Report reveals the impact of Freedom to Speak Up


A new report published by the National Guardian’s Office reveals that the perception of the speaking up culture in health is improving.

An annual survey, conducted by the National Guardian’s Office, asked Freedom to Speak Up Guardians, and those in a supporting role, about how speaking up is being implemented in their organisation. The results reveal details about the network’s demographics and their perceptions of the impact of their role.

There are now over 500 guardians supporting workers to speak up in a variety of healthcare settings, including at least one in every trust in England. Freedom to Speak Up Guardians were introduced into the NHS following the Francis Inquiry into the events at Mid-Staffordshire NHS Foundation Trust.

Headlines from the survey include a measure of whether those in speaking up roles think their work is making a difference, with 76 per cent agreeing or strongly agreeing – compared to 68 per cent last year. They also reported that awareness of the guardian role is improving.

“It’s really important we listen to guardians in order to understand the impact Freedom to Speak Up is making,” said Dr Henrietta Hughes OBE, National Guardian for the NHS. “The report we are publishing today will help organisations better understand how to work with their guardians to improve their speaking up cultures.”

One area of concern that the National Guardian’s Office has highlighted in the past is ring-fenced time for guardians and again the survey shows that there is still work to do, with 44 per cent of guardians indicating that they have no ring-fenced time to carry out their role – an increase on the previous year.

“In my view, organisations that do not provide guardians with ring-fenced time to do their valuable, important and difficult job should not receive more than ‘requires improvement’ for the well-led element of their CQC rating,” said Dr Hughes.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said: “No service can be effective without listening to and acting on the concerns raised by its staff. Providing all staff with the confidence and means to speak up is an essential part of providing high quality care and the network of Freedom to Speak Up Guardians play an invaluable role. It’s crucial that they are given protected time to support their colleagues and we will be looking more closely at how hospital trusts are ensuring this when we inspect in the future.”

Other areas the survey has helped highlight include the need to address the fact BAME workers are under-represented in the guardian network. “While BAME workers make up 24 per cent of the NHS workforce, just 13 per cent occupy speak up roles,” said Dr Hughes.

“I have asked the NHS E/I Workforce Race Equality Standard (WRES) team to help us understand this and whether this aspect of guardian demographics does, in practice, impact on speaking up.”

Read the press release

Read the report

January 30, 2020