Changing policy in a fast moving environment

A member of staff was concerned about continuing to work in a public facing environment as the coronavirus outbreak intensified at the end of March 2020. She had serious underlying health conditions, which she had discussed with her line manager. The member of staff had received an email from the consultant managing her health, which described her as a vulnerable person who should be shielding.

Trust guidance at the time stated that without the official NHS England notification the member of staff had to remain in the work place, though an assessment of the working environment would be carried out to mitigate the risk. The individual approached the Freedom to Speak Up Guardian through one of the speaking up staff advocates to query the guidance and to see whether it could be looked at.

The Guardian approached the HR Business Partners in the first instance to find that the guidance was in the process of being updated. The update included clarification that a GP ‘fit note’, alongside NHS England notification, would also provide sufficient evidence for shielding.

With the Guardian relaying messages to protect confidentiality, the member of staff contacted her GP surgery only to find out that the surgery was no longer issuing fit notes. She was informed by the surgery that the advice from her consultant was sufficient instruction to shield for 12 weeks. With this new information passed back to the HR Business Partners, they reviewed the guidance again. The HR Business Partners changed the guidance to consider and review any ‘fit note’ provided and confirmed it was sufficient evidence for the need to shield for 12 weeks. They spoke to the line manager to notify them of the change.

The member of staff was contacted by her line manager the same day and was sent home to self-isolate for 12 weeks.

“This member of staff used the Freedom to Speak Up route because they were confused about the application of the Trust guidance at this moment in time. We were able to connect the member of staff to the right people to review this issue and get it resolved, ” says Eric Sanders, Freedom to Speak Up Guardian at University Hospitals Bristol and Weston NHS Foundation Trust.



This case study is part of our 100 Voices campaign. Our ambition is to create a database of at least 100 case studies that describe where speaking up has led to improvements for the good of workers, patients, families and carers.

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