Raising concerns ‘share and learn’11 November 2015LondonNyla Cooper, Programme LeadAdele Bunch, Senior Programme Officer
Today
Welcomeand briefintroductionsNHS Employers roleKey messages and developmentsThe role of the INO, Charles Rendell, CQCTable discussion – local guardian modelsLunch & networkingNew patient safety video,MargitVeveris, HEEOur freedom to speak up service, Sharon Landrum and CarolSkillen, Wirral University Teaching HospitalDeveloping a standard integrated policy for reporting raising concerns, Tom Grimes, MonitorEvaluation and next stepsClose
Role of NHS Employers
helpemployers understand and contribute to changes in healthcare, enabling them to improve the quality and safety of patientcarework closely with employers, key national bodies and regulators to influence policy and regulatorychangeprovide advice, guidance, information and resources tohelp employers review, develop and implement effective local arrangementsdeliver a range programmes targeted at influencing cultural change – staff experience, staffengagement, organisational development,health, work and well-being, equality and diversity andpeople-performance management
Actions from theLearning notblaming report (DH July 2015)
Actions from the Learning notblaming report (DH July 2015)
NHSEngland to produce a standard integrated policy and procedure for reporting incidents and raising concernsDepartment of Health to establish an independent patient safety investigation function for the NHS
National GuardianBriefing November 2015Charles Rendell, Strategy Manager CQCNovember 2015
Contents
IntroductionThe purpose of the National GuardianCQC’s role in relation to staff concernsPrinciples for how the Office of the National Guardian will operateFunctions of the National Guardian
Introduction
In response to concerns about the culture in the NHS, the Secretary of State for Health commissioned Sir Robert Francis to carry out an independent review:‘Freedom to Speak Up’ (FTSU).Thereview was asked to identify measures to foster a culture in the NHS in England where staff can feel safe to speak out about patient safety, as well as learning lessons by listening to those who have experiences to share, both positive and negative.The review was published in February 2015.Oneof the major recommendationswas to create anIndependent NationalOfficer to support staff raising concerns and the wider system.TheDepartment of Health (DH) consulted on Sir Robert’s recommendations between the 13thMarch 2015and 4thJune2015, including whether the Independent National Officer should be hostedby CQC.Overall, theconsultation received 103 responses from individuals and on behalf of organisations. The consultation received 75 responses regarding the National Guardian and the majority of these, 56, were infull support of the role being hosted by CQC.
National Guardian to be hosted by CQC
Learning not to Blame states that the person undertaking the role will:Advise NHS Organisations to takeappropriate actionwhere they have failed to follow good practice, oradvise the relevant system regulatorto make a direction to that effectProvidesupport to the Freedom to Speak up GuardiansProvidenational leadershipon issues relating to raising concerns by NHS workersOfferguidance on good practiceand handling concerns; andPublishreportson the office of the Independent National Officer.Source:Learning not to Blame: Government response to the Freedom to Speak Up consultation July 2015
Contents
IntroductionThe purpose of the National GuardianCQC’s role in relation to staff concernsPrinciples for how the Office of the National Guardian will operateFunctions of the National Guardian
Why do we need a National Guardian?
The National Guardian is intended to fill agap in the system, around external review of how NHS trusts handle concerns raised by staff.CQC currently looks at how well trusts handle staff concerns as part of its assessment and notes any issues in relation to the treatment of staff or systems for raising concerns. Monitor/TDA then direct trusts to address these issues. As prescribed persons, CQC, Monitor and TDA can also investigate concerns raised with them if there are outstanding safety issues.However, these mechanisms do not generally involve reviewing how individual cases were handled locally, or how staff were treated. The only way staff can raise an issue about ill-treatmentexternally isthrough an Employment Tribunal.The National Guardian is intended to provideexternal review of how cases are handled locally, where there is a cause for concern. This will involve reviewing the process that ahs been followed, not investigating the concern or forming a judgement on the outcome of any existing investigations.The National Guardian is not intended to take over investigation of cases, because this would take responsibility away from local organisations.The National Guardian willadvise staff raising concerns and providers, and willsupport the local FTSU Guardians, as well as providingnational, high-profile leadershipon the raising of staff concerns. Detail on the functions to be performed is set out on slide 5.
Contents
IntroductionThe purpose of the National GuardianCQC’s role in relation to staff concernsPrinciples for how the Office of the National Guardian will operateFunctions of the National Guardian
CQC’s role in relation to staff raising concerns
CQC is an independent regulator, on the side of people who use services and acting to encourage all providers to improve the quality of services they provide. CQC’s purpose is to ensure health and social care services provide people with safe, compassionate, high-quality care and to encourage services to improve. CQC provide robust, fair and consistent judgements of quality of care that expose poor care and variation in care, and make quality transparent.CQC has adualrole in relation tostaffraising concerns about poor care:CQClook at how well the providersit regulatesrespond to staffconcerns; andCQCwant to receive information about poor care from staff directly in order to informitsoverall assessment of individualprovidersEveryplanned CQC inspection now looks at how well services handle complaints and other concerns about poor care, as this can be an indicator of the quality of leadership and a reflection of how safe and responsive the cultureis.The National Guardian will carry out two important functions that are distinct from CQC’s role:It will review individual cases (whereas CQC, on the whole, looks at systemic issues)It will consider the treatment of the employee (whereas CQC, on the whole, looks only at quality and safety issues)
Contents
IntroductionThe purpose of the National GuardianCQC’s role in relation to staff concernsPrinciples for how the Office of the National Guardian will operateFunctions of the National Guardian
Principles for how the Office of the National Guardian will operate
Independence of the National Guardian
The National Guardian will be an appointment by the CEO of CQC on behalf of the Board. The National Guardian will not be a member of the Executive Team, thereby allowing the role to operate independently of the executive function of the CQC.TheNational Guardian willbe able to refer issues to CQC,Monitor, TDA or NHSE.This will be supported by MOUs, a bi-annual committee and annual reports to each of the Boards.TheNational Guardian will share communication channels with CQC, including website, customer service call centre and press office.TheNational Guardianwill potentiallyuse CQC branding for any reports or communications – but these will be independent reports and will not be signed off by the CQC Board.Thestorage of information by the National Guardian must be covered by an adequate level of protection.Reviewmechanisms will need to be agreed for the National Guardian to pass information to others outside and within CQC.National advisory Board – public and provider organisation representatives ( bi-annual)The National Guardian appointment reviewed periodically (e.g. every 3 years)
While the National Guardian is accountable to the CEO of CQC for delivery of their annual work programme, their decisions over which cases to review and their recommendations will be entirelyindependent .This is the same way that the Chief Inspectors operate within CQC with regards to their quality judgements.
Contents
IntroductionThe purpose of the National GuardianCQC’s role in relation to staff concernsPrinciples for how the Office of the National Guardian will operateFunctions of the National Guardian
Functions of the National Guardian
Timelines
Any questions?
Consultation paper can be found athttp://www.cqc.org.uk/nationalguardian
Guardian progress
There are currently guardians in post in 18 NHS organisations across the countryVarious models ranging from one guardian to several per trustShared learning of three models available on our websiteIf your organisation isn’t on the guardian map, let us know
Local guardian models- discussion
On your tables, discuss the progress made so far in relation to the local Freedom to Speak Up guardian including:The model you have adopted and reporting structureLearning so farSuccesses for far
Lunch & networking
New patient safety videoRosie and Margit Veveris
http://goo.gl/BmQhGj
A single national whistleblowing policy
Tom GrimesHead of Enquiries, Complaints and Whistleblowing
GOV.UK/monitor
What am I going to cover?
“aharrowing and isolating process with reprisals including counterallegations, disciplinary [action] andvictimisation”Action 2.2: NHS England, NHS TDA and Monitor should produce a standard integrated policy and procedure for reporting incidents and raising concerns and a single integrated policy.The objective is to normalise the raising of concerns through:Knowing how to raise concernsFeeling fully supportedFeeling protected
Supporting you
Template presentation and ‘how to use’ guideManager’s guide for raising concerns (whistleblowing)Self assessment toolDraw the line campaign logoPosters and flyersTop tips for raising concernsRaising concerns in the NHS – a guide for staff (new)Dedicated guardian section of the website including top tips for guardians (new)Various shared learning examples of local guardian modelsDownload yourfree copiesfrom the NHS Employers website at:http://www.nhsemployers.org/your-workforce/retain-and-improve/raising-concerns-at-work-whistleblowing
Keep updated and stay in touch
NHS Employers website:www.nhsemployers.org/your-workforce/raising-concerns-at-work-whistleblowingSubscribe to our workforce bulletin:www.nhsemployers.org/workforcebulletinFeature your organisation on the guardian mapFollow us onLinkedInor link up on Twitter @nhse_nylaGet in touch:[email protected]@nhsemployers.org
Evaluation and close
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