It is important to recognise and support whistleblowers in health care. They play a crucial role in promoting transparency, accountability and patient safety within the health and care sectors. According to the Nursing and Midwifery Council (NMC) (2023), whistleblowing is when a worker, which includes students, raises a concern about wrongdoing in the public interest.
Within the sphere of health care, the importance of maintaining integrity, transparency and accountability cannot be overemphasised. Whistleblowers are often employees who courageously step forward to disclose information regarding malpractice, ethical violations or potential dangers within healthcare systems. Recognising, supporting and protecting them is not simply a moral obligation, it is a central component of ensuring patient safety, improving the quality of care and promoting a culture of trust.
There is a difference between raising concerns and whistleblowing. For raising concerns to qualify as whistleblowing six criteria need to be met by law. For example, the individual must believe they are acting in the public interest, meaning that a number of people will stand to benefit if action is taken in response. Personal grievances and complaints, therefore, are not usually whistleblowing. If all the legal criteria are met, the person has legal protections to prevent them suffering disadvantage from their employer.
The NMC received 152 disclosures between April 2021 and March 2022 that it reasonably considered met the criteria and were ‘qualifying disclosures’. The council either took regulatory action (ie fitness to practise) or took regulatory action and shared information with another body with regard to the disclosures. The most common themes were patient safety and care; leadership and management; health and safety; and behaviour (including bullying, intimidation or harassment of colleagues) (Healthcare Professional Regulators, 2022). Potential whistleblowers may hesitate to come forward for fear of retaliation, such as job loss, demotion, harassment or damage to their professional reputation. Fear of reprisal can deter reporting, allowing problems to persist or worsen.
NHS whistleblowers come forward to flag up issues that concern patient safety and bullying. In 2022-23, record numbers of concerns were raised, up by a quarter on the previous year. Of these, 29% of reports were submitted by nurses and midwives, the highest proportion of health professionals. The NHS National Guardian (in England), whose role is to protect whistleblowers, reports that too many managers are still not protecting those who raise concerns – not only do some managers fail to protect whistleblowers, but they actively persecute them (National Guardian's Office, 2023). Despite attempts to encourage whistleblowing, some will pay a heavy price for speaking up. No one should be penalised for doing the right thing, but victimisation discourages others from coming forward.
In the wake of the Mid Staffordshire scandal where hundreds of patient deaths occurred due to poor care between 2005 and 2009, the whistleblowing system was set up. The aim was to prevent another such disgrace from occurring. However, with the pressures the NHS is currently experiencing (similar to those that existed at the time of Mid Staffordshire), there is no assurance this will not happen again. Preventing such a catastrophe requires organisations to have an open culture. We need supportive cultures that ensures the patient is at the core of all that is done and organisations that listen to staff and their concerns.
Raising a concern is everyone's business – it is not always easy, but it is the right thing to do. When people speak up something has to be done in response, but this will be pointless if speaking up leads to personal detriment. Raising concerns is about safeguarding and protecting, as well as learning from a situation and making improvements. Issues raised could be issues that affect patients, the public, colleagues or the organisation the person works for. It is important to recognise and support whistleblowers in health care – they play a key role in protecting all of us, they save lives.