Guest blog by Rob Behrens, Parliamentary and Health Service Ombudsman

Freedom to Speak Up Guardians support workers to raise issues without fear of negative consequences. They also help their organisations identify and address barriers to speaking up. Freedom to Speak Up Guardians began in the NHS, but have since spread to other organisations, including the Parliamentary and Health Service Ombudsman (PHSO) where we have a brilliant and accessible guardian, Jane Touil. As an Ombudsman, fairness, justice, and transparency are three of the most important values of our organisation, and Freedom to Speak Up is a vital tool in making sure that these values are preserved and promoted for staff and service users alike.


Speak Up – How can a Freedom to Speak Up Guardian help me raise a concern?

2015’s Freedom to Speak Up Review identified some of the barriers that employees may experience when wanting to come forward with work-related problems. The report recommended that every NHS Trust should have a Freedom to Speak Up Guardian.

Freedom to Speak Up Guardians: 

  • support workers to speak up, preserving anonymity if this is requested  
  • address barriers to speaking up 
  • make sure that issues raised are used as opportunities for learning 
  • help their organisations foster a positive culture of speaking up. 

By doing the above, guardians improve the experience of both workers and people who use public services. They also help create a culture of learning and improvement, rather than blame and cover-up. 

You can raise a concern about risk or wrongdoing which you think is harming service provision, employees or the working environment. Examples include: 

  • failure to act in accordance with organisational policies and values 
  • unsafe working practices 
  • bullying and discrimination 
  • financial wrongdoing  
  • failure to act in accordance with the law/professional standards.


Listen Up – How can organisations develop a learning culture?

Time and again, independent inquiries have shown that ignoring mistakes made by clinicians or managers has led to significant, systemic failure. This can, and has, cost lives. 

In many ways, the experiences of NHS workers and patients are similar – speaking up can take real courage. Patients may be scared to express their concerns when they are worried about how it could affect their care, and workers may fear that speaking freely could impact their career. We know of cases where whistleblowers have reported clinical mistakes, only to be turned upon by the management and viewed as ‘the problem’, rather than the systems and processes they say are failing. 

This is what needs to change. If there is a blame culture, people are not open about mistakes and the opportunity to learn and improve is lost. Indeed, negative consequences may cause performance to decline further. 

Speaking up, on the other hand, is about learning and improving. A speaking up culture is one where people are able to make suggestions, constructively criticise and be open about errors without fear of reprisal. Organisations with a strong speaking up culture listen to employees and learn from failings so that services can improve. The real issue is not whether mistakes are made, but how we react to them when they are made.


Follow Up – What can leaders do to bring about change?

Leaders can and must do more to consider what gets in the way of listening – including confronting difficult truths. In all spheres, including the world of the Ombudsman, leaders can be reluctant to own up to mistakes for fear that doing so will damage their reputation. But good leadership requires the integrity to admit when things go wrong, report problems and, if necessary, accept the consequences. 

No one organisation or person is perfect, or has all the answers. Leaders must show that they are willing to learn. They must be prepared to adapt longstanding approaches and seek out feedback, acknowledging where things could have been done better so that, in future, they will be. 

This requires a working environment where making a mistake is not automatically a reason for ‘blame’ and where those who raise issues or problems are thanked rather than vilified. At a time when NHS and other public sector services are under unprecedented pressure, it is more important than ever that those in positions of power seek service improvement above self-preservation. Freedom To Speak Up is one major way this cultural shift can be achieved.

Rob Behrens: Freedom to Speak Up is a vital tool in making sure that these values are preserved and promoted for staff and service users alike.