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Ahead of publishing the consultation response into the functions of the office of the National Guardian, Dame Eileen Sills has set out the principles and priorities that will guide her first months in post.

Dame Eileen, who is also Chief Nurse at Guys and St Thomas’ NHS Foundation Trust, was appointed as National Guardian earlier this month. 

As the National Guardian for the freedom to speak up, Dame Eileen will help to lead a cultural change, initially within NHS trusts and NHS foundation trusts, so that healthcare staff always feel confident and supported to raise concerns about patient care.

The need for an independent National Guardian for the NHS was highlighted in Sir Robert Francis’s ‘Freedom to Speak Up’ review in February 2015, which found that patients could be put at risk of harm because vital information about mistakes and concerns was not being raised by NHS staff routinely. The review found that reporting systems were either insufficient or not used because healthcare professionals did not feel able to speak up. The creation of the National Guardian was one of the key recommendations from this review; an arrangement which the Secretary of State for Health confirmed last July.

The set of principles will be revised as the office of the National Guardian develops over the coming months and ahead of it becoming functional from 1 April 2016.

Dame Eileen Sills, the National Guardian for the freedom to speak up in the NHS said: “As the National Guardian, I am determined that this role will provide independent national leadership to influence the creation of the right environment for all NHS staff to speak up safely.

“As we begin the process of setting up the office, I think it’s important that I set my working priorities - until the publication of the results of the consultation in March - and my expectations for the first year of the role of Guardian.”

Purpose of the role

As National Guardian I will:

1. Establish and support a strong network of local freedom to speak up guardians.
2. Highlight NHS providers that are successful in creating the right environment for staff to speak up safely and share this best practice across the NHS.
3. Independently review cases where NHS providers may have failed to follow good practice, working with statutory bodies to take action where needed.  I will publish my findings and follow up on my recommendations.

My year one expectations

• I will have established the ways of working for the Office of the National Guardian and how we can work effectively with our stakeholders whilst maintaining independence.
• I will have created a network of local freedom to speak up guardians.
• I will have made it clearer to staff working in NHS provider organisations how they can speak up safely.
• I will have started to work towards developing a set of common standards for handling staff concerns and to showcase examples of good practice.
• I will have begun to influence good practice through the Local Guardians and through effective communication across the NHS.

Next steps

The National Guardian will publish the responses to the consultation in March.

As the National Guardian, Dame Eileen will be completely independent, highly visible, and will speak freely and honestly about where changes are needed among NHS trusts and foundation trusts. While she will work in partnership with CQC, NHS England and NHS Improvement to reinforce good practice, she will also take an independent stand to report on any matters of concern affecting these bodies where required.

If you work within the NHS and would like to know how to raise any concerns you have about care to CQC, please visit: http://www.cqc.org.uk/content/report-concern-if-you-are-member-staff.