Speaking up is about anything that gets in the way of providing good care to both patients and the lives of our staff.
When things go wrong, we need to make sure lessons are learnt and things are improved. If we think something might go wrong, it’s important that we all feel able to speak up so potential harm is prevented.
Even when things are good, if they could be even better we should feel able to say something and should expect that our suggestion is listened to and used as an opportunity for improvement. Freedom to Speak up is about encouraging a positive culture where people feel they can speak up and their voices will be heard, and their suggestions acted upon.
The ICB has developed a Freedom to Speak Up Policy to help explain how the process works.
Below are links to a number of short videos about why Freedom to Speak up is important to the organisation. Freedom to Speak Up – elearning for healthcare (e-lfh.org.uk) Learning & Resources – National Guardian’s Office
The Freedom to Speak up Guardian for the ICB is Martin Fahy m.fahy@nhs.net and The Freedom to Speak up Lead is Vanessa Wort vanessa.wort@nhs.net.
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Speaking Up!
When you raise an issue with a Freedom To Speak Up (FTSU) Guardian or Champion, you might not be sure how best to pursue it, or even whether you’ve come to the right place, so we’ll take some time to clarify your issue with you and then help you decide.
Speaking up can include any of the following:
• Raising a concern
• Making a disclosure
• Offering a suggestion or improvement
• Making a complaint
• Making a qualifying disclosure
• WhistleblowingWhere possible, our Freedom to Speak Up & Raising Concerns Policy aims to address concerns at the earliest possible stage. When a concern is raised our Freedom to Speak up Guardian/Champions will be able to support you if you are unsure of the next steps. Of course, you may feel comfortable in raising issues directly and that is completely acceptable fine. Where appropriate, the Freedom to Speak up Guardians may look at progressing your concerns raised, where these can be addressed under the framework of the policy.
The Freedom to Speak up Champions will work with the Freedom to Speak up Guardians to resolve any issues that are raised.
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Freedom to Speak Up Structure
The Freedom to Speak up Guardian for the ICB is Martin Fahy m.fahy@nhs.net and The Freedom to Speak up Lead is Vanessa Wort Vanessa.wort@nhs.net
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Is “speaking up” the same as “whistleblowing”
‘Whistleblowing’ is defined as the disclosure by an employee of confidential information which relates to some danger, fraud or other illegal or unethical conduct connected with the workplace, be it of the employer or of his / her fellow employees.
With speaking up, staff can speak up about things that concern them and which may get in the way of high-quality effective care, or that affects their working wellbeing.
Speaking up can take many forms, from a quick discussion with a line manager or an improvement idea through staff suggestion scheme, to raising an issue with a Freedom to Speak Up Guardian or bringing a matter to the attention of a regulator.
Some people may interpret all, or some, of these actions as ‘whistleblowing’, while others may only associate ‘whistleblowing’ with something that is more ‘formal’ Speaking up is about raising your concerns within the organisation under the Freedom to Speak Up and this can include things that some staff may consider ‘whistleblowing’.
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Who can speak up?
Speaking up policies and processes are there to support all of our staff. This includes any healthcare professionals, non-clinical staff, senior, middle and junior managers, volunteers, students, bank and agency staff, and former employees.
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The work of Freedom to Speak Up Champions
Freedom to Speak Up Champions support workers to speak up when they feel that they are unable to do so by other routes. They also work proactively to support their organisation to tackle barriers to speaking up. Their role is independent and impartial.
The National Guardian’s Office also expects health and care leadership organisations and regulators to appoint Freedom to Speak Up Guardians. Meet our Freedom to Speak Up Champions.
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Freedom to Speak Up Guardian
Freedom to Speak Up Guardians support workers to speak up when they feel that they are unable to do so by other routes. They ensure that people who speak up are thanked, that the issues they raise are responded to, and make sure that the person speaking up receives feedback on the actions taken.
The Freedom to Speak up Guardian for the ICB is Martin Fahy m.fahy@nhs.net and The Freedom to Speak up Lead is Vanessa Wort vanessa.wort@nhs.net
More information about the role of a Freedom to Speak Up Guardian can be found here: nationalguardian.org.uk/for-guardians
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Are all concerns dealt with under the Policy?
When a concern is raised it is important that the correct approach is identified so that any issues are dealt with under the correct policy. Therefore not all concerns will be deal with under the ICBs Freedom to Speak & Raising Concerns Policy. The Freedom to Speak up Guardian will identify whether the concern should be dealt with under this policy or whether another route is more appropriate under the framework of other ICB policies.
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Questions and answers for line managers
If an employee raises a concern under the ICBs Freedom to Speak up Policy what are my responsibilities?
Most concerns should be able to be resolved in the same way as any day-to-day queries that you may receive from employees. If a concern cannot be resolved in this way, the employee should document their concern on the FTSU 1 (informal concern form) and send it to you. This will enable you to investigate their concern in more detail and provide an appropriate response in writing as appropriate (e.g. by e-mail).
As part of your response, you should ask the employee to confirm whether or not their informal concern has been dealt with and provide details of the formal procedure and a link to the FTSU 2 (formal concern form). Please see our template letter that you may wish to adapt for this purpose.
Please ensure that where informal concerns are raised and resolved by you, that you always e-mail the matter and resolution to licb.ftsu@nhs.net for logging (as per letter template)
If an employee indicates that they wish to raise a formal concern what do I do then?
If you have responded to an employee and they have indicated that they wish their concern to be escalated, you should make them aware of the next steps as set out in the policy. Please use the letter template to respond to the employee copying in licb.ftsu@nhs.net
What is the process for resolving concerns?
This very much depends on the nature of the particular issue. For some issues under the informal procedure, a conversation may be all that is required. However, if an informal concern is raised in writing, it may be that there is a need to investigate the matter. In this case it may be necessary to speak to an appropriate subject matter expert or the FTSU Lead Officer (Vanessa Wort – vanessa.wort@nhs.net) or the Freedom to Speak up Guardian (Martin Fahy – m.fahy@nhs.net) for specific advice depending on the nature of the issue.
What are my responsibilities under the formal Freedom to Speak up Process?
If the concern is escalated to the Formal Process then you do not have to investigate the matter as the FTSU Guardian or Lead will arrange for the matter to be dealt separately. However, as part of that process you may be required to participate in any investigation so please ensure that you have kept a record of your previous responses as part of the informal procedure.
What happens if I feel conflicted by the concern that has been raised?
If you feel conflicted by a concern that has been raised you should seek advice from the FTSU Lead or the FTSU Guardian. You should not attempt to resolve this if the concern is specifically about you.
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Learning lessons
It is really important that when matters are brought to our attention, we understand how we can learn from events at an individual, team, and organisational level. Our approach will always be to investigate things thoroughly and part of this process will be to learn from incidents that are bought to our attention through Freedom to Speak Up, so that matters that can be prevented are prevented and the necessary support, training and interventions are put in place for our staff.
For patient safety incidents the ICB will follow the principles in NHS England’s Just Culture guide to ensure that patient safety always remains our highest priority. The principles of Just Culture facilitate the fair treatment of staff and supports a culture of fairness, openness and learning, by making staff feel confident to speak up when things go wrong, rather than fearing blame. See Just Culture guide: NHS England » A just culture guide
- Freedom to Speak Up forms and documents