In February, the National Guardian’s Office published its report “Listening to Workers” following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
The National Guardian’s Office (NGO) undertook this Speak Up review as the speaking up culture in NHS ambulance trusts appeared be more challenged compared to other trust types.
The Speak Up review heard from a number of ambulance workers, ex-workers, managers and senior leaders of their experiences of a culture of bullying, harassment and discrimination which contributed to not feeling able to speak up for fear of retaliation.
The fear of the consequences was one of the main barriers to people speaking up about anything getting in the way of delivering great patient care. Those who did speak up often faced intimidation or inaction as a result.
The report summarises the key findings of the review into five themes:
- Culture of ambulance trusts
- Leadership and management
- Experience of people who speak up
- Implementation of the Freedom to Speak Up Guardian role
- Role of system partners and regulators
The target-driven, command and control environment of ambulance trusts meant that Freedom to Speak Up – and by extension – workers’ wellbeing, was often not viewed as a priority by leadership.
The full report can be found here. This report is a gift of feedback and provides opportunity for improvement.
Chair of the Association of Ambulance Chief Executives (AACE) Daren Mochrie QAM said:
The Association of Ambulance Chief Executives welcomes this review, the greater insights it provides into the current workings of Freedom to Speak Up Guardians within NHS ambulance services, and the further opportunity it presents for comprehensive and consolidated improvement in this area for the benefit of staff and patients alike.
Alongside and on behalf of our members, AACE will support and work with the National Guardian’s Office, NHS England and the Department of Health and Social Care to implement the recommendations and ensure that they have a meaningful and sustainable impact within the ambulance sector.
Although we may have different roles in the ambulance sector, we all have our parts to play in Speaking, Listening, and Following up, to improve psychological safety in the work place, to protect patient safety, and to improve the lives of workers.
All ambulance trusts are represented at the AACE National Ambulance FTSU Network and the network will continue to work closely with AACE and the NGO in response to the recommendations made in this report.
Do reach out to your local guardians if you want to know more, or keep an eye out for further articles in Keeping P’AACE, or contact the Guardians’ co-chairs of the AACE National Ambulance FTSU Network via email – Carmen Peters or Simon Holbrook.
Authors: Carmen Peters and Simon Holbrook
Co-chairs, National Ambulance FTSU Guardians’ Network
