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National guidelines on Freedom to Speak Up training

Our national guidelines on the content of speaking up training for all organisations in the health sector in England have been created following a recommendation made in one of our recent case reviews. We observed that training on Freedom to Speak Up had not kept pace with developments in the field and did not fully reflect the NHS’s approach to speaking up.

Consequently, we undertook to develop national guidelines that are designed to improve the quality, clarity and consistency of speaking up training across the health sector in England to support those commissioning and delivering training. We consider that speaking up training has an essential part to play in patient safety and the experience of workers and as such, should be considered on a par with other mandatory training.

The guidelines are set out in three parts covering three broad groups of workers: core training for all workers; line and middle managers training; and senior leaders training. They include details of the methodology that organisations could employ when designing training. 

Many organisations will already have training on speaking up in place. We would encourage those organisations to bring their training in line with our guidelines at the earliest opportunity.  We will be working with HEE over the coming months to explore the production of a widely accessible training package at a national level that organisations could utilise should they prefer to use something centrally designed. 

Read the guidelines below:

100 Voices campaign

The 100 Voices campaign will acknowledge and celebrate the difference that speaking up is having in the NHS. Our ambition is to create a database of at least 100 case studies that describe where speaking up has led to improvements for the good of workers, patients, families and carers. These case studies are all opportunities to learn, change, and improve.

You can submit a case study if you have spoken up, supported a worker who has spoken up, or responded to a situation where someone has spoken up – this is not just limited to Freedom to Speak Up Guardians. You can also submit more than one case study. No story is too big or too small – they’re all important.

Some of these will be published alongside the National Guardian’s 2019 Annual Report to communicate the impact of Freedom to Speak Up in the NHS.

Please submit your case study to the National Guardian’s Office using this online form.

Campaign links:

New guidance on settlement agreements referenced in NHS standard contract

Settlement agreements can create a barrier to speaking up. They can leave workers unclear about what they can speak up about, or even if they can speak up at all. 
Sometimes they include ‘non-disclosure agreements’ which can result in workers fearing that they can’t access the support they need during what is, often, a very stressful time. The National Guardian’s Office has therefore been working with partners to make some important changes. 
The work began with a summit of major law firms convened by NHS Employers. The NGO contributed to this summit and has been working alongside NHS Employers, NHS Improvement and the Department of Health and Social Care to produce clearer guidance on the use and content of settlement agreements.
NHS Employers produced an easy-to-read factsheet that makes it absolutely clear that workers can speak up, and seek support. Dr Henrietta Hughes, the National Guardian for the NHS, also contributed to Radio Four’s Today programme to discuss the issue.
Collaborating with major law firms who work with the health service, NHS Employers have now published this updated guidance and the accompanying factsheet. The NHS Standard Contract has also been revised so that it refers to this guidance.

Official documents about the National Guardian's Office

Last updated:
11 October 2019