Who are Freedom to Speak Up Guardians?

The Freedom to Speak Up Guardian acts as an independent and impartial source of advice to staff at any stage of raising a concern, with access to anyone in the organisation, including the chief executive, or if necessary, outside the organisation. There are over 500 fully trained Guardians appointed with varying professional and seniority backgrounds within the Healthcare Sector.

The National Guardian’s Office supports the Freedom to Speak Up Guardians in the NHS, providing leadership, training and advice for Freedom to Speak Up Guardians based across all NHS trusts. Led by Dr Henrietta Hughes, her office provides challenge, learning and support to the healthcare system as a whole by reviewing trusts’ speaking up culture and the handling of concerns where they have not followed good practice.

The National Guardian’s Office is an independent, non-statutory body with the remit to lead culture change in the NHS. The office is not a regulator, but is sponsored by the CQC, NHS England and NHS Improvement.

How did Freedom to Speak Up Guardians come about?

The Freedom to Speak Up review by Sir Robert Francis QC in November 2013 reviewed the experience of whistleblowing in the NHS. His conclusion was that there is a serious issue in the NHS with whistleblowing that

“requires urgent attention if staff are to play their full part in maintaining a safe and effective service for patients”.

Sir Robert made a number of recommendations (Freedom to Speak Up Review) to deliver a more consistent approach to whistleblowing across the NHS and the report identified the Freedom to Speak Up Guardian as an important role

Reporting on Freedom to Speak Up in the NHS

  • Speaking Up in the NHS in England Data Report 2018/19 Between 1 April 2017 and 31 March 2019, 19,331 cases were raised to Freedom to Speak Up (FTSU) Guardians in trusts and foundation trusts. 12,244 cases were raised to FTSU Guardians in trusts and Foundation trusts between 1st April 2018 and 31st March 2019. The total number of cases raised in 2018/19 was 73% higher than that raised in the 2017/18 reporting period. The number of cases raised in Q4 of 2018/19 was 38% higher than that raised in Q1 of the same year. The FTSU Index is a key metric for organisations to monitor their speaking up performance, drawn from a subset of questions from the NHS Annual Staff Survey. Read the latest full index report here
  • The National Guardians Office Case reviews identify where the handling of NHS workers’ concerns may fall short of the standards of accepted good practice in supporting speaking up. They make recommendations to trusts to help them take appropriate action where they have not followed good practice, while the reviews also commend areas of good practice.

Get Involved in Speak Up Month this October

Speak Up Month in October is the highlight of National Guardians calendar – a chance to put a spotlight on and raise awareness of Freedom to Speak Up Guardians and the work which is happening across organisations to make speaking up business as usual. Watch out for #SpeakUpABC which will be used to share and collaborate all the great work being done across the NHS.

This year’s Speak Up Month will be a real celebration of Freedom to Speak Up and all that has been achieved in working towards making speaking up business as usual. 2020 has been an extraordinary year, and everyone, whatever their role or sector, has been under increased pressure from the COVID-19 crisis.

This year the National Guardian’s Office is planning a national campaign to showcase the depth and breadth of the Freedom to Speak Up movement.

We’re devising the Alphabet of Speak Up, from ‘anonymity’ to ‘zero-tolerance’; 26 letters of the alphabet and 26 days to explore the issues, the people, the values, the challenges – everything which goes into what Freedom to Speak Up means in the NHS and beyond.

Each day in October will be assigned a different letter of the alphabet. We would love to include a diverse range of voices to share what speaking up means to you and your organisation. This could be with videos, blogs, twitter cards, case studies or endorsements.

We will be sharing our knowledge base throughout the coming months on our social channels in support of #SpeakUpABC highlighting solutions to challenges, sharing values and guidance, ebooks and useful content to help you achieve a speaking up culture within your organisation.

Ways WorkInConfidence support Speaking Up in the NHS

WorkInConfidence Pulse improves your Organisational Health by building trusted communications and benefits your people by encouraging confidence to communicate freely with you. The system enables Trusts to measure and report on their progress in this and other related areas. WorkInConfidence pulse supports the work of the FTSU Guardians as another channel for staff to raise concerns anonymously within a number of NHS Trusts and other healthcare providers across the UK. To find out more, read our case studies.

“WorkInConfidence Protect means that our staff, wherever they are, can log in, raise an anonymous question, and get an answer the next day” – Gloucestershire Health & Care NHS Foundation Trust

Employee voice is key to creating a healthy, well run, engaged organisation. A strong employee voice builds trust, enhances respect, increases engagement and job satisfaction. It’s worth noting that engaged organisations enjoy increased productivity, improved employee wellbeing and reduced absenteeism/attrition.

WorkInConfidence PULSE platform underpins a healthy culture by redefining how you connect, engage and communicate with your people. Protect your people by providing a secure environment for sharing issues or ideas. Understand and Learn about the health of your organisation with regular real-time measurements; Share and Excite by diving in, top to bottom, bottom to top and side to side where teams offer instant feedback on improvements and direction.