October 2018: Focus on Whistleblowing
Employee whistleblowing – the raising of concerns or ‘speaking up’ about unsafe, unethical or poor-quality care by employees to persons able to effect action – has emerged as a central issue in debates over quality and safety in the NHS.
Indeed, several inquiries and reports into poor standards of NHS care, most recently the review into deaths at Gosport War Memorial Hospital, have highlighted the vital contribution that whistleblowing can play in the detection and prevention of harm to patients. Frontline staff working in the NHS are often best placed to identify substandard care and alert colleagues and managers if patients are at risk. Yet staff are often fearful of raising legitimate concerns and have sometimes been bullied and victimised for doing so.

Against this background, Professors Russell Mannion, Martin Powell and Dr Ross Millar and colleagues have co-authored a National Institute for Health Services (NIHR) report which draws on a rich stream of theoretical research, empirical evidence, legal analysis and stakeholder work, with the aim of sharpening thinking around speaking up and whistleblowing. Some of the key implications for the development and implementation of Whistleblowing and Speaking Up policies in the NHS are summarised by Russell Mannion in a recent HSMC Viewpoint. Other NIHR funded research led by Russell Mannion has highlighted the impact that hospital boards have on creating a climate where staff feel confident in raising concerns as well as staff perceptions that their concerns will be responded to appropriately. This aligns with the findings of recent research evaluating the impact of the recommendations of the Francis Inquiry on hospital boards.
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HSMC News in Brief
The National Assistance Act - 70 years on (Tuesday 6 November, 17:00-19:00)
This event will explore the history and ongoing legacy of the National Assistance Act in relation to health and care integration and the roles of the third sector and local government. We will be sharing research findings from the ESRC's Sustainable Care Programme and discuss how the UK's four nations are developing their relationships with the Act. Speakers include Professors Catherine Needham and Jon Glasby.
More information ».
Phronesis (practical wisdom) and the medical community:
follow-on project
An HSMC-led research team has been successful in securing funding from the Arts and Humanities Research Council (AHRC) for a follow-on project to the study on phronesis and the medical community. The main aim of the follow-on study is to generate impact on patient care and community well-being by improving ethical decision making for the medical community in the UK. We will use our established links to work with medical education providers across the UK to help develop their work in the field of medical ethics education by building on our research findings. This new project will run until June 2019.
More on Phronesis ».
BRACE rapid evaluation: collaborations between GP practices
For its first project, the BRACE Rapid Evaluation Centre is carrying an evaluation to assess the benefits and costs, enablers and barriers of collaborations between GP practices. The first stage of the work involves a rapid assessment of international evidence on the implementation and impact of primary care collaborations. At a workshop in November, the team will share the emerging findings of that work and invite participants (including representatives from NHS England and leading researchers in the field) to help shape the research questions and design for the next stage of the study, which will involve in-depth case studies of four collaborations. The BRACE Centre is also scoping two further projects that will start in early 2019, and details will be made available in due course.
More on BRACE ».
Whistleblowing, board leadership, strategic purchasing, NHS at 70 - recent publications by HSMC academics
Mannion, R., Blenkinsopp, J., Powell, M., McHale, J., Millar, R., et al. (2018)
Understanding the knowledge gaps in whistleblowing and speaking up in health care: narrative reviews of the research literature and formal inquiries, a legal analysis and stakeholder interviews. Health Services and Delivery Research [online], 6(30).

Mannion, R., Davies, H., Blenkinsopp, J., McHale, J., Millar, R., Powell, M. and Snowden, N. (2018) Speaking Up or Blowing the Whistle for better, safer healthcare. In: Tingle, J., O'Neill, C. and Shimwell, M. (eds) Global patient safety: Law, policy and practice. London: Routledge.

Chambers, N., Thorlby, R., Boyd, A., Smith, J., Proudlove, N., et al. (2018) Responses to Francis: changes in board leadership and governance in acute hospitals in England since 2013. Department of Health: Policy Research Programme.

Sanderson, J., Lonsdale, C. and Mannion, R. (2018) What’s needed to develop strategic purchasing in healthcare? Policy lessons from a realist review. International Journal of Health Policy and Management [in press].

Powell, M. (2018). Aneurin Bevan’s long shadow over 70 years of the British National Health Service. Health Services Management Research [online].