When I joined the Hereford and Worcestershire Integrated Care Board in April 2024 as an externally appointed Freedom to Speak Up Guardian, I stepped into a completely blank space. The board had never had a Guardian before, nor any formal speaking up processes.
What we did have, however, was an opportunity to create something meaningful and develop a culture where speaking up wouldn’t be feared but welcomed.
This journey has been both professional and deeply personal. It was not just about setting up systems but also building trust, removing barriers, and creating the psychological safety that every worker deserves.
Foundations
The first few months were all about listening, observing, and slowly building the foundations. Together with colleagues and with the help of my more experienced Freedom to Speak Up buddy, I launched:
- An information page on the board website so staff and external partners could understand what the role involved and how to contact me.
- A Freedom to Speak Up portal providing a secure, accessible route for anyone to raise concerns.
- A range of posters and promotional materials because visibility matters.
- Clear messaging around breaking the barriers to challenge stigma.
- Actively promoted a Speak Up culture by highlighting the value of the worker voice at team briefings “it’s better to speak up then silently resent”.
It has been a mutual learning process between me and the organisation. There was openness from the start, curiosity, warmth, and a willingness to learn together.
Relationships
I’ve been delighted by how warmly I was received. From the beginning, staff saw me not as a formal role-holder, but as a person. That integrity, being who I say I am, became the cornerstone of the relationships I built across the organisation.
One of the early defining moments was when a concern was raised about a recruitment process. It was a difficult issue, but it was raised constructively and taken seriously. Senior leaders listened. And more importantly, they acted, amending the policy to make it fairer and more transparent.
That one case became a turning point. It sent a strong message: “This process works. Speaking up leads to positive change.”
Aman Gill-Knobbs, non-executive director for Freedom to Speak Up: “I commend the dedication and efforts of our Freedom to Speak Up Guardian and the senior leadership who have enabled and facilitated a robust Freedom to Speak Up culture within the Hereford and Worcestershire ICB, recognising the pivotal role it plays in fostering psychological safety, organisational learning, and a transparent environment where staff feel empowered to raise concerns and contribute to continuous improvement.”
Listening
The year before I joined, the staff survey results were average, and participation was limited. It was clear people didn’t yet feel confident that their voice mattered.
To change this, I showed up in person, not just in posters. I joined team meetings, talked with staff in their own spaces, and made sure my presence wasn’t just seen, but felt. I shared why speaking up isn’t about blame, it’s about better systems, better outcomes, better working lives.
This year’s NHS Staff Survey showed a dramatic improvement in the four domains related to speaking up:
- I feel safe to speak up about anything that concerns me in this organisation: 66.4 per cent in 2024, up from 57.9 per cent in 2023.
- If I spoke up about something that concerned me, I am confident my organisation would address my concern: 57.1 per cent in 2024, up from 50.08 per cent in 2023.
- I would feel secure raising concerns about unsafe clinical practice: 74.2 per cent in 2024, up from 71.4 per cent in 2023.
- I am confident that my organisation would address my concern about unsafe clinical practice: 64.36 per cent in 2024, up from 56.87 per cent in 2023.
We are now performing significantly above the national average in areas where we were previously lagging. These numbers represent a shift towards openness, honesty, and care.
Culture change is hard. It takes work and effort, but it also takes heart. The progress we’ve made is real. Trust has been built. Processes are in place. Staff members are speaking up, and leaders are listening.
Simon Trickett, chief executive: “Freedom to Speak Up has made a real difference here. Our people feel more confident to share their concerns, and we’re seeing genuine improvements as a result. I’m so pleased to see the openness and trust across our teams continue to grow.”
Progress
And most importantly, we’ve proven that with passion, integrity, and dedication, a positive culture can be created, even from a blank page.
We are on a positive trajectory toward a safer, kinder, and more open workplace culture. Speaking up is no longer seen as a risk, but as a vital part of organisational learning and improvement.
The success of our speaking up journey is shared by every individual who had the courage to raise concerns, every leader who listened, and every colleague who promoted the message that every voice matters.
As we move forward, it is essential that this momentum is not only maintained but built upon. Investment in psychological safety and Freedom to Speak Up capacity proves that organisations have a map how to thrive.