Common purpose / People and culture
Speaking up
Staff who raise concerns still describe detriment. Freedom to Speak Up was the national answer in 2015. Reviews since, including Thirlwall, say the arrangement is uneven and the oversight has been weakened.
11 reviews · 9 recommendations
Reviews, most recent first
- 2026Thirlwall Inquiry
Lady Justice Thirlwall
- 2025Dash review of the safety landscape
Dr Penny Dash
- 2024Shanley review, Edenfield
Professor Oliver Shanley
- 2022Neurology Inquiry (Watt)
Brett Lockhart KC
- 2019NHS Patient Safety Strategy
NHS England and NHS Improvement
- 2018Gosport
Bishop James Jones
- 2018Liverpool Community Health
Dr Bill Kirkup
- 2015Freedom to Speak Up
Sir Robert Francis KC
- 2015Savile NHS lessons
Kate Lampard and Ed Marsden
- 2013Francis public inquiry
Sir Robert Francis KC
- 1994Clothier (Allitt)
Sir Cecil Clothier
What they asked for
Issue a one-page protocol for when staff suspect a colleague may be causing deliberate harm. Concerns raised in good faith must be acted on, and moving the person can be a neutral step to protect patients.
NHS England
Move National Guardian functions to the Parliamentary and Health Service Ombudsman, with power to look at how whistleblowing was handled.
Government
Simplify where the staff voice sits after the National Guardian functions move.
DHSC and providers
Involve patients and staff in safety work as a condition of the system, not an extra.
NHS providers
Give staff an external route when the trust itself is the problem.
NHS England
Put a Freedom to Speak Up guardian in every NHS organisation, with a national office to support the role.
NHS and government
Ask the Secretary of State to report regularly on whether speaking up is getting safer.
Government
Make it easier for staff and patients to report concerns about people who seem untouchable.
NHS trusts
Make openness the default, and protect staff who speak up.
NHS providers