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This chapter is subject to review, due to potential changes to legislation as a result of the Francis Report (please see below).

Robert Francis Inquiry report into Mid-Staffordshire NHS Foundation Trust

The Board should give priority to ensuring that any member of staff who raises an honestly held concern about the standard or safety of the provision of services to patients is supported and protected from any adverse consequences, and should foster a culture of openness and insight. (Francis Report, 2013).

Most staff put the interests of service users at the heart of what they do and understand they - as much as their employers - are responsible for ensuring the health and wellbeing of all those who use their service.

All agencies whether statutory, voluntary or private should have their own policies to encourage staff to speak up and to provide a safe alternative where the normal route - through line management - is not possible for whatever reason. These may be called "whistle-blowing" or confidential reporting policies and are often linked to codes of conduct/practice. There may also be separate anti-fraud policies to deal specifically with matters of financial impropriety.

Inquiries into institutional abuse have repeatedly found that some staff who had serious concerns were either too frightened to raise them, or not sure to whom they should speak. New or temporary workers, such as students on placements, can bring different perspectives to organisations, but may not feel in a position to challenge existing practices or cultures.

Staff need to know what the in-house reporting lines are if they have concerns within their service. They also need to know who they can discuss their concerns with outside of the service, if they do not get an appropriate response, for example their professional regulator or the Care Quality Commission (CQC) (also see links below).

The Public Interest Disclosure Act 2003 sets out a framework for public interest whistleblowing, which protects workers from reprisals because they have raised a concern about malpractice. Only a disclosure that relates to one of the broad categories of malpractice can qualify for protection under the Act. These include (s.1, s.43B) concerns about actual or apprehended breaches of civil, criminal, regulatory or administrative law; miscarriages of justice; dangers to health, safety and the environment; and the cover-up of any such malpractice. The Act applies across the private and voluntary sectors as well as to public bodies. The charity Public Concern at Work (PCAW) produces a useful guide to the Act - see Public Interest Disclosure Act - Guide to Law and Practice.

Staff who are not confident about raising a concern locally or using other internal or external routes - whether in a whistle-blowing policy or not - should contact Adult Social Care (see Local Contact Details) or the following organisations for information or advice.

Care Quality Commission;

Action on Elder Abuse

A charity whose helpline provides information, advice and support to victims and others who are concerned about or have witnessed abuse of the elderly.

For more see Action on Elder Abuse website or telephone the helpline on 080 8808 8141;

Public Concern at Work

Whistle-blowing charity. A confidential advice service for anyone concerned about wrongdoing at work who is unsure whether or how to raise it.

For more see Public Concern at Work website or telephone the helpline on 020 7404 6609;

The Carers Line

A national helpline that provides information and support to carers who voluntarily look after family, partners or friends who are ill, frail or disabled.

For more see Carers UK website or telephone the helpline on 0808 808 777 or 020 7922 8000.