Discrimination stops temp workers speaking up

An investigation has revealed that a culture of fear and discrimination is preventing temporary staff from raising concerns over safety. So how can we strive to address a more open culture of learning, where staff feel safe to speak up?

The latest investigation report from the Health Services Safety Investigations Body (HSSIB) has revealed there is widespread discrimination against temporary staff in the NHS and this creates a culture of fear that stops them speaking up about patient safety. The findings were identified during an investigation HSSIB were carrying out looking at the integration of temporary staff into healthcare providers.

During their investigation, HSSIB heard the discrimination experienced by temporary workers is due to their work status and sometimes due to their ethnicity. As well as having a negative impact on their wellbeing, HSSIB report states that temporary workers' experience of discrimination and barriers to speaking up may mean they do not share patient safety concerns, and therefore mitigations to safety risks may not be put in place.

Throughout the course of their investigation HSSIB carried out site visits and engaged with NHS trusts, providers of bank staff, agencies that supply staff to the NHS, substantive (permanent) NHS staff, bank and agency staff, and a range of national stakeholders. Agencies told HSSIB that because of the culture that can exist within healthcare providers, temporary staff can feel vulnerable about raising concerns. Temporary staff told the investigation that raising concerns can lead to them being seen as a "troublemaker", potentially resulting in them being "blacklisted" from working at the provider.  They also described feeling unwelcome, not part of the team and "disposable" while working in the NHS. They had been told "we don't need you" when having been deployed and substantive staff sticking together, not providing them with support and, on occasion, not passing on important clinical information or answering questions.

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