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Freedom To Speak Up

What is ‘Speaking Up’?

Speaking up is about anything that gets in the way of providing good care.

When things go wrong, we need to make sure that lessons are learned, and things are improved. If we think something might go wrong, it’s important that we all feel able to speak up so that potential harm is prevented. Even when things are good, but could be even better, we should feel able to say something and should expect that our suggestion is listened to and used as an opportunity for improvement. Speaking up is about all of these things.

Is speaking up the same as ‘whistleblowing’?

You can speak up about anything that gets in the way of delivering safe and high-quality care or affects your experience in the workplace. It is something that should happen as ‘business as usual’. Speaking up may take many forms including a quick discussion with a line manager, a suggestion for improvement, raising an issue with a Freedom to Speak Up Guardian, or bringing a matter to the attention of a regulator. Some people may interpret all or some of these actions as ‘whistleblowing’, others may only associate ‘whistleblowing’ with something that is ‘formal’, or a matter that is escalated outside an organisation, or to describe something that may qualify for ‘protection’ under the Public Interest Disclosure Act. Speaking up is about all of these things.

Who can speak up?

Speaking Up policies and processes are here to support workers. This includes any healthcare professionals, non-clinical staff, senior, middle and junior managers, volunteers, students, bank and agency staff, and former employees. There are other routes for patients and their families to raise matters of concern or to make suggestions for improvement, including Patient Advice and Liaison Services (PALS) and the Complaints Service

If I want to speak up about something, what should I do?

Usually your line manager will be your first point of call, but if you don’t feel you can speak up to them or use other formal routes, then you should refer to your Freedom to Speak Up Guardian, who will be able to offer guidance and support.

Why were Freedom to Speak Up Guardians created?

The role of the Freedom to Speak Up Guardian was created in response to recommendations made in Sir Robert Francis’ report “The Freedom to Speak Up” (2015). These recommendations were made as Sir Robert found that NHS culture did not always encourage or support workers to speak up, and that patients and workers suffered as a result. Further information on the Francis Report can be found here.

What is a Freedom to Speak Up Guardian?

Freedom to Speak Up Guardians support workers to speak up when they feel that they are unable to do so by other routes. Guardians also work proactively to support their organisation to tackle barriers to speaking up.

​Contact your FTSUG via email at or by phone on 07557 287749 or see the national directory for FTSUGs across England, by clicking here​.