Overseas-trained workers make up a significant part of the NHS workforce, and they often face additional barriers…...
1 May 2025
About speak up reviews
Speak up reviews seek to identify learning, recognise innovation and support improvement, and, ultimately, improve the experience of workers, patients, and the public.
We work with others to carry out reviews and promote and embed the learning.
How we decide what to review
We are seeking to give as many workers as possible a voice in what we decide to review and, in doing so, aim to have as much impact as possible by focusing on areas of priority for workers.
We look at a range of indicators to inform our decisions as to what we review, including:
- Freedom to Speak Up guardians – speaking up data
- Staff engagement data such as the NHS staff survey
- Information shared with the National Guardian’s Office
We are working with stakeholders to continue to improve the understanding of the speaking up landscape in healthcare in England.
Latest published Speak Up review
Our report following our review into overseas trained workers has now been published. The review brings together a wide range of insights, including what we heard directly from more than 850 overseas-trained workers and 150 Freedom to Speak Up guardians through interviews, surveys and focus groups.
For more information about this review, please refer to the terms of reference for this review.
Learning from reviews
We have carried out case reviews where we received information to suggest that speaking up had not been handled in accordance with good practice. Where we found that good practice had not been followed, we recommended remedial action.
We have collated recommendations from the nine case review reports 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.
This can be used be used, along with other guidance published on the National Guardian’s Office website, as a self-review tool to identify and improve gaps in organisations’ speaking up arrangements, for the benefit of workers, their organisations and the people they support.
Published reports
See the graphic below for an update on progress against the four recommendations: See a text only…...
19 December 2024
The National Guardian’s Office carried out a Speak Up Review of NHS Ambulance Trusts in England to understand…...
23 February 2023
The National Guardian’s Office received information indicating that a speaking up case may not have been handled following…...
14 October 2021
The National Guardian’s Office undertook a review of the handling of two speaking up cases referred to it…...
21 April 2021
The National Guardian’s Office reviewed the handling of two speaking up cases referred to it by workers from…...
21 April 2021
In 2019, the National Guardian’s Office conducted a review of the speaking up processes, policies and culture at…...
21 April 2021
In 2018, the National Guardian’s Office conducted a review of the speaking up processes, policies and culture at…...
21 April 2021
In 2018, the National Guardian’s Office has conducted a review of the handling of speaking up cases at…...
21 April 2021
In 2018, the National Guardian’s Office conducted a review of the handling of speaking up at Derbyshire Community…...
21 April 2021
In September 2017 the National Guardian’s Office conducted a review of the speaking up policies, processes and culture…...
31 March 2021
In August and September 2017 the National Guardian’s Office conducted a review of the speaking up processes, policies…...
31 March 2021