Zoe Grant, Freedom to Speak Up Guardian at North Staffordshire Combined Healthcare NHS Trust, said, “I had been the trust’s Freedom to Speak Up Guardian for just over six months when two staff approached me. I have never underestimated how much courage it takes for people to step forward and speak up, particularly if they are associated with the team that they work in.”

Peter and Joanne – who have asked to be named as they want to promote speaking up and reduce the stigma – were experiencing significant levels of stress due to challenges in safely managing their patient caseloads. They reported that other members of the team felt the same, with some reduced to tears as a result of the stress.

“Together we agreed that action needed to be taken immediately because their professional responsibilities were being compromised,” said Zoe.

She contacted their Service Manager, Rachel Birks, who agreed to meet that very afternoon. “This in itself had a great impact,” she said. “Straight away Peter and Joanne felt that their concerns were being taken seriously and that they were no longer going to be dismissed, as well as feeling that they did not have to accept that this was ‘just how it is around here’.”

Rachel listened to the issues and supported by offering constructive advice and guidance. A plan was formulated to ensure the team were able to address their issues quickly and efficiently without compromising service delivery.

“We are a very busy service and sometimes you do not always recognise when staff are struggling,” said Rachel. “We continually strive to ensure that there are opportunities for staff to discuss issues and concerns and Peter and Joanne’s case has helped us to improve this.

“Our team meetings feel much more inclusive now and we have made sure that all staff know that we have an open-door policy to discuss any issues they may have.

“Although there are regular opportunities for supervision and reflective support sessions, we have since reinforced to staff that they can use these to discuss their own well-being and to talk through any build-up of stress levels so that the appropriate support mechanisms or improvements can be put in place.”

When Peter and Joanne provided Zoe with an update several weeks later, they reported that speaking up had made a big difference. “The discussion and advice had made them feel empowered and valued and their voice continues to be heard,” she said.

“The team they both work in continues to have challenges, but these are being managed as improvements are gradually being made. What they both value the most is being actively involved in the discussions and decision[1]making and being kept up-to-date with all team and service developments.”

Jane Munton–Davies, the Associate Director of the Directorate, said, “It is fundamental for us to recognise and understand when staff are under pressure.

“Our caseload management system was under review at the time when Joanne and Peter highlighted their concern. The Freedom to Speak Up concern was subsequently escalated to the trust’s Executive Team, who helped to progress the review of the caseload management tool. We now have a new improved version which is being piloted.”

Zoe said, “This story emphasises the importance and value of managers being open, transparent and responsive to staff concerns and why we should never undervalue the power of ‘team’ by taking proactive steps to support and encourage staff.”

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]