Freedom to speak up - annual report 2021-22

We launched Safe to Challenge as a lynchpin of our People Plan in October 2021. The initiative has helped us to embed Freedom to Speak Up Guardians into our organisation and introduced more transparency and opportunity for colleagues to speak up and raise concerns. 

During our transition to the new NHS England, this initiative has become more important than ever. One of its core objectives is to build trust in speaking up where this is may not be present via traditional routes. Our Guardians want colleagues to feel safe to speak up so that they can understand concerns and support needs effectively. The Guardian role is one of independence, impartiality and objectivity and our four Guardians are a safe place for colleagues to seek guidance and support via Safe to Challenge when they feel they may be unable to in other ways.

You will see in this report how we are continuing to deliver many of our Freedom to Speak Up commitments set out in our People Plan and how these actions are helping us to support colleagues. We continue to listen, learn and understand perspectives from colleagues through Safe to Challenge to ensure they feel supported and able to thrive.

Our ambition is to make our organisation a great place to work by creating an environment where colleagues feel that they can perform to their full potential, regardless of background, identity, or circumstances. We want everyone in our organisation to speak up so that we can create a culture where they feel valued, that they belong and that their contribution matters.

Best wishes,

Simon Bolton, Interim Chief Executive Officer

The Safe to Challenge service was launched in October 2021 as one of our People Plan 2020: NHS Digital People Plan priorities. Safe to Challenge is a ‘one stop shop’ for our people to raise concerns of any type, anonymously or in person. ‘Our people’ includes everyone, irrespective of their contract type with us. 

A core component of this service is the work undertaken by our Freedom to Speak up Guardians. Crucially, Safe to Challenge enables concerns to be raised with Guardians both anonymously and in person. This is a core element of its strategic design that sets it apart from many other Freedom to Speak Up models, and is a fundamental part of overcoming barriers to raising concerns, including fear of doing so.

Our Guardians are part of a country-wide network of Guardians. Selected via open internal recruitment and trained by the NGO, their role is at the forefront of our communications and engagement activity across the organisation about speaking up, raising its profile in line with the Francis 2015 report: Francis 2015 report. Although as an Arm’s Length Body we are not mandated to offer a speaking up service, we chose to opt in to support the over-arching ambitions of the People Plan, in particular 'Our employee experience needs to reflect our overarching ambition - that NHS Digital be the best place to work, knowing that our people are our most valuable asset.'

Our Guardians provide an alternative route to normal internal channels, both formal and informal. The remit is to identify and tackle barriers to speaking up, such as issues of bullying culture, poor levels of awareness, and processes that place an undue burden on individuals when they raise issues, including fear of repercussions.

Guardians share good practice and ideas for improvement where people have raised concerns, and there is a feedback mechanism for people to anonymously share their own views of the Guardian service once their concern has been resolved, which is also designed to inform a cycle of continuous improvement. 

The aim of promoting a positive culture for all, in which the principle of psychological safety is embedded, underpins the Guardian role. Their work is designed to give the organisation critical high-level insights as part of our ongoing conversations around topics including race, inequality and inclusion.

This report focuses on Guardian work only, in line with NGO guidelines. It does not include data or information from the wider Safe to Challenge service offer.

Between 11 October 2021 and 30 September 2022, the Guardians received 40 concerns in total. Behind that number sits more than 40 people – in some cases, individuals have come forward to discuss shared concerns on behalf of several others as well as themselves. Of 
these, 26 are closed and currently 14 remain open.

Almost half of all concerns raised with Guardians have been raised anonymously. This ties into the lack of trust mentioned in Simon’s foreword. We would not have heard these concerns If we did not have an anonymous reporting route.

The way Guardians receive anonymous concerns is via an externally commissioned platform called Work in Confidence, a web-based portal that operates outside NHS Digital systems. Here, colleagues have the option to remain anonymous or identify themselves if they choose to do so. And although half of all the Guardians’ work to date began with an anonymous concern raised through this platform, as trust built through the online dialogue between Guardian and colleague, many then shared their identities.

The chart below summarises themes for concerns raised to Guardians between October 2021 and September 2022. The category listed is self-selected by the colleague raising the concern.

In line with the national picture, bullying and harassment outweighs all other types of concern raised. The NGO 2021-22 Annual Speaking up Data Summary: NGO 2021-22 Annual Speaking up Data Summary tells us that 32.3% of total concerns raised to Guardians were about harassment and bullying. Of total concerns raised to our Guardians, 55% are about harassment and bullying.

Sub-themes include:

• team culture issues
• individual bullying of another person by a colleague
• bullying of individuals by line managers
• the impact of a senior manager’s behaviours across a team
• feeling marginalised

It is vital that colleagues have confidence that when they speak up, their concern will be listened to and properly heard. Here we list some high-level descriptions of what happened after concerns were raised:

• in some cases, people just wanted a safe place to talk about an issue, seek advice or put a marker down in case what has happened is repeated. Whilst these individual concerns were not taken further, the generality of the issue is useful to contribute to wider conversations on where change may be needed
• in other cases, having spoken to a Guardian, individuals then took action themselves, for example, by raising their concern with their line manager or a more senior manager in their management chain
• one data security concern was explored by the Guardian and closed as it was already lodged with the Information Commissioner’s Office
• one whistleblowing concern was discussed with the whistleblowing team, logged and reported to the Audit and Risk Committee. The whistleblowing team advised the Guardian on next steps. The concern was dealt with informally by the line manager at the request of the employee raising the concern
• reported concerns and attitudes about diversity and inclusion to EMT, resulting in the topic being covered in an NHS Digital all-hands call
• other actions include seeking advice and input from the following sources:
  - Human Resources Business Partners about behaviours and organisational change
  - Staff Networks about matters related to protected characteristics
  - Business Lead for concerns about the wellbeing of others
  - EMT Directors about behaviours
  - Capacity and Capability Programme about recruitment concerns

In 2021, the National Guardian’s Office conducted a survey to gain insight into the implementation of the Guardian role across the network. The Freedom to Speak Up Survey was published in March 2022.

You can expand the following headlines to see how NHS Digital compares to identified areas in the survey:

Over the past 12 months, our Guardians have taken the speaking up message out to various internal audiences. It is evident from the March to April 2022 People Survey results that this work will continue to be a key focus area over the next 12 months.

A Safe to Challenge communications campaign was launched to support the Freedom to Speak Up initiative in October 2021. Its purpose is to build trust, increase awareness and encourage colleagues to raise concerns.

Colleagues received key messages about our bullying and harassment toolkit, Freedom to Speak Up Guardians and independent reporting platform on the NHS Digital intranet, dedicated microsite, all-hands events led by EMT, and articles in our newsletters for managers and for colleagues.

The initiative was launched successfully but communications were not sustained as the merger announcement took place shortly after and became the priority message for colleagues. As a result, the feedback received from colleagues in our 2022 People Survey results highlighted that there is bullying, harassment and discrimination taking place in the organisation and colleagues still don’t understand the routes to raise concerns.

We have responded to this feedback by simplifying our dedicated microsite to ensure that it is clear which routes are available to raise concerns, how colleagues can access them and which ones can be accessed anonymously and which ones should be used when you want 
to be known. We also now run weekly articles in our newsletters.

During the month of October, we are raising the profile of the initiative and our Guardians during Speak Up Month. We will continue encouraging colleagues to speak up until the end of March using our integrated communications campaign as we believe that the initiative is more important than ever to support the wellbeing of our colleagues as we transition to the new NHS England. 

In line with objectives outlined in the People Plan 2020, you can find out about our development and continuous improvement activities during 2022-23 by opening the expanders below:

Processes have recently been introduced to capture protected characteristic data for individuals raising concerns. This demographic information is captured in both the Independent Reporting Platform (the principal route to contacting a Guardian) and the feedback form sent to everyone raising a concern with a Guardian. Both data capture points are optional, and in line with other demographic capture tools a significant number of those contacted choose not to respond.

Where appropriate, Guardians can also flag concerns raised to note protected characteristics, where whistleblowing policy may need to be consulted, and cases with elements of racism. From a user perspective, anecdotal reports tell us that the pathways to raising concerns still need work to make them fully inclusive

Guardian activity data for the organisation (case numbers, and whether anonymous or not) are uploaded quarterly to the National Guardian’s Office. Safe to Challenge and Whistleblowing meet regularly to ensure Guardian compliance with ARC reporting requirements.

The Chief Executive is accountable for ensuring that Freedom to Speak Up (FTSU) arrangements meet the needs of our people. The Chief People Officer is the Executive Lead for FTSU and provides leadership to the operational arrangements for speaking up within the 
organisation. The FTSU independent Non-Executive Director (NED) acts as an independent advisor and is available to the FTSU Guardians and support as required. Guardians have direct access to the Chief Executive and other Executives as required, and seek support 
from the Head of Safe to Challenge as required. There are no concerns about the support that has been provided to the Guardians during the reporting period.

The Board is asked to consider and endorse the content of the action plan, and note the content of this report.