A report published by the National Guardian’s Office  shows the experience of Freedom to Speak Up Guardians amid the continued pressure of the pandemic on the healthcare sector.

While the majority of Freedom to Speak Up Guardians who responded to our annual survey were positive about the speaking up culture in their organisation, there are warning signs that more action is needed.

The proportion of guardians who reported a positive culture of speaking up in their organisation has dropped by five percentage points on last year, to 62.8%.

This drop correlates with the findings of the 2021 NHS Staff Survey, published 30th March, where the proportion of staff who say they feel safe to speak up about anything which concerns them in their organisation has also fallen by more than three percentage points to 62%.

The proportion of Freedom to Speak Up Guardians who say that speaking up culture in the healthcare sector has improved has also dropped – from 80% in 2020 to 72% in 2021.

There has been a drop in the proportion of Freedom to Speak Up Guardians who responded to the survey saying that their senior leaders support workers to speak up. This has fallen by 9 percentage points on last year, to 71%.

Although the majority believed that their senior leaders understand the role of Freedom to Speak Up Guardian, 1-in-10 of respondents say that senior leaders do not.

Dr Jayne Chidgey-Clark, National Guardian for the NHS, said:

This gives me cause for concern. Senior leaders should discuss the findings of this survey with their Freedom to Speak Up Guardian, and their workers, and look at their plans to continue to improve the speak up culture in their organisations.

As the sector works to recover from the pandemic, leadership in healthcare has never been more pressured. A strong speak up culture is essential in delivering high quality and safe services and supporting the wellbeing of workers.

Guardians can be a significant source of support for leaders in this, as they share themes of what workers are speaking up about – whether those are patient safety concerns, ideas for improvement, or issues affecting their work or wellbeing.

But to help create the right climate for change, leaders must listen and act on those concerns. Collaborative and compassionate leadership is essential to retain the loyal and committed workers who have given so much over the past two years.”

To support leaders in their understanding of the benefits and drivers of fostering a healthy speaking up corporate culture, the National Guardian’s Office is launching a new module as part of its Freedom to Speak Up e-learning package, in association with Health Education England.

The first module – Speak Up – is for all workers and has been completed by over 46,000 people. The second module, Listen Up, for managers, focuses on listening and understanding the barriers to speaking up. A third and final module, Follow Up, for senior leaders will be launched next month.

Read the report: Freedom to Speak Up Guardian Survey 2021: Senior leaders’ essential role in Freedom to Speak Up

Read the press release