Nurses fear speaking up at work puts their jobs in jeopardy
Posted 12 June 2023 - 14:00
More nurses feel raising concerns at work is risky and futile, according to analysis of the NHS Staff Survey by the National Guardian’s Office
Nurses are increasingly worried about raising concerns at work for fear of losing their jobs, with little change in the culture of speaking up, a nurse who helped to expose the Mid Staffs scandal has warned.
Analysis of the latest NHS staff survey results by the National Guardian’s Office (NGO) shows a drop in nurses’ confidence to speak up, with just 65% saying they would feel confident to raise concerns about anything in their organisation.
The figure has stayed the same since 2021 but is down from 2020, when 68% of nurses said they felt confident about raising concerns.
Nurses also less confident in raising concerns about unsafe clinical practice
There was also a drop in nurses feeling confident in raising concerns about unsafe clinical practice, with 80% saying they would feel secure raising these issues compared with 81.5% in 2021.
Nurse Helene Donnelly, who helped expose poor care at Mid Staffordshire NHS Foundation Trust while working as an emergency nurse, said that while some progress had been made with the establishment of the NGO following the Francis inquiry into what happened at the trust, the COVID-19 pandemic had resulted in staff increasingly being told to ‘put up and shut up’ about their concerns at work.
Ms Donnelly said: ‘What really worries me is when I was speaking up ten years ago I was given that same messaging. So ten years on from the Francis inquiry we’re going back to that same attitude and culture.
‘The worst thing that can happen is you might be deliberately ignored or silenced because people don’t want to hear it or it makes senior leadership look bad,’ she told Nursing Standard.
NHS England working with employers to improve ‘freedom to speak up’ rates
‘There are also so many nurses struggling financially, so there is a very real fear that speaking up could be career-limiting and impact their income.’
The NGO warned there is a growing feeling among staff that speaking up in the NHS is futile. Its analysis, which looked at the freedom to speak up section of the most recent NHS staff survey results, revealed 72% of NHS workers feel they can raise concerns about unsafe clinical practice, down from 75% in 2021.
Overall, some 61% of NHS workers felt they could raise concerns about anything at work, fractionally lower than in 2021 and down from 66% in 2020.National Guardian for the NHS and registered nurse Jayne Chidgey-Clark said: ‘These responses show there is a growing feeling that speaking up in the NHS is futile – nothing changes as a result.’
NHS England said it was working with employers to improve freedom to speak up rates.
A spokesperson said: ‘There is still too great a proportion of staff who do not feel safe to speak up about something that concerned them – and there is more to do to improve confidence in speaking up in the NHS.’
Further information
- National Guardian’s Office (2023) Fear and Futility: What does the Staff Survey tell us abut speaking up in the NHS?
- NHS Staff Survey (2022)
In other news