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Reviews / 2015

Independent reviewPublishedWorkforceEngland

Freedom to Speak Up

Sir Robert Francis KC · work from 2014 · published 2015

What this was

Independent review of how NHS staff raise concerns. It proposed principles for speaking up, a guardian in every trust, and a national office to support them.

Why it sits in the hub

Guardians became part of the NHS contract. Dash then recommended moving National Guardian functions, and Thirlwall found in 2026 that many staff still feared detriment and that national oversight had been hollowed out.

Findings

  1. Finding 1

    Staff did not speak up because they expected nothing to change, or expected harm to their career.

    Culture and conductSpeaking up

Recommendations in this hub

Paraphrase of the public recommendations, not the official text.

  1. 1Partly doneNHS and government

    Put a Freedom to Speak Up guardian in every NHS organisation, with a national office to support the role.

    The role was created. The National Guardian's Office was later closed, with functions due to move, which Thirlwall criticised.

    Regulation and oversightSpeaking up
  2. 2Not publicly clearGovernment

    Ask the Secretary of State to report regularly on whether speaking up is getting safer.

    Leadership and boardsSpeaking up