A member of the Endoscopy team spoke up to the Freedom to Speak Up Guardian with concerns about blurred boundaries between clinical and nonclinical staff when advising patients about the medications they should cease before attending for endoscopy.

Most Standard Operating Procedures relate to patient care delivered by clinical workers. The need for SOPs for non-clinical workers was recognised because of this concern being raised.

“Sometimes workers acting with the best motives to be helpful can inadvertently cross the boundaries between the role of clinical and non-clinical duties,” said Phil Gardner, Freedom to Speak Up Guardian at Royal Surrey County Hospital NHS Foundation Trust.

With the consent of the worker, their concern was confidentially discussed with the Matron for Endoscopy, and flagged to the Chief Nurse, as the Executive Lead for Freedom to Speak Up.

Two new procedures were developed which made the guidance that nonclinical staff may provide to patients clearer; any other matters must be escalated to the nurse-in-charge.

The new procedures have clarified boundaries for clinical and non-clinical staff and as a result reinforced patient safety and potentially enhanced patient experience. In addition, workers have benefited from having clearly defined parameters in which to work.

“The member of staff who spoke up has reported that the situation has improved after having raised their concern,” concluded Phil.

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.

If you have a Freedom to Speak Up story to share, please send an email to [email protected]