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In the NHS, “openness” can sometimes be more honoured in the breach than in the observance. Faced with a patient safety issue, there has been a tendency in some quarters to shy away from revealing too much and instead focus on sorting out problems behind closed doors.
This reached its nadir with trusts not informing the Care Quality Commission of damning invited reviews carried out by royal colleges, as HSJ revealed last summer. Now, the Academy of Medical Royal Colleges is planning to tighten up on this with reports sent to the CQC by its members, rather than relying on trusts to take action themselves. It is also trying to ensure there is at least a modicum of openness with summaries of its reports’ concerns and recommendations published — something very few trusts do at the moment.
Will it change the culture of the NHS? Possibly. A few years ago trusts were made to start disclosing to the CQC if they were significant outliers on national clinical audits.
Some trusts may be tempted not to commission invited reviews if they are likely to be sent onto the CQC, which would be the wrong message to take from this change in policy. The worst offence for trusts at the moment may not be having a patient safety issue but trying to cover it up and being found out. That not only leads to reputational damage for the organisation concerned but is also becoming a fast track to the exit for board members.
‘Obvious conflict of interest’
A trust must pay out nearly £70,000 to its former director of medical education after an employment tribunal found she had been constructively dismissed.
Henna Jaleel won her claim against Southend University Hospital Foundation Trust after quitting in May 2018.
The tribunal was critical of the trust’s conduct over a job interview panel. In particular, the judgment raised concerns that the trust’s then-medical director Neil Rothnie did not recuse himself from the panel despite Dr Jaleel having an outstanding grievance against him.
Employment judge David Massarella said it was “wholly inappropriate” for the late Mr Rothnie to be on the panel, citing an “obvious conflict of interest”.
However, Dr Jaleel’s constructive dismissal claim was the only one the tribunal upheld. Her other claims, including racial discrimination and harassment, were dismissed.
SUHFT has since merged with two other trusts, so the payout will be made by the new trust Mid and South Essex Foundation Trust.
MSEFT told HSJ: “We keep our policies under constant review and will be taking steps to ensure best practice is embedded throughout our interview processes.”