Shropshire Star comment: NHS staff still afraid to be open

Creating a culture is similarly something that cannot be done overnight. On this front, there is mixed news at Shrewsbury and Telford Hospital NHS Trust.

Any organisation worth its salt and genuinely seeking to improve will listen to those within it who raise concerns, treating them as friendly and constructive voices rather than troublemakers out to rock the boat.

Rather than being made to feel it is best to stay silent, they need to feel that they can speak out without fear. In the realms of the National Health Service, which holds in its hands the lives of patients, this is especially important.

The underlying culture problem was underlined by a 2018 survey of staff at the Royal Shrewsbury and Princess Royal hospitals. It showed that only six out of 10 who responded "would feel secure raising concerns about unsafe clinical practice." This was the lowest figure across the country.

And little over a half of staff who responded to the survey said they would be happy with the standard of care provided if a friend or relative needed treatment.

Clearly, something needed to done, and the trust now has a "Freedom To Speak Up Guardian" which is a sign of intent to change the culture.

However, her first report shows that although a positive journey has begun, there is still a long way to go.

“It has been reported to the FTSU Guardians that colleagues have been told not to raise concerns via incident reporting and, when they have, these have not been acted upon in an appropriate and timely manner,” says Kate Adney in a report going to the trust board.

She says “incident reporting is thought not to be taken seriously unless there is an element of severe or moderate harm”, and less serious incidents are seen as unlikely to be acted upon.

For those who do raise concerns, feedback is poor.

This is all thin encouragement for loyal staff who see things going wrong and want to make their voices heard in making sure they go right.

Kate Adney warns the trust could be failing four out of 13 of the national standards. She is recommending a number of measures.

While it is depressing that her picture is not a better one, the positive aspects are that somebody is on the case and the issue is being seriously addressed.

The verdict for the trust is that it needs to get better.