Patient safety and speaking up—learning from the literature (Roger Kline)

Summary

The ability of healthcare staff to raise concerns safely and effectively is a cornerstone of good workforce culture and safe patient care. The extent to which employee voice is heard and acted upon is a good measure of the inclusiveness and psychological safety within teams, particularly whether concerns are raised “in the moment”. In turn, inclusiveness and psychological safety contribute to whether staff feel speaking up is safe and effective.

In this review attached, Roger Kline, Research Fellow at Middlesex University Business School, explores the literature on patient safety and speaking up, arguing that staff being able to raise concerns safely and effectively is essential for patient safety, but the NHS continues to struggle with creating a culture where this happens reliably. Despite years of inquiries, policies, and the introduction of Freedom to Speak Up Guardians (FTSUGs), employee silence, fear of detriment and a sense of futility remain widespread.

This review was written ahead of the publication of the Dash Review of patient safety across the health and care landscape and the NHS 10 Year Plan but the issues explored will be highly relevant to whether the Review and the Plan achieve their stated aims for quality and safety.

Roger has written an accompanying blog discussing the findings of his review:

• Power and the sound of silence—A blog by Roger Kline