Support for Freedom to Speak Up Guardians in the NHS
Trusted by NHS Trusts
1200+
41%
What Is a Freedom to Speak Up Guardian?
A Freedom to Speak Up (FTSU) Guardian is an independent point of contact within an NHS organisation who supports staff to speak up about anything that gets in the way of doing a good job — from patient safety concerns to bullying, unsafe staffing levels, or poor culture.
The role was introduced following the Francis Report into the Mid Staffordshire NHS Foundation Trust and is coordinated nationally by the National Guardian’s Office. It remains part of the NHS Standard Contract, and from 2026/27 national oversight is transferring to NHS England as part of wider changes recommended by the Dash Review of patient safety.
Why Guardians Need Better Tools
The number of cases raised with Freedom to Speak Up Guardians has grown every year since national data collection began in 2017 — from 7,087 cases in the first year to 37,770 in 2025/26. Many Guardians are still managing that growing caseload through spreadsheets, email, and paper records, which makes it hard to spot patterns, protect anonymity consistently, or pull together the quarterly data trusts are expected to submit.
A dedicated digital channel gives Guardians a faster, more consistent way to log cases, follow up anonymously, and report trends to the board — without adding to their workload.
Anonymous Digital Reporting Channel
Give staff a phone, web, and app-based way to raise a concern with their Guardian anonymously, at any time — not just during a corridor conversation.
Case Tracking & Trend Reporting
Every case is logged and categorised consistently, making it far easier to prepare the quarterly submissions Guardians share with the National Guardian's Office.
Two-Way Anonymous Conversations
Guardians can ask follow-up questions and share updates without ever needing to know who raised the concern.
Board & CQC-Ready Dashboards
Turn case data into clear reporting for trust boards, and evidence a genuinely open speaking-up culture for CQC well-led inspections.
- Aligns with NHS Standard Contract requirements for the Freedom to Speak Up Guardian role
- Data handling designed around GDPR and NHS information governance expectations
- Supports the anonymous, two-way reporting model Guardians rely on day to day
- Case categorisation maps onto national Speaking Up Data themes
“It’s a great system, quick and easy to implement and extremely cost effective, which I was surprised by. The user experience is simplistic and very clear which I believe helps when people may be experiencing high levels of anxiety.”
Chair, South West Guardians Network
Live with trusts including Betsi Cadwaladr UHB, Royal Cornwall Hospitals, and Avon & Wiltshire Mental Health Partnership Trust.
Built Around the Guardian Relationship
Designed for a named Guardian and two-way anonymous conversation, not a generic anonymous tip line.
Maps to National Data Themes
Case categorisation is designed to make quarterly National Guardian’s Office submissions straightforward.
See It In Action
Book a free 30 minute demo today
Frequently Asked Questions
A: An independent point of contact within an NHS organisation who supports staff to raise concerns about anything affecting their ability to do a good job — including patient safety, bullying, or workplace culture — and helps ensure those concerns are heard and acted on.
A: Yes — the role is part of the NHS Standard Contract. National coordination is moving from the National Guardian’s Office to NHS England from 2026/27, but the requirement for trusts to have Guardians in place remains.
A: Yes. Cases logged through WorkInConfidence are categorised in a way that maps to the national Speaking Up Data themes, making it straightforward to pull together the data Guardians are expected to submit each quarter.
A: Staff can choose to remain fully anonymous while still exchanging follow-up messages with their Guardian — WorkInConfidence never reveals a reporter’s identity without their consent.
A: It’s built specifically around the Freedom to Speak Up model used across the NHS — supporting a named Guardian relationship, national data themes, and board-level reporting, rather than a generic anonymous hotline.