Decrease in NHS workers’ confidence to speak up: National Guardian for the NHS voices fears for patient safety if workers’ concerns are not addressed

The National Guardian’s Office today (8 June 2023) published its analysis of the questions relating to speaking up in the 2022 NHS Staff Survey.

The Freedom to Speak Up sub-score declined from 6.5 in 2021 to 6.4 in this year’s NHS Staff Survey. This fall equates to a 1.5% change in responses to the speaking up questions. Given the numbers who answered these questions (over 600,000 workers) this could be equated to a decrease in over 9,000 workers’ confidence to speak up. There were declines on all measures relating to speaking up, both relating to raising concerns about clinical safety and speaking up more generally.

While the results have improved since the 2015 Freedom to Speak Up Review and resulting actions, this continues the fall in NHS workers’ confidence to speak up since the pandemic. Of particular concern is the marked fall in how safe people feel to raise a clinical concern.

Speaking up can only bring improvements if leaders and managers listen up and follow up. The corresponding question about whether people feel that if they spoke up, their concerns would be addressed has also shown a deterioration. This creates a worrying picture of potentially increasing disillusionment and a feeling that speaking up is futile.

Dr Jayne Chidgey-Clark, National Guardian for the NHS said: “It is not acceptable that two in five workers responding to the NHS staff survey do not feel able to speak up about anything which gets in the way of them doing their job.

“These survey responses show us that there is a growing feeling that speaking up in the NHS is futile – that nothing changes as a result. When workers speak up about concerns, including the impact of under staffing and a crumbling infrastructure, their leaders themselves may struggle to be heard when trying to address these concerns.

“I would add my voice to that of others that this urgently needs to be addressed.

“Failing to do so risks compounding this sense that workers do not have the resources they need to deliver the high-quality care they want for their patients. With three in ten feeling unsafe to raise clinical concerns, this will have a direct impact on patient safety.”

This will have a direct impact on patient safety.”

For more information or interviews contact: comms@nationalguardianoffice.org.uk