Being the Lead Freedom to Speak Up Guardian at Hampshire Hospitals is a real privilege. This is the first time the Trust has had a full time Guardian, and that decision alone sends a powerful message. It shows a clear and genuine commitment to speaking up, to patient and staff safety, and to creating a culture where people feel safe to raise concerns and confident that they will be listened to.
Throughout my career, there has been a consistent focus on people, culture and safety. Before joining Hampshire Hospitals, I was Director of People and Operations at Helen and Douglas House Children’s Hospice, where I introduced the Freedom to Speak Up framework and strengthened a culture of openness and learning. In earlier roles at Cancer Research UK and the Crown Prosecution Service, I saw firsthand how strong leadership and psychological safety can transform both staff experience and organisational outcomes.
At Hampshire Hospitals, patient and staff safety sit at the heart of everything we do. When people feel able to speak up, we learn faster, improve sooner and deliver safer care. But we also recognised that this does not happen by chance. Our 23/24 staff survey results told us clearly that confidence in speaking up needed to improve. For some colleagues, fear of repercussions, unclear processes or a lack of visible advocacy made raising concerns feel difficult.
That feedback became a turning point.
In response, the Trust invested in a full time Freedom to Speak Up Guardian role which has led to a Trust wide programme of cultural change. The ambition was not simply to increase reporting, but to build a supportive, inclusive environment, where speaking up is seen as a normal and valued part of working life.
Together with colleagues across the organisation, we focused on embedding psychological safety at every level. This included refreshing our Freedom to Speak Up policy in line with national guidance, expanding our Guardian and Champion network across clinical and corporate services, delivering targeted training, and working closely with senior leaders and Board members to ensure visible leadership support.
Speaking Up Month became an important moment for engagement, with leadership pledges, ward visits, meaningful conversations and learning sessions. Freedom to Speak Up is now embedded into staff induction, so from day one colleagues understand how to raise concerns and what to expect when they do.
The impact of this work has been both measurable and meaningful.
Over the past 18 months, the number of concerns raised has increased by 56 percent, which we see as a positive sign of growing trust and confidence in speaking up and concerns being addressed appropriately. Participation in the national NHS Staff Survey has risen by 8 percent, and positive responses to speaking up questions have increased by 5 percent, the most improved scores in the survey overall. Importantly, feedback from colleagues who have raised concerns confirms that staff are not being treated detrimentally for speaking up, a crucial indicator of psychological safety.
One colleague recently described their experience of using the service in a way that really stayed with me. They spoke about feeling listened to, supported and reassured, and compared the Freedom to Speak Up service to the comfort of knowing there is always somewhere safe to return to if you need help. That sense of security is exactly what we want colleagues to feel.
This work has also strengthened patient safety. When staff feel confident to raise concerns, risks are identified earlier and addressed more effectively. Learning becomes shared, not hidden, and improvement becomes everyone’s responsibility.
We are incredibly proud that this work has been recognised nationally through our inclusion in the National Guardian’s Office (NGO) Annual Report to Parliament as a positive case study. This recognition reflects the collective effort of staff across Hampshire Hospitals and demonstrates that meaningful cultural change must be a shared endeavour, involving everyone from the board to frontline and support services.
Creating a culture where people feel safe to speak up is not a one-off initiative. It is ongoing, relational and deeply human work. It relies on trust, consistency and compassion, and on leaders at every level modelling the behaviours they want to see.
While we are proud of the progress we have made, we know this is not the end of the journey. Culture change takes time, consistency and courage, and we recognise there is still more to do to ensure every colleague, in every team, feels equally safe and confident to speak up. We will continue to listen carefully to feedback, learn from the themes that emerge and strengthen our approach so that speaking up becomes ever more embedded in how we lead, support one another and deliver care.
As Lead Freedom to Speak Up Guardian, my role is to listen, to advocate and to help remove barriers, but this culture belongs to all of us. Every conversation, every question raised and every concern addressed helps to make Hampshire Hospitals a safer place for patients and a kinder place to work.
Ashley Roper
Lead Freedom to Speak Up Guardian
