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A survey by The National Guardian's Office has revealed a drop in NHS staff members' confidence to speak up. The Freedom to Speak Up sub-score declined from 6.5 in 2021 to 6.4 in

the 2022 NHS Staff Survey. This fall equates to a 1.5% change in responses to the speaking up questions. In the medical and dental category, this fell from 6.3 in 2021 to 6.1 in 2022, with

the report citing trainees' confidence in speaking up as a 'significant area of concern', further adding that the results for this group have deteriorated markedly. While the

results have improved since the 2015 Freedom to Speak Up Review and resulting actions, this continues the fall in NHS workers' confidence to speak up since the pandemic. Of particular

concern is the marked fall in how safe people feel to raise a clinical concern. Speaking up can only bring improvements if leaders and managers listen up and follow up. The corresponding

question about whether people feel that if they spoke up, their concerns would be addressed has also shown a deterioration. This creates a worrying picture of potentially increasing

disillusionment and a feeling that speaking up is futile. Dr Jayne Chidgey-Clark, National Guardian for the NHS said: 'It is not acceptable that two in five workers responding to the

NHS staff survey do not feel able to speak up about anything which gets in the way of them doing their job. 'These survey responses show us that there is a growing feeling that speaking

up in the NHS is futile - that nothing changes as a result. When workers speak up about concerns, including the impact of under staffing and a crumbling infrastructure, their leaders

themselves may struggle to be heard when trying to address these concerns. 'I would add my voice to that of others that this urgently needs to be addressed. Failing to do so risks

compounding this sense that workers do not have the resources they need to deliver the high-quality care they want for their patients.' RIGHTS AND PERMISSIONS Reprints and permissions

ABOUT THIS ARTICLE CITE THIS ARTICLE Decrease in NHS workers' confidence to speak up. _BDJ In Pract_ 36, 7 (2023). https://doi.org/10.1038/s41404-023-2057-z Download citation *

Published: 10 July 2023 * Issue Date: 10 July 2023 * DOI: https://doi.org/10.1038/s41404-023-2057-z SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

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