Intended for healthcare professionals

Rapid response to:


Staff concerns at Mid Staffordshire trust were “lost in a black hole”

BMJ 2009; 338 doi: (Published 04 June 2009) Cite this as: BMJ 2009;338:b2297

Rapid Response:

Re: Staff Concerns and Management Action - More Data Needed

Dr West does raise an important aspect regarding our NHS culture and
ethos. At one stage our NHS was dominated by consultants and one who made
the loudest noise got what he/she wanted. It was not what patients needed
but what these consultants wanted was important deciding factor. Today, it
has changed and NHS is dominated by managers and some of them are medical
managers and it is they decide what is needed for the Trust.

Staff concerns regarding shortage of staff are ignored. Clinical
incident forms have the habit of reaching black hole and nothing much
happens except ticking the box.

In some Trusts there is still so called 'club culture' and 'old boys
network' and these are the people who decide what gets investigated and
what doesn't. These are the sad realities of our NHS.

NHS will and can improve when we put our patients and their needs
first. It is their safety, their well being and their needs which should
be at the heart of our NHS. It is equally important to make sure systems
failures are addressed, doctors and nurses are helped, supported and
guided to make sure that they are able to provide good quality care.

Sadly in the modern NHS there is still blame culture, old boys’
network and club culture and it is these clubs and old boys who decide
what happens locally. Many Board members and that too, non-executive
members are oblivious as to what happens at the level of patients and in
their wards.

Of course, things have improved but we still have a long way to go.

NHS needs an effective whistle blowing and that too someone outside
the Board to whom patients, doctors and nurses can go in confidence and
that someone must have the authority to investigate and if anyone fails to
protect patients and their needs and if there is a blame culture then the
Board should be held to account.

Of course, accountability doesn’t mean dismissal of the Board or
Board members but making sure that everyone learns lessons and patients
are protected.

Competing interests:
None declared

Competing interests: No competing interests

14 June 2009
Umesh Prabhu
Consultant Paediatrician
The Pennine Hospitals NHS Trust