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 trust’s ‘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