Over 25,000 cases were escalated to Freedom to Speak Up guardians during 2022/23, but the level of anonymity is decreasing
The National Guardian’s Office today (6 July 2023) publishes the latest annual Speaking Up data reportsummarizing the themes and insights from Speak Up data shared by Freedom to Speak Up Guardians.
The number of cases presented to them last year was the highest on record, up 25% from the previous year. In the third quarter of 2022 (October through December), guardians reported 6,947 cases, the highest number of cases ever collected in a single quarter.
There are now over 1,000 Freedom to Speak Up facilitators, supporting healthcare workers to speak up about anything that impacts their ability to do their job when they are otherwise unable to do so feel. Freedom to Speak Up guardians have handled over 100,000 cases since the National Guardian’s Office first began collecting data in 2017.
The report also shows a decrease in the proportion of cases reported anonymously, indicating a growing trust in the guardian channel. In 2022/23, 9.3 percent of cases were reported anonymously. This continues the downward trend since 2017, when 17.7% of cases were submitted anonymously.
Bad behavior and its effects remain a concern, with the highest proportion of cases – 30 per cent – involving inappropriate behaviors and attitudes. A decrease in the percentage of cases related to bullying or harassment (31.8 percent in 2021/22 to 21.7 percent in 2022/23) is due to the reporting of this new category. One in four cases addressed (27.4%) related to some aspect of workers’ safety or well-being.
Bad behavior also affects patient safety. Nineteen percent (19.3%) of cases this year involved an element of patient safety/quality, up from 18.8% in 2021/22.
Despite improvements in anonymity, interference with expression remains a problem. Although there has been a percentage decrease (to 3.9%) due to the increased numbers, this corresponds to 1,000 cases.
dr NHS National Guardian Jayne Chidgey-Clark said: “Nobody should be punished for doing the right thing. When people express their opinions, it is out of a desire for things to improve – be it for the safety and quality of patient care or the working environment for colleagues.
“Over four-fifths (82.8%) of those who provided feedback to their guardian about their experience said they would speak up again. Her comments highlight why the role of Freedom to Speak Up Guardian is so important and the benefits it can bring to worker wellbeing, staff retention and patient care.
“My heartfelt thanks to everyone who spoke up to a Freedom to Speak Up Guardian over the past year. You have created 25,000 opportunities to learn and improve for the benefit of patients and colleagues.”
For more information or interviews, contact: comms@nationalguardianoffice.org.uk
>ENDS
Notes for editors:
About this report
“For the first time I felt I was heard”: A summary of my opinions on Freedom to Speak Up Guardians 2022-2023
Released: July 6, 2023
Available from: www.nationalguardian.org.uk
This report summarizes cases filed with Freedom to Speak Up guardians between April 1, 2022 and March 31, 2023.
Freedom to Speak Up Guardians provide the National Guardian’s Office (NGO) with non-identifiable information about the Speak Up cases raised with them. This report is based on that information.
The data tables summarized in this report can be found on the NGO website.
Key Dates:
- Between April 1, 2022 and March 31, 2023, 25,382 cases were filed with Freedom to Speak Up Guardians, a 25 percent increase over 2021/22.
- In Q3 (Oct-Dec 2022), Freedom to Speak Up Guardians filed the most cases in a single quarter (6,947), a record number of cases.
- Cases brought with Freedom to Speak Up Guardians in NHS Trusts (23,392) accounted for 92.2% of cases in 2022/23. Another 1,990 cases (7.8%) were reported in other organization types.
- Workers from a range of occupation/employee groups spoke up on Freedom to Speak Up. Guardians, registered nurses and midwives accounted for the majority (29.0%) of the reported cases.
- The proportion of cases reported anonymously fell further to 9.3% in 2022/23, compared to 10.4% in 2021/22.
- In 2022/23, cases with an element of inappropriate behavior and attitudes were most frequently reported (30.0%).
- In 2022/23, 22 per cent of reported cases (21.7% or 5,506) contained an element of bullying or harassment, a 10 percentage point decrease compared to 2021/22 (31.8% or 6,471). This sharp drop is at least partly due to the reporting of cases related to the new category of inappropriate attitudes and behavior.
- One in four cases addressed (27.4%) related to some aspect of workers’ safety or well-being.
- Nineteen percent (19.3%) of cases this year involved an element of patient safety/quality, up from 18.8% in 2021/22.
- Impaired expression was reported in 3.9% of cases, down from 4.3% in 2021/22 but higher than in 2019/20 and 2020/21.
- Over four-fifths (82.8%) of those who provided feedback said they would speak up again.
Via the National Guardian’s Office
The National Guardian’s Office is working to ensure that speaking is the order of the day to bring about cultural change in the NHS.
The office manages, trains and supports a network of Freedom to Speak Up Guardians in England, providing training and challenges on speaking up to the health system as a whole.
The role of the Freedom to Speak Up Wardens and National Guardian was 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 1,000 Freedom to Speak Up advocates in NHS primary and secondary care organisations, as well as independent sector organisations, national bodies and elsewhere, ensuring workers have a voice on anything that relates to their ability to do their job , affects.
About freedom of expression, Warden
Freedom to Speak Up guardians encourage employees to speak up when they feel they are unable to do so in other ways. They ensure that people who speak up are thanked, that issues they raise are acted upon, and that the person who speaks up is given feedback on the actions taken. Guardians also work proactively to help their organization overcome barriers to speaking out.
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 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 for 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.
