The NHS’s ‘exhausted’ safety champions need greater support

A decade after the Freedom to Speak Up guardian role was first mandated following the Mid Staffordshire inquiry, the movement faces a defining moment

With the imminent closure of the National Guardian’s Office, NHS England is considering how Freedom to Speak Up (FTSU) guardians will be supported.

To support this work, Gowpen carried out a survey exploring the wellbeing of FTSU guardians to highlight the lived experience of those doing the vital work of supporting staff voice and patient safety. The findings paint a picture of guardians left isolated, emotionally exhausted, and without adequate support.

Of the guardians who responded to the survey, one in three rated the impact of their role on their wellbeing as either “negative” or “very negative”. These figures align with the National Guardian’s Office’s own most recent survey, which found that 22% of guardians often or always felt emotionally exhausted, and 13% often or always felt burnt out.

FTSU guardians deal with cases often at the very darkest side of human behaviour: bullying, racial discrimination, sexual misconduct, patient harm and, increasingly, the fallout from societal and global conflicts playing out in NHS workplaces. Many describe feeling isolated. Yet nearly half of the guardians surveyed have no access to confidential psychological supervision.

One said: “I have felt very unsupported and do not feel anyone has my back. It has led to stomach issues and loss of sleep.” 

Another said: “The mental/emotional weight of the issues that are brought forward can be quite intense. There’s only me and one other guardian in the trust, and we don’t have any psychological supervision.” 

Where support does exist, it does not meet the needs of this nuanced role. Employee Assistance Programmes lack the specialist knowledge. Internal management check-ins, which some organisations offer as a substitute for psychological supervision, create a conflict of interest. The independence of Freedom to Speak Up guardians is central to gaining workers’ trust, and this compromises both the guardian’s psychological safety and the integrity of the role.

Read full story (paywalled)

Source: HSJ, 17 March 2026

Further reading on the hub:

• Speaking up for patient safety: A new interview series about raising concerns and whistleblowing
• Speaking up for patient safety: Jayne Chidgey-Clark in conversation with Peter Duffy and Helen Hughes