Our A-Z of Speaking Up.
Throughout October (National Freedom to Speak Up month) we will be sharing information and advice and also some (not so subtle) prompts for you to think about ways in which we can all work and interact in ways that will promote the best in safety and quality and to try to make this a great place to work for everyone. Click a letter below to see more of our information.
Y is for …YOU! ALL OF YOU. You can really make a difference if you speak up. Speak up to your manager. Speak up to your local Freedom to Speak Up Champion. Speak Up to Steve O’Brien, your Freedom to Speak Up Guardian @ firstname.lastname@example.org. You could really make a difference - for your patients, for your colleagues and for yourself.
X is for (excuse the stretch!) eXcellence - a key aim for Lancashire Teaching Hospitals; delivering eXcellent care with compassion. To do the right thing for our patients and staff we need to know when we don’t get it right so that we can learn and improve. Please speak to your manager if you see anything unsafe or uncaring. Don’t forget to Datix too.
W is for whistleblowers. The decision to take concerns outside of an organisation can indicate a failure on the part of the organisation to provide the means for an individual’s concerns to be properly heard. If you have a concern please speak to your manager or, if you are unable to do that or you do not feel that your manager has listened call the Freedom to Speak Up Guardian at email@example.com or speak up to a local Freedom to Speak Up Champions whose details are on the intranet or on posters across the Trust.
W is for wellbeing. The current pressures within our healthcare systems can have such a significant impact on our wellbeing. Take good care of yourselves and each other. There is a wealth of help and support to be found on our Trust intranet site at https://intranet.lthtr.nhs.uk/health-wellbeing. Please get in touch if you are struggling or need to build resilience.
V is for voice. Everyone has one. Not everyone uses it for lots of reasons. Guardians are there to help you do just that. The smallest voice often has something of value to say. if you don’t feel able to raise your concerns with your line manager or if you’ve tried but don’t feel listened to, contact the Freedom to Speak Up Guardian at firstname.lastname@example.org. Get in touch. We will listen and help you to be heard.
V is for values. These are the words of our Chief Executive, Karen Partington: ” Here at Lancashire Teaching Hospitals our values set out the type of people we want and the behaviours we expect.” “Our values are at the very centre of what we all do and define who we are both as individuals and as an organisation. They are the bedrock of our organisation, they should remain constant in every situation and they set out the behaviour we expect all staff to show in order to provide excellent care with compassion.
We have high standards for our staff and we believe that we should always act with professionalism, compassion showing dignity and respect to staff, patients and families from all groups and background. Our values are more than just words; we as part of this team must all believe in them and seek to live by them so we create a positive, trusting, supportive atmosphere and a culture in which all staff can flourish and grow enabling us to always deliver an exceptional quality of care. Our values are designed by staff for staff, they provide a clear sense of purpose as to what we stand for, guide our actions and relationships enabling us to use the values to set out how we treat others and wish to be treated.
V is for Ves. Throughout the month Ves in our communication team has been posting our A-Z on the Trust internet and intranet pages every day, ensuring the messages get to as many as possible. Ves is a key part of the wider Freedom to Speak Up team. Thanks, Ves!
Understanding. Understanding a situation and the actions of colleagues within it do not always make that situation easier to deal with… But the act of understanding will bind those colleagues to you and serve you well through learning and action for the future. Take the time to understand and accept.
Unbiased. The Freedom to Speak Up Guardian and his team are required help and support in an unbiased way. They will demonstrate impartiality and objectivity which may not always be what you want to hear, but which is always the right thing to do. Contact the Guardian at Stephen.O’Brien@lthtr.nhs.uk or a member of the team through freedomtospeakup@LTHTR.nhs.uk.
Thank you - to all those who have had the courage to speak up to us, and to all those who will. As tough as it can be you are contributing towards a safer place for patients and makingLancashire Teaching Hospitals NHS Foundation Trust a safer place to work and a great place to work.
The Trust Leadership Team. Some important messages to remember, and shared this week by the leadership team at Lancashire Teaching Hospitals for every member of staff to see. Key messages of:
- Empowerment to act.
The team have acknowledged the need for support and provide suggestion of where to get it.
Staff are encouraged to speak up and shown the means to do so.
In the challenging times ahead strong, compassionate leadership will be so important.
Trust. Consistency is the foundation of trust. Trust brings its rewards... so does unfair treatment, intended or otherwise. Be kind and consistent in what you say and how you behave. Reap the rewards! It works. Trust us at Lancashire Teaching Hospitals NHS Foundation Trust.
Tim, the Non-Executive Director lead for Freedom to Speak Up. He works with Karen Swindley, the Independent Executive Director, to ensure we are open to challenge from anyone working within the Trust and to provide assurance to the Board that our systems and processes are as good as they can be. You can contact Tim directly at Tim.Watkinson@LTHTR.nhs.uk.
Simon is another of our Freedom to Speak Up Champions and a member of our chaplaincy team at Lancashire Teaching Hospitals. Simon's role puts him in a great position to support staff raising concerns and from a spiritual perspective if needed.
Solutions. Sometimes what appears to some to be the most complex of problems can have the simplest solutions that are discovered most easily by listening and talking to each other?
Support. One of the key roles of the Guardian and one often most valued by those who seek help from the Freedom To Speak Up Team. Staff can feel isolated and unsupported with the concerns. What canb you do to change that?
R is for Respect. In any interaction respect should be both earned AND offered. Listen to each other. Recognise that what might not be significant to you may be another’s world and treat as you would want to be treated.
R is Resilience - so difficult to maintain under the relentless pressure of what is now and what is to come. Remaining resilient is not ‘manning up and getting on with it’. It is not about failure. It’s about understanding and managing cause not just effect
Q is for Quality staff: invested, enabled, empowered, supported, developed and well-led delivering Quality care and treatment: safe care, positive experiences and excellent outcomes.
Patients are at the centre of everything we do and their safety is paramount. If you see anything that might compromise patient safety anywhere in Lancashire Teaching Hospitals please report it immediately to your line manager and in Datix.
It is a cliché that Rome wasn't built in a day but it still holds true. Positive change often requires planning, time, commitment, infrastructure, resource and most importantly culture change. Be patient but persevere and persist!
Every concern raised provides a potential opportunity for learning and improvement. We should be grateful to those who raise them and make sure they are not wasted. If you have any concerns please contact Steve O’Brien, Freedom To Speak Up Guardian or one of our freedom To Speak Up Champions on email@example.com
Freedom To Speak Up is all about learning, improvement and cultural change. Our workforce and education teams play a crucial role in supporting teams to make these changes. We could not do it without them! Thank you!
N is for nurses, nurse managers/specialists/practitioners/educators, nutritionists, neurologists, neurosurgeons, neuroradiographers, neonatal staff, nuclear medicine teams and any other ‘n’s’ we’ve forgotten (sorry!). If you have any concerns please contact Steve O’Brien, Freedom To Speak Up Guardian or one of our freedom To Speak Up Champions on firstname.lastname@example.org
Nichola is our Clinical Research Facility Matron and another of our Freedom to Speak Up Champion. She takes her role seriously and well understands the responsibility of supporting colleagues with concerns. Along with all our other Champions she can be contcated via her Trust email address or at email@example.com
Often derided but so important, good managers turn talent into performance, finding out what is unique about each of their team, challenging them to excel in their own way, enabling them to do so, and acknowledging them when they do.
Don't shy away from meaningful conversation. They can do so much to resolve conflict/prevent escalation. Focus on the issue not the person. Explore and challenge but listen and respond with compassion and warmth.
Michelle Benjamin is a Sister in our Same day Emergency Care Unit and another of our Freedom To Speak Up Champions. Michelle's colleagues often use her as a 'sounding board' and she is "always there for them, ready to listen". You can contact Michelle at firstname.lastname@example.org
Mel Fysh is one of our Clinical Governance Facilitator working in the Diagnostics and Clinical Support Division. Her passion for supporting colleagues to speak up has never diminished since she first became one of our Freedom To Speak Up Champions. You can contact Mel at email@example.com
We have So many inspirational leaders at Lancashire Teaching Hospitals. Leaders who know the way and, through action and example: go the way and show the way to excellent care to others.
It is not getting things wrong or making mistakes that is important but rather what we learn and what we do with it. The greatest mistake is the one from which we fail to learn and improve.
Karen Swindley is the Trust’s Executive Lead Director for Freedom to Speak Up as well as our Strategy, Workforce & Education Director. Karen is responsible for ensuring that:
- The Freedom to Speak Up Guardian is fully supported
- The Board is provided with sufficient evidence to be assured that the service is effective and that all staff are able to speak up without detriment
- That the Trust learns and improves as a result of our staff raising concerns
Steve O’Brien, Freedom to Speak Up Guardian, says that “Karen has been a great support to me and my team from the beginning, appreciative and encouraging of our efforts with the right amount of constructive challenge where needed”
Knowledge is power but often most powerful when shared with others. Lack of knowledge feeds insecurity, isolation and is potentially unsafe.
Do you share the important and small stuff when you should? Don’t you think you should?
Do you/your team have access to the information, knowledge and support you need to do your job safely? Have you had your appraisal? Do you have a development plan?
If the answer to any of these questions is ‘no’, speak to your manager, speak to your team, or contact firstname.lastname@example.org and we can help
Kerri Davies is a sister in critical care and another of our Champions. She has worked uin the Trust since 2014 and has two children and a love of cake! Kerri passionately believes that staff have the right to work in an environment that is safe and that encourages the best care. She believes that this happens when people are supported and she provides this support for staff in critical care and in our operating theatres. She can be contacted at email@example.com for a confidential chat over a coffee and more importantly, cake – what nurse doesn't like cake?
Did we mention she likes cake?
Having a just and learning culture is important, it is about making sure every member of our team is treated fairly if they are involved in an incident at work. By having a just culture staff should feel confident to come forward if mistakes are made without having the fear of being blamed or treated badly. A just culture creates a work environment where staff feel supported, safe and able to learn when things do not go as planned.
We are incorporating just culture processes and decision making in all our workforce polices and when investigating patient safety incidents. This will make sure we ask ‘what was responsible’ not who is responsible, seeking to avoid feelings of finger pointing or being blamed and finding out how the wider system and processes may have contributed to errors.Lancashire teaching hospitals is committed to the fair treatment of staff and supports a culture of fairness, openness and learning. We want staff to feel confident to speak up when things go wrong, rather than fearing blame.
We know that by supporting staff to be open about mistakes, valuable lessons can be learnt so those same mistakes can be prevented from happening again. We want to ensure that a blame culture does not exist anywhere in the Trust but rather evidence of a just culture is everywhere
Don’t be afraid to speak up to your manager, or the Freedom to Speak Up team if you have any concerns
Three Freedom to Speak Up Champions for the price of one!
Jean is our head of chaplaincy service and is always there for support when needed.
Joanne is a training coordinator in our hotel services and provides support to our colleagues who work hard to ensure that the hospitals are clean and safe and helping to provides for the needs of patients and staff.
Jaclyn is a secretary in Ophthalmology, but soon to be moving to a new role in performance management in paediatrics. To quote her 5 year old son, who is obviously wise beyond his years:
“Words are great. Let them out, otherwise they get trapped inside and never get out.”
(Arthur McVeigh, 5 years old).
Follow Arthur’s advice. Let those words out if you have any concerns. Contact the Jean, Joanne or Jaclyn through their Trust email addresses. Alternatively you can contact the Freedom to Speak Up Guardian at Stephen.O’Brien@lthtr.nhs.uk or the freedom to speak up team at firstname.lastname@example.org for advice, help and support.
Integrity is a fundamental value and behaviour. Following your moral and ethical convictions is not always an easy path to travel, and can put you in conflict with thos close to you at home and at work. It demands truth and honesty, even if that truth is difficult to confront and accept.
The freedom to speak up team will support you on that path. If you have any concerns and you are not being listened too get in touch at email@example.com or contact the guardian at Stephen.O’Brien@lthtr.nhs.uk
Although employed by the Trust, the Freedom to Speak Up guardian operates independently, impartially and objectively. If you want to raise a concern you can be sure that the guardian will listen to your concerns and help you to ensure, as far as possible, that:
- You are supported in speaking up
- Patients are protected
- Quality of care improves as a result of learning
- Your working experience and that of colleagues improves as a result of raising your concern
- Your voice is heard.
Please contact Stephen.O’Brien@lthtr.nhs.uk or the team at firstname.lastname@example.org
Call it out. Speak up to me!
One small letter often ignored! It is not selfish to take care of yourself. It is essential to look after ’I’. Make sure you set aside time to be you and to enjoy being you, and if being you is getting hard, speak up to someone about it, don’t keep it inside. The health and wellbeing page on the intranet has lots of ideas for health and support available.
You can also contact the Freedom to speak up team if you need any support. Speak up to us – we will try to help
An honest working relationship is essential to a safe working environment high quality care and treatment.
Honesty builds Trust. Trust builds Loyalty. Loyalty builds teamwork. Teamwork builds enthusiasm. Enthusiasm builds commitment. Commitment builds excellence
Be honest with each other as you work to learn and improve.
In these difficult and challenging times, don’t forget where you live. We need you but so do your family (only six at a time though!). Make time for them. That time will protect you and nurture you.
Haj is another of our Freedom to Speak Up Champions. Haj is a Manager in our Corporate Governance Team and a registered Pharmacist. She is a member of our Trust’s Raising Concerns Group and is a strong advocate of creating an open culture where everyone feels that their voice is valued and heard.
If you want to raise a concern to Haj you can reach her via her Trust email address or through email@example.com
G is for
My name is Steve O’Brien and I am the Trust’s Freedom to Speak Up Guardian. I am a Middlesbrough fan (an accident of birth – not my fault!) so working as a Guardian is a welcome distraction! I was a nurse and have worked in the Trust for 30 years (I know, I don’t believe it either!)
I have a lot of love for this Trust. Like most, if not all of you, I want the Trust to always be trying to be the best, to deliver excellent care with compassion, and to be a great place to work.
Sometimes though, we don’t get it right and at these times, it is essential that we speak up and raise concerns so that we can learn and improve. If you have any concerns about anything please speak to your manager. Don’t assume that your concern is unimportant or that there is nothing you can do. Please call it out and speak up.
If for whatever reason, you cannot raise the concern with your manager or, if you don’t feel your concern is taken seriously, please contact me at Stephen.O’Brien@lthtr.nhs.uk or one of the champions at firstname.lastname@example.org. We can offer confidential advice and support. You can contact us anonymously but it would be preferable if we were able to contact you to give you feedback. You can be assured that we would not share any information, including your identity without your permission (unless a crime has been committed though we would discuss this with you first)
Guilt and Gratitude
The emotional burden of raising a concern should not be underestimated. GUILT and a sense of betrayal of colleagues or the Trust itself can sometimes be an issue. Please bear this in mind and offer reassurance and GRATITUDE. Saying thank you goes a long way
F is for
Letting us know how we are doing is hugely important. Good or bad it helps us to grow and improve. Have you ever been in a situation where you either got no feedback at all or you only got it when you made a mistake. How did that feel?
Now, think about a time when you might have been told how well you have done in a situation, how deserved a promotion was. How did that feel? There may have been a time when someone showed you a different way to do something that was really helpful.
Good honest and constructive feedback is an essential part of making your team a great one to work in. Don’t hold back!
F is also for Fairness
Fairness is so important to us. It lets us know that we are equally valued as individuals within a team. Fairness makes us feel secure, it encourages loyalty and respect
Ask yourself… do I work in a fair environment? Do I treat my colleagues/team members in a fair and consistent way?
There is no reason why you shouldn’t is there?
E is for
It’s what we all want to be a part of. Providing excellent care with compassion is what we are all about. If not this then why are we here? Every day we see examples of excellence in action in the Trust, often a result of initiative, leadership and teamwork where ideas are encouraged, and voices are heard (even dissenting ones) and contributions to improvement are valued.
Ask yourself… Does this describe my team? How can we/I make a difference?
E is also for Empathy
The ability to understand the feelings of another, and to put yourself in their place. You can show it when you put aside how you think the person SHOULD react or behave and simply try to understand and accept that they do. Knowing that someone understands what they are going through can be a huge support to colleagues.
Think - have you ever dismissed someone’s worries or concerns as ‘trivial’, ‘emotional’ or ‘overreacting’? Next time try listening to what they are going through and try not to judge but to understand. That way you will be in a great place to help them.
D is for
Detriment is to suffer harm or damage. For some of us, the fear of detriment might prevent us from speaking up. The Freedom to Speak Up team has a key role in ensuring that everyone is safe to speak up.
No-one who raises a concern with their managers or with the Freedom to Speak Up team that might lead to improvement, should ever suffer harm or loss for doing so. If you need to raise a concern in good faith with the Freedom to Speak Up Guardian or any of the team we will take any and all steps necessary to protect you from harm. Speak up safely… speak up to us.
And finally, D is also for David
David is a Freedom to Speak Up champion and a Matron in our gynaecology services. He passionately believes in the importance of supporting people to raise concerns safely and to have their concerns heard. You can contact him via email@example.com
C is for
A civil workplace is important. Evidence shows that it reduces errors, reduces stress and promotes excellence.
Ask yourself… why would I not to work in such a place?... and what can I do to make sure I do?
Confidentiality is critical in helping people to feel safe. If you need to speak to any of the Freedom to Speak Up team you can be assured that we will respect your right to confidentiality and (except in the most exceptional of circumstances) will not share information you give us without your permission
Be in no doubt, it takes courage to speak up and how we respond is crucial to ensure that those who do feel safe and able to do so again. It can be a scary place but you do not have to do it alone. Speak to your colleagues… Speak up to your manager…Speak up to us
Our family of Freedom to Speak Up champions continue to grow, providing accessible support to anyone who needs it. Every day during October you can meet them here. All are ready and willing to help… so get in touch!
Not just something that grows in a lab! Our culture defines us. We want to create a culture everywhere where there is opportunity for learning, enhanced quality of working lives and behaviour that is at all times consistent with our values and standards. Ask yourself… what are you doing to make that happen?
And finally, C is also for
Coco and Charlotte.
Coco is a sister in the Emergency Department and Charlotte is a Midwife working on maternity ward B and can be contacted via firstname.lastname@example.org
B is for
No-one should have to come to work and experience bullying. FULL STOP! If you believe it is happening to you or a colleague, speak to your manager. If, for any reason, you are unable to speak to them, contact the Freedom to Speak Up Team at email@example.com or contact the Guardian, Steve O’Brien CALL US AND CALL IT OUT
One of the major factors in the Mid-Staffs scandal and others since was a culture where staff were not encouraged (and actively discouraged) from speaking up. What stops you or your team from speaking up and raising concerns?
Do you know how to report on Datix?
Do you feel able to raise concerns with your manager? If not, why not? TALK TO YOUR MANAGER (The Freedom to Speak Up team can help) about this
Do your team feel able to raise concerns with you? How can you make them feel safe enough? Do you thank them when they raise concerns? TALK TO YOUR TEAM
And finally, B is also for:
Barbara and Becky.
Becky is the Specialty Business manager for Child Health in the Women and Children’s division.
Becky believes in creating a supportive and open culture fit for the future.
She can be contacted via firstname.lastname@example.org
“Let’s call it out and TALK”
Barbara is a Learner Support Manager in our Health Academy.
She strongly believes in openness and transparency and believes that raising concerns as business as usual is a key way forward for the Trust. Barbara can be contacted via email@example.com
A is for
To be accountable, it is important that we all understand our roles and responsibilities and are prepared to take ownership of them. By then holding to account, we can learn and improve
Do I know what is expected of me? TALK TO YOUR MANAGER
Do my team know what I expect of them? TALK TO YOUR TEAM
Would your colleagues describe you as amenable, accessible (more A’s there!), obliging and friendly? Why not? What can you do to change that?
A is also for Andrew, one of our Freedom to Speak Up Champions…
Andrew is a Clinical Lead Physiotherapist specialising in Pain Management.
Andrew is a good listener and is very approachable. He can be contacted via firstname.lastname@example.org