As leaders we all hope that when something does not go as expected for someone their first point of contact would be the line manager. However, there are times when people have tried to speak up and feel no action has been taken or they would like to speak with someone neutral or independent to the situation.
When someone contacts the Freedom to Speak Up Guardian, it can be a difficult and distressing time for the them. The key work-related stressors, as identified by the Health and Safety Executive, are due increased workload demand, unable to control their workload, not feeling they have enough information and support, relationship breakdown and feeling bullied, or feeling disengaged when going through change. As a result, we see an increase in conflict, staff turnover, increase absences, performance related issues, staff reporting high levels of stress and an increase in speaking up to guardians, complaints or grievances in different parts of the health and care system.
The key to a successful outcome in any given situation is advanced communication skills; the ability to articulate the idea or decision with simplicity and transparency along with the purpose and intended outcome. It is difficult to get this right for everyone. As individuals, our feelings and support needs to a given situation or workplace change is subjective which means those involved in decision-making or leading change cannot always get this right.
Having been on the receiving end of feedback from someone speaking up to the Freedom to Speak Up Guardian, I was saddened that the individual was upset and did not feel able to come to me directly. The trigger for them speaking to the guardian was a joint decision that was intended to improve patient care as well as considering their learning and development needs. I was also concerned that this would be perceived as a poor reflection on mine and my fellow leaders’ professional integrity. However it was the actions that followed which defined and demonstrated the professional integrity and commitment to create a safe culture to speak up. We respected the privacy and anonymity of the person who had spoken up; we took responsibility of the feedback; we acknowledged we didn’t get it right for that individual; and we made a promise to learn from and use the feedback to feed-forward for future change and improvement.
Having a culture where people can Speak Up is just as important as the delivery of the feedback. It can be upsetting for those receiving the feedback from the Freedom to Speak Up Guardian, and a natural common reaction is to become defensive.
As leaders it is easy to forget about the purpose of the Guardian (as well as those who use the support service to speak up). Leaders have shared that it can feel a personal attack therefore it can easily impact on confidence and future decision making due to the fear of getting ‘reported’ to the Guardian which, as a result will have their decision overturned or made to feel undermined.
In my experience, a when someone raises something with the Freedom to Speak Up Guardian, it rarely changes the decision or service change, but there is learning to be made around how something was communicated, and there was a lack of understanding and sharing of information around how we have reached a decision or change in service.
In my experience, the person who is spoken up about also needs a supportive and safe environment to process the feedback, to feed-forward as much as an individual needs support and a safe environment to Speak Up. Advanced communication and active listening skills are vital so we can listen and respond to one another with the hope of mutual understanding.
As leaders we are on a continuous journey of ongoing development, and we don’t always get things right. It is important to share when we don’t get things right to create a learning culture which will determine the success of creating and improving a speak up culture and the health and safety of the workforce.
ADDENDUM
As the Freedom To Speak up Guardian at Leeds Community Healthcare I wanted to share what I saw from Victoria in responding to concerns. Victoria has always spoken about how she feels about the issue, what she knows already and how she will not be defensive but listen to understand and create change where needed. I think this sums up what ‘Listening Up’ means and calls us all to – a commitment to think of how we feel, a sense checking of what we already know and non-defensive listening and engagement to find a way forward. This way of dialogical rather than defensive practice has always, in my experience, created the best outcomes for all involved in concerns.
John Walsh
Freedom To Speak Up Guardian
Leeds Community Healthcare NHS Trust
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