Written by NHS whistleblowing · Practitioner Performance Advice · Employment tribunals
NHS whistleblowers are too often reframed as behavioural problems rather than heard as patient-safety messengers. This article examines concerns that NHS Resolution’s Practitioner Performance Advice service can be used to create one-sided paper trails against practitioners, with serious consequences for employment, professional reputation and tribunal fairness.
Publication snapshot
- The article examines concerns about NHS Resolution’s Practitioner Performance Advice service.
- It argues that unilateral behavioural narratives can be created without practitioner awareness or response.
- It highlights risks for whistleblowers whose safety concerns may be reframed as relationship or conduct problems.
- It questions transparency, record-keeping, disclosure, data retention and independent oversight.
- It proposes reforms requiring recording, practitioner access, two-sided information and tribunal scrutiny.
The role of the Practitioner Performance Advice service
For years, NHS whistleblowers have reported being blamed for alleged behavioural issues, personality concerns or relationship breakdowns rather than seeing their patient-safety or governance concerns properly investigated.
The supplied draft argues that this pattern is familiar in Employment Tribunal claims, where trust executives and NHS legal teams may reframe the narrative so that the person who raised concerns becomes the problem.
The focus of this article is the NHS Resolution Practitioner Performance Advice service. The concern is not that such a service should not exist. There may be legitimate cases where support, advice or structured intervention is needed. The concern is that a unilateral advisory mechanism can be misused where it lacks transparency, practitioner involvement and safeguards against retaliatory narratives.
The tribunal narrative: behaviour blame without clinical scrutiny
Employment Tribunal panels are expert in law and fact-finding, but they will not necessarily have clinical expertise. The draft argues that this creates a risk where NHS employers present whistleblowers as difficult, disruptive or unsafe without proper clinical context or independent scrutiny.
The PPA advisory function may contribute to that narrative where advice is obtained on the basis of a manager’s account alone. The practitioner may not know that concerns have been raised, that advice has been sought, or that a paper trail is being created around their alleged conduct.
Unilateral account
The draft alleges that a manager can seek advice based on their own version of events, without first disclosing the allegation to the practitioner.
Official paper trail
Advice obtained through a recognised NHS Resolution service may appear more objective than it is if the underlying information was not tested.
Behavioural reframing
Whistleblowing concerns may be reframed as interpersonal conflict, lack of insight, poor behaviour or relationship breakdown.
Tribunal reliance
There is a risk that Employment Tribunals may give undue weight to PPA-linked material unless its source, basis and fairness are scrutinised.
From NCAS to PPA: old concerns in a new structure
The Practitioner Performance Advice service replaced the National Clinical Assessment Service. The supplied draft argues that concerns about fairness and transparency remain, and may be worsened where informal advice can be obtained without a complete record or practitioner participation.
Managers may raise concerns without tested evidence
The article questions whether there is any mandatory requirement to record complaints formally, verify allegations, declare conflicts of interest or disclose whistleblowing context.
Practitioners may not be contacted
The draft alleges that the affected practitioner may not be informed that advice is being sought about them and may have no opportunity to respond before a narrative forms.
Records may be incomplete
Where advice is given informally or by telephone, there is concern about whether a complete, accurate and accessible record exists.
Advice may precede formal assessment
A manager may obtain advice that shapes the next procedural steps before the practitioner is able to put forward their own account.
Clinical context may be missing
The draft questions whether advice about behaviour in clinical settings is sufficiently grounded in clinical expertise and workplace context.
Conflict of interest concerns: NHS Resolution’s dual role
The draft raises a serious concern about NHS Resolution’s position. NHS Resolution is involved in funding or managing litigation risk for NHS bodies, while the PPA service provides advice that may later be relied upon in disciplinary or tribunal contexts.
The article argues that this creates at least an apparent conflict where advice about a practitioner may help an NHS trust defend a whistleblowing claim or reduce litigation exposure.
Litigation exposure
Where a whistleblower brings a claim, behavioural allegations may weaken the claimant’s credibility and reduce the employer’s liability risk.
Advisory influence
PPA advice may influence suspension, investigation, assessment, mediation, disciplinary decisions or settlement posture.
Financial incentive concern
The supplied draft alleges that undermining whistleblowing claims may reduce compensation exposure. That is a serious allegation and should be framed as a concern requiring examination.
Independence question
The core issue is whether advice can be perceived as independent where the wider organisation has a role in NHS litigation and risk management.
Risks for whistleblowers
The implications for whistleblowers are significant. A practitioner may raise patient-safety concerns, only to find that the institutional response focuses on their tone, insight, relationships or alleged behaviour.
The supplied draft identifies several risks: practitioners may be ambushed with allegations, suspended on the basis of subjective advice, left with damaging material on file, or placed at a disadvantage in Employment Tribunal proceedings.
Ambush by undisclosed material
A practitioner may only discover the existence of PPA-linked concerns when a formal process has already begun.
Subjective advice used as evidence
Advice based on a manager’s untested narrative may be treated as objective evidence of problematic behaviour.
Long-term reputational effect
The draft raises concern that behavioural allegations may remain on file and affect future employment, even where the underlying concerns were not fairly tested.
Patient-safety concerns buried
If the whistleblower is successfully discredited, the original safety or governance concerns may be marginalised or ignored.
Apology and “insight” pressure
The article questions advice that whistleblowers should apologise where doing so may later be used to suggest acceptance of fault, while refusal may be framed as lack of insight.
Bias, opacity and unaccountability
NHS Resolution describes the PPA service as providing expert, neutral and independent advice. The draft challenges whether that claim can be sustained where advice may be based on unverified management accounts and where the practitioner is not routinely given a right to know and respond.
The article also raises the issue of bias. In particular, it questions whether NHS Resolution has properly analysed whether PPA advice or related disciplinary processes have disproportionate impacts, including on BAME practitioners.
Verification
Does the PPA service test the factual basis of management accounts before advice is given?
Whistleblowing context
Are managers required to disclose that the practitioner has raised protected disclosures, safety concerns or complaints?
Practitioner notification
Are practitioners told when advice is sought about them and given access to what is recorded?
Data retention
How long is practitioner data retained, under what authority, and how can practitioners correct inaccurate material?
Audit
Has NHS Resolution audited how employers use PPA advice in whistleblowing, disciplinary and tribunal cases?
Bias assessment
Has there been a systematic review of whether advice or outcomes differ by race, role, seniority, specialty, protected disclosure history or employment status?
What needs to change
The draft proposes reforms aimed at transparency, evidence integrity, practitioner participation and independent oversight. Those reforms are best framed as practical safeguards rather than rhetorical demands.
1. Record all PPA interactions
Every PPA consultation should be recorded in a complete and auditable form, including the identity of the caller, the concerns raised, the evidence relied upon and the advice given.
2. Notify the practitioner
The practitioner concerned should be told that advice is being sought, save in narrowly justified exceptional circumstances.
3. Require both sides of the story
Advice should not be treated as balanced or independent unless the practitioner has had a fair opportunity to provide context and correction.
4. Provide access to records
Practitioners should be able to access information held about them by PPA and NHS Resolution, subject to lawful and transparent limits.
5. Audit whistleblowing cases
Independent oversight should examine how PPA advice is used in cases where the practitioner has raised safety concerns or protected disclosures.
6. Require tribunal scrutiny
Employment Tribunals should scrutinise the origin, basis and fairness of PPA advice before accepting it as reliable evidence of behaviour.
7. Review limitation issues
Time limits for whistleblowing detriment claims may require attention where covert or undisclosed mechanisms only become known later.
Escalation and public accountability
The draft invites NHS Resolution to clarify whether practitioners can report unsafe healthcare managerial behaviour directly to PPA. That question matters. If managers can seek advice about practitioners, but practitioners cannot seek equivalent advice about unsafe management conduct, the asymmetry requires explanation.
The article also calls for escalation to DHSC, the BMA, medical defence organisations, NHS England and NHS Resolution. The purpose should be to require transparency about PPA’s remit, records, safeguards, data retention and use in whistleblowing cases.
Disclaimer
This article is public-interest commentary based on the supplied draft. It is not legal advice and should not be relied upon as a substitute for specialist advice on any employment, whistleblowing, regulatory, professional-discipline, data-protection or defamation matter.
References to NHS Resolution, the Practitioner Performance Advice service, Employment Tribunals, NHS managers, behavioural allegations, conflicts of interest, whistleblowing retaliation, bias or misuse of process are presented as concerns, allegations or matters requiring verification unless established by documents, tribunal findings, regulatory findings, audit evidence or other reliable primary material.
Before publication, the author should verify PPA guidance, NHS Resolution policy documents, data-retention rules, complaint records, tribunal materials, correspondence, equality-impact evidence and any wording that may imply bad faith, dishonesty, deliberate suppression of patient-safety concerns or institutional misconduct.