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We need to support those who speak up, for everyone's safety

26 October 2023
Volume 32 · Issue 19


Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reflects on the need to support those who speak up

Following the publication of the investigation into the failings of the Mid-Staffordshire Hospitals, which saw the government committing to further actions to clarify procedures for staff to raise concerns, Sir Robert Francis QC published an independent review on the creation of an open and honest reporting culture in the NHS (Francis, 2015). The report of the Freedom to Speak Up review revealed serious cases of bullying and discrimination towards staff who had tried to raise concerns over patient care, and suggested that this was fundamentally a patient safety issue.

The review took evidence from over 600 people and 19 000 online surveys and called for:

Yet, 8 years on, we continue to see media headlines discussing how serious patient harm has occurred, and one could also argue that the psychological safety of staff who have raised concerns has potentially suffered harm and detriment. These health and care investigations often reveal that there are incidents of avoidable harm following concerns were often raised and ignored by senior personnel.

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