What is ‘Speaking Up’?

Freedom to Speak Up (FTSU) is about encouraging a positive culture where people feel they can speak up and their voices will be heard, and their suggestions acted upon.

Speaking up is about anything that gets in the way of providing good care.

FTSU is for all NHS workers - anyone who works in NHS healthcare, including pharmacy, optometry and dentistry. This encompasses any healthcare professionals, non-clinical workers, administrative workers, directors, managers, contractors, volunteers, students, trainees, junior doctors, locum, bank and agency workers and former workers. 

When things go wrong, it is important to learn lessons and make improvements. If you think something might go wrong, you must feel able to speak up to prevent potential harm. Even when things are good but could be better, you should feel able to say something.

You can speak up about anything that gets in the way of patient care or affects your working life. This could be something which doesn’t feel right to you, for example, a way of working or a process that isn’t being followed, you feel you are being discriminated against, or you feel the behaviours of others are affecting your wellbeing or that of your colleagues or patients.

Speaking up, therefore, captures a range of issues, some of which may be appropriate for other existing processes, for example, HR or patient safety or quality.

If in doubt, please speak up. It does not matter if you are mistaken or if there is an innocent explanation for the matters you raise. As an organisation, we will listen and work with you to identify the most appropriate way of responding to the issue you raise.

The animated film below informs staff about how their local Freedom to Speak Up Guardian can support them:

NHS Cheshire and Merseyside has FTSU Guardian arrangements in place for staff employed by the organisation. Details on how to access these arrangements are available on the staff intranet.

For people working in Cheshire and Merseyside (but not directly for NHS Cheshire and Merseyside) there may be a local FTSU Guardian available within your organisation or network who you should approach. The National Guardian website has details of all Guardians.

If your organisation doesn’t have an FTSU Guardian, or you feel that you can’t speak up to that Guardian, the national NHS England FTSU team can support you. The national external Freedom to Speak Up policy can be found on the NHS England website.

You can get in touch with the NHS England customer contact centre via telephone or in writing to provide details of the matters you are raising. Colleagues in the customer contact centre will listen to employee concerns confidentially and will direct them to the correct team. If you prefer, you can also email the NHS England national Freedom to Speak Up team directly.

NHS England
PO Box 16738
B97 9PT

Whichever route you choose, please be ready to explain as fully as you can the information and circumstances that gave rise to your speaking up.

Is Speaking Up the same as ‘whistleblowing’?

You can speak up about anything that gets in the way of safe and high-quality care. You can also speak up about anything that affects your experience in the workplace.
Speaking up may include:

  • a quick discussion with a line manager
  • a suggestion for improvement
  • raising an issue with the Freedom to Speak Up Guardian
  • bringing a matter to the attention of a regulator

Some people may interpret any of these actions as ‘whistleblowing’.

Others may only see ‘whistleblowing’ as:

  • something that is ‘formal’
  • a matter that involves an outside an organisation
  • something that may qualify for ‘protection’ under the Public Interest Disclosure Act.

Speaking up is all these things.

What is a Freedom to Speak Up Guardian?

Freedom to Speak Up Guardians (FTSUGs) help workers to speak up when they feel they cannot do so by other routes.

If I want to speak up about something, what should I do?

Your line manager is your first point of call. If you don’t feel you can speak up to them or use other formal routes, contact your Freedom to Speak Up Guardian.

Why were Freedom to Speak Up Guardians created?

The role of was created in response to recommendations made in Sir Robert Francis’ report, The Freedom to Speak Up (2015).