Freedom to Speak Up Guardians are very familiar with the experience of workers who try to speak up or are fearful to do so. But for patients, it can be even harder.

In my role as Patient Safety Commissioner, I often hear from patients about their appalling experiences within the health system. They lack agency in a system where clinicians hold the balance of power. Some patients describe being ignored or dismissed and their views and experiences are not taken into account. When they try to complain, they are sent round and round in circles in a system which compounds harm and does not use the information for learning. If we want better patient safety, this must stop.

We need to change the culture from one of mistrust and cover up to one of transparency and accountability. To a culture of psychological safety where patients are true partners in the design and delivery of healthcare. A culture in which it is safe to air your views without worrying that it is not the accepted standpoint, without fear of damaging your career or in the cases of patients and families, fearing that their loved ones may be harmed.

Worker safety and patient safety are two sides of the same coin. We cannot have one without the other, so we need to ensure that workers are safe to be confident that patients are also kept safe.

Freedom to Speak Up Guardians are key to this. Guardians are the conduit for essential information that when acted on appropriately, can lead to the improvements we need to protect patients and reduce harm. Guardians also provide support to those on the frontline who are caring for patients and work proactively to support positive culture change.

In this Speak Up Month, I want to say a huge thank you and pay tribute to the great work that Freedom to Speak Up Guardians do.  I have seen this for myself, particularly when Guardians work collaboratively with partners including patient safety teams, organisational development, managers and leaders to bring about change. Guardians have responded to over 100,000 cases which is an incredible achievement. The work of Freedom to Speak Up Guardians, and those who support them, makes a huge difference to individual colleagues, patients, and families, and benefits the whole organisation.

Freedom to Speak Up Guardians can help to develop restorative practice, de-escalating cases which otherwise become adversarial. Working with staff representatives, managers and individual workers, innovative solutions have been developed which help support staff and build better relationships. This is so important at a time of huge pressure on the NHS where civility and respect are vital to working effectively together to keep patients safe.

This work is taking place every day throughout the health system and national bodies. Matters are being raised, workers are being supported, patients are being kept safe and harm reduced. The work of Freedom to Speak Up Guardians is also key to the roll out of the pilot of Martha’s Rule – thinking about workers who will be making the calls, taking the calls and those helping to prevent, identify, escalate, and respond to deterioration.

I salute the brilliant work Freedom to Speak Up Guardians already do in supporting colleagues to speak up when they see things that get in the way of delivering great care. It is clear that workers need Freedom to Speak Up Guardians as in the year to April 2024, guardians handled 32,167 cases, a 27.6% increase on the previous year, again a remarkable achievement.

 

My message to leaders is – how are you supporting your workforce and your Freedom to Speak Up Guardians so that people feel safe to speak up and how are you supporting your patients and their loved ones to do the same? When we speak up, listen up and follow up we will, together, be able to make the improvements needed to keep people safe.