Accountability – our letter to NHS Employers


South West Whistleblowers Health Action Group (SWWHAG)

Mr Dean Royles, Chief Executive, NHS Employers.

Mr Rob Webster, Chief Executive, NHS Confederation.

Mr Chris Hopson, Chief Executive, Foundation Trust Network.

Dear Gentlemen,

Complaints and Raising Concerns

We note with interest the report of the oral evidence you provided to the Commons Health Committee on 8th July 2014. It is clear that the boards of NHS organisations are accountable for creating a culture where staff, patients and the public feel able to raise concerns without fear, confident that they will be investigated fairly, openly and honestly.

We felt that your oral evidence suggested that more progress had been made in improving board culture than is actually the case. Our experience tells us when members of NHS boards fail to meet the standards of culture and behaviour required by their own codes of conduct, they can still escape accountability.

In 2002 the Code of Conduct for NHS Managers was published. It says:

As an NHS manager, I will observe the following principles:

make the care and safety of patients my first concern and act to protect them from risk………..”

We have real life case study where board members of three NHS organisations breached this principle when they became aware of patient safety concerns. We requested independent investigations into evidence we provided that the Code of Conduct for NHS Managers had been breached by managers’ failure to act on concerns and protect patients from risk. Two of the organisations refused to accept the evidence for investigation. This is not surprising because those with the power to order an independent investigation would also have been the subjects of the investigation.

After we raised concerns with a Strategic Health Authority, it prompted the third organisation to commission an external investigator to review our complaint. We provided documentary evidence of a 20 month delay between a senior board member hearing of patient safety concerns and the organisation’s chief executive obtaining specific case details for review, only after the problems were exposed by Dr Phil Hammond in Private Eye.

We were told by the NHS organisation which commissioned the investigator that she had found that the Code of Conduct for NHS Managers had not been breached in the way that we “alleged”. We did not allege anything. We provided documentary evidence that senior NHS managers had not taken action to protect patients from risk. The investigator’s report has been kept secret from the public. We regard this as a sham investigation. It cost £21,000 of public money and the managers concerned have escaped accountability for the 20 month delay when no action was taken to protect patients from harm.

We ask you, the Chief Executives of organisations which bring together NHS Employers, Foundation Trusts and Providers and Commissioners, to explain in the aftermath of the Mid Staffordshire Public Inquiry:

a. Why your organisations do not mandate that proper, independent, external investigations are held when staff, patients and the public have evidence that NHS board members have breached their own codes of conduct and failed to protect patients.

b. Why your member organisations spend public money on legal firms, such as DAC Beachcroft and Bevan Brittan, to fend off public scrutiny and accountability of board members when evidence exists that they have breached the Code of Conduct for NHS Managers and put patients at risk. We have documentary proof that legal firms are used in this way.

Improvement of NHS culture has to be led from the top. In the words of the Code of Conduct, NHS Managers must be:

held to account for their own performance, responsibilities and conduct…..”

What are your organisations doing to make sure that NHS boards model the right behaviours and are held to account when they fail to do so?

We look forward to hearing from you in response to these important matters of public interest.

Yours sincerely,

Mrs Daphne Havercroft

On behalf of SWWHAG

28th July 2014

The South West Whistleblowers Health Action Group was formed by patients and the public in 2011 to campaign for safer health care in the Bristol area because of local NHS organisations’ unsatisfactory responses to patient safety concerns.

© South West Whistleblowers Health Action Group 2014


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