Speaking Up is about raising concerns to do with anything that you believe may be getting in the way of providing safe and good quality care, or that may be impacting the working life of you or your colleagues. 

Speaking Up should be encouraged in all organisations as it enables the organisation to learn lessons and continually improve the service they provide. Speaking Up might take the form of speaking to your manager or a colleague about something you have noticed or experienced, or it might be a suggestion for a way that something could be improved. Speaking up about any concern you have at work is really important. In fact, it is vital because it will help keep patients and staff safe and help improve services.

You can raise a concern about anything you think is affecting the safety and effectiveness of the service you and your colleagues deliver. Just a few examples of this might include (but are by no means restricted to):

• concerns about unsafe patient care
• unsafe working conditions
• inadequate induction or training for staff
• a bullying culture

If in doubt, raise it. Don’t wait for proof. Raise the matter while it is still a concern. It doesn’t matter if you turn out to be mistaken as long as you are genuinely troubled.

Currently for Primary Care, the guidance states that the Freedom to Speak Up (FTSU) Guardian needs to be independent of the organisation.

For the role of a FTSU Guardian to be successful and trusted, it is important that the FTSU Guardian for an organisation is not part of that organisation. This allows the FTSU Guardian to be independent and impartial.

NHS Trusts FTSU Guardians are often employed within the organisation. The main reason for the difference is the size of the organisation.

The Freedom To Speak Up (FTSU) Guardian Service is for everyone in your organisation: clinicians, administrators, receptionists, managers, students, agency staff, temporary workers and employed cleaning staff for example.

It is not a service for patients and their relatives.

To enable you to embed FTSU within your organisation it’s important to have an open and supportive culture supported by policies and procedures that actively encourage people to discuss any concerns they have. Have information like Freedom To Speak Up (FTSU) posters available in staff areas, have items on meeting agendas , consider having a FTSU champion in your organisation (Howbeck FTSU Guardians can support them), have a named lead for FTSU in your organisation. Acknowledge concerns raised and work towards resolution and communicate this and any learning to all staff.

We strongly advise signing up as a group in order to share our services across a Primary Care Network (PCN), Federation or Integrated Care System. Contact us for details of how to set this up.

Organisations that provide services under the NHS Standard Contract are required to have a nominated Freedom To Speak Up Guardian. NHS Primary Care providers are expected to follow NHS England’s guidance on appointing Freedom To Speak Up Guardians. Currently Primary care FTSU Guardians need to be independent of the organisation.

Your identity and your discussions with the Freedom To Speak Up (FTSU) Guardian will be kept confidential unless and until it is necessary to reveal this information should you choose to progress along a route requiring that your identity be disclosed.

You will always be in control of whether your concern remains confidential or not. Confidentiality is not upheld where allegations of fraud , child or adult safeguarding, or illegal activity are disclosed. This will be discussed between the FTSU Guardian and the person raising the concern.

If your concern is a personal complaint about your own employment situation, rather than a concern about patient or staff safety, or wrongdoing that affects others, then you may wish to raise a grievance using your organisation’s Grievance Policy. If you’re not sure, raise it and the Freedom to Speak Up (FTSU) Guardian will discuss options for next steps with you.

Our service can be “Basic” or “Full”.

The Basic service gives your employees digital access to our team of registered and trained guardian via email, digital case raising and Virtual meetings can be booked via our self booking portal. Basic also gives the company a pre-agreed escalation pathway (when you sign up we collect names and contact details of the key senior leaders to ensure we can bring matters to the attention of the right people when we need to escalate). A basic subscription gives the company quarterly reports and feedback detailing themes and trends, and any identified barriers to speaking up.

The basic package is so easy to mobilise that you can sign up and get started right now!

Our Full packages gives your company a names allocated Guardian, 24/7/365 access via a 0800 number, as well as the access pathways listed above. Our full package includes face to face mobilisation introductory meetings with your Lead Guardian to assess and plan escalation routes for your organisation. The Full package includes monthly in person visits from your Lead Guardian to work with you on policy changes, manager training and barrier breaking. Full package also includes bespoke quarterly blog posts for your organisation and 6 monthly in-person training sessions for your leadership teams to help them be better listeners and respond to the reports.

All packages include full compliance with the NGO national reporting for your organisation and a certificate to confirm you are utilising a registered service, which can be shown to the CQC as part of their Well Led enquiries.