Four doctors have criticised the “breakdown of trust” at a hospital that asked staff for fingerprints to try to find the identity of a whistleblower.

Jon Warby received an anonymous letter about failings in his wife’s care at West Suffolk Hospital after she died there in August 2018. A government review is being held into whistleblowing at the hospital.

The hospital said it had apologised to staff involved and it had begun a review of its “culture and openness”. The hospital was accused of conducting a “witch-hunt” after it asked staff for fingerprints and handwriting samples in an attempt to find the letter’s author.

Following the Department of Health and Social Care’s request for a review, Dr Rinesh Parmar from the Doctors’ Association has shared views from four doctors with the BBC.

They said the atmosphere at the hospital was “still tense” and “not a lot of learning has happened”. There was a general feeling among staff that the “external investigation is going to take too long and may not lead to a change in the senior management team responsible”, they said.

It was claimed a senior member of management told staff “nothing different would be done in the future if the same situation was to occur”.

“There seems to be a disconnect between us and senior management,” the Doctors’ Association was told. “This has all just led to a breakdown of trust.”

You can watch the full story on BBC Inside Out East at 19:30 GMT on BBC One Monday evening, and afterwards on BBC iPlayer.

West Suffolk Hospital’s demand for fingerprints to track down a whistleblower – as revealed by the Guardian last month – was “unprecedented and concerning”, according to the Care Quality Commission (CQC). This and a series of other failings around patient safety has led to the first ever relegation of a hospital from an “outstanding” status to “requires improvement” by CQC inspectors.

The regulator’s in-depth inspection was triggered after 10 separate whistleblowers from the hospital voiced alarm. When the CQC went in they found:

-Management and doctors at loggerheads and that had led to a damaging breakdown in relationships.

-What a senior doctor at the hospital called a “‘them and us’ situation”.

-Tensions so great that they were affecting the running of the hospital’s medical services. -Staff “feared reprisals if they raised concerns”.

-Widespread concern about “bullying and harassment”.

The trust hired fingerprint and handwriting experts to track down the member of staff who had anonymously tipped off a family about medical blunders that had occurred before a patient – 57-year-old Susan Warby – died.

The Doctors’ Association UK, which represents grassroots medics, said the findings – and the review, which NHS England is undertaking – should lead to changes in the hospital’s leadership. “We do feel that this should raise questions for the health secretary. Despite previously committing to work with doctors on a Learn Not Blame culture in the NHS, Hancock appears to have stuck his head in the sand when clinicians have tried to raise concerns with him directly regarding patient safety issues. “His silence on this issue has been deafening, and will do little to reassure staff across the NHS that their concerns will be listened to.”

Excerpt from The Guardian, read the full article by Denis Campbell and Matthew Weaver here:

https://www.theguardian.com/society/2020/jan/30/hospital-hired-fingerprint-experts-to-unmask-whistleblower-report-finds

Once among the sector’s top performers, it is now facing fundamental questions about its leaders’ conduct and its overall performance. It is very unusual for a provider to drop two ratings from a single inspection, and the change makes West Suffolk one of a very small number of trusts which have earned then lost an “outstanding” rating.

The rating downgrade follows ministers ordering NHS England and Improvement to launch a “rapid and independent” review into WSFT following concerns over how it handled an alleged “witch-hunt” for a whistleblower.

Rinesh Parmar, chair of the Doctors’ Association UK, which campaigns for better working conditions for doctors, said: “The CQC’s findings have sadly tallied with what doctors on the frontline have told us, in particular, that ongoing patient safety concerns raised by clinicians have been dealt with in such a manner that staff no longer feel able to speak up.

“Despite this, dedicated staff at West Suffolk have spoken tirelessly of their commitment to patients, and we hope now that this report, in combination with the recently commissioned rapid review, will be the start of positive change within the trust.”

Excerpt from the HSJ, read the full article by Nick Kituno here.

Inspectors say they found significant concerns and risks to patients within the maternity and midwifery service, which included the failure to track and score observations of some women and new-born babies in order to identify deterioration.

The Care Quality Commission say they raised these concerns with the trust immediately following the inspection and a warning notice was issued stating that improvements must be made by 31 January 2020.

The Doctors’ Association UK raised the alarm after our members brought to our attention that doctors were being finger-printed by West Suffolk in an effort to identify an anonymous whistleblower. The story was first broken by The Guardian and DAUK in December.

Speaking to ITV news DAUK’s Learn Bot Blame lead Dr Jenny Vaughan said: “The only way you can make patients safer is by providing a very open environment…if you don’t get that you get a cover up culture..you get bullying…Doctors that approached DAUK said they felt persecuted.” Her comments come after “witch hunt for a whistleblower”

For the full news reel: https://www.itv.com/news/anglia/2020-01-30/west-suffolk-hospital-requires-improvement/

The Doctors’ Association UK first raised the alarm in December after members approached DAUK alleging that the trust was finger-printing staff and asking for samples of handwriting to identifying an anonymous whistleblower. The story first broke in The Guardian with Denis Campbell.

Speaking to Stephen Foster on BBC Radio Suffolk Jenny said:

“You learn from mistakes, if you can report them without feeling bullied without feeling intimidated that’s much safer for patients. Unfortunately what happened here was the opposite. The trust unfortunately decided to go after a whistleblower who must have felt unable to raise concerns in other way. There seems to be some kind of disconnection between what’s going on at senior management level and what’s going on with frontline staff.”

It has emerged that in a new case, relatives of retired lorry driver Horace Nunn were not told of suspected mistakes in his care until two months after an injury in hospital that contributed to his death in July 2016. They only learned of a problem when a staff member tipped them off that the hospital was planning to investigate delays in the diagnosis of a neurological problem, known as an epidural haematoma, in March.

The new tipoff raises further questions about patient safety standards at the Bury St Edmunds hospital, and a possible breach of the strict NHS-wide “duty of candour” obligation to tell patients and relatives about damaging lapses in care. Last month the Guardian revealed Hancock repeatedly failed to respond to concerns the hospital was bullying and intimidating senior staff to prevent them raising patient safety issues.

Last week, the Guardian further disclosed the trust had spent more than £2,500 on handwriting and fingerprint experts in its hunt for the whistleblower in the Warby case.

Dr Rinesh Parmar, chair of the Doctors’ Association UK, said: “We are incredibly concerned that a second whistleblower has had to raise concerns directly with a family regarding possible harm at West Suffolk. “This pattern speaks of a toxic culture where clinicians feel unable to speak up when things go wrong for fear of retribution. Given recent reports of West Suffolk’s ruthless response to hunt down anonymous whistleblowers, these fears appear to be well founded.”

Excerpt from The Guardian, read the full article here: https://www.theguardian.com/society/2020/jan/24/west-suffolk-hospital-faces-fresh-questions-over-whistleblower-tipoffs

The Department of Health and Social Care (DHSC) has told NHS England to commission a “rapid review” of the actions of bosses at West Suffolk hospital. They are under fire for demanding that staff give fingerprints and samples of their handwriting to help identify who wrote to a family alerting them to failings in care that contributed to a patient’s death.

The review could raise difficult questions about what Hancock – a professed champion of NHS whistleblowers – knew about the trust’s tactics and what he did about it.

The Doctors’ Association UK, which has voiced alarm about the “toxic culture” at the trust, welcomed news of the review.

“We support all initiatives to improve patient safety and therefore welcome this rapid review commissioned by the government, which we hope will shine a light on concerns raised about decisions taken by senior managers,” said Dr Rinesh Parmar, the association’s chair.

“We hope that going forwards the dedicated staff at the trust are given all the support they need to reinstate an environment and culture of openness. Not only will this improve staff morale, it will create a palpable change that commands the confidence of the patients of West Suffolk.”

The review follows a series of Guardian revelations that have highlighted serious patient safety concerns and the “bullying” of doctors who hospital bosses believed raised the alarm.

Excerpt from The Guardian by Denis Campbell and Matthew Weaver, read the full article here.

Jon Warby, a former police officer, said the letter “knocked me sideways” when it arrived two months after his wife, Susan, had died aged 57 after an operation for a perforated bowel at West Suffolk hospital (WSH) in 2018.

Speaking after the adjournment of an inquest in Ipswich into Susan’s death, Warby confirmed that the letter outlined errors in his wife’s surgery that had already been disclosed to him by the hospital. But he also revealed that it contained allegations about the treatment of at least one other patient. He declined to give details.

Last month the Guardian revealed that the anonymous letter had prompted an unprecedented “witch-hunt” by the hospital bosses to try to identify the staff member who had sent the letter. This week the Guardian further revealed that the trust had spent more than £2,500 on handwriting and fingerprint experts after demanding samples from staff.

Senior doctors at West Suffolk hospital said the trust’s demand for fingerprints and handwriting typified a bullying management style. They were also angered when Hancock failed to respond to concerns about the trust’s treatment of staff.

Dr Rinesh Parmar, chair of the Doctors’ Association UK, said: “The witch-hunt for a whistleblower following the tragic death of Mrs Warby highlights a deep-seated toxic culture at West Suffolk hospital. A culture where alleged bullying and intimidation of senior doctors is the chosen strategy by senior managers to silence whistleblowers concerned about patient safety.”

He added: “Rather than address the widespread patient safety issues leading to Mrs Warby’s death, the senior management at the trust sought instead to divert their attention to targeting the whistleblower. Meanwhile the health and social care secretary, Matt Hancock, who purports to champion patient safety, and in whose local hospital this is happening, has simply buried his head in the sand when approached about the matter.

“The very fact that a clinician felt it was necessary to contact the family directly in an anonymous manner is all too telling of a draconian blame culture where staff feel too afraid to speak up when things go wrong. There is no doubt that staff’s worst fears have been confirmed by the trust’s subsequent punitive and needlessly high-handed response.”

Read the full article in The Guardian by Matthew Weaver:

https://www.theguardian.com/society/2020/jan/17/widower-surprised-west-suffolk-hospital-fingerprint-whistleblower

In December 2019 The Doctors’ Association UK was able to bring to light the extraordinary and unprecedented actions taken by West Suffolk to identify a whistleblower in what has been described as a “witch hunt”.

Following the tragic death of Susan Warby, 57, an anonymous whistleblower wrote to Mrs Warby’s widower, to raise concerns about the treatment Mrs Warby had received at West Suffolk for a perforated bowel. We understand the letter was given to the police in the first instance followed by the coroner.

Subsequently, doctors approached The Doctors’ Association UK alleging that the Trust had demanded both fingerprints as well as samples of handwriting in a shocking attempt to identify the whistleblower. The clinicians further alleged that it was made clear that a refusal to submit either finger prints or samples of handwriting would be evidence of guilt.2 DAUK were able to expose this extraordinary behaviour in The Guardian, which first reported on the situation on the 11th December 2019.

It is our view that the Trust’s actions were utterly reprehensible. We remain bewildered as it why this was deemed to be an acceptable approach to staff attempting to raise patient safety concerns. The very fact that a clinician felt it was necessary to contact the family directly in an anonymous manner is all too telling of a draconian blame culture where staff feel too afraid to speak up when things go wrong. There is no doubt that staff’s worst fears would have been confirmed by the Trust’s subsequent punitive and needlessly high-handed response.

As the Coroner’s Inquest draws to a close we hope that this has provided some much needed answers for Mrs Warby’s grieving family. We call on West Suffolk to reflect on their actions and issue an much overdue apology to staff who have told us they remain too speak up about patient safety incidents and near misses.

CONTACT

press@dauk.org

1. The Doctors’ Association UK (DAUK) is a trade association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession. Following the case of Dr Hadiza Bawa-Garba DAUK launched the Learn Not Blame campaign for a just culture in the NHS in the House of Commons in November 2018

2. Subsequently it has been reported in The Guardian that West Suffolk spent £968 on a handwriting expert and £1,512 on a fingerprint expert in their atrocious attempts to try identify the whistleblower. The Trust’s investigation was allegedly lead by a non-executive director who sits on the Trust’s board who is a former assistant chief constable.

Susan Warby, 57, died at the West Suffolk Hospital on 30 August, 2018.

During an inquest into her death, it was heard she had been given glucose instead of saline via an arterial line.

The hospital reportedly asked doctors for fingerprints and handwriting samples to identify the whistleblower.

The Doctors’ Association described the attempt by the hospital to find the letter writer as a “witch hunt”.

Jon Warby said he received the letter two months after his wife’s death.

He said he was “quite surprised” by the lengths the hospital reportedly went to to find its author.

The inquest in Ipswich heard both Suffolk Police and the hospital launched investigations into the letter at the request of the coroner.

The hospital said an investigation into the nature of Mrs Warby’s care was already under way by the time the letter was sent.

Suffolk’s senior coroner Nigel Parsley said Mrs Warby’s family acknowledged her death was the “progression of a naturally occurring disease” but wanted to know if “errors may have had a contributory effect”.

‘Deep-seated toxic culture’

It was heard Mrs Warby also suffered a punctured lung during an operation to replace the arterial line.

Her cause of death was recorded as multi-organ failure, with contributory causes including septicaemia, pneumonia and perforated diverticular disease, affecting the bowel.

The inquest into mother-of-two’s death was adjourned so an independent medical witness can be brought in at the family’s request.

The Doctors’ Association said it was approached by medics who said the hospital had demanded both fingerprints and samples of handwriting.

It said clinicians claimed they were told if they refused that would be evidence of guilt.

“The witch hunt for a whistleblower following the tragic death of Mrs Warby highlights a deep-seated toxic culture at West Suffolk Hospital,” it said.

The hospital said it would not comment until after the inquest had concluded.