Following Lucy Letby, 71% of doctors say whistleblowing damages careers

ITV's Tonight programme has been investigating the way whistleblowers are treated in the NHS, as UK Editor Paul Brand reports

A majority of doctors believe raising safety concerns damages their careers, according to a new survey.

Following the case of Lucy Letby, the hospital doctors' union - the Hospital Consultants and Specialists Association (HCSA) - surveyed more than 500 consultants for ITV’s Tonight programme.

71% of them said it isn’t possible to raise patient safety concerns without harming their careers.

Of those who have spoken up in the past, 93% said they weren’t satisfied with the response from management.

The Tonight programme has been investigating the way whistleblowers are treated in the NHS, following claims by doctors at the Countess of Chester that they warned managers about Letby but were told to stop raising concerns, and were even made to apologise to her.

The Countess of Chester NHS Trust, where the nurse worked, is currently subject to a police investigation into alleged corporate manslaughter. She is now serving a life sentence for murdering seven babies and attempting to kill a further six.

One of the consultants who raised the alarm about her, Dr Ravi Jayaram, travelled with the Tonight programme to meet other doctors and patients who’ve tried to raise concerns about other cases.  

In Lancaster, Peter Duffy was named ‘Doctor of the Year’ at his NHS Trust. But within a year, he’d been forced to resign.

He raised concerns about a patient waiting days for a kidney operation that should have happened within hours.

"I wanted to make sure we learned," Dr Duffy told Dr Jayaram and I. "And make sure it could never happen again."

But Dr Duffy says managers turned against him after he went to the Care Quality Commission.

“It was the most terrible few months of my life," he continued.

"My pay was cut at the end of that month and we then embarked on a series of punishments and detriments, and threats of disciplinary action. So at that point I resigned."

Dr Duffy eventually won a case for constructive dismissal. He was awarded over £100,000 and a wider NHS inquiry into failures at the hospital was damning.

It has since improved, with the trust accepting that governance “wasn’t good enough”.

But across the country, other whistleblowers say their concerns are being suppressed too.   

“They are common themes," says Dr Jayaram.

"What you see here is an attempt to bury it – let’s keep us looking good. Stop them making a fuss.

"It’s almost as if there's an unwritten rule book of how to escalate things to shut people up who are raising concerns. And what I don’t understand is why they do that."

The way whistleblowers are treated within the NHS is of particular concern amid rising pressures on our health system.

96% of doctors in our survey said staffing shortages and delays to treatment have reduced patient safety.

At East Suffolk and North Essex Trust, we were given the rare opportunity to ask Chief Executive Nick Hulme why NHS managers can be reluctant to listen to whistleblowers.

"I have to say that after Letby, more people have emailed me their concerns they might have had for a while."

But he says rising pressure means unacceptable treatment is slowly being normalised.

“It is endless. It is absolutely relentless. It is literally one in one out (at the hospital) pretty much 24/7.

"Two years ago, if a patient waited an hour in an ambulance outside an A&E that would be a serious incident. Now, it happens every day in lots of hospitals up and down the country.

"My concern is that because that has become business as usual, we’ve become almost anesthetized to it."

We spoke to Sir Robert Francis, who chaired the inquiry into failures at Mid Staffordshire NHS Trust.

He told us that the pressures on NHS managers are partly responsible for concerns sometimes being overlooked.

"No manager I’ve ever met or leader of an NHS Trust has ever gone to work in the morning saying I want to make the place less safe, I want to do less for patients," he said.

"They're all under the cosh when it comes to pressures from above saying you must deliver, you must stop ambulances queuing up outside, you must cut waiting lists – often in impossible circumstances.

"I think if you put people under enough pressure, in order to go home at night and sleep, they begin to tolerate things that shouldn’t be tolerated."

Dr Naru Narayanan is the President of the HCSA which conducted the survey for ITV's Tonight programme. He said: "The shocking findings of this joint research underline the scale of the challenge facing our NHS to allow staff to speak freely on patient safety."

“We are witnessing a breakdown in faith in measures put in place after the Mid-Staffs scandal," Dr Narayanan said.

"Doctors see the current system as weak, fundamentally flawed and not fit for purpose. All too often those who raise the alarm fall victim to persecution which destroys careers.

“Against the backdrop of the horrendous details which emerged during the Letby trial, we now need to tear down the barriers to speaking up. This must never happen again."

In response to the programme, NHS England told us: "It is vital that everyone working in the NHS feels they can speak up.

"The NHS has updated Freedom to Speak Up Guidance and brought in extra background checks to prevent directors involved in serious mismanagement from joining other NHS organisations."

'After Lucy Letby: Silence on the Wards?' on Thursday 9 November at 8.30pm on ITV1 and ITVX. 

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