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National Guardian urges NHS leaders to play their part as survey finds just 51% feel supported to speak up

The National Guardian’s Office leads, trains and supports a network of Freedom to Speak Up Guardians providing learning and striving for cultural change on speaking up matters in NHS Trusts in England.

The role of Freedom to Speak Up Guardians (FTSUGS) and the National Guardian, Dr Henrietta Hughes, were established in 2016 following serious failures at Mid-Staffordshire NHS Foundation Trust and recommendations from Sir Robert Francis’ Freedom to Speak Up Inquiry.

There is now a wide-ranging network of over 600 Freedom to Speak Up Guardians in over 400 organisations, in primary and secondary care, the independent sector and national bodies. But, five years on, are FTSUGS making much of a difference in NHS Trusts? Why do we keep seeing appalling patient care in NHS Trusts? Why do staff continue to be victimised for speaking out?

The National Guardian Office (NGO) Annual Report highlighted just 51% of staff agreed management supported staff to speak up – but this was an improvement from 43% in 2019.  As we all know too well, 2020 was not a normal year. National Guardian Dr Henrietta Hughes said, “It’s important that leaders both deal with the issue raised, but also apply the learning across the whole of their organisation. Only by taking action can they hope to truly embed the learning gained.”

Dr Henrietta Hughes, National Guardian, said: “Our Annual Report highlights the distance we have come since the Freedom to Speak Up Review was published in 2015. But now we are at a tipping point. The Freedom to Speak Up network has grown because of the commitment and passion of guardians. But there is still much more to do and this requires all leaders to play their part.

“Principles from the Freedom to Speak Up Review are not being followed by all organisations. Regulators are mobilising and taking this more seriously but there is more to do to get a consistent and aligned response to speaking up. The pandemic has highlighted how much this matters to keep patients and workers safe.”

When training organisations, our Business Development team at Protect drive home the importance of senior management and Board buy in when it comes to robust speak up or whistleblowing arrangements. Too often, managers do not listen, or act on whistleblowing concerns – or the action they do take is to victimise or dismiss the whistleblower.

It is no surprise research from the NGO shows that in high performing trusts, there is a more positive culture of speaking up and that it is ‘Down to leaders to foster the right environment.’

Since the NGO formed, it has made more than 100 recommendations from case reviews – and it says all healthcare providers are encouraged to review these recommendations and check whether they can learn from them and make changes.

Dr Henrietta Hughes said: “It is time that these are adopted and embedded to prevent the national scandals which are still happening, where, had the voices of workers not been suppressed or victimised, patient safety could have been improved.”

Read the National Guardian Office 2020 Annual Report

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