Freedom to Speak Up

We are making speaking up business as usual in Team BSMHFT

Sir Robert Francis’ Freedom to Speak Up review in February 2015 found that patients had died and been harmed because concerns about their treatment and care raised by NHS staff were ignored. The review also found that many concerns were not taken seriously, staff were not listened to and they were sometimes targeted for speaking up. In the report, he recommended the need for independent Guardians in NHS trusts to provide leadership and protection for staff who speak up or feel that they have been poorly treated by their employer or other bodies. 

You can find a copy of the full report

Emma Randle and Lucy Thomas are the Freedom to Speak Up Guardians here at BSMHFT. Guardians help create a culture of openness and transparency where all our colleagues (including TSS, medical trainees, volunteers, students and new starters) are encouraged to speak up and are supported in the process.

Speaking up literally saves lives.

We encourage our colleagues to speak up in a number of ways. To their manager, in a clinical team meeting, during supervision or with a Freedom to Speak Up Champion who can offer advice and guidance in their local area. As well as concerns about patient safety and quality our colleagues can also speak up about something which doesn’t feel right, for example a way of working or a process which isn’t being followed or the behaviour of others which is contrary to our values of compassion, inclusivity and commitment.

As individuals and as an organisation, when we reflect on what has gone wrong, we learn lessons, make changes, and the care we give our patients improves as a result.

Guardians are employed by Trusts. They have positive working relationships with the Executives, the Board, and are linked in to all clinical and non-clinical areas. Guardians approach their work impartially using their judgement and experience and report directly to the Board. This enables them to function independently providing challenge and support to the organisation. They also work closely with the Board Non- Executives, their regional networks and the National Guardians Office.

Team BSMHFT have seen a year on year increase in the number of colleagues who are speaking up and raising concerns and the following story provides an example from one of our junior doctors: A Junior Doctor Speaks Up About Supervision – National Guardian’s Office

The Lead Guardian presents a Board report in person twice yearly and you can find them here: Trust board papers – Birmingham and Solihull Mental Health NHS Foundation Trust 

You can find out more about the National Guardians Office and how they support their Guardians here: The National Guardian’s Office – Freedom to Speak Up

Guardians once trained, are listed in a national directory. You can find your local Guardian here: Find My FTSU Guardian – National Guardian’s Office

For any queries our contact details are: or 0121 301 3940 (24 hour confidential voicemail).

Speaking up with Emma podcast

In this episode, we chat with Emma who is a Freedom to Speak Up Guardian.  Emma has a unique role where she supports employees from Birmingham and Solihull Mental Health Trust to have a voice. She offers an independent, confidential space to share concerns about patient safety, quality of care and any other challenges that staff might face at work.

Emma has her own lived experience of mental ill health when she was a teenager. Emma had two hospital admissions during the late 1980s and reflects on how services were very different to how they are today. Emma was on a mixed-sex ward aged 17 and was discharged with very little community support.  Emma thoughtfully shares how her experiences have shaped her life, but also how she feels her lived experience helps her in her current role to support others with compassion, empathy and kindness.

Thank you Emma for sharing your experiences with us.

Listen to Emma’s podcast

Emma Randle

Two Trainee Nursing Associates separately contacted Emma Randle, Freedom to Speak Up Guardian at our Trust, because they were worried that they were expected to perform procedures which they were not qualified to do.

National Guardian 100 Voices story: Listening to trainees
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