October is Speak Up Month, which means health organisations throughout England will be making a special effort to raise awareness of speaking up and their willingness to listen to concerns, worries and issues. It can be difficult to speak up about issues or concerns, and you may not know who to speak up to. You may feel that anything you do raise will not be taken seriously and nothing will be done as a result. Speaking up is about anything that gets in the way of providing good care.

Freedom to Speak Up Guardians are appointed in all NHS and Foundation trusts in England, and it is planned that they will be appointed in primary care. They provide a safe space to raise concerns about anything that gets in the way of high-quality effective care, or that affects their working life. 

Speaking up may take many forms including a quick discussion with a line manager, a suggestion for improvement submitted as part of a staff suggestion scheme, raising an issue with a Freedom to Speak Up Guardian, or bringing a matter to the attention of a regulator. Some people may interpret all or some of these actions as ‘whistleblowing’, others may only associate ‘whistleblowing’ with something that is ‘formal’, or a matter that is escalated outside an organisation, or to describe something that may qualify for ‘protection’ under the Public Interest Disclosure Act. Speaking up is about all of these things.

Learn Not Blame is a campaign to move away from the blame culture endemic in the NHS, and instead develop a just culture which acknowledges and learns in a constructive and fair manner when things go wrong.

Protect (formerly Public Concern at Work) is another organisation which advises whistleblowers.

There are other routes for patients and their families to raise matters of concern or to make suggestions for improvement, including Patient Advice and Liaison Services (PALS).

See our next edition of Medical Women, which includes an article on Whistleblowing.