BY

EMAIL

31 October 2015

Mr David Behan Chief Executive Care Quality Commission

Dear Mr Behan,

Proposed CQC listening event with whistleblowers

Thank you for agreeing to hold a further whistleblowing event as suggested. However, I have
several concerns about the way CQC is approaching the event. I do not feel CQC has learnt from last
years mistakes of selectivity and opacity.

I asked you on 14 July to hold a general listening event on CQCs handling of whistleblowing and to
be inclusive of as many whistleblowers as possible by publicising the event well in advance.

However, you have not publicised the event, you have given relatively late notification of the event,
you have restricted the agenda to discussion about the new National Guardian and CQC has been
highly selective again in its choice of participants. Behind closed doors, CQC selected a very small
sample of the same whistleblowers whom it listened to last year (twenty eight people) to attend.
CQC has relied on the advice of only one whistleblowing campaigner, ignoring many others and all
of the many campaigners who lead on social care whistleblowing.

CQC has and continues to fail whistleblowers. If CQC only listens to advice and feedback with which
it is comfortable, these grave failures to whistleblowers and therefore patients, will continue.

Nevertheless, it is constructive that CQC has invited my comments on the format of the event.

I note that CQC intends to hold only a half-day event. CQCs draft details of the day are attached, as
are the details of the whistleblower listening event that CQC held last year. The timetable for this
years listening event is as follows:

A few words of introduction (30 mins)
Tell us a little bit about yourself and your experience

UPDATE - Outputs from the last event (20 mins)
How CQC approaches the issue now

Consultation principles: are they the right principles? (45 mins x 2)

1) NG principles and Independence/governance

2) Functions

Get into 2 groups for discussion of point 1 and feedback, then repeat for point 2

Impact discussion (45 mins)


Next Steps and Thank Yous (15 mins)

CQC has put forward the names of two individuals who will host this event, who I presume are
facilitators. Unlike last year when David Prior CQC Chair took part, there is no clear indication this
year that any CQC board member will be present at the event.

I am afraid CQCs proposed agenda appears to be tokenistic and a paternalistic pat on the head for
whistleblowers. It will not engage the many and serious core issues about CQCs weak
whistleblowing governance. For example, the 30 minutes set aside for people to speak about their
horrific experiences is quite pointless, not to mention thoughtless. In any case, experiential data
about whistleblowing is already well documented and there is no need to rehearse it.
Notwithstanding, many are still gagged about their experiences. What whistleblowers need from
CQC is action.

I suggest:

CQC sets aside a day for the event. Even this will not allow all issues to be addressed but a
pre-event survey would make efficient use of conference time.

CQC urgently advertises the event on its website and on social media.

CQCs publicity about this event includes an assurance that participants travel expenses will
be reimbursed. This is an important practical issue for many whistleblowers who would
otherwise not be able to attend. I am sure you will be aware that for some whistleblowers,
the choice is to eat or to heat.

The number of facilitators provided is commensurate to the number of participants. More
facilitators will be needed if more whistleblowers decide to attend. Please advise if you
would be happy for whistleblowers to facilitate as well.

CQC undertakes a brief survey of participants ahead of the event and posts the findings
before the event. A suggested format is appended.

CQC notes any information and issues posted by whistleblowers on a new twitter hashtag
that has been set up in advance of the event: #ListenCQC

At least half of the event is focused on unresolved issues of CQCs whistleblowing
governance that concern whistleblowers the most, and small group work on these issues. I
attach a revised format for CQCs consideration.

CQC Board members attends the event. Ideally, a combination of an executive director and
a non-executive director. I ask that you and Professor Louis Appleby attend the event given
your operational oversight and Professor Applebys chairmanship of CQCs Regulatory
Governance Committee. As Sir Robert Francis has not substantively responded to
whistleblowers concerns or to many letters about his proposals from Freedom to Speak Up

Review, and as he has taken part in the appointment process for the National Guardian, I
also ask that he attends.

A report of the days proceedings is published by CQC, so that there is a transparent record
of what whistleblowers have asked of CQC. Last year, there was no such structured record
after the event, only CQCs own filtered summaries and blogs about the event. A
transparent record is needed as part of accountability, and also inclusiveness as it would
allow whistleblowers who are not able to attend to follow the debate. Many will not be able
to attend because they cannot break cover. Please allow participants an opportunity to
comment on the document before it is published.

I await your response to these issues and would be grateful for a swift response.

Yours sincerely,

Dr Minh Alexander

Cc Rt Hon Sir Anthony Hooper
Sir Robert Francis QC, CQC NED
Professor Louis Appleby CQC NED and Chair of CQC Regulatory Governance Committee
House of Commons Health Committee
Public Accounts Committee
Sir Jeremy Heywood Cabinet Secretary
Rupa Huq MP
Charlotte Leslie MP
Sir Peter Bottomley MP
Helen Vernon Chief Executive NHSLA
Vicky Voller Director of NCAS
Secretary of State for Health
Shadow Secretary of State for Health
His Honour David Pearl Chair MPTS
Committee on Standards in Public Life
Chris Day CQC Director of Engagement
Matthew Silk CQC Insight and Engagement Manager




APPENDIX A : Suggested brief pre-event survey of participants


1) Are you:

o A health care whistleblower
o A social care whistleblower

2) Please tick if you have concerns about any of the following:


o CQCs response to individual whistleblowers concerns
o CQCs inspection methodology in assessing organisations whistleblowing governance
o CQCs transparency about whistleblowing issues
o CQCs overall organisational competency in handling whistleblowing issues
o CQCs support for whistleblowers
o CQCs performance on holding those who victimise whistleblowers to account
o CQCs independence and willingness to put patients first

3) What are the three most important things that CQC should do to improve its performance on
whistleblowing?

a.



b.



c.

4) What do you think CQC does well at present, with respect to whistleblowers and whistleblowing?





APPENDIX B : Suggested revised event format


Introduction and brief feedback of participant survey (30 minutes)


1) Small group work (45 minutes) in parallel sessions on:

a) CQCs response to individual whistleblowers

b) CQCs inspection methodology on whistleblowing

Brief small group feedback (15 minutes) and notes from small group work stored.

2) Small group work (45 minutes) in parallel sessions on:

a) CQCs strategic learning from whistleblowing events & use of whistleblowers
feedback of their experiences of CQC

 b) CQCs handling of Regulation 5 Fit and Proper Person

Brief small group feedback (15 minutes) and notes from small group work stored.

3) Update from CQC about its proposals on the National Guardian (20 minutes)

4) Small group work on (45 minutes) on CQCs principles for the National Guardian and the
function of the National Guardian

Small group feedback 30 minutes and notes from small groups stored.

5) Open session for any other issues (45 minutes), with points from the discussion recorded.

6) Thanks and next steps (20 minutes) with action points for CQC recorded.

I also ask that CQC runs a suggestion box throughout the whole day, where whistleblowers can
add any suggestions. The comments should be reflected in the report produced about the days
proceedings.