Freedom to Speak Up Guardian hub

Zoe Brown Podcast

15 / 9 / 2016 Midnight

The appointment of a National Guardian for the NHS and local Freedom to Speak Up (FTSU) Guardians was recommended by Sir Robert Francis, following his review and subsequent report into the failings at Mid-Staffordshire. In July 2015, the Secretary of State confirmed the steps needed to be taken to develop a culture of safety, including the appointment of a national guardian and a local guardian in every trust.

As part of our work programme on raising concerns and supporting organisations improve culture, we've been working with HR and senior managers to capture the excellent work being done across the country, including the appointment of local guardians. 

What is an FTSU guardian?

FTSU guardians should be in place across all NHS trusts by 1 October 2016. They have a key role in helping to raise the profile of raising concerns in their organisation and providing confidential advice and support to staff in relation to concerns they have about patient safety and/or the way their concern has been handled. They don't have a remit to assist staff who are employed outside of their trust. Read the document published by the National Guardian's Office, which outlines the purpose and key principles of the role. 

Guardians don't get involved in investigations or complaints, but help to facilitate the process where needed, ensuring organisational policies in relation to raising concerns are followed correctly. 

You can find out how the guardian role is working in practice in some shared learning we have developed with trusts in our resources, campaign materials and shared learning section and hear from Christopher Hall, Freedom to Speak Up Guardian in his monthly blog

Where have guardians been appointed?

Our guardian map shows at-a-glance which organisations have a guardian, their contact details and any associated shared learning. If your organisation has a guardian and he or she isn't yet on the map, please email

Please note that individuals with a public interest concern should only approach the guardian appointed within their organisation.

Who do guardians report to?

Guardians typically report to the trust chief executive.

What is the remit of the national guardian?

The set-up of the national guardian's office is well underway and the new national guardian, practicing GP and medical director Dr Henrietta Hughes will provide overarching leadership and support to local guardians and staff who have raised a concern that has then not been effectively dealt with by the employer. In her new role, starting on 1 October 2016, Dr Hughes will also lead on cultural change, ensuring healthcare staff always feel confident and supported to raise public interest concerns. You can find out more on the National Guardian's Office website. 

The priorities of the national guardian's office over the next few months includes:

  • establish and support a strong network of local FTSU guardians
  • highlight NHS providers that are successful in creating the right environment for staff to speak up safely and share this best practice across the NHS
  • independently review cases where NHS providers may have failed to follow good practice, working with statutory bodies to take action where needed.

The national guardian's office has published its response to its national guardian for the NHS consultation. You can read our employer informed response to the consultation here.

We will provide more information on the national guardian role and the functions of the office as details emerge. FAQ's are available on the national guardian's office website

How can I support my local guardian?

We have developed a checklist for employers to use with their guardians, to help them think about their local activity and increase their visibility to staff. Download this resource from our case studies and resources section. 

e-Learning for Healthcare has produced an e-learning module to help equip staff with the necessary knowledge and confidence to raise concerns. You can download the resource from the e-Learning for Healthcare website. 

You can also let them know about the Health Education England (HEE) raising concerns video resources that help to raise awareness of raising and responding to concerns along with building confidence among staff to do so. These are available from the HEE website

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