Private healthcare providers have witnessed a bigger improvement in the “speaking up” culture across their organisations over the last year compared to other parts of the healthcare sector, according to a report from the National Guardian’s Office (NGO).
However significant concerns remain across the sector about the culture being formed in healthcare locations, and in the support of senior leaders for workers to speak up.
The NGO report found that across all healthcare organisations 74% of those surveyed thought the speaking up culture at their organisation had improved in the last year.
However the proportion describing their organisation as having a positive culture of speaking up fell 5% to 63% and there was a 10% fall in respondents reporting that senior leaders supported workers speaking up – down to 71%.
Fear of retaliation or suffering due to speaking up was a concern for 69% of respondents while 58% thought nothing would be in done in response to their speaking up.
But 75% said action was being taken to tackle barriers to speaking up, compared with 11% who said no action had been taken.
And 72% agreed or strongly agreed that detriment was taken seriously within the organisation, but 10% thought action taken proved ineffective.
Private sector improvement
Polling more than 300 Freedom to Speak Up guardians, the NGO report found that 78% of respondents from private healthcare providers said their organisation’s speaking up culture had improved over the last 12 months.
This compared to 74% for respondents from NHS Trusts, and 65% of those working within the hospice sector.
The National Guardian’s Office and the role of the Freedom to Speak Up guardian were introduced following recommendations from Sir Robert Francis QC’s report in 2015 The Freedom to Speak Up.
Sir Robert found that NHS culture did not always encourage or support workers to speak up, and that patients and workers suffered as a result.
The office leads, trains and supports a network of Freedom to Speak Up guardians in England and conducts speaking up reviews to identify learning and support improvement of the speaking up culture of the country’s healthcare sector.
Proactive or reactive
Freedom to Speak Up guardians in the private healthcare sector were also found to spend more of their time on the proactive aspects of their role – such as working within their organisation to tackle barriers to speaking up – than reactive aspects such as supporting workers who speak up to them.
More than 70% of guardians in the private healthcare sector spent at least half of their time focussing on proactive aspects, compared with just over 50% of those within NHS Trusts and other parts of the healthcare sector.
All providers of NHS services subject to the NHS Standard Contract are obligated to have a Freedom to Speak Up guardian, and there are already almost 200 working in the independent health sector.
The Independent Healthcare Providers Network – the representative body for private sector healthcare providers – called on all private healthcare providers to appoint a guardian if they had not already done so.
The report also called on senior leaders in all healthcare providers to complete the speak up, listen up, follow up training to improve their ability to act as effective role-models for speaking up.
Dawn Hodgkins, director of regulation at the Independent Healthcare Providers Network (IHPN), said: “In helping promote a much more open and transparent culture in the health service, Freedom to Speak Up guardians play an absolutely vital role in improving safety and the quality of care delivered to patients, and we encourage all independent healthcare providers to appoint a guardian.
“While there’s still more to do on this agenda, it’s encouraging to see independent healthcare guardians working so proactively in the sector, with continual improvement in the “speaking up culture” which is so important in supporting the delivery of the best possible patient care.”