Speak up for safety

A whistleblower who raised the alarm about safety failings at Mid Staffordshire NHS Foundation Trust has described the barriers staff still face today in speaking up and how organisations can build more open and responsive cultures.

Helené Donelly OBE, a former nurse at Stafford Hospital’s A&E department, spoke to the Patient Safety Learning Hub for their series of Speaking Up For Patient Safety interviews. She described how difficult it had been for her to raise her concerns about standards of care and safety because they were “dismissed or diluted” and not taken seriously.

Helené gave evidence at the independent inquiry into the trust and the issues she faced led her to set up what would become the role of the Freedom to Speak Up Guardian. Guardians are appointed by trusts to help staff raise their concerns when they feel they can’t use other channels. Despite the move, Helené said there was still more that could be done to improve the culture in the NHS.

She told interview hosts Peter Duffy and Helen Hughes: “They [the Guardians] play a role in creating awareness around people speaking up and creating a culture of listening and trying to act on concerns early on. But I still feel we have a culture where managers in particular do not have the support or the development to address issues. Culturally, we've got a long way to go with this.”

She added: “You can only change cultures by having the tone set from the top and getting people to behave in the right way. That trickles down and you want your frontline workers to also model that behaviour."

“I don’t think cultures are ever going to be perfect – people are people and we’re not all going to behave in the best way sometimes. But when there are key systemic failures and people failing to manage people properly and address issues, then we have to hold them to account.”

Helené also highlighted the importance of instilling ideas about improving culture early in healthcare workers’ careers. She said: “The next generation is coming through and if we capture their imagination and enthusiasm so they understand what good culture looks like – how to speak up, how to behave – they’ll be able to call it out when it doesn’t happen and lead by example.”