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CQC appoints first National Guardian for the freedom to speak up within the NHS

6 January 2016
  • Media

The Care Quality Commission (CQC) has appointed Dame Eileen Sills DBE – the Chief Nurse at Guy's and St Thomas' NHS Foundation Trust – as the first National Guardian for speaking up safely within the NHS.

As the National Guardian for the freedom to speak up, Dame Eileen will help to lead a cultural change, initially within NHS trusts and NHS foundation trusts, so that healthcare staff always feel confident and supported to raise concerns about patient care.

Dame Eileen has been Chief Nurse at Guy’s and St Thomas’ NHS Foundation Trust since 2005. She has been a registered nurse for over 30 years (since 1983), during which time she has held a number of general management and senior nursing leadership posts. Dame Eileen was awarded a CBE in 2003 for services to nursing and a DBE in January 2015.

Among her responsibilities as the National Guardian, Dame Eileen will lead, advise and support a network of individuals within NHS trusts, appointed as ‘local freedom to speak up guardians’, who will be responsible for developing a culture of openness at trust level. She will also share good practice, report on national or common themes and identify any barriers that are preventing the NHS from having a truly safe and open culture.

As the National Guardian, Dame Eileen will be completely independent, highly visible, and will speak freely and honestly about where changes are needed among NHS trusts and foundation trusts. While she will work in partnership with CQC, NHS England and NHS Improvement to reinforce good practice, she will also take an independent stand to report on any matters of concern affecting these bodies when required.

Dame Eileen will remain as the Chief Nurse at Guy's and St Thomas'. To prevent any conflict of interests she has stepped down from her role as the trust’s executive lead for Speaking Up Safely, and in her external commitments she has stepped down as senior nurse advisor for the Nursing and Midwifery Council and Chair of the Shelford Nursing Group of Chief Nurses.

Commenting on Dame Eileen’s appointment, David Behan, Chief Executive of the Care Quality Commission, said: "Dame Eileen is a leader of exceptional quality and so I am delighted that she will be the first National Guardian for the NHS.

"We know that healthcare professionals are committed to delivering good care, day in and day out and that many organisations respond to any concerns they may have openly and transparently as a normal part of working. This results in better and safer care for patients.

"As the National Guardian, Dame Eileen will strive to ensure that this is common practice right across the NHS. By working with the local ambassadors within NHS trusts she will contribute to the change in culture that is needed."

Dame Eileen Sills, incoming National Guardian for the NHS, said: "I understand what it is like to provide care on the frontline. I also understand how difficult it is for staff to always to have the confidence and courage to speak out.

"In this role therefore, I will take my current experience, working with individuals and organisations, to learn the lessons from reviews and investigations to date.

"I fully appreciate that this is a very big and challenging role, but with the support of the staff who work in the NHS, I have no doubt that we can make the changes together that are needed to deliver a new culture of transparency and openness."

Health Secretary Jeremy Hunt said: "Since the events at Mid Staffs there have been significant changes to create a more open and honest culture in the NHS.

"Dame Eileen has dedicated her career to improving the quality of care patients receive and I am confident as the National Guardian she will inspire the NHS to go even further in improving how staff can raise concerns without fear of discrimination."

The need for an independent National Guardian for the NHS was highlighted in Sir Robert Francis’s ‘Freedom to Speak Up’ review in February 2015, which found that patients could be put at risk of harm because vital information about mistakes and concerns was not being raised by NHS staff routinely. The review found that reporting systems were either insufficient or not used or because healthcare professionals did not feel able to speak up. The creation of the National Guardian was one of the key recommendations from this; an arrangement which the Secretary of State for Health confirmed last July.

Sir Robert Francis QC, CQC board member and author of the ‘Freedom to Speak Up' review, said: "I am very pleased that such an eminently well qualified healthcare professional has agreed to take up this post. It is so important to patients and their safety, as well as to all staff in the NHS who want to raise their concerns.

"The task of creating the post and supporting the freedom of NHS staff to speak up will be challenging but I am confident Dame Eileen is the right person for this role. I look forward to working with her."

Katherine Murphy, chief executive of the Patients Association, said: "We are delighted at the appointment of Dame Eileen into this important new role. Through our national helpline we not only hear from patients but also increasingly professionals working within services who feel they have nowhere else to turn. We look forward to working closely with Dame Eileen to help make sure staff feel confident to raise concerns about patient care, recognising the huge impact this has on patients receiving good quality care.

Dame Eileen’s immediate priorities in post will be to respond to the recently closed consultation on the role of the National Guardian and establishing the office, due to become operational on 1 April.


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Last updated:
29 May 2017

Notes to editors

  1. For further information about what healthcare professionals working within the NHS should do if they have any concerns about care, please visit: 
  2. CQC recently held a public consultation on how the National Guardian role should work with CQC. For further information about this, please visit: CQC will publish its response to this in February 2016.
  3. On every planned inspection of a NHS trust, CQC investigates how well services handle complaints and concerns as it can be an indicator of the quality of the service's leadership and a reflection of how safe and responsive its culture is. CQC published a national report of some of these findings last year. For further information, please visit: 
  4. For further information about Sir Robert Francis’s Freedom to Speak Up review, please visit:

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.