• Many freedom to speak up guardians “not given ringfenced time”
  • Guardians at every trust dealing with bullying and patient safety issues
  • Incidents reported to guardians increase by 73 per cent

Many “guardians” tasked with ensuring staff are supported when they speak out about safety concerns are not being given time to fulfil their roles by their trusts, a national head has said.

Russell Parkinson, head of the National Guardian’s Office, which oversees their work, said many freedom to speak up guardians “still do not have any ringfenced time”. He has told the Care Quality Commission his organisation does “not believe that this is acceptable”.

More than 19,000 cases of speaking up by NHS workers in trusts have been handled by the guardians, appointed in the wake of the Francis Inquiry, in the last two years.

Of the 12,000 cases raised between 1 April 2018 and 31 March 2019, guardians reported almost a third included an element of patient safety or quality of care, and just over 40 per cent included an element of bullying or harassment.

The national guardian, Henrietta Hughes, has said there is a “wide variation” with the number of cases being reported by trusts. The highest number of cases in a single trust is 270, while the lowest number is just one case.

She told HSJ: “We welcome the organisations that have thought about how to meet the needs of their workers and have identified how much ringfenced time they need to do that.

“This is something that starts with the board and chief executives. They are the ones that should be looking at staff survey results and ‘speaking up’ [which is] happening in [their] trusts. If trusts are looking to give a good account of themselves in [CQC] well-led inspections they should focus on culture, and speaking up is part of that culture.”

In trusts and foundation trusts, the number of cases dealt with by FTSUGs increased by 73 per cent from 7,087 in 2017-18 to 12,244 in 2019-20.

In December 2018, it was estimated more than 40 per cent of guardians do not have any ringfenced time to fulfil their roles.

The report also revealed 5 per cent of the cases dealt with by the National Guardian’s Office from English NHS trusts in 2018-19 involved staff who indicated they suffered as a result of speaking up (564 cases in total) — which it described as a “disappointingly static”.

There are now more than 500 trained guardians in the NGO’s network, with FTSUGs being appointed in all NHS trusts, primary care providers including GP practices, independent healthcare providers including hospices and diagnostic services, national organisations and regulators and non-health sector bodies including education and financial services.