A new ‘independent national officer’ role should be created to oversee and review the treatment of NHS whistleblowers, Sir Robert Francis’s ‘freedom to speak up review’ has recommended.
However, the post will not have its own binding powers, and will rely on other regulatory bodies taking action in relation to its recommendations.
The review report, published today, proposes establishing the post to provide national oversight of how NHS organisations are dealing with staff who raise concerns.
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The government was expected to respond to its recommendations this afternoon, as well as announcing its own measures on patient safety.
The officer would be responsible for reviewing how whistleblowers have been treated when there are concerns that dangers to patient safety have not been properly addressed, or that individuals may have been victimised.
Where they find that NHS organisations have not followed good practice, they will advise them on what action to take.
If necessary they will make recommendations to national bodies such as NHS England, Monitor, the NHS Trust Development Authority and the Care Quality Commission, which could result in the regulatory action against organisations.
Sir Robert stopped short of recommending a specific organisation, such as the CQC, which the new post should sit within, and said this needed to be “worked out”.
Speaking at a press conference this morning, he said the INO would address the problem that when whistleblowing concerns are not properly addressed locally, “no one seems to know where to go… which regulator to go through”.
He said the officer would “know how to unblock investigations that are not focusing on patient safety issues properly, and where there is injustice can ensure something is done to correct [it] by those who are responsible for doing so”.
The individual would also be asked to support new “freedom to speak up guardians”, which the review recommends should sit within each local organisation. The officer could also issue national guidance on whistleblowing good practice.
However, they would not have binding powers and would not be responsible for taking over the investigation of concerns.
The review states: “I do not see this role as strictly comparable to that of an ombudsman. Instead, they would advise relevant organisations on any actions that should be raised to deal with the issues raised. The officer would need to operate in a timely, non-bureaucratic fashion, with the capacity to act quickly in the event of serious safety issues coming to light.”
When asked by HSJ whether the officer’s lack of binding powers would limit its effectiveness, Sir Robert said the individual would have the “authority of approval of all the systems regulators”.
“They [will] have access to the [CQC’s] chief inspectors [and] to the chief executives of the regulators, and the regulators can use their powers and of course those powers are binding”.
Sir Robert said the “tools” for holding organisations and individuals to account would be the existing “fit and proper persons test” for directors, CQC fundamentals standards, and CQC regulations under which organisations have to be “well led”.
Sir Robert’s review states the officer “should not be tasked with reviewing, let alone investigating, historic cases”.
It calls for the CQC, Monitor, the TDA and NHS England to consult on how the post should be created and resourced, and to submit proposals to the health secretary.
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