The Association of Ambulance Chief Executives (AACE) has reaffirmed its commitment to embedding Freedom to Speak Up (FTSU) as a vital part of everyday culture across UK ambulance services and the wider NHS. Speaking up when something doesn’t feel right must become an integrated, visible norm, not a peripheral or arm’s-length function.
This reassurance comes amid concern about the future of FTSU Guardians, following recommendations in Dr Penny Dash’s recent review of patient safety in England. Her proposal to bring the National Guardian’s Office (NGO) and its FTSU responsibilities into a new structure under the Department of Health and Social Care (DHSC) has raised questions for some.
However, AACE strongly supports Dr Dash’s emphasis on strengthening staff voice functions and creating clearer, more connected pathways for raising concerns.
The AACE Council (chief executives and chairs from across the UK NHS ambulance sector) is now underlining that member ambulance trusts remain fully committed to maintaining accessible, supportive FTSU teams, and promoting the role of Guardians as a core mechanism for cultural improvement, transparency, and psychological safety across the ambulance sector.
AACE Managing Director Anna Parry said:
Dr Penny Dash’s recent patient safety review reinforces that Freedom to Speak Up is not just relevant, it is fundamental to cultural and clinical improvement across the NHS. Far from diminishing its importance, the review calls for strengthened staff voice functions that are better integrated within systems and leadership structures.
This is why AACE believes these developments present a major opportunity for the ambulance sector and align fully with the review’s call for a more transparent and inclusive NHS.
Within the ambulance sector, Freedom to Speak Up is recognised as an essential mechanism for fostering transparency, accountability and psychological safety. For colleagues with concerns, Freedom to Speak Up teams within trusts remain firmly available, offering clear, supportive pathways for raising issues.
This is not just a continued commitment, it is an active endorsement of staff voice, and a clear promotion of the structures designed to listen and act in each ambulance trust. To achieve this, ambulance services will be ensuring that FTSU Guardians have the sustained support, training and supervision they need to offer safe, robust guidance.
Guardians must also be given the protected space to challenge constructively – an indispensable element in keeping our organisations safe and improving our workplace culture.
