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National Guardian’s Office publishes report on Nottinghamshire Healthcare

The National Guardian’s Office has published a review of the handling of speaking up cases at Nottinghamshire Healthcare and has made 13 recommendations required to improve the culture of speaking up at the Trust.

The review took place earlier this year and focused on two key services and specifically considered how the Trust deals with staff who speak up about a range of matters and how they are addressed.

The National Guardian’s Office is an independent, non-statutory body with the remit to lead culture change in the NHS so that speaking up becomes business as usual. It also provides challenge, learning and support to the healthcare system as a whole by reviewing trusts’ speaking up culture and the handling of concerns where they have not followed good practice.

Dr Henrietta Hughes, National Guardian for the NHS, said: “Our focus with all case reviews we carry out is to identify learning and improvement to bring about a positive culture change in speaking up, and our report published today into Nottinghamshire Healthcare is no exception.

“We looked at how the trust handled two separate cases of speaking up by its workers that occurred in two different services in the trust. I am delighted at the very positive response to our recommendations from the leadership at the trust and their commitment to create an Action Plan as soon as possible.

“Importantly, the learning is not just for this trust, but for other NHS trusts around England to reflect on and action should any of the recommendations apply to their own practices in relation to speaking up. One of our recommendations in relation to conflicts of interest will also be of interest to NHS England and NHS Improvement.

“Finally, I think it is also important to highlight the fact our case review found good speaking up practice in the trust, relating to a number of the principles that the we set out in our survey of Freedom to Speak Up Guardians in 2017.

“These included the fact the guardian was appointed through an open recruitment process; that staff working as part of the trust’s freedom to speak up arrangements demonstrated an absolute commitment to supporting workers to speak up and undertook this work with courage, energy and a willingness to learn and improve; and that the guardian presented regular reports to the trust board in person that gave a detailed commentary on their work in supporting workers to speak up, including data summaries, analysis and recommendations for action.”

Dr Julie Attfield, the Interim Chief Executive at Nottinghamshire Healthcare said: “It is absolutely fundamental that staff are able to speak freely about concerns that arise during their work, that they are positively supported to do so and that we as individuals, and as an organisation, respond positively when this is the case.  I thank the National Guardian’s Office for examining the practice in the Trust and producing this report.  I am clearly disappointed that there were areas of poor practice identified and that we didn’t respond in a timely or appropriate way. This does not reflect the values of this Trust and I am eager to make changes to ensure that these issues are considered across the organisation and improved. I am confident that we can build on those areas of good practice identified in the report and improve our staff’s experience of speaking up.

We accept all of the recommendations contained within the report and I, along with colleagues, are committed to implementing changes to make sure that all of our staff, in whichever service they work, feel able to highlight concerns and speak up to improve patient experience.

You can read the report here.



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