Any manager can receive a concern, either from someone they manage or from someone else that delivers services in their team or department.  Senior managers (such as lead clinicians or service directors) may receive concerns from anyone within their service, and more widely within their organisation, as sometimes it will be difficult to raise a concern within a department or service where this would create risk for the individual. 

In addition to line management routes, all organisations delivering NHS services must provide confidential contacts – someone that is trained in receiving concerns and the organisation’s arrangements.  This will sometimes involve signposting to another member of staff, or logging the concern and ensuring action is taken by another member of staff, if the person raising the concern is not willing to take action, but this action is necessary.

Staff wanting to raise concerns about primary care services can raise their concern with the board’s primary care confidential contact, as this may be the safest way for them to raise a concern.  The confidential contact will then need to decide how the concern can best be investigated, and share information accordingly.

Raising awareness, and showing enthusiasm for the process from senior leadership, right down to line managers, will be critical to the success of this procedure, and to engage staff in raising concerns.  

Organisations must make sure information on how to raise concerns is readily available, such as through posters and other materials which can be easily and discretely read.  In addition to this, managers and others that raise concerns will need to be trained in the procedures and how to respond when someone wants to raise a concern with them.

Communications teams play an important role too.  It can be helpful to use a range of internal communications channels, so that staff from across the organisation hear about these changes.

Beyond the process itself, good news stories and positive outcomes from when others have raised concerns will help to build trust in the process.  This is an important part of promoting the process itself which should not be overlooked.

Each organisation will need to have their own systems and structures in place for oversight and management of the whistleblowing procedure.  This oversight function will include ensuring that cases are being actively progressed, that updates are being provided to those raising concerns, and that recommendations are implemented appropriately.  

Human resource (HR) departments may have, historically, taken on this role.  However, it is considered more appropriate for this function to be given to another executive function, such as risk management.  This can reassure those raising concerns that the focus will be on improving safety rather than on HR issues.

Human resources do, however, have a critical role in ensuring that support is available for those that raise concerns, and that any HR issues that are raised within the context of whistleblowing are handled effectively and supportively, alongside any whistleblowing investigation.  They may also need to provide advice where investigations reveal HR issues which need to be addressed.

The National Whistleblowing Standards provide a standardised procedure which is a legislative requirement for all NHS service providers to comply with.  The Standards are not an HR procedure.  However, they do impact on employees, and as such, each organisation must decide whether and how they want to write these requirements into their own HR policies.  

For NHS Scotland board employees, a Once for Scotland policy will be developed for Summer 2020, so that it is in place for the implementation of the Standards.  This will apply to all NHS employees and refers directly to the Standards.  For employees of other organisations, it is up to the organisation to decide whether the Standards are written into internal HR procedures, but any internal whistleblowing policy must facilitate access to a procedure which is in line with the Standards, as a legal minimum.

Anyone delivering NHS services are covered by the Standards.  This applies to staff at every level of the organisation, as well as board members.  Each organisation must identify a suitable route for concerns raised by or about senior staff, and ensure that this route is well understood by both senior management and confidential contacts.