Guy’s and St Thomas’ is encouraging staff to show they care by speaking up

In February 2015, Guy’s and St Thomas’ NHS Foundation Trust was one of the first trusts to accept all of Sir Robert Francis’ recommendations on how to better support staff to raise concerns. Due to the size and complexity of the organisation (£1.3bn turnover; 13, 650 staff, and several sites and services across the south east), the Trust made a decision to accept all of Francis’ recommendations and to also take them a step further.

In partnership with the Trust’s staff side, a joint team from nursing, workforce and quality developed an initiative called ‘Showing we care by speaking up’ to support staff to raise concerns. This was launched on 15 June 2015. As part of the initiative, a new governance structure reporting to the Board was established. This included the appointment of one of the first Freedom to Speak Up Guardians - the Trust’s Director of Quality and Assurance, Mary Newman.

To encourage speaking up, a new ‘Advocate’ role was created across the Trust. Advocates are Trust staff who are able to offer support and advice to their colleagues about how to raise concerns. The first volunteer Advocates were identified by their directorate as people who are already offering this type of support informally and the Trust wanted to better support them through formalising the role and providing training. The first group of Advocates includes all professions and grades. They have undergone training to help them to work effectively in the role, and a key responsibility of the Freedom to Speak Up Guardian is to support their efforts and wellbeing. There are 47 trained Advocates within the first cohort with plans for a second cohort for the Autumn.

Chief Nurse Dame Eileen Sills said of the introduction of the Advocate role: “We have tried to create opportunities for our staff to raise their concerns safely and to give them the courage to do so. This is an important step for us and I am particularly grateful to the Advocates for taking this role on.”

The launch on 15 June included briefings held over a 2 week period. More than 600 managers attended these sessions to hear about the avenues open to staff and to remind them of their role as line managers. The ways of raising a concern have been printed onto a business card that fits into staff badges. Through induction and across all sites, more than 20,000 cards have already been distributed to staff. Although it is early days, feedback about the initiative has been positive. Staff are starting to use the new email address and talk to Advocates. The next stage is to determine how best to share the themes of the concerns that are being raised - whilst protecting confidentiality with the wider organisation - to enable the Trust to become a learning organisation.

For more information on the approach that Guy’s and St Thomas’ has taken, please contact Sarah Morgan, Director of Organisational Development on [email protected]
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