Freedom to speak up - guidance for managers

Read our range of guidance and resources for managers who are supporting staff to speak up.

30 September 2022

This section provides information and guidance that will support managers in the NHS to positively respond to any concerns raised.


The National Guardian’s Office, in association with Health Education England, has launched a Freedom to Speak Up e-learning package: Speak Up, Listen Up, Follow Up for anyone who works in healthcare. Divided into three modules, it helps learners understand the vital role they can play in a healthy speaking up culture which protects patient safety and enhances worker experience. 

The third and final session in the programme, Follow Up, is aimed at all senior leaders including executive board members (and equivalents), non-executive directors, and governors to help them understand their role in setting the tone for a good speaking up culture and how speaking up can promote organisational learning and improvement.

Follow Up comprises the following topics:

  • What is a healthy speaking up culture?
  • Benefits and drivers – including improved safety and organisational performance, reducing harm and costs, and worker retention.
  • Measuring the effectiveness of a speaking up culture.
  • The role of leaders in setting the tone.
  • Supporting your Freedom to Speak Up Guardian.

For more information and to access the programme, please visit the Freedom to Speak Up programme page.


Whistleblowing: list of prescribed people and bodies as outlined under section 43F of the Public Interest Disclosure Act (PIDA) 1998. This list outlines who staff can make a disclosure to if issues remain unresolved after raising them using internal processes, or where individuals do not feel able to raise the issue with their employer. It is important that all workers are clear on the routes available to them to raise concerns both internally and externally to ensure they are covered by PIDA. Employers are advised to include reference to this list within local policies and guidance.

The National Guardian's Office has a range of learning and resources over on its website including e-learning, case studies and information sessions: Freedom to Speak Up learning and resources

NHS England has published new Freedom to Speak Up guidance to help senior leaders in NHS organisations develop a culture where leaders and managers encourage workers to speak up and where matters raised drive learning and improvement. To accompany this, a self-reflection and planning tool has been developed, which will assist in highlighting areas that need improvement and where employers are succeeding.

Additional useful references

Guidance for clinical managers

Responding to concerns: a guide for doctors who manage staff: this British Medical Association (BMA) guidance aims to help managers of other healthcare professionals better manage concerns raised to them.