The National Guardian’s Office  reviewed the handling of two speaking up cases referred to it by workers from Northwest Ambulance Service NHS Trust as the workers’ referral information indicated that the trust’s response to their speaking up had not been in accordance with good practice.

We visited the trust to gather information for its review in January and February 2019 and then held discussions with the trust about aspects of that information, before returning in May 2019 with colleagues from NHS Improvement to discuss the provisional findings of the review with trust leaders and to agree actions in response. The trust supported the review process by providing all requested information and by participating fully in the engagement process to discuss the review’s findings.

As part of the review, NGO staff interviewed the workers who had referred their cases to the office and those in the trust responsible for responding to the matters they had originally raised. In addition, we met with senior leaders responsible for the trust’s speaking up arrangements. The review also looked at relevant speaking up policies and procedures and how the trust had implemented the Freedom to Speak Up Guardian role.

At the time of the review the Trust had two full time Freedom to Speak Up Guardians, supported by a number of champions across the Trust, a lead Executive Director and a lead Non-Executive Director of Speaking Up. There were a range of policies and procedures in place to support the speaking up culture and evidence of both training and effective Board reporting.

The review found areas where the trust’s response to the issues raised by the workers could be improved, including in relation to providing feedback on the progress of the trust’s investigation into their concerns.

The review also found that there was lack of clarity among workers about the scope of the Freedom to Speak Up Guardian role and what matters they could support workers to raise.

In response to the potential lack of clarity, the NGO recommended that the trust developed a single policy to describe the available support and procedures in relation to speaking up.

A central feature of the review was an engagement process, involving the NGO, the trust’s leaders and NHS Improvement, to discuss the review’s findings and agree actions in response to its findings.

Read the report and recommendations