Organisations need to ensure that their values and cultures create healthy speaking up environments in the workplace that provide the space for people to be listened to and taken seriously. It is essential in a safety culture and should be part of normal business for every individual in every organization.

For staff in the NHS to feel safe speaking up, the following elements need to be implemented:

• Staff can have open conversations with managers, and managers listen
• There is mutual trust between the person raising the concern and the person listening
• Leaders display and encourage the behaviours required for staff to feel listened to
• The approach uses psychological safety principles to create the conditions for people to be able to speak up
• Organisations will ensure individuals are not penalised for highlighting mistakes, failures or concerns. Where psychologically safety is lacking, employees are less likely to speak up and challenge inappropriate behaviours of colleagues or superiors.
• Organisations should recognise that individuals with protected characteristics are often more likely to be on the receiving end of poor practices, harassment or bullying. They are also least likely to speak up due to the fear of reprisals. This needs to be considered in the local approach and implementation
• Feedback is provided to individuals who raise concerns especially in relation to actions implemented

What organisations should do to co-produce their Speaking Up Safely culture and local processes

Organisations will be expected to co-produce their Speaking Up Safely culture and systems with Trade Union partners, staff with protected characteristics, those with lived experience, and staff from ethnically and culturally diverse backgrounds. This approach is required to ensure the process is relevant and purposeful to those who may be required to speak up.

Organisations should consider the following key principles when planning and co-designing a co-production approach:

1. Encourage active participation, the sharing of experience, and welcome diverse ideas and suggestions
2. Engage in genuine dialogue around diverse perspectives and be open to the idea that all parties can be mutually influenced by the experience and ideas of others. Avoid the perception that decisions have already been made by a small number of senior people
3. Consider how you can host events and conversations where differences of power, status, perceived expertise and privilege are minimised between those participating, i.e., leaders, staff, partners and stakeholders, and those with and without protected characteristics
4. Actively listen so that there is a shared experience of inquiry, reflection, dialogue and shared discovery

Consider the following when planning your co-production approach:

• People – who needs to be in the conversation with us?
• Invitation – how will we invite people into the conversation with us so as they want to be involved, and are able to participate?
• Power & Privilege – how will we acknowledge and work constructively with differences of power and privilege to ensure equity of contribution?
• Inviting all to have their say – how do we structure this conversation so that everyone gets time and has their voice heard?
• Interface – where and how will we meet (in person, online)?
• Agreeing the practicalities – how often should we meet, and for what time duration?
• Finding shared meaning – what are the common themes or sense of shared purpose that ties this all together?
• Goals – what are we hoping to achieve together?
• How to respond best to disagreement and conflict – how we will respond to any breakdowns in communication? What is our agreed way of doing this?

• Map what staff, partners and stakeholders would see as the organisational barriers and enablers to Speaking Up Safely; co-produce interventions to reduce and remove barriers, monitor the effectiveness of these interventions, and share and implement enablers of speaking up
• Widely and consistently communicate the agreed systems, processes for and learning from Speaking Up Safely
• Ensure procedures for receiving, reviewing and responding to speaking up concerns are timely, transparent and regularly evaluated to ensure they are fit for purpose and able to reassure staff that the process will support them when raising their concerns
• Use the lived experience of staff and others to help recognise the ways in which power and privilege manifest in the organisation and can become barriers to staff speaking up
• Provide bias and cultural awareness training and/or supervision for those who will hear the concerns staff members raise – to ensure the diverse needs of staff with protected characteristics can be openly received, are not potentially dismissed due to possible differences in peoples’ lived experiences, beliefs and world-views
• Build anonymity into speaking up processes for those staff who fear detriment from publicly speaking out
• Develop the skills of leaders to be able to listen to concerns openly, transparently and without prejudice and enable leaders to act on concerns raised. Leaders should demonstrate their skills in these areas in order to support a speaking up culture
• Ensure there is timely access to staff support and wellbeing services – as speaking up can impact on the psychological health of staff
• Review organisational data (as per Toolkit 4 ) with social partners through the organisation’s board-level committee structure
• Where staff experience detriment from speaking up, actively utilise restorative justice practices to address this, as per the All-Wales Respect & Resolution policy and process

• Who needs to be in this conversation – who has an important perspective, experience, or stake in the development of a Speaking Up culture?
• What processes can be developed for acknowledging and addressing issues when they arise? How can the organisation collaborate with staff, partners, and other stakeholders to ensure these processes are fair and supportive?
• How is learning shared across the organisation – at individual, team and service level, as well as more widely?
• How will the organisation engage with staff from diverse backgrounds, ethnicities and cultures to:
• ensure their lived experiences improve your speaking up processes?
• address issues related to bias, discrimination and inequity?
• review whether organisational policies and processes might be unintentionally causing inequity and inequality?
• How can the organization explore the ways in which hierarchy, entitlement, power and privilege might be marginalising and disadvantaging individuals?
• How can the organisation encourage and support this type of reflective conversation?
• How will the organisation identify barriers to speaking up within it? What actions can be taken to address and resolve any barriers when identified?