There has been an almost 30% year-on-year surge in the number of Blackpool Victoria Hospital workers reporting concerns under its freedom to speak up scheme.
Staff raised the alarm 369 times in 2023/24, analysis of hospital figures by The Blackpool Lead shows, with a record 122 in January, February and March alone. See our special report into an urgent review ordered at Blackpool Vic.
Since the scheme began three years ago, two in five of all concerns have related to bullying and harassment, while a quarter have related to patient safety/quality of care.
There have been at least 10 concerns about sexual misconduct/harassment since Q4 2022/23 and 87 about inappropriate behaviour/attitudes.
The biggest group raising concerns have been nurses and midwives, followed by allied health professionals such as dieticians, therapists and physios.
Case numbers at the Whinney Heys Road hospital “remain high compared to other trusts”, hospital bosses were told in documents recently, although no one has reported suffering as a result of coming forward.
Estephanie Dunn, regional director for the Royal College of Nursing (RCN) union in the north west, said: “The RCN obviously welcomes an avenue for all staff to raise concerns where they may previously have not done so. Against a backdrop of working in extremely challenging conditions due to the chronic staffing crisis in Blackpool and across the region, it is understandable that concerns and challenges have increased.
“We would expect the number of concerns from nurses to be the greatest as they are the largest part of the workforce. Our data does not seem to reflect an increase in the incidence of bully and harassment cases in the organisation, but this only reflects our membership where this data reflects the whole workforce.”
The rising figures may raise further questions about the culture at the hospital, which is currently rated ‘inadequate’ by the health industry regulator Care Quality Commission.
But there have been efforts to encourage medics to blow the whistle on problematic behaviour at the Vic in recent years, after Sir Robert Francis’s The Freedom To Speak Up report in 2015 found that the NHS’s culture did not always encourage or support workers to speak up, with patients and workers suffering as a result.
A new role - a freedom to speak up adviser - was created, with Lauren Staveley appointed, hospital documents show, while staff were told to undergo mandatory training to “raise awareness” of the whistleblowing scheme.
Some 50 “champions” of the programme have also been recruited, with their contact details and departments readily available online.
Katy Coope, the Vic’s executive director of people and culture, said: “The trust is clear with colleagues, patients, their families and visitors - as well as partners working closely with us - of the importance of speaking up when they see or hear anything that doesn’t feel right.
“When someone does raise something, we’ve worked hard to assure people that it is safe to do so, we will listen and they will be supported.
“Blackpool Teaching Hospitals has worked hard over the past five years to create a more caring, safer and respectful culture. There are a number of examples of this working in practice and we’re proud of the improvements we’ve made in this area.
“This includes strengthening the processes that encourage colleagues to speak up when they have concerns and this has resulted in an increase in reports to the freedom to speak up guardian since 2022.
“Freedom to speak up compliance is also at 90% so the trust is assured that colleagues know how to do this and there has been an impactful marketing campaign which signposts how people can speak up across the trust.”
In a freedom to speak up report last month, Staveley wrote: “The importance of listening to staff cannot be overemphasised. When staff raise concerns, they want to know that they are supported and encouraged to do so safely in a protected environment.”
Staveley added: “The trend around types of concern has remained consistent with the ‘potential of bullying and harassment’ and ‘work-related issues’ being the most common reason for staff speaking up.
“All concerns raised are escalated to the relevant level of management and actions are put in place to address these concerns which are audited to ensure concerns are being listened and responded to.
“Work has been ongoing to improve the visibility of the service and to encourage staff to speak up and speak out.”
"Courage and sense of duty"
The most high-profile whistleblowing at the Vic in recent history came in November 2018, when a student on work experience raised the alarm about nurses on the stroke unit secretly sedating patients on a night so they could have an “easy shift”.
The student’s identity has never been known publicly and the prosecutors at the trial of Catherine Hudson, 54, and Charlotte Wilmot, 48, who were jailed for drugging patients, asked for her name to be withheld.
Of the whistleblower, judge Robert Altham said: “It was only as a result of her courage and sense of duty that what was happening on the ward was exposed and stopped.”
Last month, the nurse leading the freedom to speak up scheme nationally, Dr Jayne Chidgey-Clark, said variation around the guardian role is a “big worry”.
It comes after ex-nurse and current Health and Social Care Committee member Paulette Hamilton said: “These people going in are supposed to be independent; they’re supposed to be allowed to grow and develop within an organisation.
“The problem that I have, with what I’ve read, is all organisations are required to have them but the implementation of the role varies greatly dependent on where you are and it’s quite inconsistent and it doesn’t meet with national guideline standards.”
Chidgey-Clark told a committee inquiry: “What we see is an absolute inconsistency, which is a big disappointment to me.”
She said guardian roles are well resourced at some hospitals and a good speaking-up culture tends to be linked to better ratings and better patient experience and outcomes.
But she added: “In other organisations, there absolutely isn’t that support.”
The Vic’s adviser Staveley, who has been asked by NHS England to support new and struggling trusts in the Midlands develop and embed the freedom to speak up approach, describes herself on LinkedIn as the Vic’s “lead freedom to speak up guardian” and recently posted to say she was recruiting a guardian at the trust.
The 18-month fixed contract job would see the successful applicant paid £43,574 pro rata for 28 hours a week.
Staveley’s profile says she worked in recruitment and HR at the East Lancashire Hospitals NHS Trust before moving to Blackpool in July 2021.
The unions Unite and Unison declined to comment on freedom to speak up figures.
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