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Nurses continue to be the most likely profession to raise whisteblowing concerns through their Freedom to Speak Up Guardians, latest data shows.
In 2019/20, nurses spoke up more than 4,500 times and were responsbile for 28% of cases lodged, higher than any other occupation, according to a new report released today by the National Guardian’s Office in England.
“Speaking up is about anything that gets in the way of providing good care”
While nurses have accounted for the highest proportion of cases raised each year since the launch of the scheme, with more and more coming forward annually, their share of cases overall is falling as the programme grows.
In 2017/18, the first year reporting started under the scheme, 2,223 out of 7,087 total speaking up cases (31%) recorded were raised by nurses.
The following year, nurses accounted for 3,728 of 12,244 cases (30%).
The latest data out today for 2019/20 showed a record number of cases lodged at 16,199. Of these, 4,597 cases (28%) were down to nurses.
Administrative and clerical workers accounted for the next biggest portion of cases raised with Freedom of Speak Up Guardians last year (19%), followed by allied health professionals (13%).
The fourth quarter of 2019/20 coincided with the emergence of the coronavirus pandemic and during this period Guardians received “Covid-19-related worker safety concerns”.
According to the report, these included complaints related to personal protective equipment and the impact of Covid-19 on Black, Asian and minority ethnic workers.
However, at present, Guardians only have the option to officially record and report the percentage of cases that relate to patient safety and bullying and harassment.
In 2019/20, 23% of cases raised included an element of patient safety while 36% included an element of bullying and/or harassment.
The report stated that plans were in motion to expand the categories to capture other types of concerns raised by staff, such as worker safety and wellbeing.
“Workers who experience detriment, or witnesses or hears about it happen elsewhere, may hesitate to speak up in the future”
National Guardian’s Office report
Commenting on the new data, Dr Henrietta Hughes (pictured above), national guardian for the NHS who fronts the scheme, said: “Speaking up is about anything that gets in the way of providing good care.
“So, what these figures tell us is that more and more workers are using the Freedom to Speak Up Guardian route to raise matters that our health services can act upon to improve the experience of patients and workers.”
She added that she hoped leaders would use the findings of the report to “learn and improve” and to help make “speaking up business as usual” by eliminating any fear associated with the process.
In 2019/20, 13% of those who spoke up to a Freedom to Speak Up Guardian opted to do so anonymously, an increase from 12% the previous year.
Meanwhile, in 544 cases (3%), staff members reported experiencing “detriment” for speaking up, although this was down from 5% in 2018/19.
The report warned: “Workers who experience detriment, or witnesses or hears about it happen elsewhere, may hesitate to speak up in the future.
“As workers are the eyes and ears of an organisation – and often the first to identify potential issues – the effect of detriment is a public safety issue.”
The National Guardian’s Office had pledged to use its autumn 2020 Freedom to Speak Up Guardians annual survey to find out more about detriment and the forms it takes.
When the Guardian scheme was set up in 2016 at the request of Sir Robert Francis following his inquiry into failings at Mid Staffordshire NHS Foundation Trust, its remit only extended to NHS trusts.
Now nearly 30% of the 600 Guardians in England are based in other healthcare organisations although the vast majority of speaking up is still happening in the NHS, led by cases reported from mental health, learning disability and community providers.