The Department of Health is concerned that health service workers can suffer discrimination and bullying by NHS managers if they respond openly and frankly to investigations into serious incidents (like patient homicides).
So they are consulting about creating a ‘Safe Space’ where staff can contribute to investigations without the fear of retribution.
Remarkably, their proposed solution to this bullying and ill treatment is not to tackle the bullying culture and macho managerial ethos within sections of the NHS itself, but to restrict the amount of information given to victims’ families.
This makes no sense at all and seriously threatens the interests of the families who surely have most interest in knowing how and why their loved ones died.
Our response is below, but we’d ask everyone to respond to the consultation by either e-mailing the Department (firstname.lastname@example.org) or by filling out the online response form.
The consultation closes on December 16 2016, so there’s not too much time left.
NHS Safe Space Consultation response
We are a small national charity supporting loved ones who have been bereaved by homicides by people with severe mental illness. We work with the NHS at national, regional, and local levels and have considerable experience of NHS investigations following serious incidents.
We are deeply concerned about the current safe space proposal. We believe it does not solve the problem it is trying to address.
It seems to want to address the problem of bullying of staff by NHS managers, by restricting the information given to victims’ families. This is both illogical and deeply unfair.
We would strongly oppose any restriction on the amount of information given to families.
In our view there are already sufficient safeguards for health service workers involved with investigations – as invariably their contributions are all anonymised anyway. (We’ve known psychiatrists who didn’t even recognise themselves in investigations into patients under their care).
The main methodology for NHS Serious Incident Investigations is usually ‘Root Cause Analysis’ which aims to look at systemic, rather than individual practitioner problems. It is exceptionally rare for any Root Cause Analysis investigation to criticise individual members of staff for poor practice.
We support the principle that staff should be able to make disclosures and raise concerns about poor care safely in investigations, but such disclosures should not be at the expense of victims’ families.
In our view the problem of a bullying managerial culture should be addressed by effective managerial and cultural reform, rather than ever-increasing secrecy. Additional secrecy is unwarranted and will lead to a significant weakening of public confidence in the quality of official investigations.
We believe the current proposal is ill conceived, and flies in the face of all the recent ‘duty of candour’ legislation, promoting openness, accountability and transparency in the NHS when things go wrong.
Following the scandal at Mid Staffordshire hospital, the Secretary of State said:
“Fostering a culture of openness and transparency is essential if we are to ensure we never repeat the mistakes of Mid Staffs…. A culture which is legalistic and defensive in responding to reasonable challenges and concerns, all too easily permits the persistence of poor and unacceptable care.”
In our opinion, the current Safe Space proposal is highly legalistic and defensive, and will not foster a culture of openness and transparency. It will not solve the problem of bullying of staff and will not help victims and their families.
We think it should be withdrawn and reconsidered.