The number of concerns reported by NHS England staff through the freedom to speak up process almost tripled last year, the organisation’s latest board papers have revealed.
There were 152 cases received by the internal freedom to speak up guardians in 2021-22 compared to 56 in 2020-21. This year 54 cases were received in quarter three alone.
The most common concerns are related to allegations of bullying and harassment. These accounted for nearly 40 per cent of the total. People and team management concerns accounted for a third of FTSU cases. Within the latter, there were sub-themes of breakdown in relationships, failure to offer role models and sanctioning or ignoring poor culture.
According to the NHSE report, its commercial directorate received the highest rate of FTSU complaints with 3.4 cases per 100 staff. This was followed by the Healthcare Safety Investigation Branch with three complaints per 100 staff, and then primary care (2.9) and the people directorate (2.75).
An FOI by HSJ revealed the people directorate received 26 FTSU complaints in 2021-22, compared to fewer than 10 the year before. The NHSE said the directorate had introduced “directorate-wide listening events to inform the development of an improvement plan to address the issues raised through the FTSU process”.
The NHSE’s most recent internal staff survey showed the people directorate came bottom in seven out of nine key measures.
This week’s report also set out the NHSE FTSU guardian’s next steps. These include appointing a lead guardian, finalising a strategy and continuing to engage with Health Education England and NHS Digital staff as they are brought into NHSE next year.
According to Richard Barker, NHS regional director for North of England and author of the FTSU paper, it is “difficult to infer too much from higher or lower numbers of cases”.
Mr Barker said: “Higher numbers could signal a healthy confidence that staff have in speaking up as well as indicate there are challenges. The National Guardian’s Office’s annual data report indicates that the number of cases received by NHS England is comparable with other organisations of a similar size.”
The report also found the proportion of NHS staff who wanted to be kept anonymous fell from 59 per cent to 35 per cent, but with a 7 per cent rise in people who wanted their name kept confidential.