Monday, 11 February 2019

How to protect yourself if you need to blow the whistle.

An honest practitioner with a very high level of integrity, wishes to ‘come out’ about the failure of an NHS service in their area, as serious as any already in the public domain, costing lives.

What does that person have to do, to ‘come out’ safely and unscathed?  Is it even possible?

Even writing these questions feels dangerous, such is the corrupt nature of some of our NHS management.

For example, in order to prepare for his whistleblowing, a consultant had his mental health checked before he blew the whistle because he knew they would say he was mentally ill - and they did!  He had the evidence to show he was in fact perfectly sane.

If an activist ‘comes out’ the huge danger is that management will make false allegations and the activist will be suspended with all that follows, therefore stopping the campaign and  causing the activist long term harm.

Would it be possible to take a very very low profile, to be unidentifiable?  Or even resign from post. And then be active.
What a choice to have to make.

Might there be a high profile champion, and would this champion be safe from false allegations and action against them too?  Probably not judging by the high profile people who have become victims over these last years.   Ironically, allowing the failings, even knowing they are in the wrong, seems to drive management forward, loudly proclaiming their innocence almost as a matter of principle, or is it all about protecting themselves?

Craig Longstaff is a veteran whistleblower.  He added the following very insightful safety requirements.

(1) If someone wants to be "active", they need to go to the very top & garner full support from the chief executive officer, or resign & then become active.

(2) NEVER blow the whistle or rock the boat from within, while you are vulnerable & dependant on them paying you - find another job, resign (stating why in the resignation letter - as per recent case law on the issue of resignation letters / dismissal claims) - & blow the whistle in writing on the exit day.

(3) Ensure, before they start rocking the boat / striking the match, that the person has up-to-date appraisal / performance reviews (& get copies if they don’t have them) that are dated & signed by both the staff member AND (especially) the senior/reviewer.

Hopefully this will show positive outcomes; they need to make sure it is covered & documented in their appraisals that management have no issues.

When the time comes - & sadly on balance it will - where they are accused falsely, investigated & the chronology of "issues" is back-trawled (it has been known to be 4 years and longer)  they  can use their appraisal/s to link sudden changes to any "non-compliant" activity managers are claiming, thus creating legal causal link to bullying and harassment /victimisation.

(4) Be mentally & emotionally aware of the ramifications of good actions around socio-psychopathic managers & HR staff; you can never prepare for the depths they stoop to, but you can be aware & try to counter.

(5) In any investigation say as little as possible  because they WILL "misinterpret" & manipulate your words to fit their intended outcome.

It is for them to prove guilt, not the accused to prove their innocence, whilst countering any "evidence" presented where necessary.

If possible, make written statements only (so first meeting/s, let them know nothing will be said until the very end when they've provided all their accusations & evidence - be VERY aware of trap interview tactics. Reply to their questions with more questions, rather than pliable verbal replies / statements, as much as possible.

(6) Finally, keep focused & see the wood for the trees (keep situationally aware & avoid tunnel vision), & don't become a victim - I did, & I'm still recovering.

There is a lot of published research to support what is being written here.  Here is one such powerful recent example.

Dr Rachael Pope has found organisational silence to be a significant aspect of NHS organisational dysfunction that is very powerful and stops those organisations from learning and changing, hence recurrent public inquiries into failed and failing NHS services that may cost patients their lives.

Dr Pope’s research has identified a culture of blindness, deafness and destructive behaviours that effectively silence and destroy.

Staff are afraid to speak out.  Their actions won’t hit brick walls but instead effective silencing actions that can engulf and destroy them.

How different it would be if the NHS was willing to listen and learn honestly in a culture of respect.

See Organizational silence in the NHS: 'Hear no, see no, speak no' -
https://www.tandfonline.com/eprint/ziSW4NxaqbCaCKDU5nFV/full

The practitioner alone has to make the decision, one they can live with.

For myself, I would leave the organisation with all the evidence I required, get settled in my new job and then ‘blow that whistle’ but knowing that it would be a costly and lonely journey to take.

Yours sadly,
Julie

Wednesday, 11 July 2018

Disastrous monitoring by PSA protecting malfunctioning managers

Is the Nursing and Midwifery Council (NMC https://www.nmc.org.uk  ) Fit to practice (FtP)?  But maybe more importantly, is the Professional Standards Authority for Health and Social Care (PSA  https://www.professionalstandards.org.uk/home )fit to judge?  Not according to their latest performance review of the NMC’s Fitness to Practice outcomes at the beginning of June this year.  It makes for unbelievable absence of insight or sound judgement.  Instead it is another part of the destructive and failing system.

To see the document for yourself go to
https://www.professionalstandards.org.uk/docs/default-source/publications/performance-reviews/performance-review---nmc-2016-17.pdf?sfvrsn=bd067220_6 

Astonishingly the report concluded that the NMC met all but one of its standards, namely that bereaved families in the Morecombe Bay inquiry had their concerns ignored, and had not been treated with respect nor kept informed of progress. 

But wait a minute, nor do registrants get treated with respect, nor are they kept informed of the progress of their interminable cases.  All part of the wearing down process that makes it so difficult for registrants to defend themselves.

Moreover and shockingly, the fact that 1170 registrants’ cases had not been concluded for over a year, that 294 registrants were still waiting after 2 years and 71 were still waiting after 3 years was ok? 
I quote ‘There has been a significant reduction in the number of cases over 52 weeks held by the NMC, from 1,437 last year to 1,170 this year. The numbers of cases older than 104 weeks and 156 weeks have only increased by 13 and 23 respectively, indicating that the reduction in cases over 52 weeks has not just been achieved by cases passing the threshold into the next age category (whatever that means?). The overall caseload over 52 weeks has reduced this year by 231 cases.
An achievement?

Can no one in the Department of Health see these glaring failures of judgement?

There is now significant help from a closed Facebook support and information group called NMC Watch: registrant care (previously The case against the NMC) founded by Cathryn Watters.  See https://www.facebook.com/groups/460231920997990 if you wish to find out more. 

The group has powerful and substantive evidence of the harm that the NMC process causes with 60 responses to their on line survey available from the Facebook group or myself as a Word document, by emailing me enquiries@suspension-nhs.org.

But it seems the PSA is not interested or just doesn’t have insight into the terrible harm caused. 

It should be known that people who have already been through a disciplinary process with their organisation, are now in a poor state of physical and mental health.  Finances are probably in dire straits too, not to mention other aspects of their lives.  The thought of now fighting for their registration sends their anxiety levels ever higher. 

Because of the complex legalities around the proceedings, registrants find it difficult to understand the process.  The unions often don’t help, warning people against writing anything of significance in case they make their situation worse, whilst not understanding that the NMC views such lack of response as a lack of insight, which makes their defence even harder.

There is much more in the PSA report that signifies how poor the FtP process and outcomes is.  The PSA is immersed in their processes and just can’t see how the processes and legalities are failing staff most cruelly.

Is the Nursing and Midwifery Council (NMC) Fit to practice?  Am I wrong in claiming that the NMC is not Fit to Practice?

Staff who have been through the FtP process know that it is definitely not fit to practice for many reasons.  Length of time taken is an obvious one, remembering that many of these people should not have been disciplined or referred in the first place.  Another reason is the way people are considered guilty unless they have good evidence to show they are not. 

Very often, the manager’s word is believed against the registrant’s just because they are the manager.  Then there are the lost papers, papers delivered to the wrong address, a lack of any communication and updating, and problems speaking with case workers.

One midwife tells how she and her team waited for 3 hours before they discovered that the NMC court had finished for the day and gone home but had forgotten to notify them.   Unbelievable but symptomatic of the disregard they have for the ‘accused’.

Will these injustices and the suffering caused ever end?  At the present moment, with the PSA mostly blind to the failings of the NMC, sadly and realistically, I doubt it.

Yours despairingly
Julie

Saturday, 10 February 2018

Scapegoating staff after critical incidents

Poor Dr Bawa-Garba struck off by her own professional body that has not a clue about working conditions in the NHS nor the implications of their action that sounded so vindictive.  What did they hope to achieve by it?  The fallout from their action, wasting doctors’ money going to the High Court to have the verdict of the Medical Practitioners Tribunal overturned, raised all sorts of questions about them and for practitioners too.  

Jenni Middleton, Editor of the Nursing Times (www.nursingtimes.net) has commented on her article for On the pulse this week that nurse Isabel Amaro, was also convicted of manslaughter by gross negligence for her part  and struck off by the Nursing and Midwifery Council in 2016 .  

Ironically, the trust involved, has since made changes to their systems to prevent a re-occurrence of such a tragedy.  In other words the doctor and the nurse’s claims about many failings that day were justified.  Oh the injustice of it all.  https://www.leicestermercury.co.uk/news/health/hospital-chief-deeply-sorry-over-201014  

The Secret Barrister has written a very insightful article about the doctor’s case and the safety of having lay people decide complex situations about which they know very little or nothing at all, for example, the way junior doctors are expected to cover large caseloads.  https://thesecretbarrister.com/2018/01/31/some-thoughts-on-dr-bawa-garba-and-our-faith-in-the-jury-system 

This is not far removed from nurses being in a similar situation, having to care for a high number of sick people with very few staff, often covering extra shifts as well as working long hours.  Many leave their shifts in distress because they just could not physically meet the demands being made on them.  How can this ever be safe for patients and staff alike?  
www.suspension-nhs.org
Scapegoating is alive and well according to people who contact the website www.suspension-nhs.org .   What is so frustrating is that someone is seriously injured by the action taken against them – psychologically, physically, emotionally, financially.  In every way you can think of, that person is harmed.   Sometimes the harm is irreversible.  The harm to their families is immense too.   Anecdotally, relationship break up is common.

I hate to think how Dr Bawa-Garba is feeling now or poor Nurse Omara.  Maybe if their names had been double barrelled English names they might have suffered a lesser fate or even have been spared all this terrible action against them?  (The doctor was initially informed by the CPS in 2012 that she would not be prosecuted at all.  I don’t know about the nurse.)  

Consider the time all this has taken, from 2011 till 2016 for the nurse to have her career ended and now for the doctor.  What a toll it must have taken on these poor people and their families and friends.  

A frequent complaint against the NMC by staff who are unnecessarily or unjustly reported to them is that they suffer long periods of time before they discover their fate too.  Even worse, many feel they were presumed guilty until they could prove their innocence.   

What a mess.  
Julie 

Tuesday, 7 November 2017

Light at the end of the tunnel: re-thinking disciplinary action in the NHS

At present a manager informs HR that s/he is planning to suspend a member of staff for what they claim is gross misconduct.  The HR manager presumably checks that what is being alleged, is actually gross misconduct (though there is no evidence that I know, to suggest that) and then the awful process unfolds.  The worst case scenario is that the innocent victim is called to a meeting with their manager, without knowing what the meeting is about – congratulations for their hard work in very difficult circumstances maybe? 

What follows puts them into a state of shock and the direction is now downhill all the way – vague allegations, exclusion from the work premises (with the embarrassment of being marched off in many cases), long delays, no fairness or transparency in the process and finally some punitive outcome.

Patient care suffers – one less member of staff, other staff demoralised by their colleague’s disappearance, vague rumours. 

BUT there is hope.  A few managers are stopping this awful waste of staff and time.  Roger Kline, Research Fellow in Middlesex University Business School, has described the different approach in his seminal work, re-thinking disciplinary action in the NHS.  See https://mdxminds.com/2017/09/19/rethinking-disciplinary-action-in-the-nhs .  See also https://www.england.nhs.uk/wp-content/uploads/2017/03/workforce-race-equality-standard-data-report-2016.pdf for more examples of different approaches summarised by Roger  (pp 110-143).

At last some trusts are recognising that the disciplinary route is usually not appropriate or even necessary (though sometimes it is of course), that preliminary investigations need to be more robust and that most often, any clinical ‘never or near miss’ events have a strong element of systems failure when root cause analysis is used.

Using the Incident Decision Tree series of questions as an initial guide helps to clarify the issues and the course of action needed. 

The new processes move away from the destructive and futile culture of blame which usually fails to achieve a single positive outcome.  Looking at the possibility that there has been systems failure, using root cause analysis, any critical incidents are dealt with in a constructive manner and ‘lessons truly are learnt’ as trusts like to say, when it usually means quite the opposite under the present system.

These new approaches may also prevent unnecessary formal disciplinary procedures where unsubstantiated allegations have been made because of personality clashes, or worse still, bullying behaviour by inept, incompetent even possibly psychopathic managers.  The damage to people’s health, relationships and career to name just a few outcomes of the destructive nature of suspension and all that follows, is immense.  Employees disappear into the NHS ‘Black hole’ a place  little recognised by the public till recently, thanks to the high profile whistleblowers and the reporting of the often illegal actions taken against them to silence them.

What now needs to happen is that these improvements are rolled out throughout the NHS and made mandatory, with reports to a central agent to identify where there are problems in an organisation.

What a hope and what a difference it would make.  Thank you Roger.
Julie Fagan  

Wednesday, 20 September 2017

Dysfunctional NHS managers with narcissistic or psychopathic personality disorders

A contact recently sent me an article about people with narcissistic personality disorders.  If you enter those words into your search engine, several articles will appear giving the same information.  Most of it is copyright.  It was new information to me. 

There is some work on the difference between psychopaths and narcissists on line too.  One writer says not to worry about the label, just avoid becoming a victim.  That is all very well in personal relationships if you can get away from them, but very different if you have to work with them. 

Signs of serious problems will be the number of staff who leave.  Another sign is the number of staff who are being suspended, a very effective way of destroying an innocent person who dares to complain.  My strong advice in those situations is to leave.  If you read the stories on the www.suspension-nhs.org  website and see what power and harm these people can do, you will understand why I write that.

Why do organisations fail to recognise this obvious sign and continue to support the perpetrator, unless of course the whole culture is one of bullying by the management team including the person at the helm, the chief executive?

If you are or have suffered at the hands of a malfunctioning manager/team leader/ work colleague, who is unbelievably bullying and manipulative the information is very relevant.  The signs of these disorders are very clear by the way they behave.  For example, they never apologise and never take responsibility for their actions.  It will be yours or someone else’s fault.  

They lack empathy.  They really don’t care.  For narcissists, the theory is that the person is deeply hurt from childhood and cannot face dealing with the hurt.  For the psychopath, there is no obvious reason why they lack emotional intelligence. 

I feel sad for these people.  Treatment is not easy or obvious and if they don’t realise they have a problem, then the future looks bleak.

I feel alarm for their victims because the perpetrators are so powerful within the structures of the NHS due to the absence of accountability, the anonymity of the people working in the organisations and the perpetual culture of blame that encourages this type of behaviour. And the Department of Health has too many problems to deal with this one even if it wanted to it seems inspite of the huge costs.  How will it ever change?

If you have any ideas please email me at enquiries@suspension-nhs.org Thank you
Julie  

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