We welcome the findings of General Sir Gordon Messenger and Dame Linda Pollard and their seven recommendations to support health and social care leaders to deliver their best for patients, service users and the workers they lead.

The Review notes: “In the NHS, we sensed a lack of psychological safety to speak up and listen, despite the excellent progress made since the Francis Report. We would observe that the Freedom to Speak Up initiative can be narrowly perceived through the lens of whistleblowing rather than also organisational improvement, and we would encourage a broader perspective.”

The Review recommends consistent management training and accreditation. Along with the selection and recruitment of leadership for the right values and approach to supporting an open culture, understanding the importance and benefits of how to foster such a culture must be integral to any implementation.

An understanding of the importance of Freedom to Speak Up must be included in the proposed national induction programme and within standards and accreditation frameworks for managers. How managers and leaders listen and respond to speaking up should also be included in appraisal and performance management frameworks.

To support these future improvements, the National Guardian’s Office has worked with Health Education England to develop Freedom to Speak Up eLearning. ‘Speak Up, Listen Up, Follow Up’ is divided into three modules aimed at workers, managers and leaders.

The final module – Follow Up – completes the package. Developed for senior leaders throughout healthcare – including executive and non-executive directors, lay members and governors – to help them understand their role in setting the tone for a good speaking up culture and how speaking up can promote organisational learning and improvement.

In addition, the National Guardian’s Office has worked with NHS England/Improvement on the soon to be published updated Freedom to Speak Up national standard policy and guidance for leaders across the sector.

Dr Jayne Chidgey-Clark, National Guardian for the NHS, said: “The Review notes some examples of inspirational leadership practice, but poor behaviours remain in some areas, with some workers still not feeling comfortable speaking up.

“The current pressures on the service mean it is even more vital that leaders across the sector are supported to implement fully the Review recommendations. This includes improving their understanding of the benefits and drivers of fostering a healthy culture, where speaking up is seen as an opportunity for learning, not blame.

“The proposed training, accreditation and appraisal implementation is a golden opportunity to ensure that fostering a healthy Speak Up, Listen Up, Follow Up culture is at the core of future leadership requirements.”


Read the report:  Leadership for a collaborative and inclusive future