Freedom to Speak Up Report September 2025

Meeting: Trust Board – Public Meeting

Date: 10 September 2025

Report Title: Freedom to Speak Up Report (The Guardian Service)

Agenda Item: PUB25/09/6.3

Author(s): Kym Gillingham & Dani Marshall, The Guardian Service Limited (external FTSU Guardian), Liz Cunnell, Chief of Staff

Lead Director: Neill Moloney, Chief Executive Officer

Purpose: Information/Noting

Assurance: Reasonable

Link to CQC domain:

• Caring
• Responsive
• Effective
• Well-led
• Safe

Link to EEAST’s Strategic Mission:

• Patient Mission
• Partnership Mission
• People Mission
• Productivity Mission

Link to Strategic Risk:

• SR2 Quality Governance

Equality Impact Assessment: No negative impact identified

Purpose: To inform the Board on Freedom to Speak Up (FTSU) and provide detailed reports for the trust for cultural improvements.

Recommendation:

• The Guardians meet monthly with the chief of staff and chief executive officer to review cases and emerging themes within the Trust. These meetings facilitate the ongoing exchange of best practices, insights, and opportunities identified across other trusts within the network.

The Guardians previously submitted recommendations to the Board via the annual report and have since provided additional recommendations for consideration. To enhance transparency and accountability, the Trust should provide regular progress updates to the Guardians regarding the implementation status of all recommendations. This information is essential for the Guardians to include comprehensive updates in their biannual and annual reports.

Upon completion of actions, these outcomes could be communicated to the workforce, demonstrating the Board's commitment to responsive leadership. This approach will reassure staff that their concerns are valued and acted upon, fostering a culture of open communication and continuous improvement.

• The Guardians have received multiple concerns from staff seeking HR assistance, involved in formal processes, or needing guidance. A recurring theme in these concerns is limited or no communication from HR and Employee Relations teams over extended periods. Staff have reported feeling ignored due to delayed or absent responses, leading them to escalate issues to the GSL. It is recommended that the Trust review how these teams communicate with staff and introduce more frequent updates in line with existing policies.

Executive Summary:

The Guardian Service Limited (GSL) began providing the Freedom to Speak Up Service for the East of England Ambulance Service (EEAST) on 5 August 2024. This report marks one year since the East of England Ambulance Service commissioned The Guardian Service to deliver the Freedom to Speak Up Service.

Between 5 August 2024 and 31 July 2025, a total of 229 concerns were raised by staff members. Of these, 123 were escalated to the Trust, and the average length of time that concerns remained open was 60 days.

For the purpose of this bi-monthly report, 32 concerns were raised with the Guardians between June and July 2025.

No staff member reported suffering a detriment as a result of speaking up. However, the number of staff members raising concerns anonymously has increased, with three cases in the past two months.

A few recommendations are detailed at the end of this report for the Trust to consider.

Introduction / Background:

With regard to the results for the last two months the number of cases has started to increase following the promotional work undertaken to highlight the service. Anecdotally, the guardians have confirmed that this trend continued through August (although the report is not yet ready) – these months are often less busy because people are on holiday or otherwise occupied. A consistent increase in numbers is considered positive.

Previously, we highlighted a lack of cases in Bedford operations and worked closely with the team to promote the service. In July, 3 cases were reported, and early intelligence suggests there will be more in the August report. This suggests that the intensive communications and engagement plan has been effective in increasing awareness. However, we are continuing to focus efforts in this area.

The diagram to below demonstrates the themes for cases for year-to-date. A series of meetings has been arranged with the Head of HR Services to monitor the themes within the system and process cases to ensure improvements can be made based on the feedback.

With regard to the results for the last two months the number of cases has started to increase following the promotional work undertaken to highlight the service. Anecdotally, the guardians have confirmed that this trend continued through August (although the report is not yet ready) – these months are often less busy because people are on holiday or otherwise occupied. A consistent increase in numbers is considered positive.

Previously, we highlighted a lack of cases in Bedford operations and worked closely with the team to promote the service. In July, 3 cases were reported, and early intelligence suggests there will be more in the August report. This suggests that the intensive communications and engagement plan has been effective in increasing awareness. However, we are continuing to focus efforts in this area.

The themes are also reviewed in the Raising Concerns Forum and triangulated with the themes from our staff survey results and ER cases. Actions arising from the discussions are referred to the People Committee for follow up.

Recommendations The chief of staff and the Guardians will review the recommendations from the annual report and provide a progress update in the next report. In view of the recommendation regarding transparency, this can also be shared as part of the ongoing communications campaign for FTSU.

Key Issues / Risks:

The most recent efforts by the Trust to help promote GSL are reflected in the growing number of concerns received by the Guardians. The Guardians have reported an increase in concerns and staff members have shared that they felt comfortable to raise concerns via GSL due to colleagues who previously used the service and had a positive experience.

Concerns received are recorded by GSL against specific themes: Management issues, system and process, bullying and harassment, discrimination and inequality, behaviour and relationship, and patient safety/quality and worker safety.

Over the past two months, the top two job groups raising concerns were Additional Clinical Services (5) and Allied Health Professionals (16). Another seven concerns were raised without disclosing the staff member’s job group. This indicates that the staff member either preferred not to have this information recorded or felt their position at EEAST could be easily identified.

The most common themes for new cases were System & Process (12) and Management Issues (9). Staff members have disclosed concerns that policies and procedures are not being consistently applied at an operational level and expressed dissatisfaction with how managers are perceived to be following processes.

Norfolk & Waveney A&E Operations continues to have the highest number of concerns raised. This should be viewed as encouraging as staff appear comfortable speaking up.