• As NHS England is being integrated into the Department of Health and Social Care can I still speak up to you and be confident you can consider my concerns?
• What can I speak up to NHS England about?
• Is there anything that I cannot speak up to NHS England about?
• Can I speak up to NHS England directly?
• Can I speak up anonymously if I want to or do I have to give my name?
• Are there any circumstances in which you would share my name and details?
• How do I get in touch?
• Can I escalate my personal complaint to NHS England if I do not think my employer has responded appropriately?
• Does NHS England provide protection to staff who speak up?
• What is the experience of speaking up like?
• What outcomes can I expect from speaking up?
• How long does it take from speaking up to receiving feedback?
• What happens if I speak up and then decide I do not want to engage with the process?
• Where can I find support?

Updated: 10 February 2026

As NHS England is being integrated into the Department of Health and Social Care, can I still speak up to you and be confident you can consider my concerns?

Yes. NHS England is a body prescribed in legislation that can hear speaking up matters. Until this changes, we will continue to review all concerns we receive in line with our speaking up policy and decide what action we may need to take.

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What can I speak up to NHS England about?

NHS England can only act on information that is in the public interest and relates to matters we regulate. This means we cannot act on a personal issue or grievance.

Matters you can speak up to us about are:

• serious and/or widespread matters related to unsafe patient care
• a widespread bullying culture. This is bullying across a team or organisation that is not being addressed by the senior leadership of the organisation. Individual instances of bullying should be reported within your organisation
• serious financial irregularities or mismanagement (suspicions of fraud should also be reported to your organisation’s counter-fraud team)
• serious conduct matters related to senior leaders (that is, board members, senior partners)

• poor overall governance of an organisation

If in doubt, please speak up. It does not matter if you are mistaken or if there is an innocent explanation for the matters you raise. We will consider all information we receive and decide whether any action is required, taking account of the wider information we hold.

You can find more information on what you can speak up to NHS England about in our speaking up policy.

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Is there anything that I cannot speak up to NHS England about?

Yes. We have no remit to act on matters relating to:

• healthcare in Scotland, Wales and Northern Ireland
• social care

The national Freedom to Speak Up (FTSU) team also cannot resolve employment matters, such as complaints about:

• employment terms and conditions and working environment
• organisations not following grievance policies and suspensions that are under 3 months
• bullying, harassment and discrimination that only affects you

These concerns are usually best raised within your own organisation as it is unlikely that we would take action based on your individual experience. Any concerns stemming from your own experience of working in the NHS can be raised within your organisation by talking to your line manager, FTSU guardian or local HR team.

Should these types of concerns be raised with us, although we will not take any action on them, we do consider whether trends and themes in individual experiences indicate wider governance or leadership concerns regarding an organisation.

Occasionally, some complex matters that are raised with us may have aspects that are within our remit as well as those that are outside our remit. In these cases, we may take action on the former but may not be able to on the latter. We will explain this to you when we have made our decision.

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Can I speak up to NHS England directly?

Yes. However, most matters are best resolved by raising them within your organisation. Its remit will be broader than NHS England’s as the matters you speak up to us about need to meet the criteria set out in our speaking up policy.

The organisation where you work should provide details of how you can speak up on its website or intranet.

You can find out if your organisation has a FTSU guardian from its intranet and/or internet site.

If you cannot speak up within your organisation – for example, you do not have the confidence to do so or the matters you want to speak up about relate to serious failings – you can speak up to the national FTSU team at NHS England and we will assess your concerns.

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Can I speak up anonymously if I want to or do I have to give my name?

Yes. You can speak up anonymously if you want to do so. We understand that speaking up can be daunting.

If you choose to contact us by email, you can create an anonymous email address. You do not need to use either a work or personal email address.

However, speaking up anonymously may make it difficult for us to ask you for further information about the matters and may make it more complicated for us to act to resolve the issues. It also means that we might not be able to advise on further support you can access, and we may be limited in our ability to provide feedback.

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Are there any circumstances in which you would share my name and details?

It is very unlikely that we would do this, but there are some exceptional circumstances in which it may be necessary for us to share your personal information. If we need to share your information without your consent, we will discuss the best way to do this with you.

We would only share personal information if:

• we are concerned that you or someone else is at risk of serious harm or in danger
• the public interest justifies it
• we are acting according to the law – for example, we must report criminal activity to the police.

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Can I escalate my personal grievance to NHS England if I do not think my employer has responded appropriately?

The national FTSU team does not provide a grievance escalation function and cannot investigate any matters that relate to you alone, even where you feel your employer has not responded appropriately. You should follow your organisation’s escalation process.

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Does NHS England provide protection to workers who speak up?

Staff who speak up and make a ‘protected disclosure’ are afforded protection under the Public Interest Disclosure Act 1988. This provides remedy for staff who suffer a detriment or any form of retribution as a result of making a protected disclosure, provided that the disclosure meets the legal definition.

NHS England cannot give you legal advice. Please seek independent advice from Protect or a legal representative to understand if you meet the criteria for protection under the Act.

Depending on the matters you raise with the national FTSU team and how your employer treats you as a result of this or other whistleblowing, you may be able to lodge a claim with an employment tribunal. You can find further information about how to do so on the GOV.UK website.

We cannot provide advice on making a claim, but we can signpost you to organisations that can support you through any process that may apply.

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What is the experience of speaking up like?

Feedback from people who have spoken up tells us the experience can be a mix of empowering and daunting. It can be empowering because speaking up allows you to advocate for change to address matters that may impact on patient care or your work environment. It can be daunting because people can be nervous about the potential for repercussions. The national FTSU team will do everything possible to make the experience as easy as possible for you.

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What outcomes can I expect from speaking up?

We may decide we need to make enquiries of your organisation to gather more information that enables us to decide what action, if any, is needed to address the matters of concern.

We will inform you of our action as soon as we can. For some matters, we may need to take immediate action, before we are able to discuss this further with you.

If the matters require specific investigation, we may do this by:

• approaching a relevant organisation for further information – for example, the Care Quality Commission (CQC)
• asking the integrated care board (ICB) to investigate
• asking the organisation (to which your concerns relate) to investigate the matters, often with our input or supervision
• for concerns relating to individual GPs, dentists or optometrists, referring the matters for review to the ‘responsible officer’ who manages performance concerns

In exceptional circumstances, we may investigate the matters ourselves. In deciding whether we do, we will consider the following factors:

• the potential impact of the matters raised on patient safety
• whether the matters have already been looked at or investigated by another organisation and how effective its response has been
• whether NHS England has delegated the responsibility for considering matters to ICBs, as may be the case for primary care organisations, and whether we have consent to share information with ICBs
• our confidence in the ability of the organisation’s senior leadership to respond and investigate effectively
• the potential learning for the wider system from an investigation
• how long ago the events in question occurred

We will tell you how we will use the information you have given us. Where possible we will inform you of the expected duration of any investigation and ask you how often you would like to be updated.

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How long does it take from speaking up to receiving feedback?

This depends on the nature of the matters you raise, the action we decide is needed and what action has already been taken by other organisations to consider the matters.

If you do not have the time in working hours to contact us, then you can communicate with us by email at your own pace.

We will discuss what we can do to keep you updated about any actions we take.

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What happens if I speak up and then decide I do not want to engage with the process?

You can let us know at any time if you decide that you do not wish to continue with our speaking up process. We will keep a record of the matters you have raised.

Should you let us know that you no longer wish to engage with the process, your case manager will let you know if it is likely that we will still take action. If we do decide we need to take action (this is usually in cases where we have received matters related to serious wrongdoing or patient safety risks), we will do all we can to protect your identity.

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