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Raising concerns in the workplace

Since the Francis Report and the events at Mid-Staffordshire NHS Trust, the Society believes that members need to be aware of both their duty to raise concerns and how to do so. 

The SoR will support members and offer appropriate advice and support to members who do raise concerns but it is important to stress that the SoR cannot raise concerns on behalf of members and it is not the body to whom the concerns are raised.

The Society has published a document to provide guidance for members

We have adopted 6 principles that all employers, whether in the NHS or elsewhere, are encouraged to adopt:

  1. Commit to always improve patient care. 
  2. Employ leaders who trust the clinical judgment of staff allowing them space to exercise their judgment.
  3. Employ healthcare professionals committed to the continuing development of patient care based on rigorous analysis of techniques and procedures.
  4. Regard speaking out on clinical and professional matters as a key mechanism facilitating this development.
  5. Investigate errors of judgment as part of the continuing development process and not solely and immediately to apportion blame.
  6. Show clear commitment to the continuing professional development of all healthcare professionals

We urge members to discuss these principles with managers to ensure they have widespread circulation and, where appropriate, seek the support of local staff sides to ensure their Trust adopts these principles.  

The Society will also promote these principles nationally through the Social Partnership Fora.

Duty of care

These principles, if adopted, provide the framework to support members to exercise their professional duty. All staff, regardless of grade or qualification, have a duty of care towards the patients with whom they come into contact whether this is within the area they are working, the waiting area, or on a ward. 

Radiographers are obligated, as a registrant of the Health and Care Professions Council (HCPC), to uphold the Standards of Conduct, Performance and Ethics.

Failure to do so may result in a caution, suspension or even being struck off.

Standard One makes it clear that acting in the best interest of service users is the prime responsibility of all registrants. It emphasises the fact that registrants have a personal responsibility to report any concerns regarding patient safety to a senior colleague or another appropriate person. The HCPC have published advice for registrants on raising concerns at http://www.hcpc-uk.co.uk/registrants/raisingconcerns/

The Society of Radiographers’ Code of Professional Conduct, para 4.2, says: 

You must report any concerns you have about malpractice or patient safety to your manager or other senior professional, ensuring that you follow up such a report where appropriate.

If you believe that patients are being put at risk by the malpractice of another member of the workforce, you have a duty to report your concerns using local systems for whistle-blowing.

 Examples of issues of concern

  • You suspect a colleague of drinking alcohol at work although you have no ‘proof’. 
  • The equipment you are using is old and has been decommissioned in most departments. You are concerned that the images you are obtaining are not showing all possible information which might lead to incomplete diagnosis.
  • You are concerned by the rough way in which a nurse colleague in A&E treats a patient whilst they are helping you position them for a mobile examination. 

Roger Kline and Shazia Khan have produced a handbook, Duty of Care of Healthcare Professionals, containing practical advice on the duty of care of healthcare professions and their employers towards the patients in their care and what must be done to help protect both patients and staff. The advice is endorsed by the SoR as being applicable to our members.

Whistle-blowing

Where members’ concerns have been raised and not dealt with, or they are of an urgent nature, then members may be left with little or no alternative than to whistle-blow. 

In an everyday sense, whistle-blowing can be described as ‘a mechanism through which concerns, real or imagined, can be raised’. 

Whistle-blowing can be distinguished from a ‘complaint’ because it is done ‘in the public interest’ rather than simply in the employee(s)’interest. 

It is critical that SoR members understand the difference. 

Always contact your local SoR representative for advice in the first instance before raising a concern. Critically, whistle-blowers are protected by law against victimisation, whereas those raising individual or collective employment issues, generally speaking are not.

Examples: 

  • A radiographer who feels that they are being asked to work too many nights will probably have an individual complaint against the employer and should seek to address this through the Trust’s Grievance Procedure.
  • A group of radiographers who believe that the rota is too demanding will probably have a collective complaint and this should be addressed as a collective grievance.
  • An individual or group of radiographers who believe that the work system causes stress, tiredness, lack of concentration to an extent that it compromises patient safety may have cause to ‘whistle-blow’.

Again, it is important to stress that the SoR will offer advice and support to any member or group of members who feel they need to blow the whistle. However, we are not able to blow the whistle on behalf of members and we are not the body to whom the whistle is blown. 

Our role is to ensure members understand their responsibility and, should they need to blow the whistle, that their concerns are treated professionally and with respect without any fear of reprisal.

We therefore support the role of the Whistle-blowing helpline and would encourage members to read the comprehensive guide, Raising Concerns at Work, which the SoR endorses. We recommend that all members familiarise themselves with this guide. 

The Francis Report has provoked much discussion and advice. Sir Robert has completed a Freedom to Speak Up review into whistle-blowing in the NHS.

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