Exercising the right to be heard

Throughout history whistleblowers have been viewed in one of two ways: as honest and brave individuals carrying out their moral responsibility, or as traitors to the organisation and people they work for. However, for health professionals, including paramedics, the act of whistleblowing should be seen as an obligation rather than a choice.

Standard 1 of the Health and Care Professions Council’s (HCPC) Standards of Conduct, Performance and Ethics states that registrants should act in the best interest of service users (HCPC, 2012). It goes on to say it is the duty of registrants to act immediately if they become aware of a situation where a service user may be put in danger, and to take appropriate action to protect the rights of children and vulnerable adults who are at risk (HCPC, 2012). In short, registrants are required to place the safety of service users before any personal or professional loyalties at all times (HCPC, 2012).

But while it may be the duty of staff to raise concerns where necessary, this will not be done if they feel whistleblowing policies are not implemented properly.

The Francis Inquiry into the scandal at Stafford Hospital illustrated what can happen when staff fail to speak out against inappropriate care. As a result, one of the key recommendations that emerged from the Inquiry was the promotion of whistleblowing. However, what the Inquiry also revealed was the ‘culture of fear’ that exists around the act. Although theoretical protection is provided to NHS staff by the Public Information Disclosure Act 1998 (c.23), this is unlikely to be of much reassurance to potential whistleblowers who know they will have to face the wrath of their colleagues (The Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013). Ken Lownds of CURE made the point that regardless of protective legislation and policies, it was the culture that mattered. Without a positive culture, it will never be easy to raise concerns (The Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013).

Only last month a paramedic was banned from two hospitals after he spoke out about overcrowding in A&E (BBC, 2015). Luckily the individual involved was later issued an apology and had the restrictions lifted, but this did not stop union bosses claiming the case was a clear example of victimisation.

The raising of complaints and concerns is essential in ensuring the highest quality of care is upheld in the NHS. Employees who raise concerns should be valued, respected and protected, not victimised and bullied. A recent report from the Health Committee admitted that the treatment of whistleblowers remains a ‘stain’ on the reputation of the NHS (Health Committee, 2015). It is therefore imperative that this stain is eradicated so that staff are emboldened to carry out their duty without fearing the consequences.

References

BBC (2015) Worcestershire hospitals ban paramedic Stuart Gardner. BBC. http://tinyurl.com/p6de2zo (accessed 2 February 2015)

Health and Care Professions Council (2012) Standards of Conduct, Performance and Ethics. HCPC, London

Health Committee (2015) Fourth Report of Session 2014–15, Complaints and Raising Concerns. HC 350. The Stationery Office, London

The Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Robert Francis QC. Volume 1: Analysis of evidence and lessons learned (part 1). The Stationery Office, London

Public Information Disclosure Act 1998 (c.23) The Stationery Office, London

Taken from Journal of Paramedic Practice, published 6 February 2015.

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2013: the year in review

As paramedics across the country are recovering from the busiest shift of the year, the Journal of Paramedic Practice thought it would look back over 2013 and consider some of the notable events that occurred, both good and bad.

The beginning of 2013 will be remembered by most for the tragic loss of Roland Furber, President of the College of Paramedics, who passed away on 4 February. Roland and his late wife Carol were known for the huge contribution they made to the paramedic profession and the establishment of the professional body, which was then the British Paramedic Association (BPA). As the inaugural chief executive of the BPA, Roland made an enormous impact on the founding of the profession.

February also saw the release of the final report of the Mid Staffordshire NHS Foundation Trust Inquiry chaired by Robert Francis QC, which though not directly affecting paramedics, raised a number of important questions concerning the care of those who are older and more vulnerable. Perhaps more than anything it highlighted the need for a cultural change within the NHS, where patients are placed at the centre.

One of the most notable events of the past year was the long-awaited publication of the UK Ambulance Services Clinical Practice Guidelines 2013, which was issued following lengthy development with JRCALC and National Ambulance Service Medical Directors. The first major re-write since 2006, it features a number of significant changes in terms of guidance for clinical care. Work is already underway scoping future editions and updates, as can be seen in the obstetrics and gynaecology update published in this issue.

April saw the new health and care system in England become fully operational, with its ambitious aims to deliver the content laid out in the Health and Social Care Act 2012.

August saw the publication of the end of study report for the Paramedic Evidence Based Project (PEEP). Commissioned as a result of the growing interest in the delivery of paramedic education and training, the project called for the introduction of a national education and training framework for paramedics.

Perhaps the biggest piece of news came with Sir Bruce Keogh’s report on the first stage of his review into urgent and emergency care, published 13 November, which presented a significant step in the progression of the paramedic profession. Sir Bruce’s call for the development of 999 ambulance services so that they become mobile urgent treatment services, illustrated an appreciation of the skillset of paramedics and their potential in the delivery of pre-hospital care.

Finally, 2013 marked the five-year anniversary of the Journal of Paramedic Practice, which was launched in October 2008. On behalf of the journal I would like to thank the editorial board, the consultant editors, all those who have contributed to the journal, helping to make it an informative learning resource, and most of all, you the readers, without which this publication would not be possible. I look forward to another exciting year and wish you all the best for 2014.

Taken from Journal of Paramedic Practice, published 10 January 2014.