Sarah Reed and having the freedom to speak up

Sarah Reed worked in the NHS for 10 years as a therapeutic radiographer before changing career and graduating as a physiotherapist in 1997. In 2000, she started working in Spire Cardiff Hospital as an MSK physiotherapist and last year she took on the role of Freedom to Speak Up Guardian for the hospital. Sarah is one of 39 Guardians across Spire Healthcare who are making speaking up a normal part of everyday working life and culture.

What is a Freedom to Speak Up guardian?

In recent years several healthcare scandals have hit the news, including the 2013 Francis Report into failures of care at Mid Staffordshire NHS Trust, which showed unsafe practice being associated with a workplace culture where staff feared reprisals if they challenged poor procedures. The report advised that each NHS Trust needed to break down barriers to staff voicing their concerns about things stopping them doing a great job. Part of the solution was setting up the Freedom to Speak Up (FTSU) process. 

Spire Healthcare launched its Freedom to Speak Up initiative during 2018 and is the first independent acute provider to work with the National Guardian’s Office to deliver training to its Guardians. In Spire Cardiff, there is a team of seven FTSU Ambassadors, but it is the Guardian who takes concerns directly to the senior managers and ensures that issues are explored. The FTSU process does not replace hospital procedures, but gives a way of raising issues if, for whatever reason, a member of staff feels hesitant using conventional reporting lines

Why did you volunteer to be a FTSU guardian?

The reasons for setting up the initiative totally resonated with me and I knew that the communication skills I use every day as a physio would be a good fit for this role. 

How do you ensure people have confidence in the scheme and remain strictly anonymous?

All issues are submitted electronically. There’s an option to submit anonymously, and I am the only person in our hospital who can see what has been submitted. Our Corporate Guardian also has sight of all concerns raised within Spire, and she uses this data to troubleshoot any recurring issues, or to escalate anything that compromises patient safety.

Interestingly, half of those who have used our service have chosen not to be anonymous, suggesting that confidence in the process has grown as more people have a positive experience of it. 

What challenges and achievements have you faced as a FTSU guardian?

Setting up the service locally was a significant challenge but the Cardiff FTSU team have achieved a lot since the launch of the service last June. We have an easy to use system to report concerns up to our hospital director who has proactively worked to find solutions. FTSU is a compliance issue, so we have also made it a part of our mandatory training programme.

The best thing about being a FTSU Guardian is being part of a system that promotes staff and patient safety. From June to December 2018 there were 124 matters raised from the 39 Spire Hospitals, with 10 reported at Cardiff, along with many informal impartial conversations, signposting colleagues towards others who could help with their concerns. 

How do you fit being a FTSU guardian around your clinical practice?

I just do. There is ring-fenced time in my diary for regular meetings with the hospital director, but once a concern is formally raised I let her know what the issue is as soon as I can because it’s important we don’t sit on issues that need urgent review. So a degree of flexibility is part of the role and it’s working well.

How do you relax?

I love travel, and I’m often found walking up a mountain somewhere, but never happier than with a group of friends and a glass of wine.