Speaking up
Embedding a healthy speaking up culture
Read top tips to creating a workplace speaking up culture that supports health and wellbeing on the NHS Employers website. Find out how leaders and line managers can develop a speaking up culture and read examples of good practice from NHS trusts.
External freedom to speak up policy for NHS workers
This policy provides information on how NHS workers can speak up to NHS England (NHSE) about anything they think is harming the NHS healthcare service their organisation delivers or commissions, to the extent that relates to NHSE's role.
Read the policy on NHSE’s website.
National speak up policy for the NHS
In April 2016, NHSE launched a national, integrated whistleblowing policy to help standardise the way NHS organisations support staff who raise concerns. The policy was updated in June 2022. All NHS trust and foundation trust boards were requested to update their local policy to reflect the new national template by the end of January 2024.
The policy sets out:
- who can staff can speak up to
- the process for speaking up
- advice and support for someone who speaks up
- what the organisation will do and the process to be followed when an investigation is needed
- what will be done with the findings of the investigation.
Read the policy on NHSE’s website.
NHS freedom to speak up guide
In June 2022, NHSE published the NHS freedom to speak up guide. The guide is designed to help senior NHS leaders to develop a culture that encourages workers to speak up and drives learning and improvement.
The guide includes eight principles:
- Value speaking up.
- Role-model speaking up and set a healthy freedom to speak up culture.
- Make sure workers know how to speak up and feel safe and encouraged to do so.
- When someone speaks up, thank them, listen up and follow up.
- Use speaking up as an opportunity to learn and improve.
- Support guardians to fulfil their role in a way that meets workers’ needs and National Guardians Office requirements.
- Identify and tackle barriers to speaking up.
- Know the strengths and weaknesses of the organisation’s speaking-up culture and take action to continually improve.
NHSE has also published case stories from NHS organisations that have used the principles to cultivate their own plans to develop healthy speak up cultures.
Read the freedom to speak up guide and case stories on NHSE's website.
Speaking up support scheme
The ‘Speaking Up support scheme’, supports individuals who have experienced challenges in moving forward with their professional or personal lives following a formal speak up process.
Speak Up
Speak Up offers free, independent, confidential advice on the speaking up process for employers and employees in the NHS and adult social care.
You can find more information on the Speak Up website.
Freedom to speak up guardians
Every NHS trust and foundation trust should have a freedom to speak up guardian. Their role is to work with the board and the executive team to support an organisation be an open and transparent place to work. They should act in an independent and impartial capacity, listening to staff and supporting them to raise concerns.
Find your freedom to speak up guardian on the National Guardian website.
Freedom to speak up e-learning
The National Guardian and Health Education England developed training for everyone in healthcare which sets out what speaking up is and its importance in creating an environment in which people are supported to deliver their best.
To access the training see the e-learning for Healthcare website.
Freedom to speak up review
In February 2015, Sir Robert Francis QC published his report on the Freedom to speak up review. The review was set up in response to continuing disquiet about the way NHS organisations deal with concerns raised by NHS staff and the treatment of some of those who have spoken up.
The report sets out 20 principles and actions which aim to create the right conditions for NHS staff to speak up, share what works right across the NHS and get all organisations up to the standard of the best and provide redress when things go wrong in future.
The principles and actions are designed to:
- promote a culture in the NHS where staff feel safe and encouraged to speak up
- make sure all concerns are heard, investigated properly and the right support is on hand for staff
- protect vulnerable groups, such as student nurses and medical trainees, from intimidation
- prevent discrimination against people who have been brave enough to speak up and help them get back into work.
