For the last few years, we’ve looked at the results from the annual NHS staff survey to see how the sector has been performing in the areas of bullying, harassment and speaking up, and if they have been improving over time. The publishing of the National Guardians FTSU Index Report takes a subset of the annual staff survey questions and show some improvements around culture and process.

This year we report on the NHS staff survey, but also consider insights from elsewhere which highlight the ongoing need to keep bullying and harassment top of the organisational health agenda.

The results overview

This year’s results show the national average for the FTSU index has continued to rise. This continued improvement is a fantastic achievement and testament to the hard work of Freedom to Speak Up Guardians and those who support them. However, we are starting from a place where many staff do not feel psychologically safe. The responses to the questions on which the index is based show there is still much to do to make speaking up business as usual. For example, less than two thirds of respondents nationally (59.7%) agreed their organisation treats staff who are involved in an error, near miss or incident fairly. Seventy-two per cent (71.7%) of respondents said they would feel secure raising concerns about unsafe clinical practice – which suggests that over a quarter of the workforce potentially does not feel secure raising concerns. extract from National Guardians FTSU Index Report

It’s important to note that the themes that came up in this years’ survey results don’t just apply to the NHS and healthcare sector – they potentially apply to every organisation


Any discrimination within the workplace is certainly a negative, but some industries seem to suffer it more than others. For example, over 80% of women in the charity sector think that gender discrimination is present in their workplace, while 48% have experienced it directly. This can be something as simple as an ambitious woman being described as ‘pushy’ when displaying the same behaviour as an ambitious man, to a refusal to promote women above men. Research into discrimination in the charities sector results also show a rise in discrimination based on age, skills and ethnicity.

Bullying & Harassment

Bullying and harassment remains an ever-present workplace challenge. One requiring constant focus. Vigilance is required to identify individual instances and encourage reporting. It remains the case with this year’s NHS staff survey that many incidents still go unreported: 43% of those who experienced harassment and bullying or abuse at work didn’t report it. The trend for victims to remain silent is not unique. It requires a multi-faceted approach to victims and witnesses wherever they work, they must feel safe to speak up and trust that their organisation will protect and support them.

Thus, to truly move the dial on speaking up, requires organisational commitment and resolve to address systematic behaviours of bullying and harassment. For if left unchecked, a toxic culture can develop and become endemic. Doing untold damage to individuals physical and emotional wellbeing, as well as impacting organisation performance and creating repetitional risk. An example of this recently emerged in relation to the GMB union. The resulting investigation report describing the culture as one where “bullying, misogyny, cronyism and sexual harassment are endemic”.

source: acas

Toxic culture

The investigative report into GMB’s management of sexual harassment was carried out by Karon Monaghan QC in August 2020. The immediate trigger for the investigation was the receipt of an undated letter addressed to Barbara Plant, the President of the GMB. The letter contained allegations of a “serious sexual assault (rape)”, drug use and sexually predatory behaviour, by a senior man within the GMB. 

One complaint of a serious incident of sexual harassment was made following the correct procedures, which an internal investigation found reasonable grounds to conclude that the accused had committed an act of gross misconduct and the disciplinary process should go to the next stage. Upon which a senior GMB man intervened and assisted ‘the accused’ via a ‘compromise agreement’ to find alternative employment elsewhere.

GMB report findings

The investigative report gives 27 Recommendations and in summary, acknowledges that it will take robust and committed leadership to successfully push this through. And those who do try to drive through change must be supported and applauded. Extracts from Karon Monaghans report sited:

“The GMB is institutionally sexist. The General Secretaries and all regional secretaries are, and always have been, men. Women are underrepresented throughout the GMB’s ranks.

“The evidence I have heard indicates that there are, and have been, regional secretaries who maintain power largely through bullying, threats and victimisation and by creating a climate of fear. Sometimes sexual harassment is used as a form of bullying with examples given to me of men deliberately sexually harassing women in public to humiliate and embarrass them.”

Recommendation 21 is that a “safe place” is permitted to allow anonymous reporting with monitoring capabilities so management are able to measure and report the number of cases raised.

Speaking up and reporting

So, how do we tackle the issues that are still so prevalent in our workplaces, like discrimination, bullying, violence or harassment, including sexual harassment? Putting guidance and policies in place and taking appropriate action against those who break the rules is a good starting point. However, the main problem is that employees won’t report experiencing these things if they are scared of repercussions, being targeted or worse, nothing changing. That’s why opening up a “safe space” to have a secure dialogue is so important. 

Creating an independent platform that allows employees to report issues to management on a completely anonymous basis, opening up communications and helping employees feel safer when disclosing sensitive information. Meaning any member of staff can easily and anonymously discuss concerns, problems or ideas, and management can take action in areas that otherwise might have gone unnoticed – before it’s too late. 

Achieving a positive speaking up culture is also associated with higher-performing organisations. One’s where ideas flow freely and management can leverage insights from within their teams to benefit all their stakeholders.

Learnings and signposts for building organisational good health

Although, the NHS staff survey metrics highlight the need for ongoing focus to overcome bullying, harassment and discrimination. There is much good practice that is transferable for other sectors to encourage employees to communicate freely with their employers. Arguably, if some of which had been in place, in instances such as those highlighted in GMB report, outcomes might have been different.

An independent reporting system

Builds confidence in victims or witnesses to speak up. We would advocate that anonymous feedback with independent data security is the gold standard in building employee trust. Providing protection for the victim against perpetrators who may be direct line or senior management.

Creation of focal points

Such as ‘mental health first aiders or National Guardians’ to demonstrate organisation commitment and good governance. Such independent ownership of workplace “equality, diversity and respect (EDR)”, helps to keep it high on the corporate agenda and given the appropriate resourcing, can be a strategic advantage in both attracting and maintaining staff.

Annual staff surveys

Provides a consistent feedback vehicle for employees and for employers, are a vital benchmark for progress or otherwise in EDR and other organisationals health indicators.

Pulse surveys or mini polls

Also useful engagement tools to create a two-way communication culture and gauge employee sentiment. This is proving to be especially important during the current pandemic. Contributing insights that help management engage efficiently and show empathy.

Discussion groups or ideas forums

Facilitate sharing and encourage participation and if used in conjunction with the appropriate recognition programmes can be a source of innovation for the company and rewarding for the individual.

About WorkInConfidence

WorkInConfidence help organisations improve their Organisation Health; increasing employee involvement and feedback which enhances management understanding. Enabling organisations to improve levels of employee engagement and performance whilst mitigating problems associated with bullying and harassment.

Protect: Anonymous Speak Up: A safe and secure way for your people to anonymously raise concerns via phone, tablet, or PC, ensuring you are aware of any workplace issues and can respond quickly and accordingly

Consolidated Case Management: A secure online place to record, track, update, and report on all speaking up matters, whether raised through WorkInConfidence or directly.

Surveys: Easily set up, run and interpret surveys on engagement, respect, wellness or other topics to ensure you always understand your people, their needs and motivations.

Discussion Boards: Demonstrate your commitment to collaboration with discussion boards to accelerate employee engagement and gain greater insights – anonymous if required.