Our chair Ms Helen Fernandes, vice chair Dr Ellen Welch, past co-chair Dr Matt Kneale, Learn Not Blame lead Dr Shonnelly Novintin, and committee member Dr David Nicholl attended the service of thanksgiving.

Dr Nicholl, who met Jenny when they were students, was among the people who spoke at the service at St Paul’s Church in Hammersmith.

Paying an emotional tribute to his friend and colleague, he said: “She was an absolute legend within the DAUK and lobbied for so many colleagues and helped so many colleagues, I don’t know how she did it.

“If we think of the general election and parties talking about reform of whistleblowing legislation, something she has campaigned about for years, that’s part of Jenny’s legacy.

Warm, funny and emotional anecdotes came from Jenny’s family and friends. There was a tribute from David Sellu, who she supported in quashing his conviction for gross negligence manslaughter, while neurology colleagues described her devotion to her patients.

Ms Fernandes said: “The service was a wonderful tribute to Jenny and a chance for so many people to give their thanks.

“Jenny was a force of nature who was absolutely pivotal in founding DAUK, and she’s helped and supported so many people and touched so many lives in a meaningful way.

“Her legacy lives on in DAUK.”

Watch the service again by clicking here.

Full details to be posted here.

Covid-19 is having “a chilling effect”, says Samantha Feinstein, a staff attorney at the Government Accountability Project, a Washington-based organisation that supports whistleblowers. “In the US, we’ve seen a huge increase in the use of gag orders and we’re also seeing it in other countries . . . people are afraid to blow the whistle, because they’re afraid they’ll lose their job.”

One way to make workplaces safer is to provide secure channels for reporting wrongdoing. In the UK, organisations including the whistleblowing charity Protect, WhistleblowersUK, and the Doctors’ Association UK are campaigning for change. Reform is also the goal of a private members’ bill sponsored by the MP Philippa Whitford and of a House of Lords’ bill sponsored by Baroness Kramer.

Full article available here: https://www.ft.com/content/284f67a5-c221-443d-b525-258a3fc7ee66

When: 28th September 2020

Where: Virtual conference (CPD certified)

How, sign up here: https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/doctors-in-difficulty-and-difficult-behaviour

Why:

• Network with colleagues who are working support doctors in difficulty

• Reflect on the experience of a Doctor with lived experience

• Learn from outstanding practice in working with doctors to tackle unprofessional, difficult or disruptive behaviours which can impact on patient safety and outcomes

• Develop practical solutions to bring joy back into day to day practice

• Reflect on national developments and learning

• Explore the practicalities of managing doctors in difficulty from a Clinical Directors perspective

• Improve the way concerns are identified and responded to

• Develop your skills in managing and working with difficult behaviour

• Understand how you can improve support for doctors experiencing mental health, physical health or clinical performance concerns

• Identify key strategies for enabling resolution and remedial/developmental action

• Understand the HR and Legal context

Some 46.9 per cent of respondents said they had been told not to raise the issue on social media. A similar number, 47.6 per cent, said they had been warned about speaking to the press during the pandemic.

Medics say that stopping the flow of information – including drawing attention to safety issues – is especially egregious during such a crisis because it prevents life-saving knowledge being effectively shared.

In one Orwellian example of senior managers apparently trying to control this flow, a newsletter sent out to NHS staff listed topics they should be tweeting about. It included thanking people for hard work and retweeting the trust’s own posts – but specified medics should avoid “commenting on political issues, such as PPE”.

Dr Jenny Vaughan, law and policy lead at the Doctors’ Association UK, said: “If you have a transparent, open culture of reporting and people feel free that they can speak up about safety concerns, it saves lives”.

In a statement, she added: “Sadly we are in the biggest public health crisis in a hundred years due to a highly infectious disease where PPE is an especially important aspect to save workers lives.

“It is vital that staff are free to speak up so that we know where the gaps are to keep people safe. This survey shows worrying levels of harassment and bullying to suppress concerns.”

Dr Jenny Vaughan, law and policy lead at campaigning organisation Doctors’ Association UK, said their concerns “weren’t listened to properly”.

“These are people who had tried the right channels. These are people genuinely raising concerns who went to the people who should have listened to them and felt either they couldn’t raise a concern or they weren’t listened to.

“If you have a transparent, open culture of reporting and people feel free that they can speak up about safety concerns, it saves lives”.

They are worried,” said Dr Jenny Vaughan. “And what we’re hoping is that the government will get a grip of this situation and that they will get hold of more gowns.”

Dr Alison Pittard, from the Faculty of Intensive Care Medicine, said not enough testing had gone into the washing and re-using of PPE and “you have to err on the side of caution”.

She added: “If there are any signs that it is degraded in any way when it has been washed then it shouldn’t be used because that would put us at unnecessary risk.”

Protect Chief Executive Liz Gardiner said, “Whistleblowing is the best early-warning system in the NHS and now more than ever staff need to feel safe and supported when they speak up and that issues are properly investigated and resolved.

“We want NHS workers who are working under extremely difficult circumstances to feel reassured that they can get independent and confidential advice about whistleblowing by calling Protect.”

Protect handles around 3,000 cases each year through its free, confidential Advice Line. In addition, it trains businesses and organisations on best practice speak up arrangements.

If an NHS worker has a whistleblowing concern, NHS staff can raise the matter internally at the Trust, speak to their Freedom to Speak Up Guardian (England only), or call the NHS Whistleblowing Advice Line SpeakUp for signposting information. For NHS workers in Scotland, they can call the Alert and Advice Line. For strategic advice on how and where they can raise their concerns further, in addition to legal advice as to what their rights are in doing so, they can call the Protect Advice Line.

However, charity Protect says it has been approached by some NHS staff with concerns.

“Some NHS staff have told us they do not feel safe speaking up within their Trust and are not aware of what support channels exist. Our service at Protect is unique – we offer advice on how to raise concerns effectively, as well as explaining whistleblowers’ legal rights” said Protect’s Chief Executive Liz Gardiner.

Dr Jenny Vaughan, Learn Not Blame Lead, at Doctors Association UK, said, “Sadly the Doctors’ Association UK has been approached by many doctors who have been disciplined for raising concerns about lack of personal protective equipment (PPE) and been told not to speak to the press. Patient safety is never best served by driving staff concerns underground. Bullying of staff when they speak out about safety is completely unacceptable.”

She added, “Doctors and nurses on the frontline have a right to speak out if they or their families or patients could be at risk. Our health service, both private and public, will only benefit if we learn from each other’s experience and we have a Learn Not Blame culture.”

Protect has the support of a number of lawyers who have agreed to give further support to health and social care workers during the crisis.

Protect Chief Executive Liz Gardiner added, “We hope that employers will listen-up when concerns are raised – but we’re grateful to the many lawyers in our legal support network who have kindly agreed to help, including barristers Daniel Stilitz QC, Mukhtiar Singh, and Joseph England and solicitors Paul Daniels at Keystone Law, Leigh Day Solicitors and Slater & Gordon lawyers – but please call Protect in the first instance”.

If further law firms or Chambers wished to lend their support and advice during the Covid 19 crisis, Protect are co-ordinating whistleblowing support to key workers should it be needed.

Doctor Katie Sanderson, who works in acute medicine [and is a DAUK committee member] said “Healthcare workers are practising in very challenging conditions. It is crucial that everybody working in the NHS feels able to voice concerns openly, and that they are aware of the appropriate channels to do so. It is important that doctors and others are aware that free, high quality legal advice is available if they need it.”

Support for whistleblowing doctors:

ProtectProtect Advice Line – Tel: 020 3117 2520
Email whistle@protect-advice.org.uk

SpeakUp
NHS Whistleblowing Advice Line SpeakUp: 08000 724 725.

Alert & Advice Line – NHS ScotlandTel: 0800 0086112
Email: alertline@protect-advice.org.uk

“Aisha Majid asks why ethnic minority doctors are more likely to be investigated by the UK’s medical regulator and what is being done about it

If you’re an ethnic minority doctor working in the NHS you’re twice as likely as a white doctor to be referred by your employer to the General Medical Council (GMC). If you trained outside the UK that figure rises to two and a half times as likely.

These facts are not new. But less is known about the reasons why, says Roger Kline, research fellow at Middlesex University Business School and coauthor of Fair to Refer?, a 2019 report commissioned by the GMC that sought to understand why certain groups of doctors more often fell foul of complaints about their fitness to practise.

“People have known there’s been an issue around disproportionality without understanding what lies behind it,” says Kline. He says that the case of Hadiza Bawa-Garba, who was struck off the medical register after the death of a 6 year old child and then reinstated, was the tipping point for action.

Although it’s not only employers who can refer doctors to the GMC, only referrals by employers show a disproportionate representation of ethnic minorities (see box). Complaints from employers make up only 4.3% of all referrals—but 77% of these result in a GMC investigation, compared with only 9% of complaints from patients.

Dynamics of belonging

The Fair to Refer? report highlighted a pervasive insider-outsider dynamic in the NHS. Doctors perceived as lower status outsiders—such as doctors trained outside the UK—are not given the support they need by bosses and colleagues and are more likely to end up being blamed and facing disciplinary action when things go wrong.

Ethnic minority doctors, whether trained in the UK or overseas, may also feel less confident about raising concerns or challenging an accusation for fear of a backlash. They are also over-represented in roles that can isolate them, such as in locum posts or in small or demanding general practices, leaving them more vulnerable to complaints.

About 40% of doctors working in the NHS in England in 2019 were from ethnic minorities,2 and 38% of the 300 030 doctors working in the UK had trained overseas. A BMA survey carried out the same year found that only 55% of ethnic minority doctors felt included in the workplace, compared with 75% of white doctors.3…

Dr Jenny Vaughan is law and policy lead at the Doctors’ Association UK and led the successful campaign to overturn the conviction of David Sellu, a surgeon who was wrongfully accused of gross negligence manslaughter. She says that the reluctance of some ethnic minority doctors to raise concerns is what makes them particularly vulnerable.

“Minority ethnic doctors feel less confident about reporting concerns, because they feel they are more likely to be blamed because there’s a lot of subconscious bias,” says Vaughan. “Fair to Refer? revealed how toxic working conditions are more likely to lead to a disproportionate referral rate of ethnic minority doctors to fitness to practise processes. The figures [in the report] illustrate how it appears easier to blame ‘outsiders.’”

https://www.bmj.com/content/368/bmj.m338