Freedom to Speak Up Policy for the NHS

A new updated Freedom to Speak Up Policy for the NHS has now been published by NHS England.

The refreshed materials also include learning from the previous separate versions for primary care and NHS trusts to ensure a consistent approach for our NHS people, and signpost to a wider variety of support.

They will help an organisation deliver the People Promise for its people, ensuring they have a voice that counts, and a speaking up culture where leaders and managers listen to workers, thereby driving learning and improvement.

All NHS trusts and foundation trust boards have been asked to update their local policy to reflect the new national template by the end of January 2024. By this time, they should have also seen the outputs from using the self-reflection tool and provided at least one progress update.

Freedom to Speak Up Policy for the NHS
Freedom to Speak Up Guide cover

Freedom to Speak Up: a guide for leaders in the NHS and organisations delivering NHS services

We have worked in partnership with NHS England to co-produce new and updated Freedom to Speak Up guidance, which can be applied to primary care, secondary care and systems.

This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.

Using this guide, and the accompanying self-reflection tool, will help you:

  • build a culture and behaviours that is responsive to feedback from workers
  • ensure that your organisation focuses on learning, to continuously improve quality of care and the experience of staff, patients and service users alike
  • improve staff survey scores and other worker experience metrics
  • demonstrate to regulators or inspectors the work you are doing to develop your speaking up arrangements
Download Freedom to Speak Up: a guide for leaders in the NHS and organisations delivering NHS services

Freedom to Speak Up: a reflection and planning tool

This improvement tool is designed to help you identify strengths in yourself, your leadership team and your organisation – and any gaps that need work. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services.

Completing this improvement tool will demonstrate to your senior leadership team, your board or any oversight organisation the progress you have made developing your Freedom to Speak Up arrangements.

All NHS trusts and foundation trust boards have been asked to update their local policy to reflect the new national template by the end of January 2024. By this time, they should have also seen the outputs from using the self-reflection tool and provided at least one progress update.

Freedom to Speak Up: a reflection and planning tool

Freedom to Speak Up Policy Review Framework

This framework is intended to act as a useful tool for reviewing your organisation’s speaking up policy.

Use the Policy review framework

Learning from Case Reviews: a tool to support gap analysis to improve speaking up arrangements

Following feedback from Freedom to Speak Up Guardians, we have collated together recommendations from the nine case review reports which have been published and grouped them thematically.

To help with gap analysis, we have included a tool which Freedom to Speak Up Guardians and others responsible for speaking up in their organisations can use to review arrangements and develop plans and actions for improvement.

You can use this this, along with other guidance published on the NGO website, as a self-review tool to identify and improve gaps in your organisation’s speaking up arrangements.

Learning from Case Reviews: a tool to support gap analysis to improve speaking up arrangements

National Guidelines on Speaking Up Training in the Health Sector in England

These guidelines are designed to improve the quality, clarity and consistency of training on speaking up across the health sector to support those commissioning and delivering training. They include guidance and learning objectives for training all workers, managers and senior leaders.

National Guidelines on Speaking Up Training

Settlement agreements: a factsheet for employers and workers about speaking up

This factsheet is designed to help employers and workers understand their rights when entering into a settlement agreement. It includes key information around the use of confidentiality clauses and reassures employers and workers who may wish to speak up to ensure high quality safe care is maintained.

It should be read in conjunction with NHS Employers’ guidance on the use of settlement agreements and confidentiality clauses, which has also been updated.

It was developed following a roundtable led by NHS Employers and the National Guardian’s Office, as well as six law firms who provide legal services to the NHS: Bevan Brittan, Capsticks, DAC Beachcroft, Hempsons, Mills & Reeve and Ward Hadaway. It has also subsequently been reviewed by Unison.

Settlement agreements

Exploring Freedom to Speak Up in Primary Care and Integrated Settings

This report looks at the challenges in implementing Freedom to Speak Up in primary care, as well common themes and learning.

We’ve identified two types of model to support primary care organisations in developing their speaking up arrangements:

  1. Freedom to Speak Up within an organisation – an individual organisation model – such as a GP practice or Dental surgery; or a Clinical Commissioning Group
  2. Freedom to Speak Up within a network or defined structure – a partnership model – for example Primary Care Network or alliance between opticians; a local support model – eg practices supported by their local committee, CCG or NHS Trust; or an Integrated Care System Model.
Exploring Freedom to Speak Up in Primary Care and Integrated Settings