Published on: 20 August 2021

Every NHS trust must have a Freedom to Speak Up (FtSU) Guardian to give independent support and advice to staff who want to raise concerns and I am fortunate to hold the position as the Head of the Freedom to Speak up Guardian’s Office across both Blackpool Teaching Hospitals (BTH) and East Lancashire Hospitals NHS Trust (ELHT).

Guardians work with colleagues at all levels, to ensure NHS trusts become more open, honest and transparent places to work. I feel really passionate about this service and whilst it can be challenging, I love my job and can honestly say that over my 23 years carer in the NHS, this is the most rewarding position I have ever held.

People are encouraged to 'speak up' about anything that is worrying/concerning them without fear of any negative consequences for them. Our campaign is “If you see something, say something”, supporting colleagues to raise concerns about anything that is worrying them at work.

And whilst the number of concerns raised has risen each year since I began in the role in 2017, I think this is positive testimony to the value of the service. In addition, we have Freedom to Speak Up Champions in a variety of teams, which add diversity and lived experience to the support we’re able to provide.

I’m really proud of everything the team is able to do and the difference we’re able to make to people’s lives and experiences at work and most importantly the excellent care that this allows us to give our patients.

I would actively assure patients and their families, carers, partners and our stakeholders that the fact we have this confidential and independent service for which our colleagues can speak out is very positive for them too. Colleagues are encouraged to come forward and raise issues which we work together to resolve, improve and learn lessons. This most definitely has a positive impact on all our services.

We know one of the main reasons colleagues do not speak up is that they fear they might suffer detriment. Another is that they don’t believe anything will change as a result. I want to be clear, we feel very passionately about helping to bring about tangible, measurable change and ensuring no one who speaks out receives detrimental treatment because of it. e have the full support of the Trust board to enable us to deliver our service effectively and to embed the culture of “speaking out” throughout both Trust.

It’s important to note that the office is completely independent too. We are guided by the National Guardian’s Office (NGO) which is an overarching body which in turn works closely with the Care Quality Commission (CQC). The CQC is the main regulator of healthcare services in the UK, primarily focused on NHS operations. It’s of paramount importance that colleagues internally and partners, patients and their families external to both Trusts know that we are completely independent in our work.

It can be a difficult role albeit I wanted to be the Freedom to Speak Guardian for a very long time. Throughout my career I have always wanted to make a difference and support colleagues ensuring we can deliver excellent care to our patients. It touches everyone and if we get it right and together we can make the biggest difference possible.

There can be a lot of sadness, frustration, upset, distress and even anger at times from colleagues who come to the team for help and support and sometime they just need to off load and have time out for someone to listen and we are here.

It can be difficult to speak out though, especially if you’re feeling unsure about something. That’s where a lot of people come to see the Guardian’s. We can coach colleagues about how to approach an issue and how to raise it themselves with their manager or someone relevant. We can even accompany and support colleagues who feel that they may just need some extra support to sit down and speak to their managers about a concern they may have and come to a resolution together. You’d be amazed how many times we raise an issue with a manager on a colleague’s behalf and the Manager is encouraging and supportive and wants that person to come and talk to them in more detail to help and support.

Of course there are those that are scared of what might happen if they speak up. I make no apologies for repeating the message that the Guardians, along with the Trust Board, are determined to ensure no one is treated detrimentally because they have spoken up or out and that everyone who does is thanked for doing so.

From concerns that are raised we can examine facts, give feedback and learn lessons and create lasting, real tangible outcomes and improvements that make a difference to the organisation and the care we provide for our patients and the community.

Jane