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Speak Up Month: Our commitment to speaking up

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Senior Caseworker and Freedom to Speak Up Guardian

As Speak Up Month draws to a close, I want to highlight the Parliamentary and Health Service Ombudsman’s commitment to, and support for, speaking up.

Having a culture where staff feel safe to raise concerns and report mistakes is essential for learning and continuous improvement. 

A strong speaking up culture is one where employees feel empowered to make suggestions, point out wrongdoing and be open about mistakes. Organisations that have this strong culture are high performing as they learn from the matters staff speak up about. 

Freedom to Speak Up Guardians

In his 2015 Freedom To Speak Up report, Sir Robert Francis found that NHS culture did not always encourage and support staff to speak up about mistakes and bad practice. He found that both patients and workers suffered as a result. 

Sir Robert recommended the creation of the Freedom To Speak Up Guardian to help change things. Every hospital trust in England now has a Freedom To Speak Up Guardian, and other organisations in the health sector and beyond are starting to introduce the role.

Freedom to Speak Up Guardians support workers to speak up when they feel that they are unable to do so by other routes. They make sure that people who speak up are thanked and that action is taken in response to the issues they raise. They also help their organisations tackle barriers to speaking up. 

Measuring progress: The NHS Speak Up Index

The annual NHS staff survey asks four questions to measure the how well the speaking up culture is being implemented in NHS organisations. The answers allow organisations to be ranked an in index. 

The 2019 Freedom To Speak Up Index Report [PDF 802KB] shows that NHS trusts with the best speaking up scores also tend to be those rated highest in Care Quality Commission inspections. Trusts can compare their scores to others and buddy up with those that have received higher index scores. This helps promote learning and good practice.

Speaking up at the Parliamentary and Health Service Ombudsman

Over the past few years our organisation has worked to create a more open and transparent culture. We’ve introduced a number of ways for staff to raise issues, including directly with senior staff.

In May 2019 I was appointed as the Ombudsman's first Freedom To Speak Up Guardian. Since then I’ve supported a number of staff to raise concerns and I believe my role really makes a difference. 

I’m also updating policies to support speaking up and engaging with staff to understand any worries they might have about speaking up. 

Of course, as the National Guardian Henrietta Hughes rightly says, speaking up is only effective if there is also ‘listening up’. Senior staff here have been very supportive so far and have demonstrated both interest and commitment.

It’s early days, but I have every confidence that our speaking up culture will grow steadily stronger as colleagues see the positive impact.

Listen to our podcast

Listen to our recent podcast with Dr Henrietta Hughes to hear more about speaking up and the work of the National Guardian: