistleblowing to the media remains highly contentious.
10:03:55:19 They need to take advice, preferably legal advice. There are certain risks to their employment if they go to the media certainly unless they’ve made attempts to raise concerns internally first. If their concerns are exceptionally serious then they may be protected.
10:04:17:14 Whistleblowing to the media isn’t easy as Dr Raj Mattu found out. He went public after his concerns about patient deaths in overcrowded bays at the hospital where he worked were not dealt with.
Dr Raj Mattu, Cardiologist
Dr Raj Mattu:
10:04:31:21 To whistleblow is a huge act especially to whistleblow in the public domain. For me personally that was one of the hardest decisions that I’ve ever had to make.
10:04:42:20 But Dr Mattu’s actions were treated as an employment dispute rather than a whistleblowing case by the hospital management. Senior management failed to focus on the issued he raised and missed the opportunity to learn as an organisation.
Dr Raj Mattu:
10:04:58:08 You end up finding yourself being totally ostracised, demoralised and in my case I was suspended. It’s important to recognise that my experiences are not unique in the National Health Service. There are many other whistleblowers who have spoken to me over the 13 years I’ve been suspended and its remarkable the common theme that runs through them.
10:05:21:20 In 2014 a Tribunal cleared Dr Mattu of wrong doing, stating it was not an employment dispute, and that he had whistleblown correctly by exhausting internal procedures, before he went public.
Dr Raj Mattu:
10:05:37:23 I think it’s an absolute requirement that the culture is changed and that whistleblowing is seen as a positive thing. I hope that in time we will have a situation where whistleblowers will stop being seen as the problem, people will stop trying to shoot the messenger and actually start seeing whistleblowers as part of the solution.
Dr. Wim Vandekerckhove, Senior Lecturer, University of Greenwich
Dr. Wim Vandekerckhove:
10:06:04:12 We need to stop looking at the whistleblower. We need to start looking at the manager. We know people raise concerns, sometimes against all odds. People have concerns and they talk about them. May be they don’t raise it to management but they talk about those concerns among themselves. So what you need to start looking at is what makes managers listen to concerns and what holds them from listening to concerns.
Wirral Case Study
10:06:33:10 Some care organisations are exploring new ways to respond to whistleblowers, as in this case from the Wirral, after a student nurse raised concerns with her University tutor.
Pat Clarke, Senior Lecturer, Faculty of Health and Applied Social Sciences, Liverpool, John Moores University
10:06:47:10 The types of issues she was raising were to do with medicine administration, manual handling, how people were generally being cared for, and also how they were being communicated with.
She didn’t perceive that the experiences were very compassionate or caring from the staff there. She reported it to the manager who was at the placement, and she didn’t feel that the issues were being taken seriously while she was at that placement, so she felt that she was not being listened to.
10:07:23:06 Pat Clarke reported these concerns to the Wirral’s social services. The response was immediate. The care home was investigated, and working with the local NHS Care Commissioning Group, an action plan was put in place.
Val Tarbath, Designated Nurse and Manager for Safeguarding Adults, NHS Wirral CCG
10:07:39:23 It was a surprise, I think the surprise was the extent or the range of difficulties from you know not answering a buzzer to actual alleged assault and varying degrees in between. We were quite taken aback that we didn’t realise if you like, it was a warning shot to the organisation.
10:08:04:21 Social Services and the CCG’s adult safeguarding team then set about learning lessons from the incident. For example, new quality selfassessment forms were introduced to help improve standards across 108 Care Homes.
10:08:20:09 The documents themselves contain a series of questions, staffing requirements, staff training, supervision, actual environment, what is the actual environment like for a resident that lives in that home. Is it safe?
Stevena Burke, Deputy Manager, Daleside Care Home. Open door policy
10:08:35:01We have an open door policy at Daleside which I find very important for all staff, carers, residents, relatives and visiting professionals. Any concerns raised no matter how big or small can also have a positive impact on our future practice if we learn from them.
10:08:55:04 There’s been a cultural shift towards listening more carefully to concerns, and student nurses on placements have been encouraged to take a more proactive role.
10:09:05:18 The message really for me would be we need to take any concerns raised through the whistleblowing seriously and follow them up, even though as in this case we thought at first, surely not, all those things could not be going on in the home, when in fact the majority of them were.
Dr. Wim Vandekerckhove:
10:09:33:01 For whistleblowing to work in organisations it takes more than top management wanting to listen to concerns. You need to have communication that shows people, that tells people, these people have come forward with their concern, here’s how they raised their concern and look this is how we were able to improve our services. That’s the kind of communication you need.
10:09:58:17 Managers should be encouraging staff to raise concerns at an early stage and to do so through routine processes like supervisions, through appraisals, through team meetings.
Dr. Wim Vandekerckhove:
10:10:12:05 They need to make it happen and they do that through performance management. Through making their middle managers somehow accountable for listening to concerns. You need to have a kind of a performance measurement system. People behave towards what is being measured.
10:10:30:11 The key issue that we’re looking for when we inspect services, and this is a part of our new methodology, we’ll be asking the question how well led organisations are. And what we’ll be looking for there is how open and transparent are organisations?
10:10:48:00 Anna Paterson is an Owner Manager of a home care agency, where carers go into people’s homes. How does she foster a spirit of openness?
Anna Patterson, Carewatch Lewisham
10:10:58:21 If you encourage an open culture it makes your life much easier as the leader. Because people will be forever having good ideas. Because if they see something they’re not going to see it as, oh let’s hide that. They’re immediately going to say flag it up and it’s come to you. For instance I had somebody the other day, because we have such a culture, when she made a mistake she immediately came and said, look I made a mistake but I’m looking at ways of how I’m going to correct it. If she’d hidden that that could have gone unnoticed but then laid there underneath the surface and could have created more problems for us. And it’s a much more, how we say, a more, happier environment that people can live in. People don’t feel as if they need to look over their shoulders all the time. I think it makes people feel more comfortable.
Key learning points
Raising concerns at work should be seen as part of normal day to day good working practice
Managers and staff should listen to what the whistle blower is saying and make sure the concerns raised are managed well
Whistleblowing isn’t always easy. However, if seen as part of routine practice, organisations have a better chance of making quality improvements for staff and the people who use their services
An open culture where concerns can be raised helps to build a safe working environment and effective learning organisation