Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.

Launch of Patients First

Wednesday December 14th 2012 saw the launch of Patients First. Angie Nisbet from Care by Design was privileged to be invited to the launch event. The purpose of Patients First is ‘to reduce death and harm in the NHS by campaigning for the UK Government to create policies and laws that ensure the NHS becomes open and accountable and we will actively support all those who raise concerns about patient safety’.

The changes we are campaigning for:

  1. No more gagging whistle-blowers. Compromise agreements should only be used in exceptional cases. Currently these contracts are used in every case. They prevent any future discussion about the concerns raised by the employee, the amount paid, and the existence of the agreement itself. NHS employers generally suppress any concerns about the safety of patients. This cannot continue.
  2. A legal duty to protect patients. There must be a legal duty to act on concerns from staff and failure to do so must result in serious consequences. At present there are no consequences for those involved in suppressing concerns regarding patient safety. This cannot continue.
  3. Transparency. All legal fees in compromise agreements must be declared as part of the scheme of publications required by the Freedom of Information Act 2000,  that was implemented from 2005. Currently, costs, legal and other fees are rarely published in full. NHS organisations have spent up to £380,000 per individual case fighting legal battles to silence those who have raised concerns. This cannot continue.
  4. The Care Quality Commission must be fit for purpose. The CQC must be reformed to deal with this or an independent patient safety body formed with extensive legal powers of investigation and the ability to bring prosecutions if necessary. The CQC has failed to act on concerns from individuals and groups of staff. When inspections have been carried out they have been inadequate. This cannot continue.
  5. Employment law must change. The statutory cap on unfair dismissal claims should be removed along with the ‘good faith’ test for whistle-blowers. Currently claimants in an employment tribunal may lose their case if they did not raise their concern ‘in good faith’. It was argued after Shipman that this test should be removed. The motivation to raise a concern is irrelevant to the existence of something that may or has harmed patients. This cannot continue.
  6. The Health Select Committee should investigate. The HSC must review the approach the NHS has taken against whistle-blowing. Part of this inquiry should include all cases of whistle-blowers in the past 5 years whether they were successful in a court or Tribunal or settled out prior to that. The Health Select Committee’s approach, announced in September 2011, to call for more pressure on employees is wrong and does not address the problems those employees face. The issues lie with Government policies, law and management practices. These cannot continue.

Everything they do is voluntary and they need are support so donate now. Visit their website at

Published 1st November 2018