Cherma St Clair, the Freedom to Speak Up Guardian at Hillington Hospital NHS Foundation Trust, does regular walkabouts around departments. It was during one of these walkabouts that a newly appointed worker raised a concern face-to-face and in confidence about something that had occurred the day before which did not seem right.
A young woman attended out-patient services for tests, having been referred by her GP. She was accompanied by an adult and appeared very anxious and distressed. While she undressed for her test, staff noted healed wounds on the covered areas of her body which looked like cuts from a razor blade.
The worker was concerned for the patient’s safety and unsure whether these were from a previous selfharm episode, or whether this could be a safeguarding issue.
Although the trust safeguarding lead was not on duty that day, following advice from the trust safeguarding administrator, Cherma contacted the local authority for social care and health services. She discovered that the patient was currently under the mental health team for young adults.
A discussion with a social worker highlighted that there were red flags indicating that the patient’s condition was deteriorating. As it was nearing the Christmas holiday period, a rescue plan was put in place that included psychologist input and referral to the community dietician to addres the patient’s eating disorder.
The worker was informed of the safeguarding process and where they could get help in future. Staff revealed that they did not know what to do in this situation, and they were encouraged to raise all issues that they felt uneasy with or anything that just did not feel right.
“By speaking up, the worker promoted the well-being of the patient by preventing admission to in-patient mental health services. The workers said that they felt relieved that they were able to tell someone and that something was done,” said Cherma.
“Induction of new staff is critical to performance,” she concluded. “Freedom to Speak Up is now part of trust induction for all new starters. This case also underlines how vital visibility is to the guardian role.”
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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