38,158 cases were brought to Freedom to Speak Up guardians throughout 2024/25.

  • Concerns related to worker safety or wellbeing rose by a significant 36 per cent to 14,171 cases, representing 39 per cent of all cases raised.
  • Inappropriate behaviours and attitudes were the most commonly reported issue for the second consecutive year, featuring in 40 per cent of all cases.
  • Bullying or harassment was a factor in 18 per cent of cases.
  • Concerns related to patient safety or quality comprised 18 per cent of cases in 2024/25, a decrease from 19 per cent in 2022/23 and sustaining a downward trajectory.
  • Only 3 per cent of cases in 2024/25 indicated detriment for speaking up, a 1 per cent decrease from four per cent in 2022/23.
  • The proportion of cases raised anonymously rose to 12 per cent, a 45 per cent increase in volume from 2023/24, the largest percentage change across all themes.
  • 9,369 pieces of feedback received in total, 80 per cent of the workers who spoke up would speak up again

Latest figures

On a quarterly basis, Freedom to Speak Up Guardians are expected to share non-identifiable information with the National Guardian’s Office about the speaking up cases raised with them. This information provides invaluable insight into the implementation of Freedom to Speak Up.

For detailed data reported to the National Guardian’s Office please see below

2025/26 speaking up data (Excel)

Annual Speaking Up Data Reports

These reports reflect trends and themes from the speaking up data in previous years.

  • Over 30,000 cases were brought to Freedom to Speak Up guardians throughout 2023/24.
  • Over 25,000 cases were brought to Freedom to Speak Up guardians throughout 2022/23 – a 25% increase on the previous year.
  • The number of cases brought to Freedom to Speak Up guardians in 2021/22  remained at the level seen during the first year of the pandemic  at 20,362.
  • Between 1 April 2020 to 31 March 2021, the first year of the COVID-19 pandemic, over twenty thousand (20,388) cases were raised with Freedom to Speak Up Guardians. This was a 26-percentage point increase from the previous year.
  • Guardians received over 16,000 speaking up cases in 2019/20 – an increase of 32% compared to the previous year. This is nearly half of the 35,000 cases raised with guardians since we started collecting data in 2017/18.
  • 12,244 cases were raised to Freedom to Speak Up Guardians in trusts and Foundation trusts between 1st April 2018 and 31st March 2019 – 73% higher than that raised the previous year.
  • For the first year in which we collected data – 1 April 2017 to 31 March 2018 – 7,087 cases were raised to Freedom to Speak Up Guardians in NHS trusts and foundation trusts

Culture is a patient safety issue

Summary of Speaking Up to Freedom to Speak Up Guardians for 1 April 2023 to 31 March 2024

"I felt heard for the first time"

Summary of Speaking Up to Freedom to Speak Up Guardians for 1 April 2022 to 31 March 2023

Annual Speaking Up Data Summary

Speaking Up data - film summary for data collected 1April 2021 - 31 March 2022

The year of the pandemic: A summary of speaking up to Freedom to Speak Up Guardians

Speaking Up Data report for 1 April 2020 and 31 March 2021

Annual Speaking Up Data Report 2019-20

A summary of speaking up to Freedom to Speak Up Guardians

Annual Speaking Up Data Report 2018-19

Speaking up in the NHS in England: A summary of speaking up to Freedom to Speak Up Guardians in NHS trusts and foundation trusts

Annual Speaking Up Data Report 2017-18

Speaking up in the NHS in England A summary of speaking up to Freedom to Speak Up Guardians in NHS trusts and foundation trusts

Why is speaking up data important?

The data Freedom to Speak Up Guardians submit provides invaluable insight into the implementation of the Freedom to Speak Up.

The data also helps provide confidence – and assists in learning and improvement – for the colleagues and organisations they support, and other Freedom to Speak Up Guardians.

NHS England use this data, along with other indicators and intelligence, to inform their thinking around where to offer improvement support in relation to Freedom to Speak Up.

NHS England also upload this information to the Model Health System. Freedom to Speak Up Guardians and leaders can use this service to build a more holistic picture of their organisation’s speaking up culture.

Case Study

Freedom to Speak Up Guardian, Ken Levins shares how he uses technology to further measure the impact of Speaking up at Lancashire and South Cumbria NHS Foundation Trust.

The Guardian uses the reporting system to run a weekly reporting dashboard for each locality. The services can then triangulate their own data, take ownership of any issues and make plans for self-improvement.  The system also allows for triangulation of information to proactively identify hot spots areas of concern within the Trust.  The Trust produces heat maps, which are shared with the services monthly and used along with other assurance methods to look for areas of best practice and improvement.

Read More

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