Speaking up for patient safety: Bethany Carter in conversation with Peter Duffy and Helen Hughes

Summary

In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care.

In this episode, Helen and Peter speak to Bethany Carter, currently Head of Quality and Clinical Governance at Combat Stress. Bethany discusses her career from military nursing and infection control to becoming a Freedom to Speak Up Guardian and later a senior leader at the National Guardian’s Office. She reflects on how organisational culture determines whether staff feel safe to raise concerns, drawing on both positive and negative personal experiences of speaking up.

The interview explores the importance of supporting Guardians, strengthening managers’ ability to listen and respond, protecting staff from detriment, and maintaining independent national oversight as the National Guardian’s Office closes.

Bethany's central advice is that anyone with a concern should not be deterred by terminology or process: they should find someone they trust, seek support and speak up so organisations can learn and improve.

Content

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Transcript of the interview

Read a blog from Peter and Helen about the interview series

About the author

Bethany is an accomplished Queen’s Nurse and influential healthcare leader with a distinguished track record in clinical leadership, patient safety and organisational culture transformation. As Head of Quality and Clinical Governance at Combat Stress, she leads the strategic development and assurance of high-quality, safe, and effective care for veterans’ mental health services, ensuring robust governance frameworks and continuous improvement across the organisation. 

Previously serving as the National Lead for Guardian Support and Policy and Director of Operations and Strategy, at the National Guardian’s Office, Bethany played a central role in shaping national strategies that foster psychological safety, transparency and a strong speaking up culture across health and care. 

A former military nurse, Bethany has held critical leadership positions in both the Royal Navy and British Army, where she served as an Infection Prevention Nursing Officer. Her operational leadership was vital during the COVID-19 pandemic, where she led a coordinated, cross-organisational response across multiple NHS Trusts and public bodies for Solent NHS Trust.