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Health / ‘Material increase’ in concerns raised through NHS whistleblowing service

TEN concerns were raised by staff to NHS Shetland’s whistleblowing inbox during the last financial year – a “material increase” compared to before.

Health officials believe this is because of increased awareness in whistleblowing.

There have also been “considerable delays” in the time it has taken NHS Shetland to fully respond to “stage two” concerns – ones where a full investigation is required.

There is a 20 day target for dealing with stage two concerns but only one out of three investigated at this level to date has been closed within this timescale.

A report to an NHS Shetland board meeting last week appears to show that one stage two case took 245 days to deal with.

A spokesperson for NHS Shetland said after the meeting that the stage two concerns “have been very complex, and therefore we have needed longer than 20 days”.

“Similar to complaints handling, we also have a small number of staff with the skills and capacity to undertake the reviews,” they added.

One of the stage two investigations required an external investigation to be commissioned.

A report which went in front of last week’s board meeting said the “individual has been kept up to date with the progress of the investigation and has received appropriate support from a confidential contact throughout this period”.

NHS Shetland has had whistleblowing standards in place since 2021.

Whistleblowing is defined as “when a person who delivers services or used to deliver services on behalf of a health service body, family health service provider or independent provider […] raises a concern that relates to speaking up, in the public interest, about an NHS service, where an act or omission has created, or may create, a risk of harm or wrong doing”.

The health board is expected to follow national whistleblowing standards set when handling of concerns raised that meet the required definition.

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NHS Shetland also has a “whistleblowing champion”.

The report added that “we are encouraging a safe culture for staff to speak up and for managers to feel confident and competent to manage and/ or escalate concerns appropriately”.

It said the rise in correspondence with its whistleblowing “inbox” is likely to be a result of increased awareness of the service among staff.

“The concerns raised have required action at different stages of the process and have been actioned accordingly, although as noted above we have experienced considerable delays to the 20 working days timeframe for Investigation and reporting on Stage 2 concerns,” the report concluded.

Two of the ten concerns raised in 2023/24 were withdrawn or not progressed by the individual, while one was not deemed to be a whistleblowing issue.

Five issues were treated as “business as usual” cases which are lower level.

Both medical director Kirsty Brightwell and whistleblowing champion Joe Higgins paid tribute to NHS Shetland’s clinical governance team for their role in the whistleblowing process.

Brightwell highlighted that staff are also given an ‘iMatter’ survey, while a ‘Speak Up’ week was held in October.

Higgins added: “Speak Up and whistleblowing is not a project with a start and end date.

“It’s very much a cultural piece that has to ingrain itself within our organisation.”

Figures on feedback from the patient side of the NHS were also given to the meeting.

There were 55 pieces of feedback between 1 January and 31 March – three compliments, 30 concerns and 22 complaints.

Responding to stage two complaints “remains challenging”, a report said.

But it said this situation is not unique to NHS Shetland.

Two cases were submitted to the Scottish Public Services Ombudsman (SPSO) during the first few months of the year.

The report said these cases are now closed, “other than to try to meet with one of the complainants”.

“We are waiting to hear if they still wish to pursue this,” it added.

“We have one new litigation case regarding a delayed diagnosis which is in an early stage of information gathering.”

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