It is a real privilege to take up the role of National Guardian for the NHS. My thanks go to Dr Henrietta Hughes for all her dedicated work over the last five years. Together with the National Guardian Office team and with all our Freedom to Speak Up Guardians, sure foundations have been established. There are now over 800 guardians in nearly 500 organisations. The network has spread beyond trusts and into primary care, dental and optometry services, independent providers, hospices and national bodies. To date they have supported over 55,000 workers to speak up about anything which gets in the way of them doing their job.

I understand and respect the courage that it takes to speak up, raise issues, and spotlight areas for learning. As a former Freedom to Speak Up Guardian, and as a nurse and leader in healthcare, I have experienced the challenge of feeding back concerns to senior management team and exploring options to address issues raised. It is not easy. I want to thank those workers who speak up and the guardians who listen and help organisations act. Thank you all for your commitment to making the NHS a safer and better place for people who use our services and for those working in them.

My priority is to make sure that the principles of Speak Up, Listen Up and Follow Up are truly embedded into the behaviours and cultures of all organisations delivering, commissioning or regulating health care.

Freedom to Speak Up arose from the Francis review into care failings at Mid Staffordshire. Although much has been done to implement recommendations from the review, there is still much to be done. Care failings have continued which may have been prevented if workers had been listened to and issues raised acted upon.

Two years on from the start of the pandemic and the NHS is under pressure, working so hard to redress the increases in waiting lists, alongside a new COVID variant and rising cases and against a backdrop of severe winter pressures. We hear how stretched our services are, how demand for them continues to rise, and how exhausted many of our workers are.

In these times of pressure, it is even more essential that workers feel able to speak up. To feel confidence in the speaking up process, workers need to be met with consistency of response. Just as we have relied upon them, they should be able to reliably have their speaking up matters handled well wherever and to whomever they speak up – whether that’s their line managers, their leaders, their Freedom to Speak Up Guardians or regulators.

It is critical to success that Freedom to Speak Up is implemented consistently within organisations so that it meets the needs of the workforce who are giving so much. This is not just about Freedom to Speak Up Guardians. The Freedom to Speak Up Guardian role is only one of a number of ways workers can raise issues. Everyone, including leaders, need to be supported to do this by regulators who themselves role model listening up and following up. The National Guardian’s Office has established a Speak Up Partnership Group with regulators and professional bodies. We will be working with them, together with other national organisations, to develop greater consistency of response to issues raised by workers to them.

As outlined in the NGO’s Strategic Framework, we will be working to ensure that Freedom to Speak Up Guardians are equipped to execute their complex, unique and vital role consistently and effectively. I will be seeking to understand how we and the leaders in organisations that guardians work in can support the wellbeing and development of guardians.

I also want to understand what stops leaders from embracing Freedom to Speak Up in practice. How can those blockages be removed so that we effect lasting behaviour change throughout the healthcare sector? This includes leaders in primary care, hospices, independent providers and national bodies. We embrace the new opportunity to share this learning in adult social care going forward.

Leading organisations have shown how Freedom to Speak Up can go beyond aspirations to real, lived experience for everyone. The benefits of fostering Speak Up, Listen Up, Follow Up behaviours should be available for us all – workers, leaders, patients, the people who use services and society.

There is much work to do to make the ambition of the National Guardian’s Office – to make speaking up business as usual – a reality everywhere. I welcome the opportunity for us to build together upon the foundations of the past five years and give the workers who give so much and the people we serve, the care they so richly deserve.