New National Guardian appointed to lead the NHS in speaking up freely and safely

Published: 7 July 2016 Page last updated: 12 May 2022
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The Medical Director for NHS England's North Central and East London region and practising GP, Dr Henrietta Hughes, has been appointed as the new National Guardian for speaking up freely and safely within the NHS.

Dr Hughes is a practising GP with over twenty years of experience across primary, secondary and community healthcare. She has been Medical Director for NHS England's North Central and East London region since April 2013, in which she provides system leadership across 12 clinical commissioning groups and 12 NHS trusts, and she is the Responsible Officer for nearly 3,000 GPs.

Dr Hughes's selection for appointment was made by a panel consisting of representatives of CQC, NHS England and NHS Improvement, as co-sponsors for the National Guardian's Office, as well as the Patients Association and Sir Robert Francis QC, whose independent review from February 2015 into 'whistleblowing' across the NHS instigated the creation of the National Guardian role.

As co-sponsors for the National Guardian's Office, Dr Hughes's appointment has been made by a panel represented by the Care Quality Commission (CQC), NHS England and NHS Improvement, as well as the Patients Association and Sir Robert Francis QC, whose independent review from February 2015 into 'whistleblowing' across the NHS instigated the creation of the National Guardian role.

As the National Guardian, Dr Hughes will help to lead a cultural change within NHS trusts and NHS foundation trusts, so that healthcare staff feel confident and supported to raise concerns about patient care at all times.

This will include leading, advising and supporting the growing network of 'Freedom to Speak Up' Guardians within NHS trusts who are responsible for developing a culture of openness within their hospitals. Also, as the National Guardian, she will share and advise on good practice in responding to staff concerns, and provide challenge and support for the system so that it has a truly safe and open culture.

Dr Hughes is expected to take up the role in October 2016. She will be supported by a small office of staff, which is already in operation with an interim team.

Commenting on the appointment, David Behan, Chief Executive of the Care Quality Commission, said:

"I am very pleased that Henrietta has accepted the position of National Guardian.

"The need for the NHS to have a positive reporting culture, which encourages and supports its staff to raise concerns about care without fear of reprimand has been stressed time and time again and now must become common practice.

"Leading the healthcare system on this journey alongside the Freedom to Speak Up Guardians within NHS trusts will be a core aim of the National Guardian and her office, so that ultimately, patients can get the safe, high-quality and compassionate care they deserve.

"The role requires strong leadership, trust and a clear understanding of the NHS and the challenges its staff face in raising concerns. I am confident Henrietta will bring all of these qualities in abundance as the National Guardian and I look forward to working with her in this capacity."

Dr Henrietta Hughes, incoming National Guardian for the NHS said:

"I am very excited to be appointed as the National Guardian and recognise that supporting and protecting staff across the NHS who wish to speak up is a huge and tremendously important responsibility.

"It requires a great deal of courage, honesty, and selflessness to 'blow the whistle'. People should never feel that they are at risk of punishment when advocating better and safer care for patients.

"As a practising GP and with my experience in the NHS, both on the frontline and at leadership levels, I understand the challenges that lie ahead.

"Together with my office, the growing network of Freedom to Speak Up Guardians in NHS trusts, our national partners, and anyone else who has an interest in supporting and protecting staff who wish to speak up, I look forward to driving forward this agenda of openness.

"I want staff to always feel listened to regardless of where they work within the NHS, so that we can see real improvements in patient safety and staff experience. This is a real opportunity to work towards making that a reality."

Health Secretary, Jeremy Hunt said:

"The appointment of Dr Henrietta Hughes as National Guardian is an important step in our ambition to create a more open and honest culture in the NHS.

"Dr Hughes will support staff so they can raise concerns without fear of discrimination and ensure the NHS is one of the safest healthcare systems in the world."

Sir Robert Francis, CQC board member and author of the 'Freedom to Speak Up' review, said:

"No service can be effective without listening to and acting on the concerns raised by its staff, let alone one which employs such skilled and dedicated people as the NHS. They are the lifeblood of the service, and the lifeline for their patients. 

"However, the evidence clearly shows that many staff are fearful of speaking up. It is important that every part of the NHS develops a culture in which it is entirely normal to raise issues about safety, quality and effectiveness of the service, for those issues to be addressed and for those who raise them to be protected from any adverse consequences arising out of their disclosures.

"I believe that the National Guardian, her office and the network of Freedom to Speak Up Guardians all have an invaluable role to play in supporting these changes.

"I would like to congratulate Henrietta for her appointment as National Guardian. She displays a genuine commitment to want to make a real difference to the lives of NHS staff and their patients. With her leadership, I am confident that she and her office can make great strides in achieving that."

Ruth May, Executive Director of Nursing at NHS Improvement, said:

"I would like to welcome Dr Henrietta Hughes as the new National Guardian. Her extensive clinical experience and expertise means she has the know-how to encourage the growth of the Freedom to Speak up Guardian's network. Alongside the guardians, I am sure she will provide the leadership to ensure that a culture of openness within NHS trusts flourishes.

"Whistleblowers can play a crucial role in making sure that the NHS delivers the highest standard of care to patients day in, day out. If we all continue to do our part to safeguard the freedom to speak out, NHS staff will feel more confident to share vital information that can prevent the risks of harm to patients.

"I look forward to working closely with Dr Hughes, and our partners, to help NHS staff feel free and safe to speak out."

Jane Cummings, Chief Nursing Officer of NHS England, said:

"I welcome the appointment of Dr Henrietta Hughes as the new National Guardian and look forward to working with her. The experience she brings to this role will be key in delivering an open and transparent health service. Providing all staff with the confidence and means to speak up is an essential part of providing high quality care to all."

Katherine Murphy, Chief Executive of the Patients Association, said:

"The Patients Association endorses Henrietta's vision for NHS where staff feel valued and supported and where patients are treated safely and with dignity. 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 welcome Henrietta’s appointment to this important national role and look forward to working closely with her to help deliver her vision."

ENDS

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I want staff to always feel listened to regardless of where they work within the NHS, so that we can see real improvements in patient safety and staff experience. This is a real opportunity to work towards making that a reality.

Dr Henrietta Hughes, National Guardian

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.