Whistleblowers Must Be Protected

Ministers should hold NHS managers to account if whistleblowers suffer reprisals for voicing their concerns, the National Audit Office (NAO) has said.

The Department of Health should "take the lead'' to make sure that people who come forward with concerns feel protected in the health service, according to a new NAO report. 
The NAO report, which examined concerns over Cornwall's out-of-hours doctors service, said whistleblowers played a significant role in highlighting problems with the service.
"The Department of Health should take the lead in making sure that whistleblowers are, and feel, protected throughout the NHS,'' the report states. 
"Whistleblowers are a valuable source of intelligence and should be encouraged to come forward. To help reassure whistleblowers, the Department should instruct NHS bodies to publish their whistleblowing policies. 
"This would help ensure that local policies are transparent, consistent and fully compliant with national policy. The Department should also make sure local NHS bodies hold managers to account if whistleblowers suffer reprisals.''
Serco, the company that provides the out-of-hours GP service in the region, came under fire last year after a number of whistleblowers came forward with worries about the service.
Concerns were raised that Serco staff were altering data about the performance of the out-of-hours service.
An audit by the firm found that two members of staff made 252 "unauthorised changes'' to performance data and, as a result, the performance Serco reported to the primary care trust was overstated in seven instances.
"Whistleblowers' concerns had not been identified by routine management controls or by the primary care trust itself."
Subsequently the health regulator, the Care Quality Commission, said the firm was not meeting four of the essential standards of quality and safety. 
The NAO report states that last year Serco regularly had insufficient staff to fill all clinical shifts, but a review found that there was "no evidence'' that the service provided was clinically unsafe.
Dr Louis Warren, who manages the Serco service in Cornwall, said: "Over the last six months the GP out-of-hours service that Serco provides in Cornwall has been the subject of the most comprehensive scrutiny and exhaustive series of audits possible. 
"The NAO report has not only substantiated what the CQC and other reports have already shown - that the service is safe and well regarded by patients - but also confirms that we have taken swift and decisive action in response to the previous CQC report. 
"The only outstanding minor issue noted was that we need to take further action to increase the number of health advisers. Our recruitment campaign will have this resolved by the end of March. 
"While whistleblowers highlighted concerns last year, I am confident that these issues have been addressed.  We now have an outstanding culture and strong levels of staff engagement, where 79% of our team in Cornwall feel respected by their manager. 
"That's as good as any organisation in healthcare in the UK.''  


“We welcome this comprehensive report from the NAO into concerns relating to the provision of the Out of Hours service provided by Serco, particularly the commitment to ensuring whistleblowers feel protected and able to contact us with confidence in future. 

"We will review all of the recommendations and ensure these are built in to how we  monitor the contract to reinforce the quality standards set out nationally and locally for this service. We recognise the need to ensure that safe staffing levels are maintained within this service going forward, recognising that providers have the responsibility for their staffing levels. 

"Our role is to ensure providers’ services meet all key performance indicators and National Quality Requirements. 

"We are working with Serco to ensure all actions within the NAO report are addressed.”