• 33 trusts yet to appoint a freedom to speak up guardian
  • National guardian Henrietta Hughes says she will alert national bodies if progress is not made
  • She says: “NHS still has distance to go to create a universally open and honest culture”

More than 30 hospital trusts are yet to appoint a “freedom to speak up” guardian despite being required to do so under the NHS contract by October 2016.

Henrietta Hughes, the national guardian, revealed the numbers in an update today to mark her first 100 days in the job.



Henrietta Hughes: ‘Everyone has a lot to learn; improvement is possible and we are here to support’

She revealed 201 trusts had appointed a guardian, while 33 have not.

The role was recommended by Sir Robert Francis QC in his report in 2015 on whistleblowing and culture in the NHS. The trust guardians are designed to support and encourage staff to speak up about concerns. It is based on a role launched at the Staffordshire and Stoke-on-Trent Partnership Trust.

Dr Hughes said her “eyes have been opened to the full spectrum of challenges for NHS workers when they want to speak up”.

She added: “While there is good progress, the NHS still has distance to go to create a universally open and honest culture.”

Revealing the number of trusts that have yet to appoint a guardian, she said: “The national contract specifies that NHS trusts and foundation trusts are required to have nominated a freedom to speak up guardian by 1 October 2016. To date we know that 201 trusts have achieved this, which represents 86 per cent of trusts.

“We are aware of 12 trusts that are in the process of appointing. For the remaining 21 trusts, we are concerned that they may not have a freedom to speak up guardian in post and we are working closely to offer them support to appoint to this position as quickly as possible. Establishing 100 per cent coverage is a key focus for the next 30 days.”

Dr Hughes said where concerns continue “without satisfactory progress or it appears that trusts are not managing the freedom to speak up process” then she would alert national organisations such as NHS Improvement, NHS England and the Care Quality Commission.

She said: “I am working together with NHS trusts and foundation trusts, professional bodies and systems regulators to start the process that when staff speak up their concerns are heard and acted upon in a timely way, staff are not penalised as a result and receive feedback on actions that have been taken.

“The most recent national NHS staff survey highlighted that only 68 per cent of staff felt secure in raising any concerns they may have regarding clinical practice. Only 56 per cent of staff had confidence that their organisation would address their concerns if they were raised.

“There is very good work happening, however this is not universal across England. Everyone has a lot to learn; improvement is possible and we are here to support.”