Sir Robert Francis’s report into the lack of care at Mid Staffordshire NHS Foundation Trust is well-known. He has just produced a further report, entitled Freedom to speak up. In it, Sir Robert addresses continuing disquiet about the way NHS organisations – including community pharmacies – deal with concerns raised by their staff, and the treatment of some of those who have spoken up.

Sir Robert carried out a confidential online survey in a number of areas of primary care. Out of 4,644 responses, 68 per cent were from people working in community pharmacy, suggesting a lot of concern about whistleblowing.

Freedom to speak up notes that staff in community pharmacy and some other primary care settings can feel particularly isolated. It is harder to raise concerns without being identified and putting one’s job at risk because staff in a pharmacy often work in close proximity with their employer.

Sir Robert recommends that NHS terms of service should be amended to include standards for empowering and protecting staff to enable them to raise concerns freely. However, he notes that, following the abolition of PCTs, there is no formal route for raising concerns except through professional regulators such as the General Pharmaceutical Council (GPhC). NHS England has not so far assumed responsibility for dealing with whistleblowing and Sir Robert says that further consideration needs to be given to this.

For the moment, it seems that there is a vacuum that the GPhC is seeking to fill. It has just concluded a consultation on draft guidance for fitness-to-practise committees on the sanctions they should impose if a pharmacist or technician’s fitness to practise is found to be impaired. The draft guidance emphasises the importance of having in pharmacies an environment and culture that enables superintendent pharmacists, pharmacists and pharmacy technicians to raise concerns with employers.

When deciding on sanctions, the GPhC intends to tell fitness-to-practise committees that they “should take very seriously a finding that a pharmacist or pharmacy technician did not raise concerns where patient safety is at risk”. This should attract sanctions “at the upper end of the scale” and potential removal from the register where necessary to maintain public confidence.

This underlines that raising concerns is mandatory, not optional. Although the pharmacy profession was not implicated in the Mid Staffordshire debacle, the GPhC is leading the culture change, with NHS England trailing in its wake.

David Reissner is senior healthcare partner at law firm Charles Russell Speechlys LLP ([email protected])

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