Speaking up for safety

Patient care is once again going to be subjected to huge upheavals and yet another re-organisation. The latest, heralded by the new coalition Government in their recent White paper “Equity and excellence: Liberating the NHS” will be significant. The press has recently been full of the number of potential job cuts and economies which must be made. However, until the comprehensive spending review is published this month, it is all speculation. Anecdotally, many NHS Trusts are already making plans for economies, and the Royal College of Nursing (RCN) has a campaign, “Frontline First”, to gather data on cuts and waste. Dr Peter Carter, chief executive of the RCN wrote in an important message to all the organisation’s members: “I know that you want to make sure that the tremendous improvements that have been seen in nursing and healthcare are not lost as the NHS is radically changed.” Above all, we have to ensure, as healthcare professionals, that we are able to raise concerns about patient safety – whether it is reductions in staffing, re-organisation of services or merging of organisations to reduce overheads.

When concerns need to be raised, the culture of the organisation needs to be such that whistleblowing is possible. The blame culture of years gone by is all behind us. Or is it? How is the NHS performing with regards to being open? When things go wrong for patients, there has been a huge drive by many different agencies to ensure that we are transparent and open with patients. Peter Walsh,2 chief executive of Action Against Medical Accidents (AvMA) identifies that there are mixed messages being given to Trusts by the NHS Litigation Authority and National Patient Safety Agency (NPSA). It is encouraging that the NPSA has re-launched an updated version of “Being Open”,3 although he suggests that the NHS still has much further to go before it can say that the culture of denial is not alive and thriving.

Whistleblowing