A series of damaging scandals at NHS trusts along with low morale across the health service has prompted many senior management teams to take action to address longstanding problems.

Few disagree with the view that patient care will benefit from a well-led and motivated workforce and that staff should be empowered more.

The recent health and social care leadership review in England, headed by General Sir Gordon Messenger, has identified worrying levels of discrimination and bullying at some organisations.

The report recognises that many leaders across the health service do a fantastic job in very challenging circumstances, but it also comes at a time of a workforce crisis with chronic shortages amid low morale.

The latest NHS Staff Survey (2021), published in March this year, revealed increased rates of bullying and harassment. Two main themes - staff engagement and morale - worsened between 2020 and 2021. Morale fell from 6.1 to 5.8 and staff engagement from 7.0 to 6.8.

While 62.0% of staff feel safe to speak up about anything that concerns them in their organisation, this has declined by more than three percentage points this year (2020: 65.6%). In certain organisations this ability to speak up remains a major concern.

Reporting wrongdoing – whether that’s harassment, bullying, sexism, racism – is a problem across many parts of the NHS. A culture of anxiety and fear of speaking out among staff at NHS trusts is regularly identified in reviews into repeated failures and scandals around the country.

And yet there are meant to be models of best practice. Sir Robert Francis in his Freedom to Speak Up Review, recommended the need to develop a more open and supportive culture that encourages staff to raise any issues of patient care quality or safety. 

Each NHS organisation is expected to appoint their own whistleblowing guardian, an independent and impartial source of advice to staff at any stage of raising a concern. All NHS organisations in England have been advised to adopt this The Freedom to Speak Up recommendations as a minimum standard to help to normalise the raising of concerns for the benefit of all patients.

Freedom to Speak Up Guardians support NHS workers to speak up but in the latest annual survey, there is a decline in the number of staff who felt safe speaking up about anything that concerns them in their organisation. A growing number of respondents felt senior leaders did not understand the Freedom to Speak Up Guardian role. Something in the internal system seems broken.

It is clear to us that an external, independent whistleblowing hotline service may be the solution. Here at Safecall, we’ve seen a significant increase of senior managers within NHS organisations approaching us to discuss ways to set up an external whistleblowing hotline. That’s because an outsourced hotline is quicker and easier to set up and start managing than creating and staffing one in-house.

Speed and reliability enable organisations to start communicating the benefits to their employees’ and show that they are trying to prevent or stop wrongdoing. Such external hotlines can enhance the roles already provided by Speak Up Guardians.

Using an external whistleblowing service can help build trust and confidence among a workforce. We work with NHS trusts to focus on how they should encourage complaints while also protecting whistleblowers from victimisation. 

There is little doubt that those organisations that treat their employees fairly and actively adopt a speak-up culture will thrive and flourish – especially in an employment market where it’s hard to attract and retain good people.

Whistleblowing hotlines provide a range of benefits. 

• Helps prevent or contain any reputational damage – having advanced knowledge of any wrongdoing before it is exposed proactively helps senior management manage any public relations fallout. Being able to prove that procedures were followed, and due diligence took place can help mitigate the worst effects of wrongdoing. 

• Helps prevent or minimise the stress from wrongdoing incidents – take into consideration the stress and effect on the mental well-being of both management and employees from any exposure of wrongdoing.

• Provides real insight into the organization for senior management – whistleblowing can be used as a gauge of ‘business well-being.’  It gives senior leaders within the organisation tangible data on potential issues that can then be managed

• Morale - confidentiality, anonymity, and protection after a whistleblower has blown the whistle acts as a positive force versus wrongdoing. Regulators know protections for whistleblowers have an essential part of in combatting wrongdoing, and that is why external whistleblowing services – where anonymity can be maintained - are ideal.

A happier workforce is a workforce that trusts they are being looked after. Chancelle Blakey, business development manager, Safecall

• More information can be found at: www.safecall.co.uk/en