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.

Current Speak Up review

Overseas-trained workers make up a significant and growing portion of the healthcare workforce in England. However, our data and intelligence has raised concerns about the extent to which these workers feel free to speak up.

We are initiating a Speak Up Review to understand the speaking up experiences of overseas-trained workers , identify barriers and highlight examples of good and innovative practices. Our aim is to develop actionable recommendations out of this Review in order to improve policies and practices, fostering a more inclusive and supportive Speak Up culture throughout healthcare.

View the Terms of Reference for this Speak Up Review

Latest published Speak Up review

Our report following our Speak Up review into  NHS ambulance trusts in England has now been published. 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.

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