The Annual Report of the National Guardian for the NHS is today (24 November 2025) laid before Parliament, highlighting the work of Freedom to Speak Up guardians and the National Guardian’s Office. The report also shares learning which indicates that more work is needed for speaking up to be described as business as usual in the healthcare sector in England.
The laying of the report was a commitment called for by the Secretary of State in his response to the events at Gosport War Memorial Hospital as a means of holding the government to account on supporting the fostering of an open culture in the healthcare sector in England.
In his foreword to the report, Dr Zubir Ahmed MP, Parliamentary Under-Secretary of State for Health Innovation and Safety, said:
“Time and again, investigations have shown that the NHS must improve in welcoming and listening to staff concerns. More than 1,300 Freedom to Speak Up guardians now play a crucial role in enabling staff to confidently raise issues that affect care quality, and I am pleased that this report provides an important insight into their valuable work.
“As set out in the 10 Year Health Plan, whilst the distinct role of the National Guardian will no longer be required, our commitment to strengthen staff voices and promote openness and honesty in the NHS remains of paramount importance. I wish to personally express my gratitude to all Freedom to Speak Up guardians and those who support their work for the meaningful difference they are making across the healthcare system. This government is committed to enabling and supporting staff to speak up and to use it as a vehicle for the quality improvement and thereby the safety of NHS services.
“Finally, I wish to express my gratitude to all who have contributed to the National Guardian’s Office over the last ten years. This Annual Report is a testament to the valuable work you have undertaken to promote, support and empower our NHS workforce to be heard.”
Beth Carter, Interim Director of Operations and Strategy for the National Guardian’s Office, said:
“It is an honour to share the work of the National Guardian’s Office and Freedom to Speak Up guardians in this Annual Report. This year, speaking up has remained at the forefront of the news, with continued high-profile cases and the Thirwall Inquiry. Freedom to Speak Up guardians have handled more cases than ever before, and, as the ten-year health plan begins to be implemented, it remains vital that staff continue to speak up. Freedom to Speak Up guardians will continue to provide an essential route for healthcare workers to do so during this time.
“I would like to thank the network of Freedom to Speak Up guardians for the vital work you continue to do.”