30 Hospital Trusts Fail to appoint ‘Freedom to Speak Up’ Guardian

More than 30 hospital trusts have yet to appoint a “freedom to speak up” guardian, despite the fact that NHS contractual terms required them to do so by October 2016.

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

“Everyone has a lot to learn; improvement is possible and we are here to support,” Hughes commented.

201 trusts throughout the NHS system have succeeded in appointing a guardian, while thirty-three have not done so.

The role was recommended by Sir Robert Francis QC in his report in 2015 on whistleblowing and culture in the NHS.

Guardians are intended to support and encourage staff to speak up about their concerns, effectively creating a culture in which transparency and whistleblowing is possible.

Francis based the decision to introduce this role on a similar scheme that had previously been launched at the Staffordshire and Stoke-on-Trent Partnership Trust.

Hughes indicated that her early days in the job had been extremely enlightening regarding the state of the NHS.

“My eyes have been opened to the full spectrum of challenges for NHS workers when they want to speak up. While there is good progress, the NHS still has distance to go to create a universally open and honest culture.”

And the national guardian went on to discuss the trusts that have failed to appoint a guardian thus far.

“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.”

Hughes indicated that if delays continued she would be willing to induce national organisations such as NHS Improvement, NHS England and the Care Quality Commission to become involved.

“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 leader of the guardian process also outlined the evidence that supports the idea that such a guardian position is required.

“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.”


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