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Making speaking up business as usual

Posted by Robert Francis 8 months ago Posted in Blogs

Speak Up Month is coming to a close, and I believe that there has been even more activity this year than last. Freedom to Speak Up Guardians have been finding innovative ways to raise awareness and encourage workers to speak up to them. There have been events held, trees planted, cakes baked, pledges made, flags, ribbons and even a SpeakUpulance – yes, that is a Speak Up ambulance!

In the 2015 Freedom to Speak Up Review I recommended that every NHS employer should have a Freedom to Speak Up Guardian – a named person who is trusted by staff and by their leaders to listen, to advise and to facilitate getting the information to the right place to ensure that appropriate action is taken.

My recommendations were borne out of hearing evidence from NHS workers who had spoken up previously about patient safety and other concerns, but had suffered bullying or intimidation, or witnessed inaction when action was desperately needed. When this happened, they had nowhere to go for help and no-one to make sure their information was taken seriously.

The activities during Speak Up Month seek to raise awareness, not just of the Freedom to Speak Up Guardians, but of speaking up in general. Freedom to Speak Up Guardians send a message that workers can feel encouraged and safe to speak up – that it is the normal thing to do.

So, although you may be wondering what all the cakes and twitter hashtags have to do with speaking up, this month has been about making guardians and their work even more visible, so that no one can say they don’t know who to speak up to. The support from organisations to promote the guardian role that they fund and support also sends the message that they are listening organisations that want to act on what their workers have to speak up about.

Guardians bring matters to the attention of leaders so that something will be done. It is one thing to encourage workers to speak up, but that effort is meaningless unless they are heard, and action is taken on what they have said. That’s why it’s so important that concerns are investigated properly, with the right support on hand for staff, managers and others involved.

This month the National Guardian’s Office also published its Freedom to Speak Up Index which shows that organisations which support speaking up get better CQC ratings. This should encourage trust boards to focus on the benefits of encouraging an open culture and to appreciate the importance of the Freedom to Speak Up.

If workers feel listened to when they speak up and confident that their leaders will support them and embrace their issues as opportunities to learn and improve, then that will encourage them to speak up again.

Those who speak up are to be celebrated, they are an invaluable part of any organisation. Valued and engaged staff provide excellent care to their patients. If patient safety is our number one priority, we simply cannot afford to shoot the messenger. We need to focus on the issue, not the person raising it.

That’s why I want to take this opportunity to thank all those who have spoken up for all that you do to make the NHS an even better place for our workforce and for our patients. Speak Up Month may be coming to an end, but let’s make it Speak Up Month every month. Together we can make speaking up business as usual.

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This post was edited on Oct 31, 2019 by Robert Francis

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Comments (1)

Minh Alexander says... 8 months ago

This is a tour de force of non-science. It is time to mention the age old aphorism "Correlation is not causation". There is no evidence as far as I am aware which proves that trusts get better ratings if they have good Speaking Up practice, as Sir Robert implies.

It is more likely to be the reverse - that better run trusts will naturally have better whistleblowing governance. Which begs the question of why do we need Speak Up Guardians in good trusts? 

There is also no evidence of which I am aware that bad trusts are improved by Freedom To Speak Up arrangements.

On close examination, Sir Robert's model of Freedom To Speak Up Guardians was not evidence based:

https://minhalexander.com/2017/05/28/ssotp-robert-francis-exemplar-trust-has-feet-of-clay-and-jeremy-hunts-safety-claims-are-un-evidenced/

Even his own organisation the Care Quality Commission admitted this in writing.

An accumulating stack of evidence of serious failures of the Freedom To Speak Up project grows ever larger:

https://minhalexander.com/2019/09/19/the-dhsc-robert-francis-national-guardian-cabaret-inconsistencies-obfuscation-about-whistleblowers-concerns/

Sir Robert admitted that UK whistleblowing law is weak and does not protect whistleblowers but he did not recommend substantive review when he had the chance.

https://minhalexander.com/2017/11/17/sir-robert-francis-and-reform-of-whistleblowing-law/

My guess is that it's likely that in years to come, people will have a vague memory of cakes and hashtags, and not much more of this initiative.

Whistleblowers would like genuine reforms:

https://minhalexander.com/2018/07/18/replacing-the-public-interest-disclosure-act-pida/

Dr Minh Alexander

NHS whistleblower and former consultant psychiatrist

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