The trust is committed to eradicating bullying and harassment. It encourages staff to raise concerns as part of the Freedom to Speak Up campaign. The trust has a number of Speak Up Champions with whom staff can discuss and raise concerns that they may have.
Speak Up Champions are a point of contact for those who require advice. They can inform staff of the options available and direct them to take appropriate action or help them to seek support. They act as role models for creating an open, honest and transparent culture that values speaking up.
The types of concerns that you may want to raise with a Speak Up Champion could include:
bullying and harassment
someone's health and/or safety has been put in danger due to an action or inaction
damage has been caused to the environment
a criminal offence has been committed
an employer fails to obey the law (such as not having appropriate insurance)
a malpractice or wrongdoing has been covered up
Frequently asked questions
Please find below responses to some questions that have been raised by our staff. Please do let Joanna Bainbridge (Freedom to speak up Guardian) know if you have any questions you would like to ask, as we are very happy to respond and with your permission, we would like to add your questions and answers to our FAQ list.
Raising concerns, speaking up and whistleblowing are all familiar terms used to describe the reporting of anything that causes actual or potential risks to the provision of patient care. It can also be about other issues which may impact on wider NHS services, other staff and/or the reputation of the organisation. This can be fraudulent activity or a lack of response or cover up of issues being raised.
When things go wrong, it is important that there is opportunity for workers to discuss these issues, reflect on what happened, and learn from experiences and to be part of any discussion about what needs to happen to prevent future risk of harm.
Different people or organisations may use a variety of terms (as outlined above) to describe the reporting of concerns, but they all mean the same thing. Some people may interpret all or some of these actions as "whistleblowing", others may only associate whistleblowing with something that is formally escalated outside an organisation, or to describe the legal protections offered to individuals raising concerns under the Public Interest Disclosure Act.
How you raise these issues may be different, depending on local arrangements and will be dependent on how serious the issue is. Most concerns can be raised by having a discussion with your line manager or one of the Freedom to Speak Up (FtSU) Champion, FtSU Guardian or your Trade Union representative, or a representative from your professional body. They may also be raised with a regulatory body such as the Care Quality Commission.
All NHS trusts should have a policy and arrangements in place to support workers to speak up and raise issues; we have these steps in place at the trust. This includes all healthcare professionals, non-clinical staff, senior, middle and junior managers, volunteers, students, bank and temporary workers such as agency workers and contractors, and former employees.
As an employer, we have a duty to make sure that these arrangements are well communicated and understood by our workforce. We are committed to publishing arrangements on the staff intranet. This helps us to communicate the organisation's commitment to being open and transparent about its processes. It also ensures all workers can find information easily when they need it.
There are other routes for patients and their families to raise matters of concern such as the Patient Advice and Liaison Services (PALS).
Organisations should outline arrangements for temporary workers in any contractual agreement they may have with an agency or contractor. This can be done in one of two ways:
By establishing that the agency/contractor has their own effective arrangements in place to support and respond to concerns or
By agreeing that the agency/contractor promotes the organisation's own arrangements, where there are any concerns which relate to a threat or risk to the services, care and/or reputation of the organisation.
Managers are recommended as the first port of call for staff to raise any concerns they may have. Managers therefore have a critical role to play in effecting a positive and responsive reporting culture. Without their support and involvement, it will be challenging to keep the arrangements alive across the organisation.
If your concern is a personal complaint about your own employment situation, rather than a concern about patient or staff safety or wrong doing. If you do have a personal complaint and you are unable to resolve this informally with your local line management, then you may wish to raise a grievance, through the trust’s formal process. If you are unsure, please contact an Freedom to Speak Up Champion, the Freedom to Speak Up Guardian, or the Human Resources department.
Your identity and your discussion with the FtSU Champion or Guardian will be kept confidential, unless and until it is necessary to reveal this information, if you chose that the information you have given should progress along a formal route, then your identity will be required and disclosed.
You will always be in control of whether your concern remains confidential. Confidentiality is however not upheld if the concern raised is a matter of fraud, child or adult safeguarding, or illegal activity.
The Speaking Up Support scheme, is a national initiative and provides a range of support for past and present NHS workers who have experienced a significant, adverse impact on both their professional and personal lives, to move forward, following a formal speak up process.
The scheme, formerly known as the Whistleblowers' support scheme, was created in 2019 as a response to the recommendations from the 2015 Freedom to Speak Up report. This report was born from the Mid-Staffordshire enquiry into malpractice. The support scheme has subsequently been revised based on learning from previous iterations of the support scheme.
We know that not everyone feels confident coming forward to raise concerns with the FTSU service, so we are offering an opportunity for staff to raise their concerns anonymously.
If colleagues are hesitant to speak up with either their line manager or the FTSU service, providing a way to speak up anonymously can help catch concerns early before they spiral out of control.
We would like staff to feel like they can approach the service personally. However, anonymous concerns can help us establish themes and where possible feed these themes back to management and leadership teams.
You can use this form (or scan the QR code) to raise a concern anonymously, but if you wish to provide your details via this method then you are welcome to. We will keep any name or contact details relating to you completely confidential, unless you want us to share this information.
Our vision is ‘Having ambition for West Herts to be a place where staff are actively encouraged to speak up, feel safe to do so, where we listen to one another, and action is taken to follow up and learn from the concern raised”
Difference matters - the impact of ethnicity on speaking up at West Herts
Speaking up about concerns at work is important as it helps our organisation to improve patient care and the working environment for all our staff and workers. Speaking up and listening well supports equality and diversity and is essential for learning and continuous improvement.
From time to time the Freedom to Speak Up team deliver specialist projects, which seek to explore the impact of the service. One such project that was delivered in the autumn of 2023 was the ‘Difference Matters’ project, which used a confidential questionnaire, designed to reach out to specific groups of staff and to ask them about their own experiences of speaking up.
The responses to the Difference Matters questionnaire were gathered and analysed, the report provides an analysis of the responses made to the questionnaire from staff.
One of the frustrations we get though concerns from our staff who raise a concern is the length of time that it can sometimes take to get a response to the issue. The FTSU team prides itself on acknowledging the concern and offering a meeting generally within 24 hours.
A team leader contacted the FTSU team to discuss an incident in which a manager had met with a group of staff. The interchange had become extremely difficult and the communication style from the manager had caused alarm to members of the team. The Guardian agreed to make the senior management aware of the incident.
Using a ‘Kind Life’ approach (focused on fostering kindness and positive change) to understand why the behaviours at this meeting had fallen below the standards expected. The manager reflected on their role and returned to the team to apologise.
The team leader contacted the Guardian to acknowledge the support and confirm the team considered the matter closed, this was also confirmed by the team member who had raised the concern.
Several staff within the same team had raised similar concerns regarding pressures of work within the department and how this situation was impacting upon their working lives, through increased stress and pressures of work.
These staff were happy for the FtSU service to escalate their concerns (anonymously) to the management team. This was done and resulted in the management team understanding the issues from the perspective of the staff and being able to give assurance through certain plans and actions, including a recruitment plan that were in place that things would change and working lives would improve.
This was fed back to the staff who had raised the concerns and over the following 6 weeks positive improvements were recognised and acknowledged by the staff who raised the concerns.
A worker at an NHS trust raised a concern with the Freedom to Speak Up Guardian, describing incivility that they had experienced working in a patient environment and as part of a supporting multidisciplinary group of staff. The poor behaviour had originated from the substantive staff working on the ward. Other colleagues in the multidisciplinary team had also experienced the same behaviours.
The Freedom to Speak Up Guardian met with the manager and team leaders where the incident had taken place, to try and better understand the experiences of the team. It became clear that the multidisciplinary team frequently experienced incivility in these circumstances and those examples included sarcastic remarks, rudeness, sharp and overly critical comments, rolling of eyes, and tutting.
To assess the level of incivility being experienced, the team manager invited all the multidisciplinary team members, to complete an anonymous survey on workplace incivility and to capture their experiences.
This survey results showed that 70% of respondents had either experienced or witnessed incivility. Team members shared that they felt anxious and reported poor psychological safety within the team. This highlighted that incivility was increasing patient safety risk as it increased fears of speaking up. This was escalated to the Trust patient safety team.
The survey response led to several restorative actions being put in place, including the production of a ‘kindness and civility matters’ video through the trust’s Patient Safety, which was shown to all staff and included a reflective discussion session. Everyone agreed that a change in behaviour, to a more civil and kind approach was needed, particularly because this behaviour was not in line with the trust values and expected standards of behaviour. Trust executives responsible for patient safety including the Chief Nurse, Medical Director and CEO were also included as Champions of the development sessions.
The changes that followed these interventions included, providing the multidisciplinary team who had experienced the incivility with additional support to rebuild psychological safety over several months. This provided them with increased confidence within the workplace, together with the confidence to assertively challenge inappropriate behaviours.
The FtSU Guardian at the trust concluded that “When dealing with complex issues, it is vital that the right people with authority and influence are involved in learning and resolution, as this drives action for change.”
