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.

We are currently updating our processes and key documents about our speak up reviews and will have more information about this in the coming months.

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 Guardian 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.

Ongoing reviews

We are undertaking a piece of work with NHS Ambulance Trusts and other stakeholders to understand the speaking up culture in NHS Ambulance Trusts to identify learning and make recommendations for improvement. We proposed this review in response to consistent findings that, despite their inspection ratings, the speaking up culture in NHS Ambulance Trusts tended to be more challenged compared to other trust types.

This review will consist of two main phases:

• phase 1 – desk-based research, including analysis of publicly available and requested data and intelligence
• phase 2 – engagement events, including focus groups (including specific sessions for minority ethnic workers) and interviews with workers, Freedom to Speak Up Guardians and senior leaders.

All NHS ambulance trusts will be included in the first phase of the review. The second phase will focus on five trusts selected to capture a cross-section of ambulance trusts. We will be using this selection criteria to determine which ambulance trusts will be selected for phase 2.

For more information about this Speak Up Review, please refer to the ambulance review terms of reference

Learning from reviews

The NGO has 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 NGO 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