Understanding employee whistleblowing in health care

Health care scandals, such as the most recent at Mid-Staffordshire, have demonstrated that uncaring and ineffective practices can flourish in hospitals when the organisational context goes wrong.

When this happens, patients not only have unpleasant experiences during care but they can be hurt or even die as a consequence. In such situations it is important that staff feel that they can raise concerns or blow the whistle when they see poor quality or unsafe care. All NHS organisations are required by law to have policies in place to help support employees to raise such concerns, but recent hospital scandals and the findings of numerous staff surveys have shown that, for a variety of reasons, many staff feel inhibited in raising concerns, and even when they do, that NHS organisations often fail to act at all or respond inappropriately.

This research seeks to explore this in more depth, with the goal of providing evidence-informed practical guidance for the design and implementation of effective whistleblowing policies in the NHS. The work will involve reviewing the theoretical and empirical evidence from different industries, sectors and countries with regard to the policies that can help support (or inhibit) whistleblowing. It will also examine the legal framework for whistleblowing in the EU member states, and outline the lessons for the NHS from such comparisons. The work will also distil the key lessons for whistleblowing based on an analysis of the evidence and conclusions of recent public Inquiries into serious failings in NHS care, focusing on the reasons why some NHS staff fail to raise concerns and why health care organisations have sometimes failed to respond appropriately when they do. We will also undertake interviews to gather the views, expectations and experiences of a range of stakeholders, including service user representatives, about the development of effective whistleblowing policies in the NHS and perceptions on how current reforms and organisational incentives are impacting on the motivations of employees to raise concerns.

All the lead applicants are skilled communicators and are embedded in a wide range of service user, professional and academic networks suitable for disseminating and mobilising the findings. We will share our findings and recommendations through a national seminar held in London, professional and trade journals, social media including blogs and twitter, and through patient charities and Healthwatch.


November 2015 - May 2017


Chief Investigator


  • Professor Huw Davies (University of St Andrews)
  • Dr Ross Millar (University of Birmingham)
  • Professor Martin Powell (University of Birmingham)
  • Professor John Blenkinsop (University of Hull)
  • Professor Jean McHale (University of Birmingham)


May 2017 is the estimated publication date for this report, but please note that delays in the editorial review process can cause the forecast publication date to be delayed.