Standing up for patient care

Published: 17 August 2011

A recent Panorama documentary showing shocking abuse of people with learning disabilities at a residential home in Bristol appalled the nursing profession. Secret filming exposed a culture of physical and emotional torture in an environment where vulnerable people should have been safe. Questions were asked about how it was allowed to happen and why concerns raised at the care home were not escalated in an appropriate way. Others pondered why more staff members didn’t speak up and come forward to raise the alarm.

What should you do if you witness poor care?

Blowing the whistle isn’t easy. Many people feel scared about the impact it might have on their career, the implications for their reputation and the attitudes of colleagues where they work. It can be a difficult decision so it is advisable to be sure about what you saw before raising the alarm. If, however, you are convinced patient safety is at risk, it is important you share your concerns.

Although as a health care assistant or assistant practitioner you’re not regulated by the Nursing and Midwifery Council (NMC), the advice it gives on the issue is a good guide on how to act. Its publication Raising and escalating concerns says nursing staff have a professional duty to put the interests of the people in their care first and act to protect them if they consider they may be at risk.

It also advises:

• acting without delay if you believe that you, a colleague or someone else may be putting someone at risk
• informing someone in authority if you experience problems that prevent you working safely
• reporting your concerns in writing if problems in the environment of care are putting people at risk
• reporting your concerns without delay to the appropriate person or authority if you witness or suspect there is a risk to the safety of people in your care and you consider there is an immediate risk of harm.

The RCN is also here to help. Speak to a local representative, like a steward, who may be able to raise the issue through organisational policies. You could also call the RCN’s confidential whistleblowing hotline on 0345 772 6300 if local attempts to resolve the issue have failed.

What does the law say?

There is legal protection in place for people who whistleblow. For example the Public Interest Disclosure Act 1998 (PIDA) protects against victimisation of workers who speak out against genuine concerns about malpractice. The PIDA extends the greatest protection to those who disclose to their employer. While you will also have some legal protection if you disclose to someone else there will be a greater expectation on you to be sure the information you disclose is true. You are also protected if you disclose information in the course of obtaining legal advice or to a statutory body such as the Care Quality Commission (CQC). It is more difficult to get protection under PIDA if you disclose your concerns to the media.

How do I raise concerns the right way?

The RCN recommends the following steps:

• make sure your concerns are being raised in the public interest. Never use whistleblowing procedures to pursue a private grievance
• record your concerns in writing
• read the NMC guidance Raising and escalating concerns and act in accordance with its advice
• read the whistleblowing policy of the organisation where you’re working. It should be explicit who on the board has ultimate responsibility for enforcing the policy. If there isn’t a policy, raise this with your local RCN representative/regional or national office
• if you have exhausted other options but still have concerns about patient care, you can call the RCN’s confidential whistleblowing hotline on 0345 772 6300.