An NHS Change Day Pledge

Flo Panel-Coates, Director of Nursing

and

Ashley Brooks, National Patient Champion and Independent Lead for Guardian Service

BHRUT & THE GUARDIAN SERVICE

BHRUT & THE GUARDIAN SERVICE

WHY?

1) NHS Change Day at BHRUT – Pledges to Change

2) Lack of engagement with Whistleblowing Policy

3) Challenges in the Trust but no issues or concerns raised by staff.

BHRUT & THE GUARDIAN SERVICE

RESEARCH:

1) Survey of Views/Research at NHS Events

2) Interviewed 3 x ‘Whistleblowers’ to assess process – all said despite backlash, would do it again

3) BMJ Doctors Conference – Invited to run Impromptu Focus Group

4) Visit to University of Surrey – Professor at Cardiff University Study - Findings of Whistleblowing research:

– Whistleblowing viewed as ‘Career Suicide’– Don’t call it ‘Whistleblowing’– Needs to be independent of the Organisation

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HOW? High level leadership to drive forward and

engage – Director of Nursing and Director of PD and OD

Governance Structure – RAG System created:– Green: 72 hours to alert - non patient safety– Amber: 48 hours to alert - staff bullying/harassment– Red: Immediate action - patient/staff safety

Alert key personnel for action: – Director of Nursing and Medical Director– Director of People Development and Organisational

Development

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COMMUNICATION OF SERVICE TO STAFF:

Email Via Communications Department and Directorates

Director of Nursing Newsletter LINK e.magazine Staff Briefings ‘Word of Mouth’

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The Pitch:

“Would you use, a member of NHS staff, a truly independent service where you can raise a concern, issue or problem about anything pertaining to your role, colleagues or work place in complete confidentiality and anonymity? The service would not have any vested interest in your career and would not even need to know your name. A service that created a safe environment for you to come and just have a conversation."

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The Service: Dedicated Phone Line Dedicated Email Post Room Address Planned Drop In Sessions including Nights and

Weekends Off site meetings at venue of choice (Prior

notification registered with the Trust regarding place and time of meeting)

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Method of Contact:

Telephone has been the most popular form of first contact, email hardly used and post never used

Drop in sessions never used - all interactions face to face have been pre-arranged

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The Guardian Service Interview: Explanation of what the Guardian Service can do -

informal way of raising concerns Highlight the Trust existing Policies and Processes Discuss concern(s) – captured with series of questions Last question – “do you want this to be confidential

and/or anonymous?” Overview of the interview is repeated at the end to

ensure agreement to what will be reported Doesn’t always lead to further action

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Who has visited the Guardian Service: Nurses including Senior Sisters/Charge Nurses Health Care Assistants Matrons Doctors/Consultants Clerical/Administration Staff Volunteers Porters Pharmacy Staff

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Sessions Held In the First Six Months:

51 Sessions (3 were repeat sessions) 37 Face to Face Meetings 6 Telephone Sessions 5 Meetings arranged but subsequently not

attended

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Themes/Allegations:– 10 x aggressive, bullying, harassment and intimidating

behaviour reporting– 5 x HR or employment advice– 3 x significant patient safety reporting– 2 x gross misconduct reporting by colleagues– 2 x unsafe work practices– 1 x reporting on poor patient experience– 5 x cases no explanation / no show– 2 x reporting on improper use of process– 1 x fraudulent behaviour– 6 x cases wanted no further action / withdrew their concern

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The Service provided at BHRUT completely addresses the recommendations outlined in the Francis Report in the area of ensuring an open and honest culture of raising concerns.

Note: This work all preceded the Francis report on Mid Staffs published February 2013. Time and time again the recommendations coming from this report called for a more open and honest, clear and easy way for staff to raise their concerns within the NHS. The Guardian Service was ahead of this report and we used this as our main Trust wide pledge for NHS Change day in March 2013. We launched the service on June 27th 2013.

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Total2012

%2012

Total2013

%2013

Would you feel safe raising your concern?

Yes 752 58% 1072 80%

No 192 15% 269 20%

Would you feel confident your Trust would address your concern?

Yes 516 40% 932 70%

Staff Feedback and Impact So Far:

The following responses in the 2013 NHS Staff Survey in the Health, Wellbeing and Safety at Work category had the largest overall shifts in the Trust when compared to 2012:

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The Future of the Service: Business case to continue the pilot into

2014/15 Greater feedback to Trust Staff regarding

themes and actions taken Link into Staff Survey results, when National

results available Sharing at 2014 Change Day