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Why we all need to speak up

11 January 2024
Volume 33 · Issue 1


Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the Freedom to Speak Up report and its importance in ensuring patient and staff safety

At the end of 2023, MP Maria Caulfield laid the 2022/23 Freedom to Speak Up annual report before Parliament (National Guardian's Office, 2023). Although she recognised some excellent examples of practice, Caulfield shared concerns about health and care leadership. These concerns follow the Messenger review, an independent review commissioned by the Department of Health and Social Care (DHSC), to examine the leadership of health and social care organisations. It found a lack of consistency in leadership support for speaking up, noting:

‘In the NHS, we sensed a lack of psychological safety to speak up and listen, despite the excellent progress made since the Francis Report. We would observe that the Freedom to Speak Up initiative can be narrowly perceived through the lens of whistleblowing rather than also organisational improvement, and we would encourage a broader perspective.’

Caulfield stated that it was chilling to think of the harm that might have been prevented and/or the lives that might have been saved if colleagues had felt able to raise concerns, or had been listened to and appropriate action taken swiftly when they did. She specifically cited reports from the Lucy Letby case, and those by Donna Ockenden and Bill Kirkup, and the inquiry into University Hospitals Birmingham. She stated that these show why Freedom to Speak Up has never been more important.

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