This portfolio thesis has three parts. Part one is a systematic literature review in which the existing research literature on the psychological and systemic factors that influence healthcare staff’s decision to whistleblow on poor care is examined and its quality evaluated. Part two is an empirical paper which uses Interpretative Phenomenological Analysis (IPA; Smith, 1996) to explore the experiences of families of people with intellectual disabilities when noticing and reporting concerns in healthcare services. Part three comprises the Appendices, containing supporting information relating to parts one and two and epistemological and reflective statements.Abstract - Systematic literature review:Purpose This systematic literature review aimed to investigate the psychological and systemic variables influencing whistleblowing decisions in healthcare settings. Design/methodology/approach A search of academic databases was undertaken and reference lists of the resulting articles were searched. In total 17 studies using a range of methodologies were analysed using Narrative Synthesis. Methodological quality was assessed. Findings Psychological variables were grouped into beliefs about advocacy and professional roles, fear and diverse responses to wrongdoing. Systemic variables were grouped into relationships with peers, the culture of the organisation and feedback, however there was a complex interplay of factors. Research Implications Further research is needed to examine the efficacy of these interventions and to represent the views of a wider range of healthcare professionals. Originality/value This was a timely review given recent reports on the treatment of whistleblowers in healthcare, indicating interventions to facilitate whistleblowing such as increasing the ease of reporting systems, providing feedback and creating a more compassionate organisational culture.Abstract : empirical paperBackground: This study aimed to increase understanding of the lived experiences of families of people with intellectual disabilities when noticing and raising concerns in services. A qualitative design was employed. Methods: Seven participants were recruited through local and national voluntary agencies; five were mothers of people with intellectual disabilities, one was the aunt and one the sister. Participants took part in semi structured interviews centred on their experiences of noticing and raising concerns, these were recorded and transcribed. The data was analysed using Interpretative Phenomenological Analysis (IPA; Smith, 1996). Results: The data was grouped into three overarching themes: relationships between staff, family and service user, the nature and importance of concerns and the process of raising concerns. Conclusions: This research highlights important implications for services such as the need to simplify the process of raising concerns, attend to the relationship with families and ensure advocacy services are available for those without family
