FREEDOM TO SPEAK UP (WHISTLE BLOWING) · The Freedom to Speak up Review was then announced on 24...

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Norfolk and Suffolk NHS Foundation Trust HRP006 Speak Out Safely v5.0 Page 1 of 16 Title: FREEDOM TO SPEAK UP (WHISTLE BLOWING) Purpose: To outline a process for staff and workers to reasonably and responsibly disclose areas of concern. To confirm the protection afforded to those individuals to enable them to raise genuine concerns without fear of recrimination. Introduction The Francis Report (2013) has highlighted the importance of staff feeling confident that they can raise genuine concerns and that these will be taken seriously. The Freedom to Speak up Review was then announced on 24 June 2014 by the Secretary of State for Health and was led by Sir Robert Francis QC, and published in February 2015. It is an independent review into creating the open and honest reporting culture in the NHS. The review team concentrated on five overarching themes; culture, handling of cases, supporting good practice, vulnerable groups, legal protection. The review sets out 20 Principles and Actions which aim to create the right conditions for NHS staff to speak up, share what works right across the NHS and get all organisations up to the standard of the best and provide redress when things go wrong in future. Our Trust encourages all staff to use internal mechanisms for reporting any concerns regarding professional conduct, malpractice, illegal acts or omissions this includes; clinical and non-clinical staff, volunteers and trainees. All staff have a positive duty under their Contracts of Employment and the NHS Constitution to report concerns relating to malpractice, patient safety, financial impropriety or any serious risks that are in the public interest. Our Trust is committed to achieving the highest possible standards in public life and in all of its practices and is committed to an open and honest culture. Speaking up about any concern you have at work is vital because it will help us to continually improve our services and therefore enhance the safety of our patients and staff. The Trust acknowledges that it can be difficult for staff to raise genuine concerns for fear of appearing disloyal or being victimised, but this should not put people off. Concerns responsibly raised will be taken seriously. Staff will receive information about raising concerns at the Trust Induction and Workplace Induction. All staff are bound by Trust policy and, where relevant, their registered bodies to alert managers to any issue if they are concerned that patient safety is at risk or a criminal act has been undertaken. Raising concerns is reviewed within Safeguarding and Patient Safety mandatory training and at appraisal. Approved By & Date: Trust Partnership Meeting – 6 September 2017 For Use By (Area/Staff): All permanent and temporary staff, students, trainees and volunteers Reference No: HRP006 Version: 4.0 Published Date: September 2017 Review Date: December 2019 Equality Assessment: Speak out Safely Policy - Equality Asse

Transcript of FREEDOM TO SPEAK UP (WHISTLE BLOWING) · The Freedom to Speak up Review was then announced on 24...

Page 1: FREEDOM TO SPEAK UP (WHISTLE BLOWING) · The Freedom to Speak up Review was then announced on 24 June 2014 by the Secretary of State for Health and was led by Sir Robert Francis QC,

Norfolk and Suffolk NHS Foundation Trust HRP006 Speak Out Safely v5.0 Page 1 of 16

Title: FREEDOM TO SPEAK UP (WHISTLE BLOWING)

Purpose: To outline a process for staff and workers to reasonably and responsibly disclose areas of concern. To confirm the protection afforded to those individuals to enable them to raise genuine concerns without fear of recrimination.

Introduction The Francis Report (2013) has highlighted the importance of staff feeling confident that they can raise genuine concerns and that these will be taken seriously.

The Freedom to Speak up Review was then announced on 24 June 2014 by the Secretary of State for Health and was led by Sir Robert Francis QC, and published in February 2015. It is an independent review into creating the open and honest reporting culture in the NHS. The review team concentrated on five overarching themes; culture, handling of cases, supporting good practice, vulnerable groups, legal protection. The review sets out 20 Principles and Actions which aim to create the right conditions for NHS staff to speak up, share what works right across the NHS and get all organisations up to the standard of the best and provide redress when things go wrong in future.

Our Trust encourages all staff to use internal mechanisms for reporting any concerns regarding professional conduct, malpractice, illegal acts or omissions this includes; clinical and non-clinical staff, volunteers and trainees.

All staff have a positive duty under their Contracts of Employment and the NHS Constitution to report concerns relating to malpractice, patient safety, financial impropriety or any serious risks that are in the public interest.

Our Trust is committed to achieving the highest possible standards in public life and in all of its practices and is committed to an open and honest culture. Speaking up about any concern you have at work is vital because it will help us to continually improve our services and therefore enhance the safety of our patients and staff.

The Trust acknowledges that it can be difficult for staff to raise genuine concerns for fear of appearing disloyal or being victimised, but this should not put people off. Concerns responsibly raised will be taken seriously.

Staff will receive information about raising concerns at the Trust Induction and Workplace Induction. All staff are bound by Trust policy and, where relevant, their registered bodies to alert managers to any issue if they are concerned that patient safety is at risk or a criminal act has been undertaken.

Raising concerns is reviewed within Safeguarding and Patient Safety mandatory training and at appraisal.

Approved By & Date:

Trust Partnership Meeting – 6 September 2017

For Use By (Area/Staff):

All permanent and temporary staff, students, trainees and volunteers

Reference No: HRP006 Version: 4.0 Published Date: September 2017 Review Date: December 2019 Equality Assessment:

Speak out Safely Policy - Equality Assessment 2017.doc

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Signed:

Sarah Ball Head of Organisation Development & Human Resources (on behalf of Trust Management)

Carol Briggs (on behalf of Staff Side)

Date: 14 September 2017

Date: 14 September 2017

Review and Amendment Log

Version Number

Reasons for Development/Review

Date Description of Change(s)

NSFT 1.1 Policy Working Group August 2013 Numerous changes to document as a result of feedback from PWG.

NSFT 2.0 To incorporate learning lessons

December 2014 Clarification on what constitutes a disclosure. Process for disclosure.

NSFT 3.0 In response to the external audit undertaken in Nov 2015

November 2015 Change of policy title to Speak out Safely in line with Francis review Speak up 2015 and the Trusts alignment to the Nursing Times and Health and Safety Journal’s campaign. Inclusion of volunteers and trainees. Addition of a flowchart (appendix 3) Addition of a reporting template (appendix 2) Change in occupational advisor Addition of support agencies (PCW and ACAS) Removal of forum Addition of central governance record for all concerns Change of monitoring

NSFT 4.0 Edited following publish of the national Freedom to Speak up Whistleblowing policy

July 2017 Numerous changes to include content from the national policy

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Contents

Process Flowchart 4

1.0 Duties 5

2.0 Definitions 6

3.0 Who can raise concerns? 6

4.0 What concerns can be raised? 6

5.0 Feel safe to raise a concern 6

6.0 Who to raise the concern with? 7

7.0 Confidentiality 8

8.0 How to raise a concern 8

9.0 What will happen once a concern is raised? 8

10.0 Formal investigation 8

11.0 Further investigation 9

12.0 Communication and Feedback 9

13.0 Support 9

14.0 Making a protected disclosure under a PIDA 10

15.0 Taking the disclosure further 11

16.0 Governance 12

Monitoring Statement 12

Supporting Information 13

Appendix 1 Record of Concern 14

Appendix 2 Examples 16

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Process Flowchart

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1.0 DUTIES 1.1 All members of staff have a responsibility to:

Act in a way which reflects our Trust’s values and behaviours and be mindful of their impact on others, particularly during stressful situations which are inevitable during a period of raising and investigating concerns

1.2 Employees raising a concern have responsibility to:

Raise the concern in adherence to this policy, following relevant processes codes of conduct and in line with other relevant policies.

1.3 Managers receiving notification of a concern have responsibility to:

Ensure that, an investigating officer is appointed and that the investigation runs to the stipulated timescales.

1.4 The investigating officer has a responsibility to:

Pursue the investigation in a timely and impartial manner being conscious of trust values and behaviours

1.5 Employees subject of the concern raised have a responsibility to:

Participate in all investigations, disclosing information as required honestly and without prejudice.

1.6 The Freedom to Speak Up Guardian responsibility to:

Provide guidance and support to those raising concerns. Ensure processes are adhered to and timescales for actions met. Ensure lessons learned from this process regardless of outcome, are disseminated in a transparent, proportionate and accessible way throughout the wider Trust. Unless otherwise indicated the Freedom to Speak up Guardian holds the duty to feedback the outcome of the investigation to the employee raising concerns.

1.7 The Head of Patient Safety and Safeguarding and non-Executive Director have

responsibility to:

Maintain an overview of the processes being followed by the FTSUG and ensure they are performing their role in accordance to the policy and good practice.

1.8 The Director of Nursing, Quality and Patient Safety alongside the Director of Strategy and Resources have a responsibility to:

Ensure that there are sufficient and robust processes in place to implement, monitor and evaluate this policy

1.9 The Trust Chair, Board of Directors and Chief Executive Officer have a responsibility to:

Ensure that this policy is in place and adhered to.

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2.0 DEFINITIONS Term Definition Whistleblowing / raising a concern

You will hear a number of phrases in relation to this area: speaking up, raising concerns, whistleblowing. We want to make it as easy as possible for staff to raise concerns (when the normal line manager/support arrangements are not working) It is not easy to give a precise definition of the difference between a concern and a whistleblowing case. Essentially, the Trust’s overriding principle is that it welcomes staff raising concerns in a culture of openness and dialogue.

Legal protection will be given to all workers who raise a concern which falls within the Public Interest Disclosure Act guidelines (Ref Section 14)

3.0 WHO CAN RAISE CONCERNS? 3.1 Anyone who works (or has worked) in our Trust, or an independent organisation that provides

services on behalf of our Trust can raise concerns. This includes agency workers, temporary workers, students, volunteers, governors and suspended staff.

4.0 WHAT CONCERNS CAN BE RAISED? 4.1 You can raise a concern about risk, malpractice or wrongdoing which you think is harming the

service we deliver. Some examples of this might include (but are not restricted to):

• Unsafe patient care

• Unsafe working conditions

• Inadequate induction or training for staff

• Lack of, or poor, response to a reported patient safety incident

• Suspicions of fraud (which can also be reported to the counter-fraud team on 01603 421523)

• A bullying culture (across a team or organisation rather than individual instance of bullying which should be addressed using HRP004 Dignity & Respect in the Workplace)

4.2 Remember that if you are a healthcare professional you may have a professional duty to report a

concern. If in doubt, please raise it with your line manager or seek advice from your professional body.

4.3 Don’t wait for proof. We would like you to raise the matter while it is still a concern. It doesn’t

matter if you turn out to be mistaken as long as you are genuinely troubled.

4.4 This policy is not for people with concerns about their employment that may affect only them – this type of concern is better suited to being handled through HRP015 Resolution policy.

5.0 FEEL SAFE TO RAISE A CONCERN 5.1 Speaking up about any concern you have at work is extremely important. In fact, it’s vital

because it will help us to continually improve all our services and keep them safe for all patients and staff.

5.2 You may feel worried about raising a concern, and we do understand this but please don’t be put

off. In accordance with our duty of candour, our senior leaders and entire board are committed to an open and honest culture. We will look into what you say and you will always have the support you need.

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5.3 Our Trust is committed to achieving the highest possible standards of service and the highest possible ethical standards in public life and in all of its practices and acknowledges that it can be difficult for staff to raise genuine concerns for fear of appearing disloyal or being victimised. Concerns responsibly raised will be taken seriously.

5.4 All staff will receive information about raising concerns at the Trust induction and local induction

points. All staff are bound by their registered bodies and Trust policy to alert managers to any issue if they are concerned that patient safety is at risk or a criminal act has been undertaken. Raising concerns is reviewed within the safeguarding and patient safety mandatory training programmes and at appraisal.

5.5 If you raise a genuine concern under this policy you will not be at risk of losing your job or

suffering any form of reprisal as a result. We will not tolerate harassment or victimisation of anyone raising a concern. Nor will we tolerate any attempt to bully you into not raising any such concern. Any such behaviour goes against our values as an organisation and, if upheld following investigation, could result in disciplinary action against the perpetrator.

5.6 Provided you are acting honestly, it does not matter if you are mistaken or if there is an innocent

explanation for your concerns, there will be no come back on you.

5.7 Further protection comes from the Public Interest Disclosure Act 1998 (see section 14), which gives significant statutory protection to employees and workers, who reasonably and responsibly disclose information relating to concerns of malpractice, within defined circumstances, that it is in the public interest to know about. This Act provides a framework of protection against victimisation for workers who blow the whistle on criminal behaviour or other wrongdoing.

5.8 The protection offered by this policy extends to the Counter Fraud and Corruption Policy. If you

have a suspicion of fraud you can follow the link on the Trust’s Intranet homepage. 6.0 WHO TO RAISE THE CONCERN WITH?

6.1 In many circumstances the easiest way to get your concern resolved will be to raise it formally or

informally with your line manager, lead clinician or tutor.

6.2 If raising the concern with your line manager, lead clinician or tutor does not resolve matters, or you don’t feel able to raise it with them, you can contact one of the following people:

• The Freedom to Speak up Guardian (FTSUG), 07557 287749, [email protected]. This is a role identified in the Freedom to Speak up Review to act as an independent and impartial source of advice to staff at any stage of raising a concern, with access to anyone in the organisation, including the Chief Executive, or if necessary, outside the organisation.

• The Trustwide confidential phone line 01603 421583

• The Risk Management Team, 01473 277271

• Any Executive Director

• The Non-Executive Director with responsibility for whistleblowing via [email protected]

6.3 All these people have been trained in receiving concerns and will give you information about

where you can go for more support.

6.4 If for any reason you do not feel comfortable raising your concern internally, you can raise concerns with external bodies listed in section 15.

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7.0 CONFIDENTIALITY 7.1 We hope you feel comfortable raising you concern openly but we also appreciate that you may

want to raise it confidentially. This means that while you are willing for your identity to be known by the person you report your concern to, you do not want anyone else to know your identity, therefore we will keep your identity confidential unless required to disclose it by law (for example, by the police). You can choose to raise a concern anonymously, without giving anyone your name, but that may make it more difficult for us to investigate it thoroughly and give you feedback on the outcome.

8.0 HOW TO RAISE A CONCERN 8.1 You can raise your concerns with any of the people listed above in person, by phone or in writing,

including email.

8.2 Whichever route you choose, please be ready to explain as fully as you can the information and circumstances that gave rise to your concern.

9.0 WHAT WILL HAPPEN ONCE A CONCERN IS RAISED? 9.1 Our Trust is committed to listening to staff, learning lessons and improving patient care. On

receipt, the concern will be documented and you will receive an acknowledgement. The central record we keep will record the date the concern was received, whether you have requested confidentiality, a summary of the concerns and dates when we have given you updates or feedback.

9.2 The FTSUG will perform a fact finding investigation to determine how to progress the concern. In

some cases this will bring about a resolution, in others there will need to be a formal investigation.

10.0 FORMAL INVESTIGATION 10.1 Where the concern cannot be resolved informally, we will arrange for an investigation to be

undertaken using a staff member who has undergone investigation training within the organisation. They will be suitably independent which will usually mean from a different part of the organisation.

10.2 Wherever possible a single investigation will be carried out. For example where a concern is

raised about a patient safety incident, we will undertake one investigation that looks at your concern and the wider circumstances of the incident.

10.3 The investigation will be objective and evidence-based, and will produce a report that focuses on

identifying and rectifying any issues and learning lessons to prevent problems recurring. Where it identifies improvements can be made, we will track them to ensure necessary changes are made and are working effectively. Lessons learned will be shared with teams across the organisation, or more widely, as appropriate.

10.4 Confidential information will not be shared with the individual raising the concerns other than

where appropriate to confirm that an investigation is taking place and that the investigation has been completed.

10.5 The Investigating Officer will prepare an initial report of findings within 20 working days. This will

be submitted to the Freedom to Speak up Guardian, Executive Director or Deputy Director with a recommendation as to the appropriate next steps depending upon the circumstances of the particular case. This might be but is not limited to one of the following:-

• A recommendation that no further action is taken and the employee who raised the concern is informed.

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• A further and fuller investigation is appropriate, internal or external as set out in the terms of reference and the Executive Director or Deputy Director will be responsible to appoint an investigating officer or to ask the existing investigator to continue. The investigation report deadline is 60 working days from when the concern was raised. (in practice this means 40 days after the initial 20 day report is submitted).

• The individual raising the concern is referred to an alternative more appropriate Trust policy e.g. the Resolution Procedure where this is felt to be the correct procedure to follow.

• There is sufficient information from the employee’s statement and/or the report of findings for the Trust to take an appropriate course of action to remedy the concern raised by the employee. For example a clear first impression is formed that a disciplinary offence may have been committed and the disciplinary process is therefore invoked in respect of relevant parties.

• There is evidence that the disclosure is malicious in which case the Executive Director or Deputy Director will consider use of HRP016 Disciplinary policy.

11.0 FURTHER INVESTIGATION 11.1 It is possible for a further investigation to be carried out under terms of strict confidentiality by not

informing the subject of the complaint until (or if) it becomes necessary to do so. This may be appropriate in cases of suspected fraud. In certain cases, however, such allegations, for example ill treatment of service users may require some action for the protection of service users in respect of the person/s named by the employee/worker whilst the investigation is undertaken. The protection of service users is paramount in all cases.

11.2 If the result of the investigation is that there is a case to be answered by an employee(s) of our

Trust, HRP016 Disciplinary or HRP060 Performance Management will be followed.

11.3 Where there is no case to answer but the employee/worker had a genuine concern and was not acting maliciously, the Executive Director or Deputy Director is responsible for ensuring that there is no negative impact on the parties as a result of the reporting the concerns.

11.4 It is recognised that on occasion, investigations may be particularly serious and/or complex and

could require an external inquiry. 12.0 COMMUNICATION AND FEEDBACK 12.1 We will treat you with respect at all times and thank you for raising your concerns. We will

discuss your concerns with you to ensure we understand exactly what you are worried about. We will tell you how long we expect the investigation to take and keep you up to date with its progress. Wherever possible, we will share the full investigation report with you whilst respecting the confidentiality of others.

13.0 SUPPORT 13.1 Trade Unions: The Trust acknowledges that our staff may often be the first people to know when

something is genuinely going seriously wrong. The Trust recognises employees may wish to seek advice and to be represented by a Trade Union representative when implementing this policy. The Trust acknowledges and endorses the role Trade Union representatives play in supporting their colleagues to raise legitimate concerns.

13.2 The Trust is very clear of its duty to support employees who raise concerns within this policy and

will take reasonable steps to provide ongoing support to any employee doing so. Support is also available from the following:

• Line Management supervision structure

• Workplace Health and Wellbeing (Occupational Health)

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• Non-Executive Director with responsibility

• Union representatives

• Insight Wellbeing at Work

• Advisory, Conciliation and Arbitration Service

• Public Concern at Work Charity

13.3 If you raise a concern in good faith as described above under no circumstances will the Trust permit reprisals, victimisation or any detriment for you doing so.

13.4 NSFT does not support agreements or employment contracts which include clauses which

prohibit an employee from raising a concern about patient safety issues. Clauses which seek to prevent an individual from raising such a concern under the Public Interest Disclosure Act (PIDA) 1998, are not enforceable in law.

• Staff are advised; you must not enter into contracts or agreements with your employing or contracting body that seek to prevent you from or restrict you in raising concerns about patient safety. Contracts or agreements are void if they intend to stop an employee from making a protected disclosure.

• If you have a management role or responsibility, you must make sure that you do not try to prevent employees or former employees raising concerns about patient safety – for example, you must not propose or condone contracts or agreements that seek to restrict or remove the contractor’s freedom to disclose information relevant to their concerns.

13.5 If you are the subject of a concern it is recognized that the Trust has a duty of care towards you

and you are entitled to appropriate ongoing support through the channels previously mentioned. This is regardless of whether the concern raised is found to be proven, or not. Support will continue to be available throughout even if formal disciplinary or capability action is taken.

14.0 MAKING A PROTECTED DISCLOSURE UNDER THE PUBLIC INTEREST DISCLOSURE ACT

(PIDA) 14.1 The Act is not intended to provide a platform to disgruntled staff to make irresponsible

disclosures or malicious claims. 14.2 The law defines clearly what types of disclosure qualify the person making them for protection

against dismissal and detriment. These are known as 'protected' disclosures and require the reasonable belief that one of the following situations exists:

• A crime or other legal breach has been committed, is being committed or is likely to be committed.

• There is a miscarriage of justice.

• There is a health and safety risk.

• There is a risk of damage to the environment.

• A cover-up of any of these, including the attempt to conceal information relating to any of these.

• Acts against patients.

14.3 Your disclosure will be protected under the Act if;

• you have followed the organisation’s policy;

• you are an employee, former employee, seconded to the organisation, volunteer or contractor;

• the information is about serious wrong doing in or by your workplace;

• you reasonably believe the information is true or likely to be true.

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14.4 Disclosures are protected whether they concern:

• an action or omission that took place in the past;

• improper conduct occurring in the present; or

• the prospect or likelihood of an action or omission occurring in the future.

14.5 Using the contact details set out in section 6 please detail your concern including, date, area, your contact details to receive feedback and protection under the Act.

14.6 You will be protected under the Act to approach the CEO directly if you believe that your

managers, and the Freedom to Speak up Guardian, are involved in the wrongdoing. If you believe that the CEO is involved in the wrong doing approach the Trust Chair.

14.7 You will be protected under the Act to go outside of the organisation to an appropriate authority

(see section 15) if you believe that; the CEO is involved in the wrongdoing, urgent or exceptional circumstances, no action has been taken within 20 working days.

14.8 When the concern is received a decision will be made by the Freedom to speak up Guardian as

to whether it meets the public disclosure threshold above (appendix 1), or should follow a different pathway to resolution. The outcome will be fed back to the person who has raised the concern, and the issue passed to the relevant senior lead e.g. Executive Director or Deputy Director with that area of responsibility. All concerns raised will be submitted to a central register using the attached template (Appendix 2)

14.9 If the disclosure concerns fraud it will be flagged to the lead Local Counter Fraud Specialist

(LCFS). 14.10 Where it concerns patient safety/allegation of abuse, or neglect, it will be referred to the Director

of Nursing, Quality and Patient Safety and the Trust will carry out a safeguarding investigation in accordance with C89 Safeguarding Children or C90 Safeguarding Adults at risk of Abuse.

14.11 Where the disclosure is related to discrimination as defined in the Equality Act 2010 the matter

will be referred to the Trust Secretary and the Equality and Engagement Manager for investigation.

15.0 TAKING THE DISCLOSURE FURTHER 15.1 Employees are encouraged to resolve concerns via this policy first but there are a number of

bodies to which a qualifying disclosure might be made and who will be able to offer advice and guidance.

15.2 If an employee reasonably believes that appropriate action has not been taken, as a result of

their disclosure and continues to have concerns that they believe are in the public interest he/she may report the matter to the appropriate external authority. The legislation sets out a number of bodies to which qualifying disclosures may be made. These include the:

• National Guardian’s Office:- 0300 067 9000

• National Whistleblowing Helpline:- 08000 724 725

• Care Quality Commission (CQC):- 03000 616 161

• HealthWatch England:- 03000 683 000

• Advisory, Conciliation and Arbitration Service (Acas):- 0300 123 1100

• Public Concern at Work:- 020 7404 6609

• Financial Services Authority:- 020 7066 1000

• Health and Safety Executive:- 0300 003 1647

• Environment Agency:- 0114 282 5312

• Director of Public Prosecutions:- 01245 455800

• Serious Fraud Office:- 020 7239 7272

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• Local Member of Parliament:- Contact details found at http://www.parliament.uk/mps-lords-and-offices/mps/

16.0 GOVERNANCE 16.1 The Board of Directors will be given high level information about all concerns raised by our staff

through this policy and what we are doing to address any problems. We will include similar high level information in our annual report. The board supports staff raising concerns and wants everyone to feel free and able to speak up.

16.2 The Assistant Director of Nursing maintains an overview of cases within the scope of this policy.

See Monitoring Statement below. 16.3 All concerns raised will be confidentially logged on the central register and an anonymised

version is monitored through the processes outlined in the body of this policy for transparency and audit purposes.

16.4 The efficacy of this policy will be audited annually by measuring compliance in answering

concerns in terms of meeting the 20 and 60 day investigation report deadlines and providing feedback to those raising the concern.

Monitoring Statement

Aspects of the policy to be monitored

Monitoring method

Individual/Team responsible for monitoring

Frequency Findings: Group/Committee that will receive the findings/monitoring report

Action: Group/Committee responsible for ensuring actions are completed

The number of ‘protected’ disclosures made internally within this policy against the number of protected disclosures made to an appropriate external agency.

This will be monitored by the Head of patient safety and safeguarding

Safeguarding Team

Quarterly

Annually

Quality Governance Committee

Executive and Non-Executive Board

Executive and Non-Executive Board

The number of each cases raised against each identified theme

This will be monitored through the confidential log of cases

FTSUG Quarterly Quality Governance Committee

Executive and Non-Executive Board

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Supporting Information

With reference to: Data Protection Act 1998 Equality Act 2010 Francis Report 2010 (Mid Staffordshire Inquiry) Health and Safety at Work Act 1974 Human Rights Act 1998 Public Concern at Work Public Interest Disclosure Act 1998/2013 Speak Up Review 2015

Associated trust policies and documents

C89 Safeguarding Children C90 Safeguarding Adults at Risk of Abuse Counter Fraud and Corruption HRP004 Dignity & Respect in the Workplace HRP013 Promoting Equality, Diversity & Inclusion HRP015 Resolution HRP016 Disciplinary HRP060 Performance Management Q11 Serious Incidents Requiring Investigation

Written by: Saranna Burgess, Assistant Director of Nursing Reviewed by: Liz Keay, Freedom to Speak Up Guardian;

Dr Jane Sayer, Director of Nursing, Quality & Patient Safety; Marion Saunders, Non-Executive Director

In consultation with: Policy Working Group – August 2017, Equality and Engagement Manager

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Appendix 1

Record of concern raised to NSFT (return to [email protected] please attach or post any original paperwork/email) Date concern received: Raised to who and by what means: External e.g. CCG, CQC Internal e.g. NED, Exec, CEO Locality, team or named person concern related to: Responsible Executive Director: Detail of concern: Examples of relevant disclosures; fraud, theft, harm to the environment, patient safety incidents including unsafe professional conduct and management of patients, harassment or victimisation to the extent that staff are unable to do their jobs effectively, falsification/manipulation of records to achieve targets both financial and commissioning, failure to comply with legislated duties for example under the MHA, MCA, Children Act, or Care Act, failure to comply with NHS England contracts, discrimination in respect of the Equality Act.

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Immediate action taken including date and by whom:

Name of senior manager to investigate including date of delegation (20 working days to provide feedback): Form completed by: Date:

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Appendix 2

Examples of protected disclosures; fraud, theft, harm to the environment, patient safety incidents

including unsafe professional conduct and management of patients, harassment or victimisation to

the extent that staff are unable to do their jobs effectively this includes any form of discrimination,

falsification/manipulation of records to achieve targets both financial and commissioning, failure to

comply with legislated duties under the MHA, MCA, Children Act, or Vulnerable Persons Act, HSE,

failure to comply with NHS England contracts, discrimination in respect of the Equality Act.

Examples of what is not a protected disclosure; grievances between staff including;

bullying/harassment where it is not impacting on patient safety, clinical disagreements between

colleagues and or managers and junior staff, malicious or vexatious allegations, dissatisfaction with

role or job description, concerns related to a person’s personal life unless within any of the

parameters in the title box above. The majority of these issues should be managed through line

management, supervision or Human Resources processes including; mediation, capability, or

disciplinary frameworks

The difference between a grievance and a public interest disclosure: When someone raises a

grievance, this tends to be an issue, problem or complaint about their work, working conditions or

employment rights. The person wishes to complain to management about their treatment and they

have a personal interest in ensuring the issue is addressed. A concern raised through a protected

public interest disclosure tends to be about malpractice or serious wrongdoing such as dangerous or

criminal activity which affects others (e.g. patients or service users, members of the public, or their

employer). The person is not usually directly, personally affected by the danger or illegality.

Therefore, the person should be treated as a messenger alerting others to a concern so that they can

address it, and not be expected to prove the malpractice. They do not have a vested interest in the

outcome of the concern raised, unlike a grievance where they will normally be expected to be able to

prove their case under the grievance procedure.

When an individual raises a concern with a manager, they should consider whether it is a qualifying

public interest issue or whether the matter is a personal employment issue which would be more

appropriately dealt with through the organisation’s grievance procedure.

Grievances can be raised using the Resolution Policy on the intranet, via your manager, HR

Business partner or Union. If you do not feel able to approach your line manager directly; go to their

manager and so on.