Freedom to Speak Up - e-Learning for Healthcare
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This programme is in partnership with...
  • Health Education England
  • https://www.england.nhs.uk/
  • National Guardian Office

About the Freedom to Speak Up programme

To improve safety and make the health service a better place to work, we need leadership and a culture that places less emphasis on blame when things go wrong and more importance on transparency and learning from mistakes in the NHS. We need organisations to demonstrate that speaking up is celebrated, and used to address errors or failings, and make improvements that turn ‘good’ practice into ‘great’.

In response to concerns about culture in the NHS, the Secretary of State for Health and Social Care commissioned Sir Robert Francis to carry out an independent review: Freedom to Speak Up (www.cqc.org.uk/content/national-guardians-office ). The review recommended that every NHS organisation should provide training on the value of speaking up which complies with national standards. The independent report by the Commission on Education and Training for Patient Safety has set out the future of education and training for patient safety in the NHS over the next 10 years.  These e-learning sessions will enable organisations to support learners and workers to speak up, respond appropriately and take necessary action as recommended by the report.

The ‘Speaking Up in Primary Care’ and ‘Speaking Up in Secondary Care’ e-learning sessions will act as a helpful resource to current and future healthcare staff by promoting relevant policies, procedures, good practice and available support in relation to speaking up. The resource teaches NHS staff across primary and secondary care the value of speaking up and highlights the support that is available. Speaking up at the earliest opportunity can protect patients, improve the experience of the NHS workforce and help organisations embed a culture of continuous learning and improvement.

The ‘Supporting Speaking Up in Secondary Care’ e-learning session helps managers and designated contacts understand their roles and responsibilities in relation to speaking up.

Additional resources

Two education and training films – ‘Raising Concerns’ and ‘Responding to Concerns‘ – have been developed to raise awareness on the importance of speaking up, build confidence amongst staff on how to do so and equip managers with the knowledge, skills and confidence to respond adequately, timely and safely.

As educational tools, the films will support healthcare professionals at all levels – ensuring they feel empowered to speak up, respond well to someone who speaks up to them and take the necessary actions when that happens.  The films look at three scenarios that highlight broad lessons to be applied elsewhere. As well as stressing the importance of speaking up, the films explain what to do and signpost to further information.

In addition, ‘Making Speaking Up Business as Usual’ is a film to promote speaking up, and to raise awareness of the Freedom to Speak Up Guardian (FTSUG) role.

The Freedom to Speak Up Guardian role

Freedom to Speak Up Guardians (FTSUGs) are appointed locally and are expected to fulfil the requirements of the National Guardian Office’s job description for the role (the ‘universal’ job description).  The role is both proactive and reactive and sets out the following purpose:

Freedom to Speak Up Guardians help:

  • Protect patient safety and the quality of care
  • Improve the experience of workers
  • Promote learning and improvement

By ensuring that:

  • Workers are supported in speaking up
  • Barriers to speaking up are addressed
  • A positive culture of speaking up is fostered
  • Issues raised are used as opportunities for learning and improvement

FTSU and the implementation of the FTSUG role is growing and developing.  There are now over 800 guardians, champions and ambassadors in NHS organisations.

Raising Concerns film

This film aims to raise awareness on the importance of raising concerns and to build confidence amongst staff on how to do so.

A subtitled version of the film is available here: Raising Concerns

Responding to Concerns film

This film aims to equip managers with the knowledge, skills and confidence to respond to concerns adequately, timely and safely.

A subtitled version of the film is available here: Responding to Concerns

Making Speaking Up Business as Usual film

Making Speaking Up Business as Usual is a film to promote speaking up, and to raise awareness of the Freedom to Speak Up Guardian role.

A subtitled version of the film is available here: Making Speaking Up Business as Usual

Executive group

  • Russell Parkinson

    Russell Parkinson

    Interim National Guardian Directorate Manager (Engagement)
  • Samina Malik

    Samina Malik

    Education and Training Policy Manager (HEE)
  • Rosie Courtney

    Rosie Courtney

    Former Programme Lead for Learning to be Safer Programme (HEE)
  • Cathy James

    Cathy James 

    Chief Executive, PCaW

Project team

  • Jon Cunningham

    Jon Cunningham

    Development Director, PCaW
  • Margit Veveris

    Margit Veveris

    Assistant Project Manager, HEE
  • Dr Maslah Amin

    Dr Maslah Amin

    Clinical Fellow, HEE
  • Zoe Brown

    Zoe Brown

    Safety and Experience Lead (Freedom to Speak Up Guardian), Cambridgeshire and Peterborough NHS FT
  • Andi Blackmore

    Project Manager, HEE e-Learning for Healthcare
  • e-LfH staff - Neha Baj

    Neha Baj

    Content Development Lead, HEE e-Learning for Healthcare
  • Nyla Cooper

    Nyla Cooper

    Programme Lead, NHS Employers
  • Adele Bunch

    Adele Bunch

    Senior Programme Officer, NHS Employers
  • Liz Teasdale

    Liz Teasdale

    Communications Project Manager, HEE
  • Profile picture of article author Alex Drinkall

    Alex Drinkall

    Stakeholder Manager, HEE e-Learning for Healthcare
  • Charles Rendell

    Charles Rendell

    Strategy Manager, Care Quality Commission (CQC)

Peer review team

  • Dr Maslah Amin – National Medical Director’s Clinical Fellow, HEE
  • Rosie Courtney – Programme Lead, National Programmes, HEE
  • Maria Earley – HR Project Manager,  Buckinghamshire Healthcare NHS Trust
  • Mary Sampson – Corporate HR Manager, Chelsea and Westminster NHS Foundation Trust
  • Margit Veveris – Assistant Project Manager, Health Education England
  • Elaine Butchard – Assistant Director of HR, OD-Medicine and Core Clinical Support Services, The Royal Liverpool and Broadgreen University Hospital NHS Trust
  • Adele Bunch – Senior Programme Officer, NHS Employers
  • Nyla Cooper – Programme Lead, NHS Employers
  • Alan Wilson – Non-Executive Director, Wirral Community NHS Trust
  • Becky Tate – Freedom to Speak Up Guardian, Stockport NHS Foundation Trust
  • Heather Bruce – Freedom to Speak Up Guardian, University of Morecambe Bay NHS FT Trust
  • Matthew Joyesst – Associate Director of Safety and Quality Governance and Raising Concerns Guardian, Lancashire Care NHS Foundation Trust
  • Carlene Holden – HR Manager, Children and Communities BSU Rotherham Doncaster and South Humber NHS FT
  • Barry Mortimer – Senior HR Adviser, Calderdale & Huddersfield Foundation Trust
  • Anita Vincent – Associate Director of Staff Engagement, Croydon Health Services NHS Trust

How to access

In order to access any e-LfH programme, you will need an e-LfH account. If you do not have one, then you can register by selecting the Register button below.

Register >

If you already have an account with e-LfH, then you can enrol on to the Freedom to Speak Up programme by logging in to the e-LfH Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My e-Learning section.

Access for NHS healthcare staff in England

The Freedom to Speak Up programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this e-Learning via ESR means that your completions will transfer with you throughout your NHS career.

Further details are available here.

e-LfH is a Health Education England Programme in partnership with the NHS and Professional Bodies