In 2018, the National Guardian’s Office conducted a review of the handling of speaking up at Derbyshire Community Health Services Foundation Trust after receiving information that the trust might not have responded to one of its workers speaking up in accordance with good practice.
During our review, other individuals came forward to share their experiences of how the trust handled their speaking up cases, which we then also reviewed.
Our review sought to identify learning on how support for speaking up could be improved, as well as to highlight existing good practice.
We found that the trust’s handling of the speaking up cases we reviewed did not always meet with good practice, including long delays in the handling of workers’ issues and a poor understanding on the part of some managers of how they should respond to them. This highlighted the need for dedicated speaking up training across the organisation, to ensure that all staff have the necessary skills and knowledge to speak up well and respond to issues being raised appropriately.
We also found that speaking up policies and procedures needed significant improvement, although the trust was making necessary improvements at the time of our review. The review also identified examples of good speaking up practice at the trust. These included a detailed communications plan to raise speaking up awareness with all workers spread across the wide geographical area covered by the trust.
There was also a dedicated speaking up web page for staff on the trust internal communications system that provided workers with information on how to speak up and included positive messages from senior leaders promoting this support, as well as a description from a worker of how this support had helped them.
Trust leaders emphasised to us that they were looking to continuously develop and improve the trust’s speaking up processes and culture, and expressed a desire to learn from our review.
Trust leaders also highlighted that one of the cases we have described in this report began before the Francis Freedom to Speak Up review had published its findings. Since that time, they believe they have moved the trust’s speaking up culture forward, on the basis of the recommendations from the Francis review, as well as from lessons learned from speaking up cases within the trust.
Our review makes 12 recommendations for the trust on how it can improve its support for its workers to speak up. In addition, we also make a recommendation for the Department of Health and Social Care and a recommendation for Capsticks Human Resources Advisory Service.
With each recommendation we have indicated the time frame within which we expect the organisation in question to implement the necessary actions.