Speak Up and Protect the Frontline

Learn not Blame Team, Doctors’ Association UK

Who are we?

The Doctors’ Association UK (DAUK) was founded in 2018 to ensure that UK doctors have a strong collective voice, empowering members to speak out about the issues that matter to them. Run by doctors at all stages of training, from medical students to senior consultants, DAUK has grown from a community of over 37,000 supporters which include doctors and medical students. We advocate for both the medical profession and patients, and we’re fighting for a better NHS for everyone.

Our Learn Not Blame campaign advocates for transformational change of the culture of fear and blame that still prevails in parts of the NHS. It promotes a culture in which we can learn in a constructive, fair way when things go wrong, and in which staff feel willing and safe to speak up early about concerns. We are frequently contacted by doctors expressing patient safety concerns in both the NHS and private sector, who say that they have been singled out for blame.

Throughout the COVID-19 crisis our members have raised concerns about their ability to speak out about issues at work, in relation to personal protective equipment and other matters. One of the main pillars of our Protect the Frontline campaign has been the call for a commitment to protect staff who speak out about concerns.

Summary of the DAUK Raising Concerns around COVID-19 survey

Between April 26th and 9th May we ran a survey to better understand these concerns. This was an in-depth questionnaire published across our social media platforms, receiving over 230 detailed responses, the majority from doctors. The results were featured on Newsnight on 14th May.

Over 75 per cent had concerns about not having access to Public Health England (PHE)-mandated PPE.
There was evidence of good practice by some hospitals and community organisations, with 50% of respondents reporting that they had not been discouraged from speaking up.

The issues raised were broadly in line with concerns that Freedom to Speak Up Guardians reported being brought to them in NGO pulse surveys, namely worker safety and wellbeing, and behavioural issues.

• 58.6% had raised concerns about the lack of access to PPE at work
• 46.9% had been told not to raise concerns about COVID-19 or PPE via social media
• 47.6% had been told not to speak to the press about COVID-19 or PPE
• 15.2% reported having offered opinions on social media and being challenged or disciplined as a result
• 32.0% had experienced bullying around the issues of raising concerns about PPE

Although good practice was highlighted in many cases, the survey painted a worrying picture in some trusts of how individuals were being treated. Even as they were attempting to secure donations of PPE or to source PPE for their workplace at a point when it was not provided by their employer, some of those trying to speak up reported instances of bullying and suppression or threats of detriment to their terms of employment.

Next steps

The ‘command, control, coordination and communication’ arrangements mandated by the declaration of an NHS England Level 4 incident should not prevent staff speaking up locally about safety concerns. As part of our ‘Learn Not Blame’ campaign we are looking to partner hospital trusts and community organisations to work with us to promote a culture in which staff are allowed to learn when things go wrong, rather than being singled out for blame.

We are committed to promoting the work and role of Freedom to Speak Up Guardians to our networks and continuing to empower our members to speak up about their concerns and experiences. Continuing to develop robust and trusted local/internal processes supporting those who speak up is a crucial cornerstone in moving away from a culture of fear and blame in the NHS. We also work to strengthen protections for those for whom internal NHS processes have not worked.

Changing the culture should be a top priority as we emerge from the current crisis. Our COVID-19 survey highlighted many instances of good practice, and we are keen to continue to work with the Office of the National Guardian and other stakeholders such as Protect to build on this.

You can find out more about our work at www.dauk.org

Authors:

Learn Not Blame team, DAUK – Dr Katie Sanderson, Dr Jenny Vaughan, Dr Ben Evans, Dr Saurabh Bahl, Dr David Nicholl and Dr Rinesh Parmar (Chair, DAUK)

This article features in the August edition of Freedom to Speak Up News

August 14, 2020