Freedom to Speak Up: NHS midwife opens up about its importance

In this exclusive interview, a former midwife, shares her experience as an advocate of the Freedom to Speak Up (FTSU) policy, and why impartiality is so important.  

Despite personal experiences with its shortcomings, she has dedicated herself to fostering a culture where everyone can voice their concerns without fear of retribution. 

What inspired you to become an advocate for the Freedom to Speak Up Policy, especially given your personal experience with its shortcomings? 

“For me, it was about being part of positive change. The culture in the NHS Trust that I worked in was one of silence, where you did as your seniors told you, regardless of your own judgement. The purpose of FTSU is to provide everyone with a voice and platform so they can speak in confidence without fear of reprisal. I had a negative experience when I blew the whistle on a senior staff member, resulting in my transfer to another ward during the investigation, even though I hadn’t done anything wrong. That experience fueled my determination to make improvements so no one else would have to go through what I did.” 

What advice would you offer to Chief Nursing Officers, Nurses, Midwives, and anyone who wants to promote a culture of speaking up within their healthcare settings? 

“Ensure that everyone is aware of FTSU. Use various channels such as posters in changing rooms, staff rooms, and email links. Emphasise confidentiality, as many staff fear being named. Make it simple and quick. Consider using QR codes for easy access. The key words to promote are ‘Quick,’ ‘Simple,’ and ‘Confidential.'” 

For anyone who might hesitate to speak up out of fear of blame, what would you say to encourage them? 

“I ask them to consider what’s worse: saying something and preventing a potential incident or risk or saying nothing and allowing it to happen. Speaking up is about preventing harm.” 

What measures can organisations take to ensure that the insights gained from anonymous reports lead to sustainable changes and improvements in healthcare practices and policies? 

“This is crucial for FTSU. Organisations should regularly review submissions and hold quality meetings to address all reports and act on each one. Transparency is key. Implement structured workflows for each submission with recorded updates accessible to the FTSU team and stakeholders.  

The beauty of using an integrated risk management system like Radar Healthcare is that you customise the workflows to fit your organisation’s needs. For example, you can create step-by-step processes for investigating issues like bullying versus a patient safety concern, all within the system, ensuring that each case is handled appropriately with the involvement of the relevant staff members. Additionally, you can ensure complete confidentiality by setting permissions. 

Additionally, consider involving frontline staff and experts in the process to ensure that the insights are translated into meaningful changes that positively impact patient care and safety. Radar Healthcare’s notice feature can be used to keep staff updated. The FTSU team can also monitor the success rate of delivering these notices to understand if any improvements are needed.” 

Finally, what steps can healthcare organisations take to create an environment where open dialogue, even through anonymous reporting, becomes a routine part of continuous quality improvement? 

“Consider integrating FTSU into your incident reporting systems. When staff report incidents, a prompt can appear, asking if it could be an FTSU report. This makes it quick and easy, removing concerns about additional work or being seen on a computer if there are other staff members present. Normalising FTSU is essential. Additionally, look at providing regular training and communicate FTSU efficiently to ensure that all staff members are aware of its importance and how it fits into the organisation’s commitment to continuous quality improvement.” 

Thank you for your time today. Your insight has been invaluable! 

For more information about how Radar Healthcare can provide an integrated solution for risk management and policies including FTSU, get in touch with our expert team here.