Thursday, 27 July 2017

Failing trusts but what about failing leaders of failing trusts?

Failing trusts but what about failing leaders of failing trusts?

In April this year, ITV News reported that Northern Lincolnshire and Goole NHS Foundation Trust was to become the first trust in the country to re-enter a failure regime after inspectors found that patient safety and quality of care had "deteriorated".
http://www.itv.com/news/calendar/2017-04-06/northern-lincolnshire-and-goole-nhs-trust-back-in-special-measures-after-inadequate-rating/ 

"Having seen improvements to patient care previously, we are disappointed that our latest inspection of Northern Lincolnshire and Goole NHS Foundation Trust found these improvements had not been sustained and there had been an overall deterioration in quality and patient safety. We will continue to monitor the trust and will return to check on the progress it must make. NHS Improvement will be working closely with the trust to ensure full support is available to make the improvements needed."
– Ellen Armistead, Care Quality Commission www.cqc.org.uk www.cqc.org.uk

Clearly something was going very wrong there but  at a public consultation held at Grimsby Town Hall, hosted by Northern Lincolnshire and Goole NHS Trust (Nlag), aimed at updating local people on the progress Nlag is making to be removed from special measures the trust chairperson insisted that things were improving. 
http://www.grimsbytelegraph.co.uk/news/grimsby-news/grimsby-hospital-trust-chair-launches-175112 http://www.grimsbytelegraph.co.uk/news/grimsby-news/grimsby-hospital-trust-chair-launches-175112

If that is so, then why had a senior manager felt the need to write anonymously to the local MPs stating that
"It is with sadness and regret that I find myself in the invidious position of having to write to you anonymously regarding the leadership and general direction of travel for the above organisation.
I do not feel able to identify myself and despite having held a senior position in the organisation for many years I feel the time has come for me to share my concerns.
Despite the CQC having recently visited us, I don’t feel that culture and general leadership have been addressed sufficiently for long term change to be made.
Despite our second visit to “special measures” in a short space of time it appears that the divisive Executive Team remain in situ. Since the CQC visit, things have worsened dramatically – the imposition of impossible deadlines, no clear sense of direction of travel and veiled threats do nothing to enhance patient care, and produce a sense of cohesiveness and wellbeing for staff.”

When I read the response of the chair, Anne Shaw, I knew there was seemingly little hope of change for that anonymous senior manager. A humble, caring, compassionate leader would apologise to the manager who had felt so powerless and thank them for taking that step, that obviously cost them dear, especially when the CQC had mentioned their concerns about the culture too. 

However, her response underlined how dysfunctional the management team had become.  The Grimsby Telegraph reported ‘in response, Ms Shaw, hit back at the author
Ms Shaw, said: "We need people like that to think about what they are doing. My door is always open to talk to staff. I want people with concerns to come to me first.
"Headlines like this make people feel anxious and upset and don't tell the whole story. It bears no relation at all to us as an organisation.
"This person is part of the reason the trust is in special measures. This individual is disappointing and is clearly frustrated.
"Any staff member who doesn't feel valued has people who they can talk to."

Having made that attack on the anonymous author, the newspaper report went on to say -
Ms Shaw also apologised on behalf of the trust for its lack of efficiency, and blamed the CQC's findings on "complex and numerous issues", as well as the "sheer number of people" seeking care, who go to hospital with complex needs.’

Yes, the numbers of people seeking treatment have risen alarmingly and it is a huge problem for trusts but what was the management speak all about - these "complex and numerous issues”!

 There you have it, a trust in great difficulty and a management that is still allowed to function, even though the CQC officials said they remained concerned about the organisation's culture, adding:
"There was a sense of fear amongst some staff groups regarding repercussions of raising concerns and bullying and harassment".  – Care Quality Commission reported by ITV News.

For the sake of the anonymous whistleblower, I hope s/he hasn’t been identified and is able to leave before more damage is done to that person’s health and family life,  that the writer described.

What hope is there for those employees while the trust continues with those managers, and how many staff will give up before then and get out, whilst patients continue to suffer?

Yours despairingly
Julie


Tuesday, 30 May 2017

Action, not words, is needed but what?



Action, not words, is needed but what?

Recently I was able to attend the Turn up the Volume 2 conference in London, called and arranged by Steve Turner.  See https://www.nonexecutivedirectors.com/steve-turner-ned-9574.html for details of Steve’s career and extensive experience.  In particular, in 2014 he set up and continues to manage Care Right Now (CIC)www.carerightnow.co.uk a Social Enterprise Company delivering healthcare service development, based on education and learning.  And yes, he was a whistleblower with the usual destructive outcomes.  Grim but after recovery from the harm, Steve is very much back in action.  Inspirational.

Steve had lined up an eminent group of people to describe what they are doing to try and change the culture in the NHS so that it is safe for whistleblowers to speak.  Better still of course would be no further need for whistleblowing, with listening and responding trust boards, as some are now starting to do.  We can dream that one day it will be all trusts.  (See the website Care Right Now (CIC) for details of the speakers at Turn Up the Volume 2.

There were frequent opportunities for the audience to contribute their thoughts. Many of the audience were whistle blowers so well placed to speak.  

When the www.suspension-nhs.org website was set up in June 2003 it attracted a small group of people who had fallen foul of their organisations, had experienced the horror of suspension, the worst thing that had ever happened to them, one of them concluded.  These people joined me in helping people in similar situations and we all began to campaign.  Some have continued but I stopped to care for my husband.  He was set free from Parkinson’s disease last year and I am free to return to the campaigning.  I am also in the process of updating the www.suspension-nhs.org website.  

I went to the conference to get some ideas of what is happening nationally and what CAUSE (Campaign Against Unnecessary Suspensions and Exclusions UK) can do to try and stop the injustice and inhumanity of unfair suspensions and all it entails. 

En route I read the document published in 2014 by the whistleblowing helpline called ‘Raising concerns at work’. (See www.wbhelpline.org.uk to read or download a copy.) The Secretary of State for Health, Jeremy Hunt, wrote in the Foreword,
‘Staff should be supported and protected when they raise concerns, as well as praised for their courage and thanked by management as a key part of the effort to build a safe, effective and compassionate culture that patients, service users, the public and the overwhelming majority of staff across health and social services expect.’

A loud amen to that but it is not happening everywhere and the usual horror story follows.  More action is desperately needed. Contact enquiries@suspension-nhs.org with your suggestions for what can be done please.  

Here is to justice and truth and patient focused honest care.
Julie

Tuesday, 12 January 2016

So what are whistleblowers up against?

Poetry makes the point

One of my great sadnesses is that staff in the NHS and elsewhere fail to understand the immense suffering caused by wrongful suspension, whether it be for a mistake, whistleblowing or false allegations from a jealous colleague. 

Becoming mentally ill is the norm, since people are unable to think clearly or sleep, and appetite disappears - all ingredients for physical and mental illness.  The body just can’t take the strain especially as the victim is usually a person of integrity with high personal standards and a great love for their job.

 I wrote an article for the Health Service Journal some years ago and the HSJ commissioned a cartoon.  The artist showed a huge liner leaving a distressed NHS employee stranded on a tiny island while it sailed into the sunset.  Brilliant.  It probably helped with my dismissal, a small but painful price to pay?

More recently, a sufferer of injustice has been putting pen to paper and conveying something of the powerlessness of the victim and the unaccountability of the well paid perpetrators.  Read on….

Whistle and they’ll come for you…

 
I’m the last of the radical nurses
I’ve got Bevan tattooed on my bum
and I believe that the sickest of patients
get the least care and that’s wrong.

I don’t like this tick-box culture
nor doing the care on the cheap
and I don’t think the family silver
should go to a great private heap

I think that the management tiers
pay themselves what I consider excess
as they preside over a system that’s failing
and ensure staff are blamed in the press.

I’ve watched all my NHS heroes
Graham Pink, David Drew….Rita Pal
speak out for what they believe in
to get thoroughly trounced
and I howl!

I’ve gone up the management ladder
to raise my concerns time by time…
So these poems are my very last option
to whistle blow here in bold rhyme.

Written warning
 
A word of wisdom in your ear…
‘You care too much!’ they said
Our job is ticking boxes
We are audit culture lead.

So take your fine ideas
You can protest in your head
Our job is ticking boxes
Initiative is dead.

Part of the union
 
When we asked for some support from the union,
we were bowled over when we were told
You must do as your managers tell you
And you’ll keep a job ‘til you’re old.

If they don’t want you to talk to the doctors
or log on their computers… OK.
It’s only about vulnerable patients
So not the management plan to this day.

and finally with thanks to the author who for obvious reasons has to remain anonymous….

Speaking up

 
If you are a doctor
they damn your career to hell.
And if you are a nurse
they discipline you if you tell.

But if you’re at the very bottom
the kicks and cuts are tough
from your erstwhile colleagues
when you are beaten up.

The suits who take the salaries
they really don’t want to know
as their next promotion
is where they are keen to go.

So don’t speak up for the patients
The vulnerable and the old
‘Cos when you work in healthcare
You should just do as you’re told.

Again my sincere thanks to the author of these verses.  They capture so much, so well.  I hope they get a wide readership.

And judging by the steady numbers of staff still contacting the www.suspension-nhs.org team, nothing has changed.  Dire for us all, in every capacity.

Julie

Friday, 16 October 2015

Can people recover from suspension and other workplace bullying?

Is there any help anywhere?  Read on……

‘Tim Field, who died in 2006 aged 53 from cancer, was a world authority on bullying and psychiatric injury, and author of the best-selling Bully in Sight (1997). His vision was for a bully-free world, and he campaigned in schools, further and higher education, and the workplace to achieve this.

In 1994, after nearly 20 years working in computing, he had himself been a victim of workplace bullying and suffered a breakdown. After recovering, he became passionate about understanding and dealing with the problem.

He set up the UK National Workplace Bullying Advice Line in 1996, and then an information website, Success Unlimited (later Bully Online), which was widely used. He formed a publishing house from which he released Bully in Sight. One review said: "Thank you for writing Bully in Sight. It's like a torch in the darkness." Tens of thousands of copies were sold in 30 countries. In 1998 Field published David Kinchin's Post Traumatic Stress Disorder: the Invisible Injury. Then, in 2001 he co-authored and published (with Neil Marr), Bullycide: Death at Playtime, an exposé of child suicide caused by bullying.

He lectured all over the world. His clients included individuals as well as institutions such as the BBC, trade unions, police forces and local authorities. He worked personally on more than 5,000 bullying cases, highlighting the lack of understanding for victims. He revealed patterns showing how trade unions often failed to deal effectively with the problem among their members.

Field believed that bullying was the single most important social issue of today, and that its study provided an opportunity to understand the behaviours which underlie almost all conflict and violence. His work inspired and influenced international anti-bullying organisations, while his personal energy, commitment and knowledge restored sanity and saved lives.’  (Written by Will Messenger http://www.theguardian.com/news/2006/jan/21/guardianobituaries.mainsection )

This year’s Memorial lecture is on Saturday, 7th November 2015 ‘Surviving Bullying at Work ‘
to be presented by Dr Keith Munday.  


It will draw on the findings of recently undertaken research which explores the experiences of those who have been bullied by their co-workers. Some of the factors which facilitate post-traumatic growth will also be considered.

Proceedings will start at 1.15pm, in the Sumpner Lecture Theatre, Floor 6, Main Building, Aston University, Birmingham, B4 7ET, UNITED KINGDOM

(15 minutes walk from New Street Station).

Email: annualtimfieldmemoriallecture@gmail.com

Facebook: www.facebook.com/AnnualTimFieldMemorialLecture

Hope you can make it.

With very best wishes for your own recovery journey
Julie

Tuesday, 24 March 2015

Robert Francis report – sack malfunctioning managers

The Robert Francis report published recently said nothing new for all of us who are whistleblowers or who have fallen foul of NHS managers by being outspoken. 

Nor does it give any hope to the many family members campaigning for the truth to be revealed after poor treatment and even the deaths of their loved ones – in many cases, campaigning for years.

The Week publication (www.theweek.co.uk) provides a summary of all the week’s news, giving multiple comments and opinions from the daily newspapers.  It was interesting to read what were some of the national newspapers’ journalists’ conclusions, journalists who are considered to be articulate, intelligent people.

One journalist reminded her readers of the terrible harm done to staff raising concerns about practices and conditions that subsequently cost patients’ lives.

These cruel actions taken against staff are depressing, distressing and of course disastrous for the patients, who are the defenseless recipients of poor care and management.

Sir Robert’s 20 recommendations are described as rather timid by one reporter who suggests that sacking bad managers would send a stronger message.  Here here!  Accountability for these unlawful actions is the word that springs to my mind. (These managers usually  ignore employment law practices designed to protect staff - and employers.)

The final comment reported by Andrew Smith in the Guardian (www.theguardian.com ) describes the number, style and reward for managers as causing them to be distanced psychologically from the workforce, acting defensively when challenged or scrutinised.  He suggested they are running the organisations for their own benefit.

Absolutely!  But what is to be done about them when the managers protect one another and tell horrendous lies to cover up, with the help of solicitors who fight their corner?
 
Taxpayers, wake up! 

Julie

Friday, 23 January 2015

Whistleblowing and psychological safety

The Psychologist’ is the journal for the British Psychological Society (BPS).  Its strapline is ‘promoting excellence in psychology’.  In its September 2014 issue, in the Letters page, Dr Joanna Wilde, Chair of the BPS Working Party on Work and Health, wrote to say that her group were ‘researching whistleblowing and psychological safety in light of the recently reported catastrophic failures in organisations’.

What is already known, she wrote, is that although they haven’t researched the healthcare sector, research in other similar sectors is that whistleblowing results in very negative consequences with 75% of respondents reporting a move to dismiss them.  Nearly all reported experiencing being bullied after raising a concern.

That is so often a precursor to suspension for many of the people who contact www.suspension-nhs.org .

There is a substantial body of research into group processes Dr Wilde wrote, so that whistleblowing can be conceptualised as a ‘form of psychological martyrdom or suicide.  For those who do not speak, it is experienced as a form of treachery, which has always been the last crime to have the death penalty removed’.

That is a brilliant description of the effect of whistleblowing for the whistleblower, who may well not even think of themselves as such but who feel they cannot continue to remain silent in the face of what is happening to their patients. 

Dr Wilde identifies predictors of low psychological safety including deficiencies in leadership behaviours and evidence of tolerance for bullying.

Again this strikes a chord and hopefully the research of the Working Party will provide further evidence to show that work needs to start at the other end of the process ie with the behaviours and accountability of managers, rather than threatening staff if they fail to raise concerns.

Thank you Dr Wilde.  We wish you every success. 

If you wish to contribute to Dr Wilde’s research, her email address is bpswhchair@gmail.com

She is also a member of the Founders’ Network,
‘a group of representatives from diverse professional and occupational organisations formed to create change within the NHS in order for staff to be able to better care for patients. We were founded in July 2014 on the initiative of Clare Gerarda, Lambeth GP, Medical Director NHS Practitioner Health Programme, and Rex Haigh Medical Psychotherapist and IGA (Institute of Group Analysis) Board Member.
We recognise that there are serious problems with working life in the NHS and are creating a destructive and sometimes toxic environment that threatens the success of the NHS. The absence of an empathic environment destroys the confidence, creativity and health of staff.  The NHS needs to create a fit-for-purpose environment in which it is possible to consistently plan, commission and deliver health care.  
   Taken from  www.foundersnetwork.uk

Maybe, along with Patients First (www.patientsfirst.org.uk ) there is light at the end of the tunnel?

Yours hopefully
Julie

Friday, 3 October 2014

Poor managers v dynamic managers


Sometimes a leader in nursing in the NHS writes something that seems so patently obvious that it is quite breathtaking that it had to be written, but is also so true.  Deputy chief nurse Pete Murphy did just that in an article for the Nursing Times about improving nursing (Nursing Times Staff Management article 24 9 14).

He wrote ‘You (as a deputy chief nurse) cannot sit in your office and be effective, you have to get out and about, see and talk to patients and staff to understand the opportunities and pressures that exist. Personal integrity is key.’ 

One of the saddest aspects of unjust and unnecessary suspensions, is the lack of knowledge by the managers concerned higher up the chain of command, who don’t know their staff, and don’t know that this is a silencing or bullying issue.  Such disloyalty, such ignorance as to the very severe damage this action does to people, sometimes destroying them, is utterly depressing. 

It also needs an environment where leaders are allowed to do this, to know staff in order to support them.  In the early days of CAUSE, we heard from a first level manager who tried to do just that and was nearly destroyed.  False allegations, suspension, disciplinary action, removal to another part of the organisation.  It was more than a year before she was well enough to work again, outside the NHS of course.  Who would trust anyone there again?

‘Personal integrity is key’ is the other staggering comment written by Mr Murphy.  Something that you would expect to be a given, has to be written.  That is another problem with unjust and unnecessary suspensions.  The suspending manager now has to justify their action, prove themselves competent to their colleagues.  A ‘transparent and fair investigation’ – they don’t know the meaning of these words.  What they do know, is that they now have to prove their action was justified, so the witch hunt begins.  Look at record keeping, talk to other staff to see if someone there will complain about this staff member who has annoyed the manager by speaking out or by being very good at their job and well respected by the patients.  Integrity?  They don’t know the meaning of that word either. 

One of the aspects of the whole sordid business for family members and friends, observing events, is their astonishment and disbelief that this can happen without any other managers being aware and that the poor powerless staff member, the ‘accused’ has no redress.  The words ‘kangaroo court’ are often used to describe these situations.

Thinking about the inquiry into whistleblowing by Sir Robert Francis, the team seem to be starting at the wrong end of the problem.  Yes they need to hear people’s stories, the like of which they have already listened to in the Mid Staffs inquiry, but they also need to be interviewing the very managers involved in the injustices to see what can be done to prevent them from behaving in these horrendous ways.  They won’t hear any truth from them of course.  They will be trying to save their careers.  That is what makes it so difficult.

So back to Mr Murphy.  I hope his words have an impact but fear that the people who should be reading them, don’t take professional journals, don’t keep up to date and avoid self reflection like the plague.

Gloomily yet again!
Julie