Freedom to Speak Up

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What is Freedom to Speak Up?

Freedom to Speak Up is about ensuring that everyone feels safe and supported to raise concerns about anything that gets in the way of delivering great care or doing their job effectively. It is not limited to patient safety issues—it includes anything that could affect the quality of care, staff wellbeing, or the integrity of our workplace.

  • Protecting safety: Speaking up helps prevent harm and ensures lessons are learned when things go wrong.
  • Improving culture: It encourages openness, transparency, and continuous improvement.
  • Supporting staff: It ensures that staff feel valued, listened to, and respected.

Meet Your Freedom to Speak Up Guardian

Hello, my name is Heidi Scott-Smith, and I am your Freedom to Speak Up Guardian. My role is to support you in raising concerns, ensuring your voice is heard, and helping to create a culture where speaking up is business as usual.

I have worked more than 20 years in the NHS as a registered nurse and health care leader, and have worked in various healthcare settings in operational, managerial, and Board level roles. My professional interests include leadership behaviours, civility, and patient safety. As a qualified coach I am passionate about fostering positive transformation and supporting the growth of colleagues within healthcare environments.

For more information contact: heidi.scott-smith1@nhs.net

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My Role as Your Guardian

As your Freedom to Speak Up Guardian, I:

  • Provide confidential advice and support if you feel unable to raise concerns through other routes.
  • Ensure that concerns are listened to and that you receive feedback on actions taken.
  • Work with practices to encourage a positive culture of speaking up
  • Making matters raised opportunities for learning and development.

FAQs

Q: Who can you speak up to?

 A:Internal line management, Practice Manager, GP Partner, PCN manager. Freedom to Speak Up Guardian who can support you to take matters internally or externally. CQC, ICB, NHS England for something that will seriously impact patient safety.        

Q: Will my concern remain confidential?
A: Yes, the Guardian provides a confidential service unless there is a risk of serious harm.

Q: Can I raise issues anonymously?
A: Yes, anonymous concerns are accepted, though direct support may be limited.

Q: What types of issues can I raise?
A: Anything that affects patient care or that effects your working life. For example this could be a process which isn’t being followed, behaviours of others which you feel is having an impact on the well-being of you, the people you work with or patients.

Even when things are good but could be even better you should feel able to say something and be listened to.

Freedom to Speak Up is about encouraging a positive culture in our workplace, where we feel comfortable speaking up and know that our voices will be heard, suggestions acted upon and we will be valued for taking a brave step in the interests of protecting patients and wellbeing of staff.

Freedom to Speak Up Champion

Purpose of the Role

The Freedom to Speak Up (FTSU) Champion is responsible for promoting a culture where speaking up, listening, and following up are valued and encouraged throughout the organisation. Champions play a key role in raising awareness of the importance of speaking up and signposting individuals to appropriate support channels.

Scope of Responsibilities

  • FTSU Champions do not manage or investigate cases. Only FTSU Guardians, who have completed National Guardian’s Office (NGO) training and are listed on the NGO’s public directory, are authorised to handle and manage cases.
  • Champions provide initial support by listening, thanking individuals for raising concerns, and directing them to suitable resolution pathways, including referral to the FTSU Guardian where appropriate.

Confidentiality

  • Champions do not record or report any identifying details of those who contact them, except where there is a legal obligation to disclose information. In exceptional circumstances—such as when there is an immediate risk of harm—confidentiality may need to be breached. Even in such cases, every effort should be made to protect the individual’s confidentiality, unless safeguarding action is required.
  • Champions share only anonymised data, such as the number of contacts and thematic information, with the FTSU Guardian to support organisational learning.

Training and Development

  • All Champions are expected to complete the Freedom to Speak Up e-learning modules, co-produced by the NGO and Health Education England, to ensure a thorough understanding of the principles and best practices for responding to concerns. This training is supplemented by an information session delivered by the FTSU Guardian.

Network and Peer Support

  • Champions are encouraged to participate in the Derby and Derbyshire regular Champions Network Meetings. These meetings provide opportunities to review data themes, share learning, and offer local peer support.

Anyone interested in becoming a Freedom To Speak Up Champion or would like to discuss this role, please contact heidi.scott-smith1@nhs.net