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All GP practices should have to appoint whistleblower guardians, says DH-commissioned review



All GP practices should have a designated, independent person to which doctors, nurses and staff can turn with concerns about care failings, Sir Robert Francis QC has recommended.

Sir Robert – who led the review into failings at Mid-Staffordshire NHS Foundation Trust – published his high-profile report into a culture of bullying of whistleblowers within the NHS today, which recommended that the GP contract should include a standard for allowing staff to ‘raise concerns freely’.

The Government announced that it supported all of the report’s recommendations in principle and would go ahead and consult on their implementation.

As part of the review, Sir Robert conducted a confidential survey sent to all NHS workers, employers and associated organisations, finding that 30% of those who raised a concern felt unsafe afterwards while 18% of those who had not raised a concern expressed a lack of trust in the system as a reason, and 15% blamed fear of victimisation.

As a result, he recommended 20 action points be taken, one of which exclusively covered the GP contract, and said that all health organisations should have a designated individual to whom staff can turn when they have concerns over care.

He said he considered it essential that the support recommended ‘should be available to NHS staff who work in primary care.’

Consideration should be given to how this can be provided, he added: ‘Federations of GP practices may be able to appoint a Freedom to Speak Up Guardian; others may be able to sign up the services of their local NHS trust’s Guardian, as happens already in at least one area.’

The GP contract should be amended to provide protection for staff who speak up, the report said.

It added: ‘NHS England should include in its contractual terms for general/primary medical services standards for empowering and protecting staff to enable them to raise concerns freely, consistent with these Principles.’

Announcing the Government’s response to the report in the House of Commons today, health secretary Jeremy Hunt said: ‘I can confirm today I am accepting all his recommendations in principle and will consult on a package of measures to implement them.’

He said that the Government will legislate to protect former whistleblowers when seeking new employment in the NHS so that they are not discriminated against and that the royal colleges will be reviewing how there can be more ‘clinical accountability’ in community care, building on the measure of accountable GPs that is already being rolled out.

Mr Hunt added: ‘The only way we will build an NHS with the highest standards is if doctors and nurses who have given their lives to patient care always feel listened to if they speak out about patient care. The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS.’

Sir Robert has been leading several reviews into the culture of NHS care since being appointed by the Government to look into failings at the Mid Staffordshire hospital during the 2000s, making several hundreds of recommendations that are being implemented by the Department of Health and NHS England.

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