Speak up for safety

Speak up for safety and quality in private healthcare! David Hare reports on progress in the sector.

This October once again saw the start of ‘Speak up Month’ – an initiative set up by the National Guardian’s Office to raise awareness of Freedom to Speak Up Guardians (FSUGs) and the work being done to make speaking up ‘business as usual’ for healthcare providers.

This was originally introduced following Sir Robert Francis’s 2015 review into ‘whistleblowing’ processes within the NHS and aims to develop cultures where safety concerns are identified and addressed at an early stage before people feel the need to ‘blow the whistle’. 

All providers of NHS services subject to the NHS Standard Contract must now have in place a FSUG and, in the independent health sector alone, over 100 have already been established.

With ‘Speak up Month’ upon us, it is therefore a good time to reflect on this issue and why it is important that all parts of the healthcare system – including the independent sector – embrace ‘speaking up’ as a way of improving the safety and quality of care we deliver.  

At a time of ever greater pressure on the healthcare system – dealing with the backlog caused by the coronavirus pandemic on top of an ageing population with more complex needs – it is vital that all of us in the sector look at what can be done to drive continuous improvement. 

Healthy scepticism 

A key part of this – and what FSUGs helps to foster – is embedding culture of ‘healthy scepticism’ in the health system and encouraging a sense of inquisitiveness and curiosity throughout organisations so that problems can be identified with and dealt with at an earlier stage. 

Indeed, as the Independent Healthcare Providers Network’s (IHPN’s) recent Medical Practi­tioners Assurance Framework (MPAF) made clear, staff at all levels are the eyes and ears of any healthcare organisation. 

They notice breaches in safety, good and bad behaviours, inappropriate investigations, treatments and interventions. But it is not always easy for staff, regardless of their role, to raise their concerns. 

So the MPAF recommended that all independent providers should have effective systems in place to enable staff to speak up and should appoint FSUGs throughout their organisations. 

Open dialogue 

And I’m pleased to say that the sector has really embraced this agenda. 

During the pandemic, many providers produced bespoke ‘Speak Up’ guidance that centred on the management of concerns relating to Covid – encouraging open dialogue and allowing staff to manage issues in a timely manner. 

This was complemented by regular reviews of their Speak Up infrastructure to evaluate their systems and processes.

Likewise, providers across the sector have worked hard to embed the importance of ‘Speaking Up’ throughout their services; for example, holding quarterly calls with FSUs across their organisations to provide updates and share best practice, and actively encouraging their Guardians to meet with their local NHS trust counterparts to learn and share from each other’s experiences.

And if anyone has any doubt about the importance of staff at all levels having the confidence to speak out about concerns on safety, quality or how things can be improved, the Paterson inquiry and its ongoing response should once and for all put those to rest. 

Appalling actions

The Bishop of Norwich’s report made clear the inconsistencies in how concerns were raised by professionals in the NHS and the independent sector with ‘inadequate’ responses in both sectors when professionals did raise concerns, contributing to a climate where Paterson was able to commit such appalling criminal actions.

As many have argued in recent years, healthcare can be a hierarchical business and that is why the ‘Speak up’ movement is so important. FSUGs not only provide a structure for concerns and issues to be raised, but also help develop a culture where employees feel free to contribute ideas, share information and report mistakes and ultimately drive improvements. 

As part of Speak Up month, I urge all those working in the independent healthcare sector to raise awareness of FSUGs and encourage many more to be established. 

Not only will you be fostering a culture where people can speak up and be confident they will be listened to, it will play a pivotal role in further improving the care provided to millions of patients every year.

David Hare (right) is chief executive of the Independent Healthcare Providers Network (IHPN)