Case study one

http://bma.org.uk/practical-support-at-work/whistleblowing/case-study-one

With the BMA's new guidance we are providing example of good practice to offer as a useful benchmark for raising concerns. This case study featured as part of a BMA online blog on 4 June 2012. Case study is taken from the Social Partnership Forum guidance. While they relate more specifically to non-doctors staff and environment, the situations described can translate into a secondary care setting.

Emergency medicine consultant An emergency medicine consultant who had worked in the NHS for over 20 years was well respected in his trust. His selfless commitment to the NHS was highly valued by both his patients and his clinical colleagues. However, he was not a man to suffer fools gladly. Chronic under-funding in the emergency department meant that nurses were forced to wash bedpans by hand. This was some years ago, but most hospitals had by this time brought in special cleaning machines years previously. This trust had resisted such expenditure. No drinking water There was also no drinking water on tap. Staff either had to boil water or go to other departments to get drinks for patients. News of these shortcomings had reached the patients representative organization. As a result, a reporter from the local newspaper had rung up the consultant asking for his comment. The consultant told the journalist that it was a disgrace and that he had had many requests for improvements turned down by trust managers over the years. He had even been forced to appeal for a donation to the Hospital League of Friends to buy some filing cabinets and had used his own DIY skills to put up shelves in the department. The next edition of the local weekly paper bore the headline: Doctor slams trust where nurses still wash bedpans by hand. The medical director wrote a letter to the consultant demanding an explanation for his actions in talking to the media in direct breach of the trusts communications with the media policy, which prohibited all staff making statements to journalists without the prior written authorisation of the trust chief executive. Consultant warned

The consultant was warned that the trust considered his actions amounted to gross misconduct and was told that he was required to attend a disciplinary interview the following week at which he could be dismissed. BMA get involved The consultant contacted his local BMA industrial relations officer, helpfully enclosing a batch of recent newspaper cuttings. In preparing his defence for the consultant, the IRO was able to rely on paragraph 330 of the Hospital Terms and Conditions of Service, which provides that: A practitioner shall be free, without prior consent of the [trust], to publish articles or speak, whether on matters arising out of his or her NHS service or not. The IRO was aware from previous cases that this express provision in the terms and conditions of service protected consultants who spoke out on matters of patient safety and provided an express contractual exception to the normal duty of confidentiality that an employee owes to an employer. Charges dropped At the subsequent disciplinary hearing, armed with this vital information, the IRO was able to get all the disciplinary charges dropped against the consultant and an apology from the medical director about the heavy handed approach that had been taken. The icing on the cake was that the trust agreed to sort out the plumbing in the department and to provide fresh drinking water for staff and patients. The consultant was the hero of the hour for all the trade unions in the trust because he had stood up to a belligerent management on a point of principle. However, without the expert knowledge and advocacy skills of his BMA IRO, the outcome could have been very different indeed