Letby: freedom to speak up rights to be strengthened across NHS
Posted 05 September 2023 - 15:11
Delays in addressing concerns raised by whistleblowers about Letby prompt move to ensure staff are confident to speak up and know who to contact
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The government has vowed to strengthen freedom to speak up (FTSU) policies across the NHS in light of the Lucy Letby case.
Speaking in the House of Commons on 4 September, health and social care secretary Steve Barclay said all NHS trusts in England will have strengthened FTSU polices in place by January. He said the national policy would bring consistency to FTSU across NHS organisations ‘supporting staff to feel more confident to speak up and raise any concerns’.
He also confirmed that NHS England will review guidance that allows trust board members to be FTSU guardians in a bid to ensure independence in handling concerns.
FTSU guardians were introduced in the NHS in 2016 in response to the Francis inquiry, which investigated failings of care at Mid Staffordshire NHS Foundation Trust, and were put in place to support staff in raising concerns.
Barclay also confirms it will be made easier for patients and families to get a second medical opinion
Currently NHS England’s national safeguarding policy advises individuals to report concerns about other staff to their line manager, who should take advice from the HR team and the national or regional safeguarding team. Should a staff member not feel comfortable discussing the issue with their line manager, they should raise their concern with a more senior manager or another senior leader in the organisation, HR or through the FTSU guardians.
Following the Letby verdict it says it has instructed trusts to ensure all staff have information on how to contact their local guardians.
Nurse and freedom to speak up guardian Helené Donnelly, who helped blow the whistle on the Mid-Staffs scandal, welcomed the commitment but said it was important to note that policy, processes and guidance ‘are only as effective as the people implementing them’.
Move will better highlight when systems, processes or leaders are failing, says FTSU guardian Donnelly
‘This will provide unambiguous direction of best practice, what “good” looks like and crucially, will better highlight when systems, processes or leaders are failing,’ she told Nursing Standard.
‘However, the cultural change clearly still required across pockets of health and social care services will only happen if we bring culture, candor, transparency, compassionate, collective and curious leadership to life, and not just written in policy.’
Alongside strengthening FTSU processes, Mr Barclay confirmed the government would look to make it easier for patients and their families to get a second medical opinion if they felt a patient’s health was deteriorating or not progressing as hoped through what is being called ‘Martha’s rule’.
Martha’s rule, named for 13-year-old Martha Mills, who died from sepsis, would be a three-step process that allows patients or their families to check a clinical review of their case from a doctor or nurse. It would be similar to ‘Ryan’s rule’ in place in Queensland, Australia.
Senior judge named to head inquiry into Letby’s crimes
An NHS spokesperson said: ‘All patients and families are able to seek a second opinion if they have concerns about their care – and, as professional guidance for doctors in England sets out, it is essential that any patient’s wishes to seek a second opinion are respected.’
Mr Barclay’s statement to MPs came after it was announced that a public inquiry into Letby’s crimes would be put on a statutory footing, giving it the power to compel witnesses to give evidence under oath. He announced to the commons that Lady Justice Thirlwall, one of the most senior judges in the country, would lead the inquiry.
Letby was convicted in August of murdering seven babies and attempting to murder six others when she worked as a neonatal nurse at the Countess of Chester Hospital in 2015 and 2016, and was sentenced to life in prison.
Since her sentencing calls have mounted to ensure whistleblowers’ concerns are taken more seriously after fears about Letby were not addressed for several months. Consultants said they sounded the alarm but were overruled by hospital managers.
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