As Scotland’s Independent National Whistleblowing Officer for the NHS, I recognise that we’re still taking our first steps on a journey towards culture change. Our first Speak Up Week showed us just how valued a speak up culture is to everyone across the NHS in Scotland. We recognise that there is a way to go on our journey, but see there is positivity and experience we can build on and learn from.
Of all of the important messages that emerged from the events of Speak Up Week, the themes that have stuck in my mind are:
- the bravery of those who speak up and the difficulties they can face
- how vital it is for there to be trust in the speaking up system, and
- the value speaking up brings to the NHS, service users and the many dedicated people who deliver those services.
Everyone, whatever their seniority, professional expertise, role or contribution, needs the freedom to speak up and give feedback safe in the knowledge that they will be listened to, respected, supported and protected. This is a simple truth, underpinned by rights and values.
Fundamental to this is a system that is open to receiving concerns. To deliver services effectively requires a healthy workplace culture and a thriving organisation. It seems to me everyone from Chairs of Boards and CEOs to the most junior of staff says this and agrees with it. And yet, I heard that in the health sector there is a fear of speaking up and a defensiveness that is not necessarily seen in other sectors.
I heard a colleague from the Civil Aviation Authority talking about how speaking up is an integral and accepted part of the aviation industry, and the energy company SSE sharing the progress they have made over the last decade to strengthen their speak up culture. There is much we can learn from those that are further ahead on this journey.
One of the personal highlights of Speak Up Week for me, was the opportunity to chat with Dr Jayne Chidgey-Clark on the benefits of speaking up. We agreed that collaboration and shared learning is a vital part of building something that works for everyone, particularly those who step forward and speak up. It was also clear that as leaders, we have a role, if not a moral duty in standing up, speaking up and working together, across borders.
So, what did I learn during Speak Up Week?
I learned that the principles behind a strong speak up culture are the same, whatever sector you work in. Workers (and others who deliver services) need to trust that it is safe to speak up and that when they do, they will be listened to. If something needs to change it should, and that change should be shared and communicated.
Transparency starts with the commitment and behaviour of senior leaders who need to be open about concerns they receive and the change that has resulted. In an ideal world, we shouldn’t need whistleblowing as Speaking Up should be part and parcel of business as usual.
I also heard, loud and clear, that trust has to be earned. It is fragile and needs to be nurtured. This is not the result of one action but of many. For example, in Scotland, one of the ways we do this is by having Confidential Contacts in NHS Boards who can help and support people who raise concerns, outside of normal management structures. My office also provides an independent review of concerns if the person who has spoken up does not feel the matters they raised have been addressed, or if they feel they have not been properly protected. These are first steps towards culture change.
One of the most important messages I have to pass on is to the leaders and managers in organisations. Be as courageous as we are asking our colleagues to be when they raise concerns. Be brave and be open to hearing what people say, and openly value their voices regardless of where they are placed in the organisation, how long they have been there or whether it feels difficult to address. The NHS will be a better, safer place for it.