Speaking up really matters. When colleagues raise concerns, it tells us they care about each other, our patients, and how we work together. Over the past year, many of you have continued to use the Freedom to Speak Up (FTSU) service, and that willingness to share what’s not working or where things could be even better is something we value.

This month, the Guardian team has presented to the Weekly Leadership Briefing and to deliver a report to the monthly Trust Board. These forums give opportunity to feedback directly to leaders throughout the organisation on the current state of play of speaking up in the organisation. These opportunities allow us to listen and learn with leaders on the approaches required to support a healthy speaking up culture at the trust.

Between October 2025 and March 2026, 580 concerns were raised through FTSU. This is slightly fewer than last year, but numbers alone don’t tell the whole story. Nationally and locally, staff survey results show that confidence in speaking up has dipped, and some colleagues feel less sure that raising concerns will lead to meaningful change. This tells us we need to look beyond processes and focus on everyday experiences.

The issues people raise are consistent with what staff tell us elsewhere – those are workload pressures, wellbeing, behaviours, communication and patient safety. Although concerns about bullying and harassment have reduced overall, they still exist and remain deeply impactful where they occur. Concerns about sexual safety continue to come forward and must always be handled with care, fairness and urgency.

The good news is that colleagues who contact the FTSU Guardians consistently report positive experiences. Most are contacted quickly, feel listened to, and over 80% say they would speak up again. What’s clear, though, is that trust in the Guardian service is often stronger than trust in what happens next at local level. This gap matters.

For leaders, speaking up is less about formal escalation and more about how we respond day to day. The way concerns are greeted, explored and followed up shapes whether people feel safe to raise issues again. Small actions, such as listening without defensiveness, being curious rather than dismissive, feeding back honestly, and owning difficult messages, really do make a big difference.

The data shows variation across divisions. That tells us culture is shaped locally. Consistent, kind and fair leadership is one of the strongest influences on whether people feel confident to speak up. Over the coming year, leaders will be asked to:

• Create psychologically safe spaces where concerns can be raised early
• Respond visibly and consistently to issues, even when they’re uncomfortable
• Support staff after they’ve spoken up, so they don’t feel exposed or isolated
• Turn feedback into learning and improvement, not just reassurance

What this means for all staff

For everyone, speaking up isn’t about “getting things wrong” or “causing trouble”. Speaking up is about protecting one another and making our systems safer. You can speak up with your manager, another leader, HR, unions, or through the FTSU Guardians. There is no “right” route – what matters is that your voice is heard and respected.

Speaking up is a shared responsibility. So is listening up. The culture we experience is created by how we treat each other every day.

Our aim as a team, and for the Trust, is to create a place where people feel safe, supported and confident that speaking up leads to action, and that every voice really does count.