Speak Up Week 2023: The week in review

"A graphic with the words: Speak Up Week 2023: Learning from Concerns 2-6 October 2023.  The writing is accompanied by decorative bunting."

NHS Scotland’s second Speak Up Week has been a great opportunity for health boards to highlight the benefits of speaking up. We’ve been delighted by the engagement we have seen from boards during the week on social media, and if you missed anything you can catch up on X (formerly Twitter) by searching for the hashtag #SpeakUpWeek.

The week started with a thoughtful conversation between Rosemary Agnew, the Independent National Whistleblowing Officer, and Tracey Gillies, Executive Medical Director at NHS Lothian. They reflected on the last two and a half years of INWO and the National Whistleblowing Standards, and discussed how boards can enable confidence in speaking up and how this is supported through the INWO process. They also considered the importance of confidentiality in building confidence to speak up, and the challenges of maintaining individual confidentiality while sharing learning openly and transparently.

Also on Monday, Mike from the INWO team presented a short video about how to encourage a speak up culture in NHS organisations.

On Tuesday, Edward from the INWO team told us about the challenges of sharing learning while maintaining confidentiality. We also posted a blog with some tips on how to do this.

On Wednesday, Fran from the INWO team shared her thoughts on recording outcomes and learning as a fundamental part of the whistleblowing process that goes a long way to enable wider learning.

On Thursday our panel session, chaired by Niki Maclean (SPSO Director), with Dr Scott Jamieson (a General Practitioner in the NHS Tayside area), Kirstie MacDonald (Whistleblowing Champion at NHS Fife) and Laura Skaife-Knight (Chief Executive of NHS Orkney) showed the importance of how leaders and managers listen to people, as well as the need for strong and visible leadership on whistleblowing from the top of all NHS organisations. Listening and acting on feedback is an everyday activity, not just for an annual Speak Up Week, and staff should have access to informal and formal options to speak up. It is important to close the loop on concerns quickly, to ease any distress for everyone involved and make changes quickly. There is a need, in particular in primary care, for clear and simple policies and procedures around whistleblowing which are backed up by training and support. The panel recognised that dealing with whistleblowing doesn’t always come naturally and that even the terminology, such as the word ‘whistleblowing’, can be alien and confusing – saying ‘speaking up’ is more accessible. It’s also important to acknowledge the courage of people speaking up and that, having done so, they deserve a timely and meaningful response, as well as ongoing dialogue around changes being made – people shouldn’t need to be tenacious to get a response. Are our leaders trained enough to have the skills to deal with difficult topics and even taboos in the NHS? Senior leaders need to be open and honest and show humility when they get things wrong. They also need to spend time understanding whistleblowing, looking at and learning from case studies to develop themselves and help upskill their staff. Capturing learning is vital, but that in itself is not enough – learning must be shared, while respecting the confidentiality of the individuals involved, and this includes celebrating successes. Speaking up cannot be seen in isolation; it is part of feedback and how it is dealt with is an indicator of an organisation’s culture. 

Also on Thursday, Amy from the INWO team explained how best to share improvements and action plans with the whistleblower.

The week was rounded off with Elaine from the INWO team giving us six tips for reporting on learning and improvements, which was supplemented by a blog about annual reports.

What happens next?

Speak Up Week has reminded us of the importance of speaking up in the NHS for the benefit of patients and staff, and the need to ensure everyone can speak up in a culture that embraces and learns from it. But it can’t be about just one week, it’s something we all need to work on every day, to help make the NHS a better place for everyone. Senior leaders and people responsible for whistleblowing governance need to demonstrate that speaking up is welcomed and valued, and line managers need to be supported to make this happen. Talking about speaking up should continue throughout the year and should be a regular focus of communication with staff.

Thank you to everyone who has taken part in Speak Up Week 2023. We were encouraged by the response of NHS organisations, and we appreciate all the work that has been put into it. We would love to hear about what you did, please send your feedback to [email protected].

Speak Up Week is an opportunity to engage staff about the benefits of speaking up and the difference it can make within the NHS in Scotland.  For more information, visit the Speak Up Week webpage.

Updated: October 10, 2023