Freedom to speak up

Leaders have a responsibility to set the conditions for a safe and effective speaking up culture. Alongside ensuring staff and managers receive training and understand your organisation’s speak up processes, consider embedding the following into your organisation’s approach to speaking up.

• Compassionate leadership - attend to, understand, empathise with and support staff in daily working life to create a psychologically safe environment that encourages people to speak up.
• Regular communication - remind staff groups across all sites of internal and external routes for raising concerns. Include information on speaking up in induction processes, spotlight it on your staff portals and consider displaying posters and handing out leaflets in staff areas. 
• Identify barriers - understand who barriers affect and develop action plans to address them.
• Respond consistently - listen and respond to concerns promptly, with compassion and a focus on learning where necessary.
• Model openness - be open and honest with staff when mistakes happen to encourage them to do the same.
• Co-design improvements – work with staff and trade union reps to develop and implement improvements and communicate how much you value staff input into these processes. 
• Raise awareness creatively - work with your communications team, line managers and trade union reps to come up with innovative ways to further raise awareness of your commitment to a positive speaking up culture. This could include encouraging wellbeing and speaking up teams to work collaboratively and linking speaking up to your work to embed a just and learning culture.
• Speak up yourself - demonstrate that speaking up is valued and leads to improvement. 
• Measure impact - evaluate improvements you make in response to concerns raised by staff, share learning with your teams to demonstrate that concerns are acted upon and ask for feedback.
• Review local arrangements - work with HR, Freedom to Speak Up guardians, trade union reps and managers to understand how effective your arrangements are and where improvements are needed.

NHS England has published national Freedom to Speak Up guidance to help senior leaders foster a culture that encourages staff to speak up and drives learning and improvement. The accompanying self-reflection and planning tool will support organisations to identify areas that require improvement.

Following the transfer of Freedom to Speak Up responsibilities to NHS England, organisations should ensure their Freedom to Speak Up Guardian is supported and that a named individual is registered to submit quarterly FTSU data by 31 August. Read further information about Freedom to Speak Up guidance for leaders. 

Managers play a vital role in supporting senior leaders to set the right tone for speaking up and handling concerns effectively. Use these tips to support the people your teams and encourage a culture when people feel safe to speak up.

• Encourage every day speaking up – remind staff that raising concerns can happen in team meetings, supervisions and informal conversations and thank them for speaking up.
• Hold open wellbeing conversations – embed compassionate leadership and psychological safety through regular, honest discussions about health and wellbeing.
• Focus on the concern - explore what could be done differently, acknowledge issues where needed and promote a just and learning culture.
• Share alternative routes - ensure staff know who else they can speak to if they do not feel comfortable raising concerns with their manager and share contact details. 
• Signpost to support - direct staff to psychological or wellbeing support during and after a speaking up process.
• Check in after investigations – follow up with colleagues to ensure they have access to ongoing support.
• Raise awareness through your team - invite your health and wellbeing champion or freedom to speak up guardian to team meetings to raise awareness of your organisation’s speak up processes and support available.
• Understand barriers - be aware of the challenges staff may face when speaking up and ways to overcome them.
• Model positive behaviour - speak up about concerns yourself to demonstrate that raising issues is valued and leads to improvement.

• NHS England and the National Guardian's Office’s Freedom to Speak Up guide to support leaders and managers to foster a positive speaking up culture.
• The National Guardian's Office’s guidance on the Requirements for recruiting and embedding Freedom to Speak Up guardians.
• The National Guardian's Office’s resources for Supporting the wellbeing of freedom to speak up guardians.
• The National Guardian's Office and Speak Up Partnership Group’s Principles for responding to speaking up, which aim to ensure national bodies have an aligned, consistent and supportive approach when staff speak up.
• The National Guardian's Office’s Learning and resources hub, including a wide range of case studies. 
• The National Guardian's Office’s podcast series on Soundcloud or Spotify, featuring conversations with healthcare leaders on how they speak up, listen up and follow up. 
• The National Guardian’s Office’s Compassionate leadership enables speaking up blog by Professor Michael West CBE.
• Our case study from Liverpool Women's NHS Foundation Trust’s demonstrating how its NHS Staff Survey staff engagement scores were improved through embracing staff feedback and cultural change. 
• Our blog Conscious retention: creating a more secure workforce from John Walsh, OD lead and freedom to speak up guardian at Leeds Community Healthcare NHS Trust, on how a positive freedom to speak up culture is instrumental in supporting the retention of staff.
• Our Guidance on the use of settlement agreements and confidentiality clauses.
• The British Medical Association’s Responding to concerns: a guide for doctors who manage staff.

• Our nine-step Change in action guide to bringing about cultural change.
• Our Professionalism and cultural transformation (PACT) toolkit to help managers foster professional attitudes and transform culture within NHS organisations. 
• Our Eight elements of positive staff experience webpage. 
• Our OD team’s webinar series to support cultural change and supporting resources. 
• Our Sickness absence toolkit, which aims to support NHS managers and give them confidence to support their staff and manage sickness absence well.
• Our Top tips for creating psychological safety webinar discussing specific actions managers and leaders can take to foster a positive culture in the workplace. 
• Our Supporting the wellbeing needs of our NHS staff guidance support managers and leaders.