Raising concerns (Whistle-blowing)
Published on: 4th April 2017 | Updated on: 15th March 2022
Whistleblowing or raising factual concerns about risk, malpractice or wrongdoing which is believed to be compromising patient care, working conditions or calling into question the induction or training for staff is nothing new. Anyone who works (or has worked) in the NHS, or for an independent organisation that provides NHS services, such as community pharmacies, can raise concerns. This includes agency workers, temporary workers, students and volunteers.
Community Pharmacy England’s most recent guidance is Community Pharmacy England Briefing 020/17: Community Pharmacy England’s guidance to contractors on whistleblowing (updated September 2017 version)
The clinical governance provisions in the Terms of Service require pharmacy contractors to ensure that there are arrangements for ensuring that all staff and locums are able raise concerns.
In order to comply with this requirement, contractors must have in place a whistleblowing policy. The aim of which is to allow an employee (or locum) to raise at the earliest opportunity, any general concern that they might have about a risk, malpractice or wrongdoing at work, which might affect patients, the public, other staff, or the organisation itself.
On 1st November 2016, NHS England published Freedom to speak up in Primary Care – Guidance to primary care providers on supporting whistleblowing in the NHS.
The guidance is for all providers of NHS primary care services including community pharmacies. It details the principles and actions to apply in primary care to support the raising of concerns by staff about the delivery of primary care services to patients and the management of the matter raised.
The NHS England guidance expects contractors to review and update their whistleblowing policies and procedures by September 2017.
The NHS England guidance also requires each contractor to name an individual as the Freedom to Speak Up Guardian who can ensure that policies are in place and that staff know who to contact if they have a concern; this person must be independent of management within the pharmacy and not be the direct employer.
NHS England’s guidance notes that there are a range of people that could be a Freedom to Speak Up Guardian, including:
- Arrangement with another local primary care provider;
- Assigned staff role within a larger provider federation/network;
- Arrangement with the local hospital trust Freedom to Speak Up Guardian;
- Nominated member of the local Clinical Commissioning Group (CCG);
- Nominated member of the Local Professional Network (LPN);
- Nominated member of the Local Pharmaceutical Committee (LPC);
- Regional manager in larger pharmacy businesses;
- Superintendent Pharmacist;
- NHS England Responsible Officers.
NHS England committed to work with CCGs, LPNs and Local Representative Committees to support local nominations and during 2016/17 will establish a network of Freedom to Speak Up Guardians in primary care so that NHS England can offer support, resources and further guidance to individuals in this role.
To protect workers, the Public Interest Disclosure Act 1998 sets out what are called ‘protected disclosures’. These include a ‘qualifying disclosure’ made by a worker which tends to show one or more of the following:
- that a criminal offence has been committed, is being committed or is likely to be committed, for example, the supply of a prescription medicine without the authority of a prescription or other authority;
- that a person has failed, is failing or is likely to fail to comply with any legal obligation to which he is subject, for example, a responsible pharmacist failing to make the appropriate record entry under the responsible pharmacist regulations;
- that a miscarriage of justice has occurred, is occurring or is likely to occur, for example, the wrong pharmacist is taking the blame for something he had no part in;
- that the health or safety of any individual has been, is being or is likely to be endangered. This is the most likely situation to arise in a pharmacy, for example in relation to prescribing errors, mis-diagnosis, dispensing errors etc.;
- that the environment has been, is being or is likely to be damaged, for example the guidance about the disposal of waste medicines is not being followed; or
- that information tending to show any matter falling within any one of the preceding paragraphs has been, is being or is likely to be deliberately concealed, for example, if a person in authority has turned a ‘blind eye’ to one of the above.
If a worker is going to make a disclosure it should be made to the employer first, usually their line manager at the pharmacy or if they feel unable to use the pharmacy’s procedure the disclosure should be made to a ‘Prescribed Person’.
A Prescribed Person is an organisation or individual that a worker may approach outside their workplace to report suspected or known wrongdoing. Making a disclosure to a Prescribed Person provides the right for a worker to take a case to an employment tribunal if they are victimised at work or they have lost their job because they have ‘blown the whistle’.
Bodies which are prescribed persons include:
- The General Pharmaceutical Council;
- NHS England; and
- Health Education England.
NHS England’s guidance includes a template whistleblowing policy; this has been adapted for community pharmacy use:
Contractors can use this template if they wish or can develop their own policy as long as the requirements of the whistleblowing legislation and the minimum requirements of the NHS England guidance are met.
Community Pharmacy England’s Regulations and Support Team updated its previous guidance to contractors on whistleblowing which is available here.
- The National Guardian’s Office is delivering a series of free workshops for Freedom to Speak Up Guardians who are new to the role.
- NHS Employers run Raising concerns share and learn forums which is a place to share local issues and discuss challenges, and solutions, in an open and informal environment.
- NHS Employers have a Raising whistleblowing concerns hub with information, resources and guidance.
- Public Concern at Work raising concerns guidance – Public Concern at Work (www.pcaw.org.uk) is a whistleblowing charity which encourages workplace whistleblowing. The organisation can assist workers with deciding whether to make disclosures and if so, to whom they should be made.
- The Royal Pharmaceutical Society has guidance on whistleblowing in its document ‘Reducing workplace pressure through professional empowerment’. The Society has also produced guidance for its members on raising concerns and speaking up safely in pharmacy.
- The GPhC has created a guidance leaflet which sets out the responsibilities of pharmacy professionals to take action if they believe patients and the public are at risk.
- The Whistleblowing Helpline is a free-phone service for employees, and organisations working within the NHS and social care sector.