Context
Helene Donnelly OBE is one of the UK’s most prominent NHS whistleblowers. She was a nurse at Mid Staffordshire NHS Foundation Trust in the years leading up to the Francis Inquiry, where she raised sustained patient-safety concerns about the trust’s handling of care. Her experience — of what NHS trusts do, in practice, to staff who raise concerns — is a rare directly-comparable body of evidence. The Thirlwall Inquiry called her on 4 December 2024 for that reason.
Key passages
A whistleblower turned expert. Helene Donnelly, who raised concerns at the Mid Staffordshire NHS Foundation Trust between 2002 and 2008, gave evidence as an expert on speaking-up culture, having served from 2013 to 2022 as Ambassador for Cultural Change and Lead Freedom to Speak Up Guardian for the Midlands Partnership NHS Trusts. She told the Inquiry that in 2015/2016 the general development of speaking-up practice across the NHS was “not very” advanced and “certainly wasn’t consistent across the NHS”, with some Trusts more proactive than others.
The independence problem. Asked about the limits of the Freedom to Speak Up Guardian role, Ms Donnelly said most Guardians are employed by the organisation they serve, so “there is a perception, even if it’s only a perception rather than a reality, that that Guardian can’t necessarily be fully independent because they are on the payroll and ultimately… they have got to do what their bosses, managers, are telling them to do”. She said she had wanted the National Guardian’s Office to employ Guardians centrally, with statutory power to enforce rather than merely give guidance.
“Bring me solutions”. Describing the culture that can meet someone raising a concern, Ms Donnelly said the response is often: “why are you bringing me this? Don’t bring me problems. Bring me solutions”, part of a “toxic negativity” in which those who speak up are seen as “being difficult” and “not being a team player”. She said that response creates “apathy and a feeling of futility”, so that people, including managers, think “what is the point in speaking up because either I will get it in the neck or nothing is going to change anyway”.
Legal risk and the Letby decisions. Asked whether it was a recognised problem that decisions could be influenced by fear of a grievance or Employment Tribunal claim, Ms Donnelly was told the Inquiry had heard evidence that decisions relating to Letby were, in part, affected by such legal-risk considerations. She replied: “Yes. I mean, again, this was a really extreme case and the ramifications were huge and I hope — well, I know that they’re not — they are not every day”, before setting out how the same dynamic — organisations preferring to let people “leave quietly by the backdoor” rather than hold them to account — recurs more routinely elsewhere in the NHS.
Apologies and escalating in doubt. Ms Donnelly said she had heard of HR advice given to staff that “Don’t apologise, don’t apologise” when speaking to families, which she said was wrong: an apology “is not an admission of liability” and failing to give one “actually makes things escalate ultimately”. Asked by Lady Justice Thirlwall whether there was anything wrong with a serious concern being raised straight to the board for it to consider safeguarding and the police, she said: “I don’t think there is anything wrong with that”, adding of her general approach: “it should be, well, if in doubt escalate up”.
Why this matters
Ms Donnelly’s evidence is not evidence of what Ms Letby did or did not do clinically. It is evidence of the institutional dynamic the consultants who raised the alarm were operating inside — and which, on any view, delayed their escalation reaching the police by almost a year.
Read alongside
Dr Brearey’s Thirlwall evidence, Tony Chambers’ Thirlwall evidence, all Officials profiles.