Intended for healthcare professionals

Feature Whistleblowing

Whistle while you work: an analysis of NHS foundation trust policies

BMJ 2010; 340 doi: (Published 18 May 2010) Cite this as: BMJ 2010;340:c2350
  1. Adrian O’Dowd, freelance journalist1,
  2. Josephine Hayes, editorial intern2,
  3. Deborah Cohen, features editor2
  1. 1 Margate, Kent
  2. 2BMJ, London WC1H 9JR
  1. Correspondence to: A O’Dowd adrianodowd{at}

The ability to raise concerns about a colleague’s work is important for patient safety, but Adrian O’Dowd and Josephine Hayes discover that some NHS trusts make it hard

On paper, whistleblowing is protected by law, written into all NHS trust policies, and supported by various bodies such as Public Concern at Work and the National Patient Safety Agency. Putting it into practice, however, is a different matter. Trusts write their own policy documents, and a recent BMJ analysis of the whistleblowing policy documents valid up to November 2009 from 118 of the 122 NHS foundation trusts shows widely differing approaches.

The BMJ obtained the policy documents from trust websites or through requests under the Freedom of Information Act. The documents were then compared against six standards set out in the Whistleblowing Best Practice guide produced by Public Concern at Work, an independent authority on public interest whistleblowing that also runs a helpline for NHS staff.1The standards are

  • The organisation takes malpractice seriously, giving examples of the type of concerns so that staff can distinguish a whistleblowing concern from a grievance

  • Staff have the option to raise concerns outside of line management

  • Staff are enabled to access confidential advice from an independent body

  • The organisation will, when requested, respect the confidentiality of a member of staff raising a concern

  • Details are given of when and how concerns may properly be raised outside the organisation (for example, with a regulator)

  • It is a disciplinary matter both to victimise a bona fide whistleblower and for someone to maliciously make a false allegation.

Giving examples

The BMJ survey found that 22 of the 118 trust policies do not give examples of types of concerns to be raised. One school of thought is that giving too many specific examples might put people off because they …

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