Concern over downward trend in speaking up about clinical safety
A drop in confidence in NHS staff feeling able to speak up about clinical safety issues has been described as “concerning” by the National Guardian’s Office.
The office, which runs the Freedom to Speak Up Guardian scheme across healthcare organisations in England, has analysed the results of the 2023 NHS Staff Survey.
“The NHS may be broken, but by listening to our people, we can begin to fix it”
Jayne Chidgey-Clark
In a new report outlining its findings, the office highlighted how confidence of health professionals in raising concerns about unsafe clinical practice had reached a five-year low.
In 2023, 71.3% of respondents to the NHS Staff Survey agreed that “I would feel secure raising concerns about unsafe clinical practice”.
The figure was a decline from 71.9% in 2022, 75% in 2021, 72.7% in 2020 and 71.9% in 2019.
“We should all feel secure to speak up about unsafe clinical practice, and it is concerning to see another year of decline in those who feel secure to do so, following last year’s decrease,” warned the report, titled Listening to the Silence: What does the staff survey tell us about speaking up in the NHS?
“Given the number of respondents in this survey, this trend potentially has significant implications for patient safety.”
Conversely, the latest NHS Staff Survey results showed a slight improvement from previous years in the question of whether respondents felt safe to speak up about “anything that concerns me in this organisation”.
In 2023, 62.3% of respondents agreed with that statement, compared with 61.5% in 2022 and 62.1% in 2021.
However, the latest result was still significantly lower than the 65.7% score in 2020. The question was not asked in 2019.
Results from the NHS Staff Survey relating to Freedom to Speak Up questions. Source: National Guardian’s Office
Since 2021, an overall “Freedom to Speak Up sub-score” has been calculated from the NHS Staff Survey by combining the results from the four questions in the survey that relate to speaking up.
The latest report from the National Guardian’s Office showed that the sub-score had remained relatively stable in 2023, although was still slightly lower than it was in 2021.
The sub-score for 2023 was 6.46, compared with 6.44 in 2022 and 6.5 in 2021.
Jayne Chidgey-Clark
Dr Jayne Chidgey-Clark, national guardian for the NHS and a nurse, said the figures “must focus the minds of those who lead healthcare organisations”.
“When workers have a good experience when they speak up, they share that experience and we will begin to change the conversation of what it means to speak up in healthcare,” she added.
“The NHS may be broken, but by listening to our people, we can begin to fix it.”
