Freedom to Speak Up Report (The Guardian Service) - November 2025
Meeting: Trust Board – Public Meeting
Date: 5 November 2025
Report Title: Freedom to Speak Up Report (The Guardian Service)
Agenda Item: PUB25/11/4.1
Author: Kym Gillingham & Dani Marshall, Freedom to Speak Up Guardians, Liz Cunnell, Chief of Staff
Lead Director: Neill Moloney, Chief Executive Officer
Purpose: Information noting
Link to EEAST Strategic Mission:
- People Mission
Link to Strategic Risk:
- SR2 Quality Governance
Purpose: To provide an update on the Freedom to Speak Up activity within the Trust.
Recommendation: The report is provided for information and includes recommendations for next steps.
Executive Summary
The number of cases raised since the new year has fluctuated but the number of cases closed has significantly improved in August and September. Following feedback from Board colleagues a regular meeting was held between the Guardians, Chief of Staff and the Head of Employee Relations to assist with escalations and resolutions. This practice will continue as it enabled cases to be appropriately closed.
Between the period of 1 August – 30 September, a total of 40 concerns were raised to The GSL. The most common themes for new cases were System and Process (13) and Behaviour and Relationship (14). This is in line with the annual themes as seen below.
There was one patient safety case raised in August.
The number of cases in Norfolk is 30% higher than other operational areas as seen in the chart below. The themes for concerns are split between management issues and system and process, with the majority relating to the latter which reflects the regional data collected on ER casework. Much of the system and process cases appear to relate to ER cases.
The engagement programme over recent months has resulted in an increase in cases being raised in Bedfordshire and Luton. Initially we had a period of three months with zero cases so this is seen as a positive improvement.
| August | September | Year to date | |
|---|---|---|---|
| Bedfordshire & Luton A&E Operations | 4 | 2 | 9 |
| Cambridge & Peterborough A&E Operations | 1 | 4 | 14 |
| Emergency Operations Centres | 0 | 2 | 13 |
| Hertfordshire & West Essex A&E Operations | 3 | 1 | 8 |
| Mid & South Essex A&E Operations | 2 | 1 | 13 |
| Norfolk & Waveney A&E Operations | 4 | 1 | 21 |
Additional support is being provided to explore and address this theme.
Recommendations
The recommendations from the previous report have been enacted as follows:
- Regular meetings for Head of ER, Chief of Staff and Guardians to review cases which require more HR communication resulting in case closures.
- A Task and Finish Group has been established between the Chief of Staff and Guardians to review progress on recommendations. Once established these will be shared on EEAST24.
- The reflective tool for FTSU was shared as part of the recent campaign to promote FTSU at EEAST.
It is important to note that all reviews of themes and recommendations protect confidentiality.
Key Issues / Risks:
- Norfolk & Waveney A&E Operations is still indicated as the highest number of concerns raised.
- The number of cases relating to system and processes
