Support for NHS Freedom to Speak Up Guardians
WorkInConfidence supports Freedom to Speak Up with a secure, easy and trusted platform where people can have a two-way conversation with you anonymously. This helps to overcome the reticence of starting a conversation by providing the psychological safety to do so. People can log their concerns or share ideas, and Guardians can securely store, update and track cases as well as spot patterns. This has been built with extensive input from NHS Trusts and other regulated healthcare operators. The platform also includes Case management and open case logging.
Trusted by NHS Trusts
1200+
41%
Freedom to Speak Up Guardians
The Freedom to Speak Up (FTSU) Guardian role was first introduced following the Francis Report into the Mid Staffordshire NHS Foundation Trust. From 2026/27, following the closure of the National Guardian’s Office, oversight of Freedom to Speak Up was transferred to NHS England.
Freedom to Speak Up Guardians are an important point of contact within any NHS organisation, supporting staff to speak up about anything that gets in the way of doing a good job. This can range from patient safety concerns to bullying and harassment, unsafe staffing levels, or poor culture.
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, giving security concerns, and making it hard to collect necessary data, hard to share cases with appropriate people, and hard to collate reports.
The WorkInConfidence Case Management aspect gives Guardians an easier, more consistent way to log cases and record necessary information. They can collect and record data, share with or add other team members when appropriate, monitor and update progress and identify and report on themes and trends. All with high levels of security and data protection in place and covered for you. Guardians can pre-determine what fields of data they will collect and set access privileges – controlling who can see what. This allows appropriate support with co-ordination of cases, without inappropriate disclosure of confidential information.
The WorkInConfidence platform combines an anonymous Speak-up conversation aspect (to give reticent people the psychological safety to Speak Up) with easy case logging and effective case management.
Anonymous or Open Digital Reporting Channel
Staff are given access to a Web App which is accessible on phone, tablet, or PC. Through this they can raise a concern with their Guardian, either openly or anonymously if needed, at any time that suits them.
Case Tracking & Trend Reporting
Every case is logged and categorised consistently, making it far quicker and easier to prepare reports to the SLT, Board or Regulator.
Two-Way Anonymous Conversations
With two-way anonymous conversations, Guardians can encourage the circa of 40% of people who do not normally Speak Up, to do so. At the same time, despite the first contact being anonymous, you are able to go back to the conversation initiator to request further information, encourage them to step forward, or keep them updated on case progress.
Board, SLT & CQC Ready Dashboards
Guardians are able to turn case data into clear reporting for Trust or organisational Boards or SLT review and evidence trusted speak-up routes for CQC well-led inspections.
- Data handling designed around GDPR and NHS information governance expectations
- Case categorisation can be mapped to 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
WorkInConfidence is already used widely across the NHS and other health care providers.
Built Around the Guardian Relationship
When raising things anonymously, staff are clear about who they are contacting rather than just a generic anonymous 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: A clear point of contact within an NHS or other healthcare organisation who supports staff to raise concerns about anything affecting their ability to do a good job – including patient safety, bullying, harassment or workplace culture. The Guardian helps ensure concerns are heard and acted on.
A: Yes. The role is embedded in the healthcare framework. National coordination has moved from the National Guardian’s Office to NHS England from 2026/27, but the requirement for Trusts and other healthcare organisations to have Guardians in place remains.
A: Yes. Cases logged on and through WorkInConfidence can be categorised in a way that maps to the national Speaking Up Data themes.
A: Yes. Staff can choose to remain fully anonymous while still exchanging messages with the Guardian. Importantly, the Guardian has a route back to the individual to encourage them to step forward or request further information.
A: It’s built to give individuals direct contact with the Guardian or other appropriate contact – specifically fitting well with the Freedom to Speak Up model used in the NHS – supporting contact with an identified Guardian rather than an unnamed contact. The platform also supports national data themes, and board-level reporting.
Learn More Today
See how WorkInConfidence gives you as a Freedom to Speak Up Guardian a modern, anonymous reporting channel and inbuilt case management used widely across the NHS.