Theme 2: Speaking up

What went wrong at Gosport?

The Gosport Independent Panel highlighted:

• a number of nurses attempted to raise concerns about poor practice, however they were not listened to and they also did not take any further action

What our Code says

Our Code of Conduct says, ‘You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk. You take necessary action to deal with any concerns where appropriate.’

What our standards say

Our current nursing standards say that nurses must:

"practise safely by being aware of the correct use, limitations and hazards of common interventions, including nursing activities, treatments, and the use of medical devices and equipment.

"The nurse must be able to evaluate their use, report any concerns promptly through appropriate channels and modify care where necessary to maintain safety."

Our current midwifery standards say midwives must:

"Provide seamless care and, where appropriate, interventions, in partnership with women and other care providers during the antenatal period which will include: discussion/negotiation with other professionals about further interventions which are appropriate for individual women, considering their wishes, context and culture"

These standards also say midwives must:

"Refer women who would benefit from the skills and knowledge of other individuals".

Our current nursing associate standards say nursing associates must:

"Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated"

Speaking up today

To enable the delivery of good and safe care, nursing and midwifery professionals must speak up if they have concerns or when things have gone wrong.

The Code requires registrants to:

• be open and honest about mistakes and to raise concerns about the delivery of poor care.
• act as an advocate for the vulnerable and challenge poor practice

It clearly sets out that nursing and midwifery professionals must acknowledge and act on all concerns raised to them.

Clear guidance to support all health professionals when things go wrong is available and actively promoted by professional regulators.

The process of Revalidation, introduced in 2016, encourages reflective practice and raises awareness of the Code and professional standards expected of nursing and midwifery professionals.

Our guidance on whistleblowing also sets out clearly how nurses, midwives, nursing associates, students or other members of staff can raise concerns with us.