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NHS England wants GP whistleblower ‘guardians’ by next year

All GP practices will have to appoint a whistleblower ‘guardian’ by April next year, under draft guidance published by NHS England.

Under the plans, each primary care provider will have to provide a named individual to whom staff can turn to raise concerns and receive support.

NHS England, which is consulting on the guidance over the next five weeks, specifies that the new ’freedom to speak up guardian’ has to be ’independent of the line management chain and not the direct employer’.

The guidance follows recommendations made by Sir Robert Francis QC in his Freedom to Speak Up report into a culture of bullying in the NHS, published in February last year.

His report suggested the GP contract should include a standard for allowing staff to ‘raise concerns freely’, noting that a smaller work setting can present challenges round anonymity and conflicts with employers.

NHS England’s draft guidance says that:

  • Each provider should name an individual, who is independent of the line management chain and is not the direct employer, as the Freedom to Speak Up Guardian. They can offer support and listen to staff raising a concern;
  • NHS primary care providers should be proactive in preventing any inappropriate behaviour, like bullying or harassment, or discrimination towards staff who raise a concern;
  • All NHS primary care providers should review and update their local policies and procedures by March 2017, to align with the agreed guidance.

NHS England suggested that in larger GP practices or federations, the guardian could be someone within the organisation, but that smaller practices could make an arrangement with, for example, another local practice; with the local hospital freedom to speak up guardian; someone in the CCG; or the NHS England responsible officer.

Neil Churchill, NHS England’s director for patient experience, said: ‘This guidance builds on existing good practice, gives staff in primary care more options to share any concerns and sets out our expectations about how those concerns should be handled.’

GPC chair Dr Chaand Nagpaul said the GPC had yet to be consulted on the plans, which ’must not just simplistically impose a single whistleblowing solution to GP practices, regardless of size and type’.

He said: ’The real elephant in the room is how we can whistleblow regarding concerns to the wider system problems GPs face, such as inappropriate demands being made of them – like being asked to arrange patient care and prescribe beyond their competence and being asked to take part in schemes with perverse incentives.

’This focuses on the microcosm of the GP practice. The far bigger issue here is not being determined in practices but in the wider environment.’

But Dr Andrew Mimnagh, a GP in Sefton, said: ’It has been easy in the past to say the right thing to the wrong person and be punished for it, especially if management systems are complicit. If you can say the right thing to the right person then yes, that would be useful.’

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