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East London trusts puts concerned staff in direct contact with execs


The largest hospital trust in England has begun using an online system that encourages staff to discuss concerns and ideas directly and anonymouslywith senior managers.

Barts Health NHS Trust launched the SpeakInConfidence system at the end of March to enable staff to have a private dialogue with a senior executive about issues they feel unable to raise with their line manager.

“The conversation is anonymous and controlled on the terms of staff, always”

Kay Riley

As well as concerns, the trust hopes the system will also allow ideas to be shared on improving working conditions, clinical care and safety, and use of financial resources.

The Care Quality Commission recently raised concerns about bullying and harassment at the trust following visits made under its new inspection regime last year.

Barts acknowledged that the introduction of SpeakInConfidence was largely a response to the CQC’s findings, adding that the system also built on its previous efforts to encourage whistleblowing.

Trust chief nurse Kay Riley said: “We are keen to show our staff our commitment to improving and resolving any issues they raise and to provide absolute assurance that although we want them to speak to us their identity will be protected if they wish to remain anonymous.


Kay Riley

“With our previous ‘whistleblowing’ support line, people told us that they didn’t feel that it was a truly anonymous way to raise concerns and they were fearful of what would happen if they spoke out,” she told Nursing Times.

The trust said that in the first two weeks of operation, almost 20 people had raised concerns through the system – ranging from seeking support about bullying to ensuring they received their full annual leave entitlement.

Staff register with the service through an online application – run by a third party organisation – and can then begin sending anonymous messages to their choice of one of 10 trust executives. The service operates 24 hours a day, seven days a week.

Simulating direct conversation, messages appear on the screen through a series of speech bubbles and the conversation is controlled by the staff member, not the executive, according to the trust. 

Ms Riley said: “The conversation is anonymous and controlled on the terms of staff, always.”

Nursing Times launched the Speak Out Safely campaign in March last year, with the aim of encouraging healthcare providers to develop cultures that actively encourage staff to raise the alarm when they see poor practice and to protect them when they do so.

Speak Out Safely logo


Readers' comments (6)

  • michael stone

    'has begun using an online system that encourages staff to discuss concerns and ideas directly and anonymously with senior managers.'

    FINALLY - a 'system' which allows frontline staff to raise and discuss issues with quite senior (i.e. 'empowered to actually make decisions') management, and to do so anonymously (so that 'fear of being bullied' is diluted or removed).

    ABOUT TIME !!!

    I hope this:

    1) Works;

    2) Is then rolled out widely.

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  • why anonymous? ridiculous!

    everybody is in the service, believe it or not, to look after their patients and their interests whatever their role and are entirely free to communicate with one another and whoever they wish to and need to, just as a cat can look at a queen! don't put people in healthcare up on pedestals where they do not belong in order to feed their ideas of grandeur and self aggrandisement which have nothing to do with and no place in the best interests of quality patient care.

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  • I think this just fuels the culture there. Pretty sad to think that people need to be anonymous in order to speak out to senior management without fear of intimidation or bullying.

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  • Anonymous | 23-Apr-2014 9:29 pm

    I agree and already wrote 23 Ap. 3.27 pm possibly rather incoherently as it makes me angry. it is a way of depersonalising nurses and other individuals wishing to complain and rather trivialising what they have to say. surely they have the right to be themselves and speak out in their own right and own what they say? Not allowing this is still a form of suppression and why are more superior members of management allowed to be vocal and every single individual nurse and every other member of staff not?

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  • michael stone

    A system which allows 'nervous' staff to raise issues anonymously, does not FORCE people to use it, surely ?

    Anyone who wants to raise issues in person could still do so - what would stop them ?

    I live in Coventry, and one of our local [ex] consultants asserts that he was 'bullied and hounded out of the NHS' (my phrase) because he raised safety concerns about too many beds on wards (5 instead of 4, which prevented access to equipment in the '5th' bed).

    This isn't about questioning the professionalism of staff - it is simply about getting necessary concerns actually raised and discussed.

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  • I do like the idea.
    I come on sites like this to have my say anonymously, read other nurses' comments and sometimes to understand a topic more, through the comments.
    Many times I will like to connect to management directly and 'anonymously', especially at a site that encourages the nurses to bring on their concers. Any platform for nurses is a good thingh

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