In some ways, it feels like the hard work in achieving a speak up culture is just beginning.
Worrying recent research from the National Guardian’s Office (NGO) found a drop in some indicators of positive speak up cultures. Some healthcare workers continue to experience “detriment” for speaking up, and speaking up is far from business as usual.
This certainly rings alarm bells for healthcare organisations. Why are we seeing this decline? Considering it’s been six years since Sir Robert Francis QC’s review led to the birth of NGO and to Freedom to Speak Up guardians like myself, what do we need to be doing differently?
I’ve proudly led the Freedom to Speak Up guardian network at The London Clinic, an independent hospital and charity based in central London, since the start of 2022. As guardians, our job is to listen and to act. Now more than ever, faced with these findings, guardians have a unique role to play in supporting their colleagues, gaining their trust and guiding them to speaking up.
For guardians, our power is in our ability to build community. At The London Clinic, having gained multiple new members earlier this year, we’re now a dozen-strong grassroots movement spanning all corners of the hospital. Diversity and representation are critical – our colleagues need to feel like they are speaking to someone “like them”.
That’s why our guardians are from different roles, clinical and non-clinical. We’ve different levels of experience, we have different backgrounds and faiths. But together, we congregate around one aim – to support our colleagues in speaking up. Many of us have shared experiences of not being listened to or not knowing who to go to in the past – we’ve been there, and we know what it’s like.
For guardians to truly thrive, they need the backing of their organisation and they need to feel fully equipped. As such, we’ve undertaken NGO Foundation and Refresher training, we’re creating a brand new Freedom to Speak Up policy and we’re working on our visibility as a priority. This has included an updated intranet page with our pictures and bios, different options to contact us, badges, lanyards, posters, a relaunch event in our canteen, and we have weekly walk-arounds to speak to colleagues in situ. Our presence is growing.
Meanwhile, my role as the lead guardian is to work with senior leaders so that they understand what’s happening on the ground, they know the discussions that are happening and the key themes that are coming up. Their buy-in is critical.
Over the course of this year, as our guardians are growing in confidence and Freedom to Speak Up is reinforced as a priority at our hospital, we can see the improvement. People are coming to us with concerns, honest conversations are being had, and ultimately bridges are being built.
The more of us there are, the more matters we address and the more positive stories we achieve, the more we can keep the culture growing. This feels like a pivotal moment, and our grassroots guardian community is showing what it means to take up space.