Flu jab urgent one day deadline as NHS warns 'it's now or never'

https://fed.brid.gy/r/https://www.mirror.co.uk/news/uk-news/flu-jab-urgent-one-day-36381460

The secret influence of NHS Resolution that ensures so many doctor whistleblowers don’t get their jobs back

Why do 97 per cent of whistleblowers fail to win their cases in employment tribunals? Why are they sacked – not for their disclosures of patient safety which is illegal – but under the nebulous title – some other substantial reason (SOSR)? This could be allegations of bullying or saying they cannot get on with colleagues.

But how does a trust gather such information to discredit a doctor? What I have discovered is that NHS trust managers can get a free advice service or an endorsement for actions considered by managers against a Whistleblower from NHS Resolution, an arms length quango from the Department for Health and Social Care.

This ” phone a friend” service would allow the manager to set up a case file under Practitioner Performance Advice without the doctor even knowing this has happened. Effectively the evidence will be later presented at an employment tribunal by highly skilled and expensive lawyers hired by the trust to discredit the unfortunate doctor.

This process has no transparency, no verification with the doctor and there are no public records of what happens in these cases.

The only information that there is such a process is in the annual reports and accounts of NHS Resolution and even that is very sparse.

While there are reams of statistics about the organisation’s public facing work dealing with patients complaints about clinical and non clinical issues which it tries to resolve without going to expensive legal action, the role of practitioner performance advice service gets very little mention.

In the 2024-25 annual report it acknowledges “NHS Resolution’s Practitioner Performance Advice service delivers expert advice, support and interventions on the fair management of concerns about the performance of doctors, dentists and pharmacists.”

How do they judge performance having branded the therapist with a “behaviour” issue at the outset even with untrue claims or without awareness of risks to patients? Only when the formal referral actioned the therapist or doctors may get an opportunity to represent their side of the story BUT if the behaviour analyse are not even clinicians, how would they understand what culture therapist or doctor has been working in.

The PPA service also claims to be very efficient. It says 90% of advice and other case interventions delivered within target timeframe – this was achieved in 2024/25 NHS Resolution annual report and accounts 2024 to 2025 90% of all exclusions/suspensions critically reviewed (where due) – this was within tolerance at 82%, with 155 of 189 exclusions/suspensions reviewed within required timescales.

What it does reveal is that trusts searching to use its services are booming.

The report says: “The service received 1,420 new and reopened requests for advice from healthcare organisations with concerns about the practice of individual practitioners as well as services in 2024/25, representing a 24% increase compared to 2023/24.The open caseload at the end of the financial year stood at 1,149, a 15% increase when compared with the end of 2023/24 .”

It adds: “Requests for assessment and remediation services remained at a high level in 2024/25, with 50 requests for professional support and remediation action plans, 44 requests for behavioural assessments, six requests for clinical performance assessments and four requests for team reviews.”

And it says:” NHS Resolution delivered OARs ( Organised Activity Reports) to 18 secondary care trusts in England, offering follow-up consultations with a Performance Practitioner Advice adviser to each, and finalized reports for primary care trusts, mental health trusts and trusts in Wales and Northern Ireland for delivery in 2025/26″.

On what grounds has this service without transparency or regulation of its advisors been set up and run?Sally Cheshire Chair of the NHSR , and Helen Vernon,CEO, need to explain this.

The only other references are likely to lead to hollow laughs from some of the whistleblowers who lost their jobs at trusts – notably Martyn Pitman at Hampshire Hospitals NHS Trust and Usha Prasad at the now St Georges and Epsom and St Helier Hospitals Trust.

It claims that the whole process is to “develop Compassionate Conversations in relation to performance conversations to support kindness and compassion within the NHS .”

It goes on to say: the aim of the advice includes” Fostering just and learning cultures rather than punitive approaches” and” Ensuring fairness and proportionality in managing performance concerns.”

If there is a lack of transparency how can it be justified as a just culture suitable for learning?

Having covered employment tribunals now in NHS sacking cases the last thing I have seen is any compassionate conversation. Instead the trusts are keen to employ numerous highly paid lawyers to terrify and frighten professional doctors reducing in some cases people to tears – at enormous cost to the taxpayer who foots the bill for their salaries.

So if NHS Resolution is boasting about saving lawyer’s fees in patient complaint cases, it is also responsible for increasing lawyer’s fees – often running to hundreds of thousands of pounds – by advising trusts on how to ruin doctors’ careers when all they have raised is patient safety problems.

If you take this process alongside my previous blog about the role of the General Medical Council and its relationship with the responsible medical officer in the trust- it is no wonder that whistleblowers have little chance of success in the NHS. I now know of senior doctors who are NOT going to report patient safety issues because they fear it will be the end of their careers if they do.

NHSR’s PPA is yet another tool like the unregulated triage by the GMC that can be exploited to bury serious concerns using public funding.

Make a one-time donation

Your contribution is appreciated.

Donate

Make a monthly donation

Your contribution is appreciated.

Donate monthly

Make a yearly donation

Your contribution is appreciated.

Donate yearly

Please donate to Westminster Confidential through Paypal link below

https://www.paypal.com/ncp/payment/865JAS3QJ3CGQ

#NHSResolution #NHSTrusts #sackedDoctors #WesStreeting

Are there flaws in the new guidance for General Medical Council investigations?

Reforms without addressing core issues may lead to persistence of key flaws  or omissions in any future changes with risks to patients

Last month I wrote about the government proposing the first major reforms for 40 years in the running of the General Medical Council. My blog was meant as a warning to ministers to scrutinise the changes very carefully because I was sceptical, after talking to a number of doctors, that there were flaws in the changes. You can read the blog here.

Now the GMC has published its new guidance by Dr Andrew Hoyle, an assistant director in the GMC’s Fitness to Practise Team He is both a doctor and a barrister.

In a high minded piece on Linked In and in a blog ( see the article here) he promises greater clarity and consistency .. and fair, flexible and compassionate fitness to practise processes. He also emphasises the GMC’s duty under the 1983 Medical Act to protect, promote and maintain the health, safety and well being of the public, promote public confidence in the profession and promote and maintain professional standards and conduct by doctors.

Now from the patient’s point of view how is this being enacted by a change to one simple process?

The first point is drawing up guidance for the decision makers on whether to proceed. There is a comprehensive list of issues to consider for the decision makers whether to start an investigation into a doctor. But the response to the concern raiser, the guidance does not specify who the decision makers are. Are they fully competent in the field or even sub-field of medicine practised by the doctor to make a sound judgment  about clinical matters? I have heard from some doctors that this is not always the case. On the question of accountability should it not be made public who made the decision and their qualifications to do so. This would reassure the public and the patients that it had been properly investigated.

The current process’s most crucial step, the  “initial triage and closure of concerns” relies on the “opinions” of the GMC postholders who in turn rely on managers. There is no mandatory requirement to immediately investigate serious harms or near miss issues that may have led to consequences to that or other patients.

This is particularly relevant as there is also the issue of the seriousness of the concern. The guidelines suggest that if there is evidence of repeated bad practice this should be relevant to striking off doctors. But there is a second flaw in this process. How does the GMC know about a bad doctor? The answer is because he or she is reported to the GMC by the responsible officer – normally the medical director or chief medical officer of the trust or far less by patients and or colleagues who are more in the know of bad practices but are fearful of consequences. See article in the Lancet.

Therefore the issue the GMC knows about may not be the first one and the GMC cannot verify it with the current approach neither can the complainant know of all issues. 

From earlier blogs I have found this process to be flawed – either because the responsible officer has targeted a doctor who has raised whistleblowing issues – whether patient safety or fraud – to discredit a perfectly good doctor – the case of Usha Prasad, a former cardiologist at St Helier and Epsom hospital is a current example – or covered up bad practice to save the reputation of the trust or private hospital.

The most egregious example of the latter is the case of Mr Ian Paterson, a breast and general surgeon, now serving a 20 year prison sentence after performing unnecessary operations on hundreds if not thousands of unsuspecting patients until a lawyer brought a civil case against him.

The public inquiry into his practice concluded “They were then let down both by an NHS trust and an independent healthcare provider who failed to supervise him appropriately and did not respond correctly to well-evidenced complaints about his practice.”

It went on: “The recall of patients did not put their safety and care first, which led many of them to consider the Heart of England NHS Foundation Trust and Spire were primarily concerned for their own reputation. Patients were further let down when they complained to regulators and believed themselves frequently treated with disdain.”

Imagine how different the outcome for hundreds of patients if this had been first reported by a responsible officer to the GMC – life changing needless operations would have been stopped rather than covered up. What the GMC should demand is that the management of NHS trusts and private hospital groups have to sign a ” duty of candour” putting them on par with doctors who raise complaints. This would require them to notify the GMC about the practices of the doctor involved and meet the legal requirement that the GMC has to protect patients and promote higher standards in the profession. Otherwise the assessment of a serious repeated bad practice is a hollow gesture in many cases.

 However if the GMC has been and appears it is continuing to rely on the Responsible Officers to provide a response can the GMC’s decisions be evidence-based  and safe for public. Even if a small minority of doctors are unsafe or dishonest,  the impact on the patient and profession must be the core of decision.

The third point is when a doctor acts inappropriately or unsafely that can be investigated by the GMC personnel but who are potentially not being regulated by any one and via a process built on reliance on an RO and in at times without transparency or evidence verification and opinion based decisions are taken that can affect lives This does not appear to be a safe approach as multiple scandals continue to occur; suggesting concerns are not really reaching the GMC due to its current system or are being ignored.

The current concern management requires a complete overhaul and not just superficial tweaks

Since I started looking at this issue I have been contacted by doctors across the country about the GMC and I intend to follow this up in a future blog.

Make a one-time donation

Your contribution is appreciated.

Donate

Make a monthly donation

Your contribution is appreciated.

Donate monthly

Make a yearly donation

Your contribution is appreciated.

Donate yearly

Please donate to Westminster Confidential

£10.00

Click here to purchase.

#doctors #GeneralMedicalCouncil #IanPatterson #medicalDirectors #medicine #NHSTrusts #Spire

Byline Times:
NHS Workers betrayed:'Cover up' Allegations As Most NHS Trusts Say No Staff Died of Covid on Their Watch

https://bylinetimes.com/2023/04/06/cover-up-allegations-as-most-nhs-trusts-say-no-staff-died-of-covid-on-their-watch/

#NHSstaff #deaths #NHSTrusts

https://invidious.nerdvpn.de/watch?v=ZEVXlhgiQ5c

#Bullying #toxicculture at one of #Britain 's largest #NHStrusts

#NHS