Bar graph with arrow going down: Has the healthcare Speak Up culture improved? There has been a sharp decline in Freedom to Speak Up guardians’ perception of the improvements in the Speak Up culture of the healthcare sector. Only 49% said there had been an improvement. In previous years most respondents had said there was an improvement (73% 2021, 80% 2020)

2023 Freedom to Speak Up Guardian Survey Report

Freedom to Speak Up guardians have unique insight into the Speak Up culture in their organisations.

Our survey of guardians  shares their experiences and how speaking up arrangements are being implemented in the healthcare sector.

Key findings

  • 45% of respondents said that there had been an improvement in the speaking up culture in the healthcare sector over the last 12 months. Over a quarter (26%) said the speak up culture in healthcare had deteriorated.
    This was a marked change compared to previous years when most respondents consistently reported improvements in the speaking up culture in the healthcare sector (73% 2021, 80% 2020).
  • It is positive to note that 84% of respondents said their organisation was taking action to tackle barriers to speaking up, a nine-percentage point increase compared to last year’s results, and three-quarters of respondents said retaliation as a result of speaking up was not tolerated.
  • Almost two-third of respondents (66%) identified the concern that nothing will be done was a barrier to workers in their organisation speaking up. This is an 8-percentage point increase compared to responses last year (58% 2021), and puts feelings of futility on a par with the fear of detriment as the main barrier to speaking up.
  • 78% said they would recommend the role to a friend
Read Listening to Guardians - 2023 Freedom to Speak Up Guardian Survey Report

Past Annual Surveys of Freedom to Speak Up Guardians

These past survey  reports provide insights into how the Freedom to Speak Up network has evolved since 2017.

Freedom to Speak Up Guardian Survey 2021

Senior leaders' essential role in Freedom to Speak Up

Supporting the wellbeing of Freedom to Speak Up guardians

Our second report on results from the 2021 Guardian Survey looking at guardians wellbeing

Freedom to Speak Up Guardian Survey 2020

Guardian insights on support for, and barriers to, speaking up

Freedom to Speak Up Guardian Survey Report 2017

The first Freedom to Speak Up Guardian Survey, published in 2017

Pulse Surveys

During the COVID-19 pandemic, the importance of workers being able to speak up freely is more evident than ever.

Between April to June 2020, we carried out monthly pulse surveys of Freedom to Speak Up Guardians on our directory to find out about how speaking up was being affected by the COVID-19 pandemic.

The results showed the pandemic was having an impact on Freedom to Speak Up Guardians and their networks.

We also found that speaking up was continuing, with the percentage of respondents reporting speaking up had increased in their organisation as a result of the COVID-19 pandemic growing each month.

Third Pulse Survey

Workers continued to be encouraged to speak up. Ninety-three per cent (93%) of respondents to this survey believe workers were being encouraged to speak up – up from 72% in April.

Second Pulse survey

Speaking up to Freedom to Speak Up Guardians was continuing with a higher proportion of respondents reporting that speaking up was increasing compared to the last survey Twenty-nine per cent (29%) of respondents said there had been no change to the amount of speaking up in their organisation as a result of the COVID-19 pandemic

First Pulse survey

The survey showed that speaking up is continuing during the pandemic, and that Freedom to Speak Up guardians are adapting as a result of illness, redeployment, or social distancing. It therefore remains imperative that leaders support their Freedom to Speak Up guardians during this period of challenge and uncertainty.