At London Ambulance Service NHS Trust (LAS), a paramedic spoke up to the Freedom to Speak Up Guardian, Katy Crichton, about a number of matters. The issues reported to Katy ranged from challenging behaviours to service-wide problems, such as a lack of training for new staff and inadequate capacity to deal with call volumes.

The paramedic told Katy, “I had sat in the office for several weeks worrying if I should speak to a colleague, a manager or a friend outside work. Occasionally, I would convince myself that I was exaggerating the state of affairs. Feeling isolated, I decided to contact the LAS guardian.

“My brief email prompted a very quick reply from the guardian. We met a few days later in a coffee shop away from work and I already felt I was going to be taken seriously.”

Katy escalated the matters and, with the involvement of the leadership team, including the Chief Executive, an action plan was established. After a couple of months, a review of the issues revealed that the actions had not gone far enough, and further measures were put in place, taking into account advice from the paramedic who spoke up.

The paramedic said, “I have seen significant changes in my place of work. It is a much more pleasant place to be. People are listened to and actions have been taken.”

As a result of the issues raised, the trust increased staffing levels in some areas, developed a new operational structure for the service, invested in additional training for staff, and monitored calls through a regular audit. Feedback from commissioners reported positive changes to the service and outcomes for patients.

Katy said, “We are very grateful that the paramedic felt able to come forward. By speaking up they have improved the working environment for themselves and for our patients.

“Listening to staff and learning from them is hugely important. It was particularly gratifying that the leadership team continued to listen, even after they had drawn up an action plan, and modified it based on further feedback. The ongoing experiences of the paramedic who spoke up really helped to address the problems in a comprehensive way.”

When reflecting on their experience of speaking up, the paramedic remarked, “One thing is for sure – an email to the guardian changed a lot, making the trust a better place to work and providing safer care for our patients.”

This case study was part of our 100 Voices publication which accompanied the 2019 Annual Report.

Case studies are vital to illustrate the good work of Freedom to Speak Up Guardians. We encourage all organisations to share the learning from their speaking up stories.

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