ITEM 13 Whistleblowing Update
North Lanarkshire Council · 27 September 2023
Back to Health and Social Care Integration Joint Board — 27 September 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
1 REPORT Item No: 13 SUBJECT: Whistleblowing TO: Integration Joint Board Lead Officer for Report: Ross McGuffie Chief Officer North HSCP Author(s) of Report Stacey Anderson, Support Services Project Manager Lesley McDonald, Non-Executive Director DATE: 27 September 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐
Page 2
2 3. RECOMMENDATIONS The Board is asked to note the update and the content of each Whistleblowing report and seek assurance that whistleblowing standards are being followed and learning shared. 4. VARIATIONS TO DIRECTIONS? Yes ☐ No ☒ N/A ☐ 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 “Whistleblowing” refers to the act of reporting concerns or wrongdoing in the public interest either within an organisation or externally, for example to a regulator. The law on whistleblowing is contained within the Employment Rights Act 1996 as amended by the Public Interest Disclosures Act 1998. 5.2 The Public Interest Disclosures Act 1998 gives protection to workers who have blown the whistle, but only if their disclosure meets statutory requirements. There are other steps an employer can take not mandated by the law to encourage effective internal whistleblowing and to protect whistle blowers; the most important of which is to develop and implement an effective and appropriate whistleblowing policy. 5.3 Both the North Lanarkshire Council and NHS Lanarkshire’s Whistleblowing Policy each provides a mechanism for employee within the Council and the NHS to report a concern about serious wrongdoing within the Council or NHS and to do so with security and in confidence. 5.4 The annual review of both the North Lanarkshire Council and the NHS Lanarkshire Whistleblowing Policy has been undertaken on the use of the Whistleblowing Policies and on any amendments required to the Policies. Copies of each report is attached within the Appendices. 5.5. The North Lanarkshire Annual Review of Whistleblowing Procedure 2022-23 details that the North Lanarkshire Council’s Whistleblowing Procedure has been reviewed with the following key findings: No amendments requiring approval are considered necessary at this time. This is on the basis that the principal objectives of the policy and procedure remain. Since the last review in 2022, Health and Social Care received one whistleblowing report.
Page 3
3 The report remains under investigation and is expected to conclude shortly. 5.6 The National Whistleblowing Standards and Once for Scotland whistleblowing policy (the Standards) were introduced on 1 April 2021. NHS Lanarkshire’s performance against the Key Performance Indicators included in the Standards has been reported to the Staff Governance Committee and the board on a quarterly basis. In addition to quarterly reporting boards are also required to prepare an annual report The key findings of the NHS Lanarkshire Whistleblowing Annual Report for April 2022- March 2023 include: 3 concerns were investigated under the Standards during 2022/2023 All 3 of the concerns related to independent primary care contractors None of the concerns were upheld. All 3 of the investigations were granted an extension. Learning from the concerns include reviewing clinical supervision in line with best practice and reviewing the hybrid model of appointments, communication and organisational structures and TURAS training compliance. 4 concerns originally raised as potential whistleblowing concerns were dealt with under HR procedures. A review by the Internal Audit Consortium of Lanarkshire of the introduction of the Standards was positive in its findings. 6. CONCLUSIONS Regular review of the Whistleblowing Procedures and Annual Reports from both North Lanarkshire Council and NHS Lanarkshire will be provided to the IJB to help provide assurance that good Whistleblowing standards are being upheld across the Health and Social Care Partnership. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐
Page 4
4 Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐ 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL This paper has been reviewed by Finance: Yes ☐ No ☒ N/A ☐ 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner NA Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details □ Involve stakeholders in the development work aimed at achieving the national
Page 5
5 outcomes ☒ Provide stakeholders with information on how to get involved Information on Whistleblowing is shared across both organisations □ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs □ Measure how well we involve community stakeholders in the planning, design and delivery of our services □ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery □ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings □ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff □ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes ☐ No ☐ N/A ☒ EQIA added to website: Yes / Date added ☐ No ☐ N/A ☒ 8. BACKGROUND PAPERS
Page 6
6 None. 9. APPENDICES Please include a glossary of terms if not already included. Appendix 1– North Lanarkshire Council Annual Review of Whistleblowing Procedure. Appendix 2– NHS Lanarkshire Whistleblowing Annual Report – April 2022 to March 2023. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Stacey Anderson Stacey.Anderson3@lanarkshire.scot.nhs.uk
Page 7
7 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed 7
Page 8
8 Appendix 1 North Lanarkshire Council Report ☒ No From Archie Aitken, Chief Officer (Legal and Democratic) E-mail aitkena@northlan.gov.uk Telephone Executive Summary North Lanarkshire Council’s Whistleblowing Policy provides a mechanism for employees of the Council and other workers within the Council to report a concern about serious wrongdoing within the Council and to do so with security and in confidence. The annual review of the Whistleblowing Policy has been undertaken on the use of the Whistleblowing Policy and on any amendments required to the Policy. Recommendations It is recommended that Committee gives consideration to the contents of the report. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (14) Ensure the highest standards of public protection 1. Background 1.1 “Whistleblowing” refers to the act of reporting concerns or wrongdoing in the public interest either within an organisation or externally, for example to a regulator. The law on whistleblowing is contained within the Employment Rights Act 1996 as amended by the Public Interest Disclosures Act 1998. 1.2 The Public Interest Disclosures Act 1998 gives protection to workers who have blown the whistle, but only if their disclosure meets statutory requirements. There are other steps an employer can take not mandated by the law to encourage effective internal whistleblowing and to protect whistleblowers; the most important of which is to develop and implement an effective and appropriate whistleblowing policy. 2. Report 2.1 There is no positive obligation on an employer to encourage whistleblowing or to implement a whistleblowing policy. The law does provide that employers refrain from dismissing workers or subjecting them to any other detriment because they have made Annual Review of Whistleblowing Procedure Policy and Strategy Committee Does this report require to be approved? ☐ Yes Ref AA/REB Date 16/03/ 23
Page 9
9 a protected disclosure.
Page 10
10 2.2 As a public body, North Lanarkshire Council is expected to have a whistleblowing policy as our whistleblowing arrangements are considered as part of our annual audit process. Whistleblowing plays an important role in safeguarding effective delivery of public services and ensuring best value. North Lanarkshire Council is committed to a culture which views raising concerns of malpractice as a valuable contribution towards its efficiency and long-term success, and assuring workers that they will be treated fairly and that their concerns will be properly addressed. Annual Review of the Whistleblowing Procedure 2.3 North Lanarkshire Council’s Whistleblowing Procedure has been reviewed and no amendments requiring approval are considered necessary at this time. This is on the basis that the principal objectives of the policy and procedure remain: 2.3.1 to convey the seriousness and importance that North Lanarkshire Council attaches to identifying and remedying wrongdoing; 2.3.2 to encourage workers to raise concerns internally as soon as possible and to give them the confidence to do so; 2.3.3 to remind workers of the standards of behaviour expected of them; 2.3.4 to ensure workers know who to approach with a concern, and to enable them to bypass the person, management level or part of the organisation to which the concern relates; 2.3.5 to outline the procedures for investigating disclosures and what steps might be taken if wrongdoing is uncovered; and 2.3.6. to make it clear what will happen to those who victimise genuine whistleblowers or abuse the system by making malicious allegations. 2.4 North Lanarkshire Council’s Whistleblowing procedure sets out the legal protections available to whistleblowers. There are further sources of help and guidance; 2.4.1 Chief Officers are designated as advisers to whistleblowers in identifying whether the concern falls under one or more of the categories or should be better dealt with under a different procedure; 2.4.2 There is access to an external counselling hotline in terms of the Employee Assistance Programme; and 2.4.3 Protect, the whistleblowing charity who provide a confidential independent helpline for whistleblowers is referred to in the procedure. Annual Review of the use of the Whistleblowing Procedure 2.5 Since the last review in 2022, Health and Social Care received one whistleblowing report. 2.6 The report remains under investigation and is expected to conclude shortly.
Page 11
11 3. Measures of success 3.1 Further review of the application of the Whistleblowing Procedure will ensure that the Council’s resources and reputation are being safeguarded and that the Council’s good governance standards are being maintained. 4. Supporting documentation Whistleblowing Policy. Name Archie Aitken Title Chief Officer (Legal and Democratic)
Page 12
12 5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts have been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☒ No ☐ If Yes, have all relevant HR impacts have been discussed and agreed with People Resources? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☒ No ☐ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact?
Page 13
13 Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services.
Page 14
14 Public Interest Disclosures “Whistleblowing” Date 8 February 2023 Version number Document status Final Governance Committee Policy & Strategy Date approved 17 March 2022 Review date April 2023 Strategic Alignment Improving the Council’s Resouce Base – Ensure the highest standards of public protection. aitkena@northlan.gov.uk aitkena@northlan.gov.uk Contact details Archie Aitken Archie Aitken Author Owner
Page 15
15 Consultation process Consultation with stakeholders carried out February 2022 Stakeholders Contacts identified for each service Joint Trade Unions JNC for Teaching Staff Distribution Change record ral changes. Date 8 February 2023 Author Rachel Blair Change made
Page 16
16 Preamble The purpose of this procedure is to provide a mechanism for employees, officers, consultants contractors and workers to report to the Council a concern which they have that there is serious wrongdoing within the Council – and to do so with both security and confidence. It draws on the rights and obligations contained within the Employment Rights Act 1996, the Public Interest Disclosure Act 1998, and the Enterprise and Regulatory Reform Act 2013. This procedure for reporting concerns at work is based on the following principles: • fair and reasonable treatment at work; • the right to report concerns reasonably believed to be in the public interest; • confidentiality; • openness and accountability, and • honesty and integrity. 1. Introduction 1.1 In the course of your employment you may become aware of serious wrongdoing in the Council or you may have information regarding malpractice. This procedure outlines the steps you should take to bring serious situations to the attention of the Council, and has been designed to provide guidance to employees on reporting incidents of malpractice or wrongdoing. It indicates how matters can be expedited thoroughly, discreetly and, so far as possible, in a confidential way if that is necessary. This procedure outlines:- • what sort of concerns may be reported; • the employees covered by this procedure; • the nominated individuals in the Council who can be contacted regarding your concerns; • the appropriate steps to be taken to report serious wrongdoing or malpractice; • how a matter may be raised in confidence when that is appropriate; • the rights of employees who are the subject of disclosures; • any obligations placed on an employee in terms of bearing witness; • the interest of the Council; • the right to raise matters of concern and not be subject to any detriment, and • the protection which is available to an employee. 1.2 The disclosure of information in the public interest involves the reporting of serious concerns about illegal or unethical conduct or behaviour which could be described as serious malpractice in the workplace. The kinds of concerns are those set out at paragraph 2.2 of this procedure.
Page 17
17 1.3. The principles and guidance outlined in this procedure have been developed against the background of the Council’s wish to be open and honest, to encourage high standards of conduct in the workplace and to develop the statutory protections available to employees. 1.4. Any employee who has a concern over what they consider is serious wrongdoing within the Council may wish to seek support and advice from their trade union which may be in a position to assist the employee in preparing and making a disclosure report under this procedure. 1.5 The title given to this procedure is Public Interest Disclosures. It may also be referred to as the “Whistleblowing” Procedure. 2. Reporting Concerns 2.1. Most personal concerns at work can be adequately dealt with using other procedures or mechanisms. For instance, if there is an issue about your working conditions which you cannot resolve through other means, you may wish to use the Council’s Grievance Procedure. The procedure outlined in this document is designed to deal with issues of illegality or serious malpractice. 2.2. The public has a right to expect high standards of service. However, there may be occasions when, due to individual acts, omissions or failings, it may be necessary to bring certain matters which give cause for serious concern to the attention of your employer. If you are concerned about an aspect of individual behaviour or Council practice it may fall under one (or more) of the following categories: • a criminal offence; • a failure to comply with a legal obligation; • a miscarriage of justice; • danger to the health and safety of an individual; • damage to the environment, and • the deliberate concealment of information tending to show any of the matters above is being deliberately concealed. 2.3. Under the terms of this procedure an employee can report a matter which they reasonably believe to be in the public interest, on a confidential basis to their employer regarding any of these six categories. The categories are by no means mutually exclusive. For instance, you may be aware of a health and safety failure that is also a criminal offence. If you are not sure whether the concern you wish to raise falls into one of the above categories then you may contact one of several Council Officers who will try to assist you in identifying whether the concern which you have falls under one or more of these categories or whether your concern should be better dealt with under a different procedure or route. The officers available to advise on this are the Council’s Chief Officer (Legal and Democratic), Chief Officer (Finance) and Chief Officer (People Resources).
Page 18
18 2.4 An employee may also be a resident in the Council’s area or have other good reason to approach a local councillor. Such an employee is free to raise an issue with their councillor. However, advising a local councillor of a concern over serious wrongdoing is not a substitute for advising the Council formally by following the Disclosure Report Procedure set out in Section 4. The onus rests on the employee to make the Public Interest Disclosure by following the defined reporting procedure. This will ensure that the Council deals with the matter formally, and in terms of both the legislation and this Procedure. 3. Confidentiality and Anonymity 3.1. One of the principles of this procedure is that an employee has the right to report a matter they consider to be in the public interest and the report will be treated on a confidential basis. For the reporting process to have credibility, employees must have confidence that any matter they draw to the attention of their employer will be handled with discretion and tact. 3.2. The Council hopes that all staff will be able to voice whistleblowing concerns openly under this policy. If an employee wishes to raise their concern confidentially, the Council will make every effort to ensure the employee’s identity is kept a secret. If it is necessary for anyone investigating the employee’s concern to know their identity, this will be discussed with the employee. 3.3. The Council does not encourage staff to make disclosures anonymously. Proper investigations may be more difficult or impossible if the Council cannot obtain further information. It is also more difficult to establish whether any allegations are credible. Whistleblowers who are concerned about possible reprisals if their identity is revealed should come forward to the officers identified at 2.3 and appropriate measures can then be taken to preserve confidentiality. If an employee is any doubt, they can seek advice from Protect (https://protect-advice.org.uk/), the independent whistleblowing charity, who offer a confidential helpline. 3.4. It has to be recognised, however, that in some cases it may not always be possible to preserve total confidentiality, for instance, if the matter reported has to involve agencies such as the police or the Health and Safety Executive. If, in such a situation, the Council can no longer preserve total confidentiality, the employee will be advised of that fact. 4. Reporting Procedure 4.1. An employee wishing to report a matter that is covered by the categories covered in this procedure should contact the appropriate designated officer in the employing Service in the Council. The designated officers are those identified in Annex 1 to this document. This report should, preferably, be in writing and in order to avoid any doubt, should be described as a “Public Interest Disclosure”.
Page 19
19 4.2 This procedure requires that disclosure reports should be made to the designated officers. Those designated offers are required to be alert to such disclosures and ensure that, as far as it is possible, the confidentiality of such reports is maintained. This will normally involve the report having the personal attention of the designated officer. 4.3 If a disclosure report is made which alleges wrongdoing by a Council Chief Officer (the Deputy Chief Executive or Chief Officer) that report should be made directly to the Chief Executive. 4.4 Once a report has been submitted the appropriate officer will advise you of the next steps and any expected timescale. This will be done within 5 working days. 4.5 At this stage of the process it is important that confidentiality is maintained by both parties where that is required to ensure that the matter can be dealt with in the appropriate way, avoid prejudice and protect individual rights. 4.6 The report will then be considered and a decision taken as to whether, and in what way, the matter should proceed. 4.7 Should the appropriate officer decide not to take any action you will be notified and given the reason(s) for this decision. 4.8 If the appropriate officer decides that further action is required on the basis of your report, then you will be notified of the decision, subject to the appropriate investigation and the likely timescale, if possible to do so. 4.9 Once the matter has been concluded and the appropriate action taken in response to your report, you will be notified of the outcome. However, sometimes the need for confidentiality may prevent the Council from giving you specific details or any disciplinary action taken as a result. You should treat any information about the investigation as confidential. 4.10 Under the terms of this procedure, you may seek a progress update from the appropriate officer regarding the status of your report, although it has to be understood that the response may have to be qualified in order to protect other interests. 4.11 While the Council cannot guarantee, the outcome you are seeking, the Council will try to deal with your concern fairly and in an appropriate way. By using this procedure, you can help the Council achieve this. 4.12 If you are not satisfied with the way your report has been dealt with, you can raise this with the Chief Executive. 5. Safeguards 5.1 Under the terms of this procedure, any employee making a Public Interest Disclosure report is safeguarded against any detriment in the course of their employment, provided that the report is made in the reasonable belief that it is in the public interest.
Page 20
20 5.2 For the purpose of this procedure, detriment is defined as any act or omission that penalises the employee for submitting the report. For example, dismissal, harassment, victimisation or any other form of punitive sanction which would not have arisen were it not for the report having been made are prohibited under the terms of this procedure. If you believe that you have been subjected to a detriment, you should immediately report that to the officer who received your disclosure report. If the matter is not remedied, you should raise it formally through the Council’s Dignity at Work procedure. 5.3 An employee must not threaten or retaliate against another employee making a Public Interest Disclosure Report. Any employee involved in such conduct, may be subject to the Councils’ disciplinary procedure. In addition, if an employee is subjected to such detriment by another employee then that other employee could be personally liable. 6. Wrong Reports 6.1 There may be instances when a report is submitted, based on a genuine belief by the employee that something is wrong at a particular time, which is subsequently demonstrated to be false or inaccurate. In such circumstances, employees will be informed of the discrepancy between their report and the facts at hand. Provided that the Council is satisfied that the employee acted in good faith and had a genuine belief that such a situation should be reported and no personal gain was involved, no further action will be taken against the reporting employee. 6.2 If an employee has deliberately submitted a report that they know to be not true or unfounded or with a view to personal gain then they may be subject to the Council’s disciplinary procedure. 7. Reporting Outwith the Council 7.1 The aim of this procedure is to provide an internal mechanism for reporting, investigating and remedying any wrongdoing in the workplace. In most cases you should not find it necessary to alert anyone externally. 7.2 The law recognises that in some circumstances it may be appropriate for you to report your concerns to an external body such as a regulator. It will very rarely if ever be appropriate to alert the media. You are strongly encouraged to seek advice before reporting a concern to anyone external. Protect’s confidential helpline is available for this. In addition, Protect has a list of prescribed regulators for reporting certain types of concern. 7.3 Whistleblowing concerns usually relate to the conduct of our staff, but they may sometimes relate to the actions of a third party, such as a supplier or service provider. In some circumstances the law will protect you if you raise the matter with the third party directly. However, you are encouraged to report such concerns internally first. You should contact one of the other key contacts set out in paragraph 2.3 for guidance. 7.4 Employees within Health and Social Care can access the National Whistleblowing Standards in relation to NHS Services. Further information can be obtained from the Chief Accountable Officer or accessed here.
Page 21
21 ANNEX 1 CHIEF OFFICERS TO WHOM PUBLIC INTEREST DISCLOSURES MAY BE REPORTED – WHISTLEBLOWING PROCEDURE 1. Chief Executive’s Service Des Murray, Chief Executive 2. Enterprise and Communities Service Derek Brown, Deputy Chief Executive 3. Education and Families Service Derek Brown, Deputy Chief Executive 4. Adult Health and Social Care Services Ross McGuffie, Chief Officer (Health and Social Care)
Page 22
22 Appendix 2 Whistleblowing Annual Report – April 2022 to March 2023 1. Introduction The National Whistleblowing Standards and Once for Scotland whistleblowing policy (the Standards) were introduced on 1 April 2021. NHS Lanarkshire’s performance against the Key Performance Indicators included in the Standards has been reported to the Staff Governance Committee and the board on a quarterly basis. In addition to quarterly reporting boards are also required to prepare an annual report, the contents of which are outlined in the Standards. 2. Key findings 3 concerns were investigated under the Standards during 2022/2023 All 3 of the concerns related to independent primary care contractors None of the concerns were upheld. All 3 of the investigations were granted an extension. Learning from the concerns include reviewing clinical supervision in line with best practice and reviewing the hybrid model of appointments, communication and organisational structures and TURAS training compliance. 4 concerns originally raised as potential whistleblowing concerns were dealt with under HR procedures. A review by the Internal Audit Consortium of Lanarkshire of the introduction of the Standards was positive in its findings. 2. Key Performance Indicators 2.1 Cumulative total – Whistleblowing Concerns Raised 2022/23 Quarter Appropriate for whistleblowing Stage 1 Stage 2 Outcome Comments 1 1 0 1 Not upheld Outcome confirmed to individual concerned. 2 0 n/a n/a n/a 3 1 0 1 Not upheld Concern related to primary care provider 4 1 0 1 Not upheld Concern related to primary care provider
Page 23
23 Total 3 0 3 See above See Above
Page 24
24 2 The Standards require stage 1 concerns to be completed within 5 working days and Stage 2 concerns to be completed within 20 working days. The table below shows the number and percentage of concerns at each stage which were closed in full within the set timescales of 5 and 20 working days, for 2022/23. This reflects any extensions agreed. Nos received % closed in 5 working days Nos received % closed in 20 working days Stage 1 0 n/a Stage 2 3 0 The table below shows concerns raised in 2022/23 where an extension was authorised. Concern Nos received Extension authorised As % of all concerns Stage 1 0 0 n/a Stage 2 3 3 100 None of the three cases raised were investigated within 20 working days. All three cases related to concerns about issues within independent primary care practices and the latter two cases were about the same practice. The individuals who raised the concerns were kept appraised of the timescales and reasons for the delays, which included sickness absence, annual leave, diary commitments and the complexity of the investigations. In light of these delays it has been decided to refresh communication with independent primary care practitioners, in conjunction with the appropriate medical director and head of primary care. 3. Analysis of numbers of concerns raised Three concerns were raised during 2022/23 and this compares to three during 2021/22, two during 2019/2020, one during 2018/19, three during 2017/18 and none during 2016/17, so numbers remain fairly constant. Figures recently published by the INWO indicate that a total of 106 concerns were handled by 22 Boards during 21/22 which would suggest that NHS Lanarkshire received slightly fewer than the national average during that year. Figures have not yet been published for 2022/23. 4. Further information on the 3 concerns raised during 2022/23, including service improvements and shared learning. 4.1 The first complaint raised in April 2022 was reported to the Staff Governance Committee in September 2022. The concern related to an independent primary care contractor and included allegations of financial impropriety and references to behaviours which would be more appropriately addressed under the primary care contractor’s HR policies. The concern was investigated at Stage 2 by three managers from NHS Lanarkshire, including the then Deputy Director of Finance and the Primary Care manager. The complaint was not upheld and the individual was notified and informed of their right to go to the Independent National Whistleblowing Officer (INWO).
Page 25
25 3 4.2 The second complaint was raised directly with the INWO by an individual who had resigned from the practice. The nature of the concern included training, clinical supervision, continuous professional development, skill mix, use of locums and prescribing practices. A lengthy and detailed investigation into the concerns was led by a director from the group of practices in question and HR support was provided by NHS Lanarkshire (NHSL). The individual who raised the complaint was also provided with support from one of NHSL’s confidential contacts. Although the complaint was not upheld a number of improvements are being made as a result of the investigation. These include a review of best practice in clinical supervision, engagement with the Board’s pharmacy team to look at clinician specific reporting, review of the hybrid model of appointments, ensuring clarity around organisational structures, escalation processes and contingency arrangements and ensuring that senior team and site managers have undertaken the TURAS whistleblowing training modules. 4.3 The third complaint was also raised directly with the INWO in January 2023 by an individual who had left the same group of practices. The complaint covered allegations of poor and unsafe clinical practices, including lack of skill mix, inadequate support and poor management procedures including a lack of employer duty of care. Although the complaint was not upheld a number of improvements are being made as a result of the investigation, including a review of clinical supervision, review of hybrid model of appointments, and identification of mental health first aid training. 5. Whistleblowing themes, trends and patterns The analysis of themes from whistleblowing concerns aids identification of any shared causes and helps to progress learning and improvement in a targeted manner. The categories/classification for whistleblowing concerns are listed in Part 2 of the Standards and are outlined below for information: Patient Safety Patient Care Poor practice Unsafe working conditions Changing or falsifying information on performance Fraud Breach/breaking any legal obligation Abusing authority Concealment of any of the above The three concerns raised would be classified as relating to patient care and safety, poor practice and fraud. Two of the concerns relate to the same independent primary care practice and, although not upheld, share the same themes of patient care and safety and poor practice. The learning and improvements resulting from the investigation are therefore being targeted and progressed in these areas. As all three whistleblowing concerns raised during 2022/2023 related to independent primary care practices, a review of the implementation of the Standards in these areas will be considered. Follow
Page 26
26 4 up will be arranged in six months with the practices involved in order to seek reassurance that safe and effective systems of clinical governance are in place. Whilst it is anticipated that the practices in question will fully cooperate with any such requests, Board members should be reassured that, ultimately, independent primary care practices can be compelled to provide such information under the requirements of Schedule 6 of The NHS (GMS Contracts) (Scotland) Regulations 2018. 6. Independent primary care contractors Three concerns were raised about primary care contractors, the details of which are included above. No other concerns were received. The Primary Care department requests quarterly information from all independent primary care contractors regarding the number of whistleblowing concerns raised. There are 455 primary care contractors in NHS Lanarkshire, including medical practices, pharmacists, dentists and optometrists. The table below provides more information and efforts are underway to improve return rates. Primary Care Whistleblowing Returns 2022/2023 Medical (%) Dental (%) Optometry (%) Pharmacy (%) Response 82 60 48 17 No Response 18 40 52 83 7. Experience of Individuals Raising Concern/s during 2022/23 The individuals who raised the concerns have left the practices in question and were not employees of NHS Lanarkshire. Regarding the second two complaints, the group of practices are involved in separate legal issues and further comments around experiences would be inappropriate at this stage. A further indicator of the satisfaction of those who raise concerns can be derived from the number of concerns escalated to the INWO after having been considered by NHS Lanarkshire. No referrals were made to the INWO after having been investigated but two concerns were raised directly with the INWO and these are detailed above. 8. Concerns raised as whistleblowing which were dealt with through other HR policies In addition to the cases outlined above which were dealt with through the whistleblowing Standards, four other concerns were logged via uMatter. After carefully considering the cases against the checklist and definitions in the Standards and using the protocols developed locally for this purpose, it was concluded by the HR and NMAHPs directors that these cases should be more appropriately dealt with using other HR policies. The individuals concerned were advised of this in writing and referred to more appropriate
Page 27
27 5 policies including Grievance and Bullying and Harassment. They were also advised of their right to contact the INWO about this decision. 9. Review of Whistleblowing 2022-2023 by the Internal Audit Consortium of Lanarkshire The systems in place to ensure compliance with the Whistleblowing Standards were reviewed during the summer and autumn of 2022. The review was undertaken in accordance with the 2022/2023 Operational Audit Plan and the final report was issued on 8th November 2022. A copy of the report is attached for information. Based on the examination of the control structure and the procedures in place, the report concluded that the system provides “substantial” assurance that objectives are met and that a “robust framework of controls ensures objectives are likely to be achieved, with controls being applied continuously or with minor lapses”. As a result of this review a communications plan has been developed, the format of the HR Standard Operating Procedure for whistleblowing has been amended. 10. Communication, Awareness and Training Since the soft launch of the Standards at the beginning of 2021 regular items have appeared in the staff briefing and in the Pulse on-line. Details of confidential contacts have been publicised and a separate briefing has also been sent to all primary care contractors, along with supporting documentation to enable independent contractors to record and report cases. The non-executive whistleblowing champion has presented to the two Health & Social Care Partnerships and Acute management teams and presentations have also been made to both the GP and GDP Sub Committees. Meetings have also been held with both PFI contractors to confirm that the Standards will be made available to their staff who provide services to NHS Lanarkshire patients and the non- executive whistleblowing champion has delivered presentations to the PFI management teams at University Hospitals Hairmyres and Wishaw. Managers in PSSD have been asked to circulate leaflets on whistleblowing for staff who do not have easy access to email. National Speak Up Week took place between 3rd and 10th October 2022 and NHS Lanarkshire’s approach focussed on awareness raising about the Standards, promotion of the role of the confidential contacts, using the annual report to evidence improvement as a result of whistleblowing and focussed work with managers and leaders. Staff side colleagues played a key role in promoting the week and examples of how we engaged with the campaign include: Articles appearing in the staff briefing and the Pulse, a banner on FirstPort as well as “footers” on emails and MS Teams. One of the articles was based on a concern raised through a confidential contact in 2021 and the confidential contact highlighted her role in receiving and taking forward the complaint. The Chief Executive also referenced Speak Up Week in her weekly video to staff. In addition to sharing INWO posts the main NHS Lanarkshire Twitter banner was updated to promote the week and a video from the whistleblowing champion was shared on the Wednesday to coincide with the INWO’s promotion of the role on that day.
Page 28
28 6 An email was sent to all in NHS Lanarkshire using content from the Pulse article and speaking up was also promoted across sites by circulating posters and leaflets. Staff side colleagues discussed at branch and other trade union meetings how best they could raise awareness during the week and when they were out in the service discussing the pay ballot. The whistleblowing lead and champion attended a leadership development programme and presented on speaking up and the role of the manager and leader. Participants had previously read an article from the Harvard Business Review and also watched a Ted Talk on whistleblowing. Communication has continued since Speak Up Week with regular articles in the staff briefing. In response to a recommendation contained in the review of whistleblowing carried out by the Internal Audit Consortium of Lanarkshire a communication plan has been developed and is attached to this report. Further awareness raising will take place across University Hospital Wishaw through the focus groups which will meet following completion of the Just Culture survey. It has also been confirmed that the following statements will be included in the iMatter staff engagement survey this year: “I am confident that I can safely raise concerns about issues in my workplace” and “I am confident that my concerns will be followed up and responded to”. It is anticipated that responses to these questions will enable us to further focus on specific departments where further awareness raising might be necessary. Training on the Standards is available through TURAS via three modules which provide an overview, a module for line managers and one for senior managers. NHS Education for Scotland (NES) provides monitoring information on the uptake of the training. During 2022/2023 216 modules were completed and since the introduction of the Standards, in April 2021, 427 modules have been completed. 11. Confidential Contacts There are six confidential contacts in NHS Lanarkshire, all of whom have completed the training modules. Their contact details are regularly publicised in briefings and in the Pulse on line and they are also available on NHS Lanarkshire’s intranet. Two of the confidential contacts are designated for private contractors, including PFIs and one is designated specifically for independent primary care contractors. A network for the confidential contacts has been established to enable them to meet with the Non- Executive Whistleblowing Champion and the HR Director on a bi-annual basis. They are also encouraged to engage with the Scottish Speak Up Network. 12. Priorities for 2023/24 During 2023/24 it is intended to focus on the following areas: 1. Implementation of the communication plan 2. Improving uptake of TURAS whistleblowing training. 3. Use the INWO’s Speak Up week in October to further promote and celebrate speaking up. 4. Review of responses to iMatter questions about whistleblowing.
Page 29
29 7 5. Improving return rates and raising awareness in independent primary care contractors. 13. Concluding remarks by Whistleblowing Champion Whistleblowing is intended to reassure staff that, where they have a concern about practices in their workplace that they don’t feel comfortable discussing with their manager, they can raise their concern with confidence that it will be investigated and addressed. My role as NHS Lanarkshire’s Whistleblowing Champion is to monitor and support the effective delivery of its whistleblowing policy, providing assurance to the Board that the organisation has appropriate systems in place and raising any issues of concern. I have been supported in this role by the Executive Lead, Kay Sandilands, HR Director and Eddie Docherty, Director of NMAHPS who worked with Kay to discuss concerns received, identify those which fell within the whistleblowing policy and ensuring that any concern was directed to an appropriate policy or process to be addressed. Our strong, enthusiastic and active network of confidential contacts supported the implementation of the Standards and were invaluable in supporting those raising concerns. Ruth Hibbert, Head of HR, Policy & Governance, held everything together in coordinating the implementation of the Standards and monitoring concerns from receipt to Board report as well as promoting the Standards. Staff side colleagues were also integral in promoting whistleblowing with their members, I am grateful to every one of them for their wise counsel and contribution. Work continues to ensure that the Standards are fully embedded across the healthcare system and I endorse the recommendations in this Report in relation to increasing awareness of the Standards across the primary care sector in particular and dealing with concerns timeously and appropriately. I would also encourage increased uptake of the TURAS training module. I consider that NHS Lanarkshire has made satisfactory progress to date. 14. Conclusion The Board is asked to note the implementation update and the content of this performance report and seek assurance that whistleblowing standards are being followed and learning shared. Director of Human Resources August 2023 Appendices Internal Audit Report Communications Plan