Holyrood committee calls for more 'transparent' NHS culture

A third of staff say they feel unable to speak up about their concerns

Published 2nd Jul 2018

Significant changes need to be made to ensure NHS staff feel able to voice their concerns, a Holyrood committee has found.

The Health Committee called for a more ā€œopen and transparentā€ culture after its inquiry into the subject found that over a third of health service staff feel unwilling to speak up.

The Scottish Government has created the post of Independent National Whistleblowing Officer, aimed at making it easier for those with concerns to bring them forward.

However the committee said there are still further steps which need to be taken to improve the system.

It has recommended the government supports the introduction of an external investigative line alongside the existing confidential advice line, and reviews how NHS managers are currently regulated and how that differs from health professionals, potentially creating an imbalance.

The committee also provided recommendations on transparency in corporate governance, calling for NHS boards to become more open and honest about pressures and challenges they face.

The report follows the publication last week of an independent investigation into NHS Lothian which uncovered a culture of ā€œbullying and harassmentā€ at the health board.

Meanwhile the recent scandal at NHS Tayside - in which charity funds were used to pay for new IT systems - raised questions over the transparency of boards' finances.

Committee convener Lewis Macdonald said: ā€œThe whole purpose of this investigation is to ensure that the culture of the NHS allows for the delivery of the highest quality of care to patients.

ā€œWe heard directly from staff, patients, NHS Board members and senior NHS managers. We heard that patients want more and greater involvement in their care and how it is delivered.

ā€œMost importantly, when things do go wrong, there should be greater transparency allowing patients and their families to feel confident lessons will be learned.

ā€œThere are also significant measures that need to be taken to ensure staff feel able to speak up about concerns. There needs to be a more open culture that values staff.

ā€œWhile there are checks and procedures in place it remains inevitable that on occasion things go wrong and it is important these can be quickly identified and not repeated.ā€

Scottish Conservative MSP Miles Briggs said: ā€œIn recent years concerns have been expressed over the culture within the Scottish NHS.

ā€œJust last week a truly damning report into the culture of NHS Lothian found a total lack of robust management with staff often afraid to raise concerns for fear of reprisals. Put simply that must change and never be able to occur.

ā€œI hope that this report's recommendations are followed by SNP Ministers and we look to build an open and transparent culture in our NHS that will benefit everyone who works in and uses the service.ā€

A Scottish Government spokeswoman said: ā€œWe have already taken steps, alongside the BMA, to introduce new legally-binding protections for doctors in training and other postgraduate trainees who are whistle-blowers.

ā€œThat builds on a range of measures already in place across NHS Scotland, including the whistleblowing alert and advice service. We are also working to have the new role of independent national whistleblowing officer in place as soon as possible. We anticipate this will be by the end this year.

ā€œAll of this is contributing to an increasingly honest and open reporting culture within our NHS, because it is crucially important that people at all stages of their NHS careers feel able and confident to raise their concerns without fear of punishment or retribution."