Abstract
Healthcare organisations reap significant benefits when workers’ concerns are adequately listened and responded to, including improved patient safety, reduced costs and improved staff experience. Although many concerns are dealt with satisfactorily, compelling evidence suggests that problems of silence (where employees do not speak up) and deafness (where organisations do not hear concerns or act) remain pervasive worldwide. In the English National Health Service (NHS) the response to these problems includes numerous policy initiatives and the introduction in 2016 of the “Freedom to Speak Up Guardian” (FTSUG) role. This globally unique role is described as potentially leading to huge improvements in the way staff concerns are handled and responded to leading to improvements in organisational learning and patient safety. Following their introduction thousands of NHS staff have already spoken up via FTSUGs. The majority of FTSUGs time is spent on bullying and harassment concerns, rather than direct patient safety concerns, which appears to have confounded FTSUGs’ and others’ expectations. This chapter opens by describing the background to the development of the FTSUG role. We then outline the literature on bullying and harassment; its shocking prevalence within healthcare workplaces and the damaging consequences of bullying borne by organisations and individual staff and patients. We also discuss our analysis of semi-structured interviews (n = 87) undertaken with FTSUGs, which illustrates the realities of dealing with colleagues’ concerns about bullying and harassment and how these realities are often overlooked in national, regional and local workplace guidance and training materials currently available to support the implementation of the role.
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Notes
- 1.
Freedom to Speak Up Guardians will be referred to by the acronym FTSUGs, or the shortened term “Guardian/s”.
- 2.
The term ‘bullying and harassment’ is used by the NHS and by Guardians/NGO to refer to these behaviours and is therefore used throughout this chapter.
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Funding Acknowledgement
This study/project is funded by the National Institute for Health Research (NIHR) Heath Services and Delivery Research Programme (project reference 16/116/25). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
We would like to thank Claire Simpson for her excellent administrative support for this project and all those FTSUGs who agreed to be interviewed.
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Jones, A. et al. (2020). Speaking up about Bullying and Harassment in Healthcare: Reflections Following the Introduction of an Innovative “Speak Up” Role in NHS England. In: Montgomery, A., van der Doef, M., Panagopoulou, E., Leiter, M.P. (eds) Connecting Healthcare Worker Well-Being, Patient Safety and Organisational Change. Aligning Perspectives on Health, Safety and Well-Being. Springer, Cham. https://doi.org/10.1007/978-3-030-60998-6_10
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