Safety and speaking up during the COVID-19 emergency

Page last updated: 12 May 2022

As the nation faces up to an unprecedented health crisis, we want to thank health and care staff all over England for their heroic responses to the many challenges facing them and the people they are caring for. We recognise that this is an extremely stressful and difficult time for everyone and that many of you will have concerns about increased risks of unintentional harm to you, your colleagues and to people who use services.

So, now more than ever, safety remains a priority for the whole system. Everyone who has a role in providing care, or who receives care in England, needs to be more vigilant so that we can reduce the risk of avoidable harm to people. You can do this by following safety systems, guidance and recommendations that ensure the right care is provided, as intended, every time and continuing to report safety incidents locally using your professional and clinical judgement. We need to continue to learn from what works as well as what does not.

All leaders of health and care services can support this by encouraging a supportive culture where people are able to speak up about risks and adverse outcomes, without fear of blame or repercussions. A psychologically safe culture provides a compassionate, inclusive, and trusting environment – one that shares safety insights and empowers people who use services and staff with the skills, confidence, and mechanisms to improve safety. This culture means we will hear more, learn more, and act more to improve care.

Importantly, we want to encourage workers to speak up about anything that gets in the way of providing good care so that potential harm is prevented. The freedom to speak up has never been more important.

There are many ways to speak up. Please continue to report anything concerning you through your local risk management system. You can also speak up through a discussion with your line manager, a suggestion for improvement, a matter raised with a Freedom to Speak Up Guardian or bringing a matter to the attention of a regulator. Speaking up is an essential element of a safe culture and should be ‘business as usual’ for everyone working in care, regardless of their role.

But speaking up is only effective if listening happens. That’s why it’s so important that leaders understand that a Speak Up culture is not just about encouraging workers to raise concerns: it is about listening to what they are saying, acting on the information and providing feedback.

CQC provides information and guidance for all health and care staff about how to speak up, and a quick guide on raising concerns on this site.

The National Guardian for the NHS supports workers to speak up through a network of Freedom to Speak Up Guardians and provides information and guidance,as well as a list of organisations that can provide support and the directory of Freedom to Speak Up Guardians.

Finally, we want to thank you for everything you are doing to encourage a safe culture and to make sure that you, your colleagues, and the people you care for are safer as a result.


You can find more details of our response to the coronavirus pandemic for members of the public and providers of health and adult social care services.