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• RAISING CONCERNS Outline presentation

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Todays presentation

• What is raising concerns
• Raising concerns post Francis
• Our organisations policy
• Our challenges and gaps
• How to influence culture change
• Why we need board or other appropriate governance
  structure buy in
• Tips and resources

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The need for culture change

• The Francis Inquiry and subsequent reports
  including the Freedom to Speak Up review have
  reinforced the need for organisational culture
  change. Organisations need to
• Assess progress in creating and maintaining a
  culture of safety and learning, ensuring the
  culture is free from bullying
• Encourage regular reflective practice,
  individually and in teams
• Have policies and procedures built on good
  practice
• Talk about and publicly celebrate raising
  concerns
• Ensure staff have formal and informal access to
  senior leaders

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Raising concerns is not exclusiveto the NHS
Clapham rail crash - an inspector failed to
report loose wiring because he didnt want to
rock the boat.
Zeebrugge Ferry tragedy - it had emerged that
staff on five occasions had raised concerns that
ferries were sailing with their bow doors open.
Collapse of Barings Bank - it was found a senior
manager had failed to blow the whistle loudly or
clearly.
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Progress v challenges
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National staff survey trends where are we?
Percentage of staff who strongly agree/agree 2012 (101,169 total responses) 2013 (203,000 total responses) 2014 (255,000 total responses)
Staff know how to report concerns about fraud, malpractice or wrongdoing 90 90 93
Staff who feel safe/secure to report a concern 72 72 68
Staff who would feel confident their organisation would address the concern 55 56 57
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Our statistics

• Use this slide to insert local staff and patient
  experience surveys or other relevant information
  available to you

ACTION! SPARE SLIDE FOR YOUR INFORMATION
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Importance of getting it right
Right Wrong
Increased patient safety Harm to patients and staff
Good organisational reputation Poor organisational reputation
Financial savings Financial implications
Organisational wide awareness and open culture Lack of staff awareness
Increase in morale, productivity and positive staff survey results Low staff morale, productivity and staff survey results
Stakeholder and regulator confidence in good governance Regulatory response/Crisis management
Lower rates of sickness absence and stress Increased sickness absence and stress Poor working relationships
Staff feel supported and valued Reduced productivity
Low turnover High turnover
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Benefits for patientsand staff
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Our raising concerns policy
ACTION! SPARE SLIDE FOR YOUR INFORMATION

• Use this slide to outline your organisations
  current position. For example
• When was the raising concerns policy last
  updated?
• Who has responsibility for championing raising
  concerns?
• How do we communicate with and engage our staff
• Any promotional materials?
• Regular channels (intranet, posters, etc.)

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Our challenges and gaps

• Use this slide to outline your organisations
  challenges and highlight any gaps

ACTION! SPARE SLIDE FOR YOUR INFORMATION
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Drivers for positive culture change

• Robust communications and staff engagement
• Strong organisational values embedded through
  values based recruitment, induction and appraisal
• Clear understanding of all supporting policies
  and procedures
• Clarity understanding the difference between a
  concern or a grievance
• Openness and transparency
• Early intervention
• Effective training for managers
• Appointing a freedom to speak up guardian to act
  as a local ambassador to ensure concerns are
  dealt with appropriately and effectively
• Nominating an executive director and
  non-executive director within your organisation
  to receive the concerns
• Nominating a manager in each department to
  receive the concerns
• Staff are given access to information and know
  where to find advice and support from external
  sources (for example, the national Whistleblowing
  Helpline and Public Concern at Work)
• All need board or other appropriate governance
  support.

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Influence culture change

• Know how to deal with a concern
• Embedding values and leading by example
• Be visible to staff
• Continually improve policies and mechanisms for
  reporting concerns
• Ensure managers are trained and supported to deal
  with concerns,difficult conversations and any
  associated emotional impact
• Ensure feedback is provided

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Freedom to Speak Up
Champions can help ensure raising concerns

• Benefits
• Raise awareness amongst staff
• Instil confidence that concerns will be listened
  to and addressed
• Offer staff an alternative reporting route to
  their line manager
• Help ensure the voice of staff is heard at a
  senior level
• Provide feedback at senior level to ensure
  constant development of policies and procedures

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Tips from other organisations

• Make raising concerns an integral part of your
  staff engagement strategy
• Encourage openness and transparency
• Think about implementing a tool, model or forum
  which allows all staff to report genuine concerns
  directly to the chief executive or senior
  management
• Recruit a Freedom to Speak Up guardian, champion
  or an ambassador for cultural change who
  autonomously reports directly to the senior
  management team
• Develop and support a network of raising concerns
  guardians, ambassadors, and champions
• Work with staff and provide appropriate training
• Use the tools and resources available to promote
  raising concerns

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Information, tools and resources

• Legislation and policy
• Draw the line logo, assessment tool, managers
  guide, presentation and how to use guide
• Values based recruitment mapping tool map your
  organisational values to that of the NHS
  Constitution
• Model process flow chart raise awareness
• Raising concerns at work Whistleblowing Guidance
  for Worker and Employers in Health and Social
  Care guidance for you and your staff
• National Whistleblowing Helpline free
  confidential advice for all health and social
  care staff
• Public Concern at Work helps you give staff
  confidence to speak up early
• Raising concerns posters help raise awareness
• Ten top tips for reporting concerns can be used
  a pay slip insert or posted on your staff
  intranet
• NHS Employers Staff Engagement Toolkit improve
  staff engagement
• NHS Employers DoOD toolkit ensure your staff
  are working as a team, towards a common culture
• List of prescribed bodies where concerns can be
  escalated
• Frequently asked questions

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Shared learning

• The resources, campaign materials and shared
  learning section of the NHS Employers website
  provides you with examples demonstrating what
  organisations are doing locally to improve
  raising concerns.