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Chilling warning that scandals across NHS will be covered up as staff say whistleblowers are ignored

In wake of missed chances to catch killer nurse Lucy Letby, figures show doctors and nurses’ widespread concerns about sounding the alarm

Rebecca Thomas
Health Correspondent
Saturday 26 August 2023 20:05 BST
Olivia Pratt-Korbel's mother says 'heart goes out' to Lucy Letby victims' families

More than half of NHS staff believe bosses would ignore whistleblowers amid fresh concerns hospitals could be covering up potential scandals following the Lucy Letby case.

New national figures seen by this publication reveal that in the majority of hospitals, most doctors and nurses do not believe their concerns would be acted upon if they were raised with senior managers.

It comes after The Independent revealed that NHS bosses accused of ignoring complaints about Letby were the very same people later appointed to act on whistleblower concerns at the hospital where she murdered seven babies and tried to kill six more.

Several doctors who worked alongside her during the killing spree say they attempted to raise the alarm with hospital managers – only to have their pleas ignored. They believe the lack of action by bosses resulted in more babies being killed, stating managers who failed to act were “grossly negligent” and “facilitated a mass murderer”.

In nearly three-quarters of general hospitals – such as the Countess of Chester where Letby worked – fewer than half of staff believed their trust would act on a concern, according to results from the latest NHS staff survey.

As the figures were revealed, the NHS was accused of a “widespread” and “pervasive” problem with addressing whistleblowers’ concerns.

Doctors who raised concerns about Letby have said more needs to be done to protect whistleblowers and have called for new laws to regulate managers working in the NHS.

Dr Bill Kirkup, who headed the East Kent and Morecambe Bay maternity scandal reviews, warned that the figures show a “widespread problem” of “denial” and “reputation management” across the NHS.

He warned of another major scandal waiting to happen if NHS hospitals fail to address the issue. “I fear the same things, which happened in East Kent and Morecambe Bay, will happen again and again,” he said.

Rob Behrens, the parliamentary health service ombudsman, also warned of a “dismissive and defensive attitude” across the NHS.

He added: “It seems leaders are more concerned about the reputation of their organisation than patient safety. This does not suggest an open, honest or transparent culture that encourages people to raise complaints or feel confident that their concerns will be listened to.”

According to the survey, in 87 out of 125 general hospitals, less than 50 per cent of staff said they would feel confident that a concern would be listened to.

Once community and mental health hospitals were included, the number of staff who felt confident in blowing the whistle was below 50 per cent, in 108 out of 220 hospitals.

Separate figures also show the number of whistleblowers complaining to the NHS’s national whistleblowers office about their treatment for speaking out has quadrupled in two years, from 171 to 937.

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Meanwhile, a charity representing NHS whistleblowers told The Independent that 60 per cent of people they dealt with so far this year felt “victimised” after raising concerns. Forty per cent of whistleblowers said no action had been taken over their concerns.

Dr Kirkup told The Independent: “Without a doubt, we have a problem. I’ve obviously seen it so many times but everything I’ve seen and heard, including the staff survey data, suggests this is a much more widespread problem.

Dr Bill Kirkup warned that the figures show a ‘widespread problem’ of ‘denial’ and ‘reputation management’ across the NHS (PA)

“I think it tracks back to this thing that we tend to call reputation management, which is the reaction of people and organisations to find reasons to deflect in the name of protecting the reputation of the organisation and, to be frank, sometimes themselves.

“I think that’s one of the reasons why they not only don’t welcome what they would say is bad news in these circumstances – but they will actively suppress it to the detriment of the people who are trying to raise the concerns.”

Ann Lloyd Keen, chair of the Patients Association, which represents NHS patients, said an open culture where staff can actively raise concerns is “critical” for patient safety but that many NHS trusts have a “defensive culture”.

Dr Ravi Jayaram was among those who raised concerns about Lucy Letby to hospital bosses (ITV News/PA Wire)

She added that trusts sometimes regard patient complaints as an “annoyance or a threat” and added that “closing ranks, denying, and defending” are a “common feature throughout the long and shameful list of NHS safety scandals”.

“The Letby trial shows the same thing happened when clinicians raised their concerns, with awful consequences,” she said.

According to the National Guardian for Freedom to Speak Up office, appointed by the Care Quality Commission to represent whistleblowing officials in each NHS hospital, there were 937 cases in 2022-23 brought to it where staff were “suffering detriment as a result of speaking up”.

Rob Behrens, the parliamentary health service ombudsman, warned of a ‘dismissive and defensive attitude’ across the NHS (Parliamentary and Health Service Ombudsman)

Dr Jayne Chidgey-Clark, the National Guardian for Freedom to Speak Up, said the staff survey results show a “worrying decline in people feeling that if they raised a concern, something would be done about it”.

She added: “If actions are not taken, workers feel powerless, and that speaking up is futile. Just as if they are retaliated against for speaking up, they may remain silent, and that silence can be dangerous.”

Dr Chidgey-Clark said Letby’s crimes were “unthinkable” but warned: “For all those leaders who think ‘this is rare, it couldn’t happen here’ – I want to challenge them to think, how would I respond to uncomfortable concerns – would I be defensive? Or would I take action? This case should focus the minds of all leaders in healthcare.”

Andrew Pepper-Parsons, from the charity Protect, which represents NHS staff members who blow the whistle, said staff who reported feeling “victimised” were mainly targeted by managers.

He said: “I think there is a natural defensiveness, unfortunately, where managers don’t want to hear bad news and the instant reaction sometimes is to focus on the messenger rather than dealing with the actual concern.”

Mr Pepper-Parsons said NHS managers not being regulated to the same standard as practitioners was also a problem. This week, Dr Stephen Brearey, who first raised concerns over Letby, called for managers working in the NHS to be regulated – something which NHS chief Amanda Pritchard is reportedly considering.

Tristan Reuser faced an employment tribunal after raising concerns over unsafe nursing levels in 2017 (Tristan Reuser)

Whistleblower Tristan Reuser faced a four-year employment tribunal battle with University Hospitals Birmingham, one of the largest NHS trusts in the country, after he raised concerns over unsafe nursing levels at the trust in 2017.

He raised the issue after being forced to use a non-clinincal member of staff to help during a procedure, for which he was later sacked.

Following a drawn-out employment tribunal, it was ruled that he was unfairly dismissed by the trust. The General Medical Council also cleared him over the use of a non-clinical staff member in surgery.

He said his concerns were “not taken seriously”.

An NHS spokesperson said it is vital that everyone working in the NHS feels they can raise concerns and that it reminded leaders of this on Friday when hospitals were told they must “urgently” ensure staff know the procedure for doing so.

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