Leaders must encourage workers to continue to speak up as the NHS returns to high risk level

Dr Henrietta Hughes OBE, the National Guardian for the NHS, has urged healthcare organisations not to allow the announcement yesterday (4 November 2020) that the NHS has been returned to the highest level of risk on its emergency preparedness framework to act as a discouragement to workers speaking up.

“We saw in the first wave some troubling reports of workers who tried to voice concerns facing victimisation and intimidation. The National Guardian’s Office carried out a series of pulse surveys that indicated that guardians were receiving speak up cases relating to PPE, social distancing, fit tests and risk assessments for BAME colleagues as the pandemic took hold during April, May and June.”

Dr Hughes has expressed concern that a second wave may give rise to similar issues. The announcement yesterday by NHS England chief executive Sir Simon Stevens that the NHS has been returned to the highest level of risk on its emergency preparedness framework, EPPR level 4, allows national leaders tighter control over local resources and decision making.

“Guardians played a vital role during the first wave, but many felt the atmosphere that permeated from the centre set the wrong tone initially,” explained Dr Hughes. “Our pulse surveys tracked a definite change in attitude and perception, with only 72 per cent of guardians who responded to the survey in April believing that workers continued to be encouraged to speak up, rising to 93 per cent by June.

“I am convinced that the work of guardians has helped restore trust and encouraged workers to continue to raise issues and speak up. This is particularly important for BAME workers who have been disproportionately impacted by COVID-19 and who may face additional barriers to speaking up. Leaders must be mindful of the impact the second wave could have on workers’ perceptions of how welcome speaking up is at this time.

“My belief is that now more than ever workers need to feel that raising matters is welcomed and with guardians embedded in every trust in England and a huge variety of other healthcare providers including Primary Care organisations and independent healthcare providers, there is now an alternate route to help them do that.

“We can’t allow anything get in the way of that and I know good leaders in healthcare organisations will be encouraging their workers to continue to speak up, to take the learning and to act on the information it provides.”

Dr Hughes confirmed that in addition to calling on leaders not to put any barriers in the way of workers speaking up as the second wave develops, her office will also be working with guardians to encourage them to proactively meet and listen to workers, checking on wellbeing and enabling productive solutions to be found. Guardians are actively encouraged to work with WRES Experts and also meet regularly in regional networks to share ideas, buddy and support one another.

“When our colleagues speak up, we need to be there to listen up, follow up and keep people safe so that fear of retribution becomes a thing of the past and speaking up becomes business as usual in the NHS.”

November 5, 2020