In the last few years, the University Hospitals of Derby and Burton have merged to create one trust. As is often the case with mergers, some workers felt anxious about changes.

Following the merger, the Executive Team attended initial roadshows at all five sites to introduce themselves. But due to the extremely high workload following the merger, and the additional challenge of being across multiple sites, workers felt that they didn’t see enough of the senior leadership team or Executive Team. They became concerned that the two-way communication process they had been
used to was no longer as accessible.

“Workers were feeling anxious that they were unable to speak to the senior leadership team about their concerns and to ask questions about what was planned,” said Alison Bell, the trust’s Freedom to Speak Up Guardian.

“Having been used to the senior leadership being very visible and responsive, they were worried that they would be unable to access them if they needed to raise clinical issues quickly.”

Along with the Non-Executive Director (NED) for Speak Up, Alison met with workers at drop-in Speak Up Surgeries across all sites where issues were raised. Some workers also chose to email the guardian directly and asked to meet to talk through their concerns. All made a request to have more opportunities to meet and talk with their senior leadership teams from their departments and the Executive Teams.

The guardian agreed with the NED that both would raise the issues with the CEO and the Director of HR and Organisational Development. Following this, a plan was agreed to set up some listening events at all sites with Executive Team members attending along with the guardian.

The communications team organised informal events across all sites with free breakfast or cake for anyone attending. They publicised them to ensure all staff knew they were taking place. The guardian ensured all staff who had spoken up were advised of the events and were encouraged to attend, which the majority of them did.

“The feedback on the events from workers who had spoken up, and others who attended, was so overwhelmingly positive, both from senior leaders being more visible and from workers feeling part of one team within the new merged trust, that it was decided to make them monthly engagement and listening events,” said Alison.

The events continue to be informal and workers have reported that they have felt safe to speak up about some issues there that had been on their mind for a while. These were considered by the leaders and have already led to further discussions about improvements.

One worker said, “I used the breakfast opportunity to speak up to [the Managing Director] about the issues in [my department]. He came down to meet the team the following week and matters have now been resolved.”

“A recent comment from a worker at a community campus was that other workers who attend the events have said they feel safe to speak up directly to the Board members when they attend. This is encouraging others to speak up within their teams,” said Alison.

“The most compelling outcome has been that the Board have seen the positive impact on workers by being on site and available in an informal setting,” she continued.

“Senior leaders now have a presence on all sites more often. This has allowed them the opportunity to respond quickly and face-to-face with workers speaking up. The CEO has spoken about how much he has learned about some of the challenges a range of workers are facing from attending the sessions. He sees them now as a valuable part of staff engagement.

“Feedback has been so positive that we now run these bi-monthly,” said Alison. “Whilst I spend a lot of time meeting workers who approach me with their issues, it is also helpful to meet workers at other more informal events as they will often speak up during those conversations as well.”

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]