Trusts can appoint guardians in the absence of any guidance

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16 / 7 / 2015 1.38pm

The Department of Health (DH) has today published its response on a package of measures to implement the recommendations, principles and actions from Sir Robert Francis Freedom to Speak Up report.

One of the key points you may wish to consider is around appointing guardians. This is a service that trusts are being encouraged to implement, which is designed to encourage staff to speak up in a confidential setting.

DH has advised that if trusts feel confident to appoint a guardian in the absence of any guidance, then it should do so, bearing in mind that any appointments made should be in line with the principles set out in the Freedom to Speak Up review.

The guardian should be appointed by the chief executive of the organisation to act in a genuinely independent capacity, raising concerns with the trust's chief executive or the board. DH also recommends the guardian should also be able to raise concerns with the independent national officer (INO) if needed.

We are currently working with a number of organisations to showcase their approach to introducing local guardian roles - read our case study from Barking, Havering and Redbridge University Hospitals NHS Trust which was one of the first trusts to implement a guardian service. Further examples will be added to the case studies section of our website shortly.

Summary of key points and timeline 

The responses to the consultation have provided DH with information that can help to inform the local implementation of the principles and actions. Employers are now expected to take forward the actions applicable to them in an effective, proportionate and affordable manner. 

Download the Learning not blaming report from the GOV.UK website. The report does not provide detail on how each of the recommendations, principles and actions in the Freedom to Speak Up report will be implemented.  Key points are summarised below for ease of reference:

  • Summer 2015 - the Care Quality Commission to consult independent national officer (INO) role implementation, taking into account principle 15 and its associated actions in the Freedom to Speak Up report.
  • By December 2015 - the INO should be appointed by the CQC. Once appointed, DH will ask the INO, to consider what national guidance might be appropriate on implementation in light of the consultation responses, taking into account good practice already adopted by NHS organisations.
  • DH will share the responses to this consultation with the relevant organisations and the INO will help inform the guidance they will develop.
  • NHS organisations to take forward the actions that are for them in an effective, proportionate and affordable manner, in advance of any guidance being produced by the INO and national regulators.
  • DH has concluded that a standardised name would be helpful, the majority of responses received were supportive of the title of ‘Freedom to Speak Up guardian’ – this title has now been confirmed to ensure local and national recognition.
  • Health Education England to produce guidance on the training needs for the Freedom to Speak Up guardian role and curriculum for NHS organisations, working with the CQC and INO.
  • NHS organisations should appoint a guardian in the absence of any guidance, where it is confident to do so. Appointments to be made in line with the principles set out in the Freedom to Speak Up review.
  • The local guardian should be appointed by the chief executive of the organisation to act in a genuinely independent capacity, raising concerns with the trust's chief executive or the board. DH also recommends the guardian should also be able to raise concerns with the INO if they have lost confidence, or think that good practice has not been followed by that organisation in handling concerns raised.
  • By September 2015 - NHS England to produce guidance on how to implement the principles and actions in primary care. The timeline for this will differ in light of the engagement NHS England will need to have with stakeholders. 
  • NHS England, the NHS Trust Development Authority and Monitor to devise a support scheme for NHS staff and former NHS staff, whose performance is sound and who can demonstrate that they are experiencing difficulties finding employment as a result of having made protected disclosures.
  • NHS England to work together with the NHS Trust Authority and Monitor to produce a standard integrated policy and procedure for reporting incidents and raising concerns. This work will continue throughout the summer.
  • DH has confirmed that they will establish an independent patient safety investigation function for the NHS. The new function will be called the Independent Patient Safety Investigation Service, and will be brought under the single leadership of Monitor and the NHS Trust Development Authority.
Background

The Freedom to Speak Up report set out the changes needed to create an open and honest reporting culture in the NHS.

DH accepted all of the recommendations in principle and ran a consultation from 13 March 2015 to 4 June 2015 on a package of measures to implement the recommendations. 106 responses were received to the consultation from individuals, NHS organisations, and the relevant national bodies. 

Further information

Further information on Freedom to Speak Up along with our response on behalf of employers is available in Sir Robert Francis - a review of whistleblowing processes in the NHS. We will continue to update these web pages as more information and guidance becomes available.

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