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New National Guardian role to lead a more ‘open and honest’ NHS so that patients get better and safer care

17 September 2015
  • Media

Applications are being invited for the NHS’s first National Guardian, who will be responsible leading local ambassadors across the country so that staff feel safe to raise concerns and confident that they will be heard.

The new role will be hosted within the Care Quality Commission (CQC), the regulator of health and adult social care in England, working closely with other bodies including, Monitor, the NHS Trust Development Authority and NHS England.

CQC has launched a public consultation today (Thursday 17 September) on the best way to establish and ensure the independence of this role and how the responsibility will lie within the organisation.

The need for an independent National Guardian for the NHS was highlighted in Sir Robert Francis’s ‘Freedom to Speak Up’ review in February, which found that patients could be put at risk of harm because vital information about mistakes and concerns were 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.

The creation of the National Guardian was one of the key recommendations from this review. The Secretary of State for Health confirmed in July that CQC should host the role.

David Behan, Chief Executive of the Care Quality Commission, said: “Staff in the NHS are committed to delivering good care day in, day out. Sometimes things will go wrong and staff will raise concerns about the quality and safety of patient care. Good organisations respond to these concerns openly and transparently as a normal part of working. This results in better and safer care.

“The National Guardian, with the support of local Freedom to Speak Up Guardians, will contribute to the changing culture that is needed to ensure that this good practice exists everywhere and that staff are encouraged to speak up and are supported to do it.”

Among their responsibilities, the National Guardian will lead, advise, and support named individuals within NHS trusts called ‘local guardians’ in carrying out investigations on how concerns are being handled, 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.

The National Guardian will be completely independent of NHS trusts, be highly visible, and will speak freely and honestly about where changes are needed – both across the NHS and about how CQC, and other national bodies, respond to information of concern from those working in the sector.

Sir Robert Francis QC, CQC board member and author of the ‘Freedom to Speak Up' review, said: “NHS staff want to do the best for their patients and when things go wrong they should be able to raise their concerns without fear of reprisals.

“The creation of Freedom to Speak Up Guardians and an Independent National Officer in the CQC will help to drive a culture of openness and transparency where it is safe to speak up and concerns are learnt from.”

CQC intends to recruit the National Guardian as quickly as possible so that the appointed individual can play a full role in the design of the Office and in responding to this consultation, which will close on 9 December 2015.

Jeremy Hunt, Secretary of State for Health, said: “I want to make our NHS the safest, most transparent healthcare system in the world and anyone who has concerns about patient safety has the Government’s full support to speak up.

“Since Mid Staffs, there have been significant changes to create a more open, honest culture in the NHS but we are determined to go further and the National Guardian will support NHS staff to be heard without fear of discrimination.”


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Last updated:
29 May 2017

Notes to editors