CQC Assessment at The Vesey


Well Led


Freedom to speak up

Freedom to speak up

There is an inclusive and positive culture of continuous learning and improvement. This is based on meeting the needs of people who use services and wider communities, and all leaders and staff share this. Leaders proactively support staff and collaborate with partners to deliver care that is safe, integrated, person-centred and sustainable, and to reduce inequalities.

There are effective governance and management systems. Information about risks, performance and outcomes is used effectively to improve care.

Freedom to speak up

Our Evidence:

Freedom to speak up

When things go wrong, we need to make sure that lessons are learnt, and things are improved.

If we think something might go wrong, it’s important that we all feel able to speak up to stop potential harm.

Even when things are good, but could be even better, we should feel able to say something and be confident that our suggestion will be used as an opportunity for improvement.

Speaking up is about anything that gets in the way of providing good care. 

There may be many channels for speaking up within your organisation, including your Freedom to Speak Up Guardian.

Find out more about who you should speak up to below.

Our team utilise national expert training modules to complete training in this modality

Freedom to speak up

Anyone can speak up

Freedom to Speak Up is for anyone who works in health. This includes any healthcare professionals, non-clinical workers, senior, middle and junior managers, volunteers, students, locum, bank and agency workers, and former employees.

Patients and their families who have concerns or suggestions for improvement, should contact Patient Advice and Liaison Services (PALS).

What can I speak up about?

You can speak up about anything that gets in the way of patient care, or that affects your working life.

That could be something which doesn’t feel right, for example a way of working or a process which isn’t being followed, or behaviours of others which you feel is having an impact on the well-being of you, the people you work with, or patients.

Speaking up is about all of these things.

We are collecting stories to show examples of the kinds of things people have spoken up about, and you can read some here.

How do I speak up?

There may be many ways to speak up within your organisation.

Speaking up may take many forms. It could be a quick discussion with a line manager, a suggestion for improvement submitted as part of a staff suggestion scheme, raising a matter with a Freedom to Speak Up Guardian, or bringing an issue to the attention of a regulator.

You can speak up anonymously, confidentially, or openly. To speak up to or write anonymously to Mr Amit Patel, Director and Freedom to Speak up Guardian.

Who should I speak up to?

Speaking up internally

Usually your line manager will be your first point of call, but if you don’t feel you can speak up to them or use other formal routes, then you may wish to contact your Freedom to Speak Up Guardian. You can find their contact details here.

Freedom to Speak Up Guardians should be able to support you to speak up and ensure that your organisation provides a response to the matters you raise. Even if you are no longer employed by the organisation, you should still be able to speak up to your Freedom to Speak Up Guardian.

Freedom to Speak Up Guardians support workers to speak up when they feel that they are unable to do so by other routes. They ensure that people who speak up are thanked, that the issues they raise are responded to, and make sure that the person speaking up receives feedback on the actions taken.

If you do not feel that the Freedom to Speak Up Guardian is an appropriate person to speak to, you should be able to contact other people with responsibility for Freedom to Speak Up at your organisation. Your organisation’s Speaking Up policy should tell you who they are.

Speaking up to regulators

If you do not feel that any internal speaking up avenue is appropriate, you can speak up externally, to a regulator such as CQC or NHS England.

Alternatively, if you would like to speak about the conduct of a member of staff, you can do this by contacting the relevant professional body such as the General Medical Council, Nursing and Midwifery Council or the Health & Care Professions Council.

Other sources of speak up support

You may also find it helpful to contact organisations  who may be able to offer support.

Speak Up Direct provide free, independent, confidential advice on the speaking up process.

The charity Protect provide confidential and legal advice on speaking up.

The Trades Union Congress provide information on how to join a trade union.

The Law Society may be able to point you to other sources of advice and support.

The Advisory, Conciliation and Arbitration Service give advice and assistance, including early conciliation regarding employment disputes.


Speaking up has no limitations – it is about anything which gets in the way of patient care and worker well-being.

The terms ‘whistleblowing’ and ‘speaking up’ are often used interchangeably. They can cover raising matters about a wide range of legal and ethical issues.

We are working to make speaking up business as usual. That means being able to speak up about anything – whether that’s something which doesn’t feel right or an idea for improvement. You should feel confident that your voice will be listened to and action taken.

The term ‘whistleblowing’ can have negative connotations which may be a barrier to speaking up.  Some people associate ‘whistleblowing’ with a formal process, or a matter that is escalated outside an organisation.

Wellbeing support

Speaking up can be a difficult and distressing thing to do. After speaking up, you may wish to take some time to talk to family or friends. If you feel you need more support with your wellbeing or mental health, you can contact your GP.

Many employers have Employee Assistance Programmes offering free, confidential support and advice for workers. The following organisations also offer support:

Download Policy:

Download Policy 2:

Relevant review:

Freedom to speak up
Our thoughts: