Dr Henrietta Hughes on why it’s essential to give people the time and space to speak up and also to be listened to
There are too many examples of patients, families and staff trying to speak up about issues, being suppressed and patients being harmed as a result. Over the last two years, I have seen really positive changes across England.
It feels there is a growing social movement as people speak up and expect to be heard. This mirrors the international movements #metoo and #timesup. What might have been norms of behaviour in the past are no longer acceptable and all organisations need to move with the times.
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Freedom to Speak Up is a catalyst for positive change, with Freedom to Speak Guardians appointed in every trust. Over 12,000 cases have been brought to guardians, leading to significant changes and positive feedback.
I’ve seen comments from workers suggesting this is the first time they have been truly listened to. Is this as a sad indictment of their working lives or, maybe, an acknowledgement of the enormous pressure that everyone working in health is under?
People need the time and space to speak up – I have heard junior doctors say, ‘I’ll hold your bleep’. Managers need the time to listen and act. Freedom to Speak Up Guardians need the time to do justice to their challenging role.
It’s worrying for me that over 40 per cent of guardians don’t have any ring fenced time. I can’t imagine how, without any protected time, they can provide that vital listening ear, but also work proactively to support improvements to the culture.
Our survey shows that without protected time guardians are less likely to meet their board or chief executive, to attend training or seek feedback. It’s time that they are given the right support and time to provide this service to their colleagues.
It’s worrying for me that over 40 per cent of guardians don’t have any ring fenced time. I can’t imagine how, without any protected time, they can provide that vital listening ear, but also work proactively to support improvements to the culture
On a more positive note, other leaders, reflecting on how the guardian role is supporting their staff, are increasing the dedicated time available.
Leadership is key to developing a supportive culture. We saw this in our HSJ Award Winner, East Lancashire Hospitals Trust, who wanted to make the staff proud after being named a Keogh trust.
Their story is an inspiration and it shows that this takes time to embed. Care Quality Commission also sees leadership as fundamental.
The chief inspector of hospitals, Professor Ted Baker told me, “We will keep it [Freedom to Speak Up] central to our Well Led Inspection”. If your trust doesn’t offer your guardian protected time, I invite you to think again and if you would like to learn more, please get in touch with me.
Speaking up also needs to be supported in primary care. As a practising GP myself, I am delighted to be developing the Freedom to Speak Up Guardian role with vanguard primary care organisations.
We’ll be drawing on the fantastic work that is already happening in trusts and adapt this to the diversity of primary care providers.
There’s a great deal to celebrate, but still much more to do. Thank you for the support you give your workers to make speaking up business as usual.