More needs to be done to support Freedom to Speak Up guardians and improve the culture of speaking in healthcare

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Managers at all levels urged to do more to help workers speak up by listening and following up

the National Guardian annual report for the NHS will be presented to Parliament today (12 January 2023) highlighting the work of the Freedom to Speak Up Guardians and the National Guardian’s Office doing the Speaking-Up as usual.

The release of the report, a commitment the Foreign Secretary had called for in his response to events at Gosport War Memorial Hospital, had been delayed due to changes in Parliament and Her Majesty’s death.

There are now over 900 Free to Speak Up guardians helping healthcare workers in England speak up about anything affecting their ability to do their job. Over 20,000 cases were filed with them last year, remaining at the record level of 2020/21 (20,362 versus 20,388 in 2020/21). Since the National Guardian’s Office first began collecting data in 2017, free speech guardians have processed over 75,000 cases.

Featuring case studies from across England and from different healthcare providers, the report shares the experiences of people who have spoken up and the difference Freedom to Speak Up guardians are making. In the words of a group of workers: “Finally we had the feeling that we were being listened to and that our opinions and thoughts counted.”

In her foreword to the report, Parliamentary Under-Secretary for Mental Health and Women’s Health Strategy Maria Caulfield MP said: “We know this is a challenging time for the NHS as we emerge from the pandemic. At times like this, it’s even more important that we listen to the voices of those on the front lines, ensuring there is an environment where employees feel safe, can speak up, and are heard and their concerns are responded to. This is an important priority for the government and for me personally.

“Through the work of the National Guardian’s Office, the Freedom to Speak Up Guardians and the commitment of NHS staff, I am confident that we can deliver an NHS where talking becomes business as usual as this will help the NHS, great.” To offer quality and safe patient care.”

dr NHS National Guardian Jayne Chidgey-Clark said: “I am very pleased to present our annual report to Parliament. The Freedom to Speak Up movement has been a catalyst for positive change, but there is much more to be done.

“This report outlines some of the work the National Guardian’s Office has undertaken across the health system to ensure freedom of speech is consistently implemented within organizations. This is an essential element in providing quality, safe and effective care and is essential to worker well-being and retention.”

The report also shares information and intelligence compiled by the National Guardian’s Office, including data speak shared by Freedom to Speak Up protectors of the cases they receive. While levels of anonymity have decreased (10.4% in 2021/22 versus 11.7% in 2020/21), reports of impairment were given in 4.3% of cases versus 3.1% in the year 2020/21.

dr Jayne Chidgey-Clark commented: “I am very concerned about the increase in reported disadvantages for speaking, which had been decreasing. When someone speaks up, it should be viewed as a gift – a gift of information that could prevent harm or lead to improvement. I expect leaders to model this behavior in their organizations and send a clear message that mistreating people for speaking up will not be tolerated.”

The National Guardian’s Office Annual Report 2021-22 is available for download www.nationalguardian.org.uk

For more information or interviews, please contact: comms@nationalguardianoffice.org.uk

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Notes for editors:

About this report

National Guardian’s Office Annual Report 2022
As usual, make Speaking Up your business

ISBN 978-1-5286-3593-6 CP701 E02769666

Date: January 12, 2023

Available from: nationalguardian.org.uk

The publication and presentation of this report to Parliament follows a commitment called for by the Foreign Secretary in his response to events at Gosport War Memorial Hospital.

Via the National Guardian Office

The National Guardian’s Office is working to make talking the norm to bring about a culture change in the NHS.

The office manages, trains and supports a network of Freedom to Speak Up Guardians in England, providing learning and challenges when it comes to raising issues with the health sector.

The roles of the Freedom to Speak Up Guardians and National Guardian were established in 2016 following the events at the Mid-Staffordshire NHS Foundation Trust and the recommendations of Sir Robert Francis’ Freedom to Speak Up Inquiry.

There are now over 900 Free to Speak Up guardians in NHS primary and secondary care, independent sector organisations, national bodies and elsewhere, ensuring workers are able to raise any issues affecting their ability to get their work done.

About the freedom to speak Guardians

Freedom to Speak Up Guardians support workers to speak up when they feel they cannot do so any other way. They ensure that people who speak up are thanked, that the issues they raise are acted upon, and ensure that the person who speaks up receives feedback on the actions taken. Guardians also work proactively to help their organization remove barriers to speaking.

Freedom of Speech Guardians are appointed by the organization they support and follow guidelines from the National Guardian’s Office. You follow that “universal job description” published by the NGO.

www.nationalguardian.org.uk

Key Dates:

The report provides a summary of case data collected from Freedom to Speak Up guardians from April 1, 2021 to March 31, 2022.

Freedom to Speak Up Guardians provide the National Guardian’s Office (NGO) with non-identifiable information about the cases brought to them where they have a say.

For more information and data tables summarized in this report, visit the NGO website.

  • From April 1, 2021 to March 31, 2022, over twenty thousand (20,316 cases reported with Freedom to Speak Up Guardians.
  • Freedom to Speak Up Guardians continued to support workers of all occupations to speak up. nurses and midwives still the largest share (28.5%) to address cases reported with Freedom to Speak Up Guardians.
  • Nineteen percent (19.1%) of cases collected with Freedom to Speak Up Guardians contained an element of patient safety/qualitya slight increase of 18% in 2020/21.
  • Over a third (32.3%)
    contain an element of behaviors, including bullying/harassment, an increase of 30.1% over the last year.
  • 13.7% of cases had an element of occupational safety. This is a new category introduced by the 2021/22 NGO in response to concerns raised during the pandemic. During the year, an increasing proportion of cases containing an element of occupational safety were recorded, from 12.5% ​​in Q1 to 15.3% in Q4 2021/22.
  • Ten percent (10.4%)
    of cases reported to Freedom to Speak Up Guardians have been reported anonymous. This continues the downward trend from 2017, when 17.7% of cases were reported anonymously.
  • disadvantage for speaking was specified in 4.3% of cases. While this is down from 5.1% in 2017/18, it has increased since last year (3.1% in 2020/21).
  • Feedback from employees on their experiences was given in 5,112 cases in 2021/22. Over 86 percent (86.7%) of those who provided feedback said They would speak again.

Via the National Guardian for the NHS

dr Jayne Chidgey-Clark was named a National Guardian in December 2021.

She is a Registered Nurse with over 30 years experience in the NHS, higher education, voluntary and private sectors. Prior to her role as National Guardian, she was Non-Executive Director at the NHS Somerset Clinical Commissioning Group, where she was also a Freedom to Speak Up Guardian.

She is the Independent Chair of the Oxfordshire Safeguarding Adults Board. She also worked for three years as a Clinical Associate with the NHS England New Care Models Program and has worked with and within the NHS as a consultant and coach since March 2015. Her clinical specialty is end-of-life care, for which she was awarded her PhD.

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