Introduction

This engagement pack sets out proposals for the future of Freedom to Speak Up (FTSU) as the National Guardian’s Office (NGO) prepares to close. We are seeking your views on how FTSU functions should be delivered to ensure continued support for speaking up across the NHS.

Key points:

• the NGO will close by the end of June 2026 following the Dash Review recommendations
• essential FTSU functions will transfer to NHS England, the Department of Health and Social Care (DHSC), the Care Quality Commission (CQC) and providers
• we are committed to maintaining support for guardians and the FTSU agenda
• your feedback will inform final decisions about future FTSU functions
• engagement runs from January to February 2026

How to participate

• attend online engagement sessions – dates and joining instructions
• complete our survey – answer the questions in this pack via our survey link
• submit written feedback
• discuss at network meetings

All feedback will be analysed and used to shape final implementation plans, which will be communicated in April 2026.

Context

In July 2025, the Dash review of patient safety across the health and care landscape recommended that responsibilities of the NGO should be incorporated into providers, with functions aligned with other staff voice functions in NHS England. The review emphasised that ensuring these functions happen in all commissioners and providers should be a core function of CQC as the independent regulator.

The 10 Year Health Plan confirmed that the National Guardian’s work will align with other national staff voice functions, meaning the distinct Office of the National Guardian will no longer be required. However, the commitment to Freedom to Speak Up remains strong, with guardians continuing to play a vital role in supporting speaking up culture.

Why we need your input

We want to ensure that as part of these changes we preserve what works well while taking the opportunity to improve and streamline functions. Your practical insights will help us:

• identify risks and mitigation strategies
• understand support needs
• design effective implementation plans
• minimise disruption to services

What happens with your feedback

All responses will be analysed thematically, and those themes will be reviewed by the NGO Closure Project Board. These will be used to inform the final implementation plans.

Vision: what success looks like

As we transition FTSU functions, we are working towards a future where:

• FTSU guardians remain central to supporting speaking up in the NHS, with clear roles and appropriate resources
• guardians feel supported both locally through their organisations and nationally through NHS England
• leaders understand expectations of their role in FTSU and receive the support they need to fulfil these responsibilities
• NHS staff have confidence in speaking up mechanisms locally and nationally, knowing their concerns will be heard and acted upon
• the system continuously improves through learning from speaking up data and experiences that benefit patients and citizens

This vision guides all our proposals for the future operating model.

Section 1: leadership of the Freedom to Speak Up agenda

Supporting local leaders, maintaining national standards and system improvement.

1.1 Guardian registry

Outcome we want to achieve:

• clear visibility of all FTSU guardians across organisations
• guardian contact details can be easily accessed by staff
• reduced administrative burden while maintaining accountability

What happens now

• the NGO maintains a central registry of approximately 1,500 guardians, this can be difficult to maintain and keep up to date
• guardian registration is mandatory for compliance purposes
• the registry is used for communications, compliance monitoring, and public queries
• guardians must update their details when changes occur

What we are proposing

• the public-facing central registry function will cease
• NHS England will retain guardian data for stakeholder engagement and communication purposes only
• all organisations will be required to list their guardian(s) prominently on their website
• the CQC will verify guardian arrangements through Well-Led inspections

What this means for you

Guardians

• no central registration required
• must complete foundation training on appointment
• update details via employer only
• continue receiving national communications

Employers

• must list guardian details on organisation website
• ensure information is current and accessible
• report guardian changes to NHS England
• Ensure guardian compliance with training

National bodies

• NHS England maintains contact database
• the CQC checks compliance during inspection

1.2 Policy and guidance

Outcome we want to achieve:

• clear, consistent FTSU standards across all healthcare organisations
• appropriate balance between national consistency and local flexibility
• easy access to guidance and resources for guardians and leaders
• preservation of valuable NGO legacy documentation

What happens now

• the NGO produces national policy and guidance documents, sometimes in conjunction with NHS England
• sets some standards for FTSU implementation and guardian roles
• provides interpretation of regulations and best practice
• maintains extensive library of resources and case studies 

What we are proposing 

• NGO policy development function will cease
• NHS England’s existing FTSU policy and guidance function will continue
• all NGO legacy documentation will be preserved and hosted by NHS England
• NHS England will maintain and update its existing guidance documents
• greater opportunity for integration of FTSU insights with broader staff experience and patient safety policy development

What this means for you

Guardians

• access all guidance via NHS England
• legacy NGO resources remain available 

Employers

• continue to follow NHS England FTSU policy and implement national standards locally
• local flexibility within national framework

National bodies

• NHS England sets expectations
• opportunity for integration of FTSU insights with staff experience and patient safety policy development
• the CQC assesses against standards

1.3 Data collection

Outcome we want to achieve:

• robust data collection to support system learning and improvement
• reduced administrative burden on guardians and organisations
• better integration with existing NHS data systems
• meaningful insights that drive positive change

What happens now

• quarterly data collection via the Guardian and Enquiries Management System (GEMS)
• NGO analyses and publishes data quarterly
• annual data report with national and trust-level insights
• manual data entry required by guardians 

What we are proposing

• GEMS system will cease after completing 2025/26 data collection (May/June 2026)
• from 2026/27, data collection will be via NHS England’s established national data process
• integration with existing NHS data collection processes creates opportunity for efficiency
  • Continued quarterly collection and annual reporting opportunity to access data via Model Health System

What this means for you

Guardian

• submit data through NHS England systems
• opportunity to utilise your employer’s existing data submission processes
• Access to comparative data via Model Health System 

Employers

• support guardians with data submission
• ensure data quality and timeliness
• use insights for local improvement
• access to comparative data via Model Health System

National bodies

• NHS England collects and analyses data
• published insights
• opportunity for integration with broader staff experience and patient safety policy development

1.4 System learning

Outcome we want to achieve:

• system-wide learning from speaking up experiences
• identification of themes and improvement opportunities
• sharing of best practice and innovative approaches
• action on systemic issues identified through FTSU

What happens now 

• NGO conducts periodic speak up reviews on specific themes or organisations
• published reports with recommendations for improvement
• reviews commissioned based on concerns or patterns
• a speak up review is generally published each year 

What we are proposing 

• standalone NGO speak up review function will cease
• NHS England’s prescribed body casework function will continue
• learning gathered through multiple channels:
  • guardian support interactions
  • network feedback
  • data analysis and trends
  • prescribed body casework functions
• thematic learning published based on insights
• stronger links to regulatory action where needed
• greater opportunity to integrate insights into workforce and patient safety policy development

What this means for you

Guardian

• contribute insights through networks
• share experiences and learning
• access published learning 

Employers

• engage with NHS England insights work
• implement recommendations
• share good practice examples

National bodies

• NHS England coordinates learning
• The CQC takes account of published learning insights in assessments
• system-wide improvements identified

Section 2: Supporting Freedom to Speak Up guardians

Ensuring guardians have the tools, training and support they need.

2.1 Guardian training

Outcome we want to achieve:

• maintain consistent, high-quality foundation training for all guardians
• clear evidence of foundation training compliance for employers
• maintain easy access to foundation and refresher training modules
• employers ensure specific continued professional development

What happens now

• NGO provides free continuing professional development (CPD) accredited foundation and refresher training for guardians
• NGO maintains central training records
• Approximately 300 to 400 new guardians trained annually
• Approximately 1000 existing guardians complete refresher training each year 

What we are proposing

• transfer existing training to e-Learning for health platform
• continued free CPD accredited online training available to all guardians
• foundation training module content maintained by NHS England
• supplemented by local peer support and mentoring
• cost-neutral for employers for foundation training
• employer responsible for ensuring guardian receives appropriate training
• integration with electronic staff records (ESR) for automatic compliance tracking 

What this means for you

Guardian

• complete nationally approved and CPD accredited online training
• local peer support
• seek relevant CPD and training opportunities as highlighted when completing their personal development plan using the Freedom to Speak Up Guardian Development Guide 

Employers

• ensure guardians complete foundation training module on appointment and receive role-specific CPD
• option to monitor compliance via ESR

National bodies

• NHS England ensures access to the existing module content
• the CQC checks compliance

2.2 Guardian support

Outcome we want to achieve:

• guardians have access to confidential, specialist support
• clear escalation routes for complex situations
• emotional and wellbeing support available
• peer support and shared learning opportunities

What happens now

• NGO provides confidential one to one support via phone and email
• National Employee Assistance Programme (EAP) specifically for guardians
• direct support from NGO team members with expertise
• approximately 200 to 300 support contacts per year 

What we are proposing

• continued access to one-to-one support for guardians
• national EAP will cease (now that local organisation EAP services are available)
• continued peer support through regional networks 

What this means for you

Guardian

• access support via NHS England
• use employer’s EAP and other health and wellbeing offer
• peer support through networks 

Employers

• ensure local EAP covers guardians and is confidential
• support guardians to access help as needed
• offer local mentoring and supervision/coaching to guardians

National bodies

• NHS England provides confidential, specialist support
• NHS England monitors quality of and access to support

2.3 Guardian networks

Outcome we want to achieve:

• effective peer support and shared learning between guardians
• regional consistency with flexibility for local needs
• sustainable network leadership and coordination
• inclusive guardian networks accessible to all guardians

What happens now

• regional networks coordinated by NGO-appointed chairs
• regular meetings (typically quarterly) in each region
• national guardian or NGO representative often attends
• mix of in-person and virtual meetings
• variable attendance and engagement across regions 

What we are proposing

• regional networks will be supported by regional NHS England teams
• greater flexibility in how each region runs its network
• national networks will be supported by the NHS England national FTSU team
• optional attendance based on guardian needs and preferences

What this means for you

Guardian

• voluntary network participation
• contribute to agenda setting
• access to peer support 

Employers

• support guardian attendance
• consider hosting meetings
• share learning and best practice 

National bodies

• NHS England coordinates
• support chair recruitment
• facilitate cross-region learning

2.4 Enquiries

Outcome we want to achieve:

• answers to FTSU-related queries are easily available
• reduced burden on national team resources
• clear information easily accessible online
• appropriate routing of complex enquiries

What happens now

• NGO handles approximately 4,000 enquiries annually
• direct email and phone support during office hours
• most queries relate to training, guardian contacts, or data submissions and reporting
• all enquiries logged and tracked in GEMS 

What we are proposing

• NHS England contact centre will handle general enquiries
• comprehensive FTSU frequently asked questions developed for common questions and updated on the website
• most information available through NHS England website
• specialist queries escalated to FTSU team 

What this means for you

Guardian

• contact NHS England for support
• access frequently asked question online
• specialists help available 

Employers

• support local query resolution
• direct staff to NHS England resources
• use standard contact routes

National bodies

• NHS England triages enquiries
• ensure specialist resource for handling complex enquiries
• maintain up-to-date information
• monitor enquiry themes

How to participate

We want to hear from everyone affected by these changes. There are several ways to share your views:

1. Online engagement sessions and joining links

Registration links will be sent via bulletin or direct email communication.

2. Survey

If you unable to join our engagement sessions, you can give your feedback via our online survey by Friday 20 February 2026. This engagement pack needs to be read alongside the survey.

The survey includes:

• structured questions on each function area
• free text for additional comments

3. Written submissions

Email detailed feedback to england.ftsu-enquiries@nhs.net

Deadline: Friday 20 February 2026

We particularly welcome submissions from:

• professional bodies and royal colleges
• trade unions
• patient safety organisations
• groups representing specific sectors (for example, primary care, mental health)

Next steps

February 2026

• online engagement sessions
• survey closes (Friday 20 February)
• written submission close (Friday 20 February)

March 2026

• feedback analysis and refinement of proposals

April 2026

• Wednesday 1 April new training platform goes live
• final decisions communicated

April to June 2026

• implementation phase
• final NGO data collection for 2025/26 (quarter 4)

July 2026

• new arrangements go live

How feedback will be used

All feedback will be:

Collated by stakeholder group and theme so that the themes can be:

• analysed by the project team
• reviewed by the NGO Closure Project Board
• incorporated into final plans

We commit to:

• acknowledging all submissions
• explaining how feedback influenced decisions
• being transparent about constraints
• providing clear rationale for final choices

Resources

• Dash Review report: Review of patient safety across the health and care landscape (gov.uk)
• Fit for the future: 10 Year Health Plan for England
• Current National Guardian Office guidance
• NHS England Freedom To Speak Up

Stay informed

• Guardian bulletin (fortnightly)
• NHS England bulletins (The Week, Human Resources and Organisational Development)
• Project updates on NGO website.

Thank you

Thank you for taking the time to engage with these important proposals. The Freedom to Speak Up agenda has made significant progress over the past decade, thanks to the dedication of guardians, the NGO team, and organisational leaders.

As we transition to new arrangements, your insights are vital to ensuring we preserve what works well while taking the opportunity to strengthen support for speaking up across the NHS.

We look forward to hearing your views and working together to shape the future of Freedom to Speak Up.

This engagement pack has been produced by NHS England in collaboration with the National Guardian’s Office, the Department of Health and Social Care, and the Care Quality Commission.

Publication reference: PRN02337