Giving NHS staff the freedom to speak up

Kirsty Dickson, the freedom to speak up guardian for Northumbria Healthcare.
Kirsty Dickson, the freedom to speak up guardian for Northumbria Healthcare.

Enabling staff to raise concerns is important in any organisation, but in the NHS it could be a matter of life and death.

We are currently in Speak Up Month, a national campaign by the National Guardian’s Office using the hashtag #SpeakUpToMe on social media, which calls on NHS organisations to increase awareness of how staff can raise concerns at work.

Every NHS trust in England has a freedom to speak up guardian and last year, more than 6,700 cases were raised to guardians.

Kirsty Dickson has been the guardian at Northumbria Healthcare NHS Foundation Trust, which runs hospitals in Northumberland and North Tyneside, for two years now.

She is passionate about her role and the difference it can make in terms of patient safety and quality of care for patients and staff.

A key recommendation from Sir Robert Francis’ review into the culture of raising concerns in the NHS, freedom to speak up guardians across the health service are there to support staff in raising genuine concerns about their work.

In July 2015, the Secretary of State confirmed the steps needed to be taken to develop a culture of safety, and supported Sir Robert’s recommendations which followed his review and subsequent report into the failings in Mid-Staffordshire.

The guardians, who are completely independent and governed by the Care Quality Commission, do not get involved in investigations or complaints, but help to facilitate the raising concerns process where needed, ensuring policies are followed correctly.

As Kirsty explained: “It’s an independent, impartial service for staff to raise concerns and speak up and also to challenge barriers to speaking up.”

Her job is also to create the right environment for speaking up, to improve the experience for health and care workers and to improve learning for staff to protect patients.

A colleague identified that Kirsty was the right person for the role, which offered the chance to use a skill-set built up over years in the NHS, working in dental nursing and occupational therapy, and she has never looked back.

Since starting in October 2016, she has dealt with more than 300 cases, now averaging one new case a day, dealing with ‘anything and ‘everything’. Some of these people may not have come forward if there wasn’t a guardian.

“Staff that have spoken to me and experienced the process have found it positive,” Kirsty said. “The feedback has been very good.”

She adds that she has been supported very well and given the time and resources she needs as well as the autonomy to use her skill-set to do the role.

This also involves strategic work as well as the day-to-day caseload with the guardians operating as a network across the country under the national guardian, Dr Henrietta Hughes.

Kirsty, as well as her role at Northumbria, is the regional network lead for the North East and Cumbria.

And she believes the freedom to speak up guardians scheme could easily spread more widely beyond the NHS: “I think where there’s people, there’s a need.”

Ben O'Connell, Local Democracy Reporting Service