Analysis

Jennifer Trueland is a freelance journalist

Find out more Copies of the Audit Scotland report, Accident and Emergency: Performance Update, are available at tinyurl.com/lr7uca7 EMERGENCY NURSE

Whistleblowers still being dismissed or redeployed, claims Patients First characteristic of senior staff in some areas of the NHS: defensiveness when confronted by mistakes and a subsequent failure to learn from them. The group also advises staff who believe patient safety is at risk that they have a duty of care to report their concerns. Ms Fecitt says: ‘Once a nurse raises concerns about patient safety, employers and unions should foresee the potential risk of fallout and act immediately to ensure provisions are put in place to protect the whistleblower. Getty Images

Staff at Ninewells Hospital, in Dundee, for example, have met the standard between 97.2% and 99.4% of the time since 2008/09, and have outperformed the interim 95% target since it was introduced in 2013. Audit Scotland points to factors that have helped staff at Ninewells, the biggest of NHS Tayside’s hospitals, hit the target consistently. These include ensuring that senior decision makers are available and that patients who have been referred by their GPs can bypass EDs. Another important factor is starting the emergency admissions process early. If, after initial triage, ED nurses decide a patient should be admitted, they alert the acute medical unit co-ordinator as soon as possible. If a bed is available, it is allocated to the patient; if not, nurses contact the co-ordinator directly. ‘All of these factors have contributed to NHS Tayside having a better managed service, which is likely to be positive for staff,’ Audit Scotland’s report says. Ms Hudson says that, although emergency nurses in Scotland are busy, they can see a potential for improvement. ‘We held an emergency care summit in November last year and nurses said that the service was facing winter pressures all year round. It is difficult to take time to think about extending roles when you are bogged down by the day job, but this is a time of opportunity and nurses can be at the forefront of change.’ The Audit Scotland report also claims that the number of patients: ■■ Attending EDs or minor injury units (MIUs) rose from 1.57 million in 2008/09 to 1.62 million in 2012/13. ■■ Waiting more than four hours rose from 3,659 December 2009 to 8,300 in December 2013. ■■ Admitted from EDs and MIUs to hospital rose from 334,879 in 2008/09 to 361,121 in 2012/13.

Campaigning group wants staff who raise concerns about care standards to receive immediate protection. Carol Davis reports MORE SHOULD be done to protect nurses who blow the whistle on poor practice but who receive no support from their employers or unions, says campaigning group Patients First. ‘Nurses are still raising concerns about patient safety but these are being played down or ignored. The nurses often end up being isolated, victimised, redeployed or at worst dismissed,’ says lead nurse for campaigning group Patients First and emergency nurse practitioner Jennie Fecitt. Patients First lobbies for an open and transparent NHS in which the over-riding goals are the protection of patients and the reduction of harm. Yet nurses who contact the group are still being victimised and bullied, says Ms Fecitt, who is also a Nursing and Midwifery Council (NMC) conduct and competence committee panel member. ‘More needs to be done to support whistleblowers and protect them from the fallout. Employers should take responsibility for what is appropriate behaviour in the workplace and stop what is inappropriate. Victimising or bullying whistleblowers is not only totally unacceptable; it is breaking the law.’ Patients First challenges two forms of behaviour its campaigners claim are

Victimised ‘Yet nurses who have raised concerns at an advanced stage in the process have been victimised and bullied because they have spoken out, and that needs to change.’ Patients First says that, in many cases, nurses’ concerns are played down or ignored, and that they are afforded little or no protection by their employers or unions. As a result, many of the nurses experience work-related stress, anxiety disorders and in some cases depression. ‘This can lead to the nurses being redeployed and sometimes dismissed under disciplinary procedures, leaving them unable to secure NHS employment again. This has to stop,’ says Ms Fecitt. Patients First is working with the Care Quality Commission to develop a more sensitive inspection process that is attuned to staff concerns. The campaigning group would welcome the opportunity also to work with healthcare unions to develop a robust system in which staff who raise their concerns know that their unions will protect them unequivocally and quickly. ‘Any nurse who has a reasonable belief that patients may be at risk should follow the NMC guidance on raising concern without delay,’ says Ms Fecitt. ‘They have a duty to make their patients their first concern at all times.’ Carol Davis is a freelance writer

Find out more More information on Patients First can be accessed at www.patientsfirst.org.uk June 2014 | Volume 22 | Number 3

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Whistleblowers still being dismissed or redeployed, claims Patients First.

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