The Guardian Service's response to The National Guardian's Office (NGO) survey of Freedom to Speak Up Guardians
'Thematic Review'
Introduction
The National Guardian’s Office (NGO) recently published a ‘thematic review’ of its latest survey of Freedom to Speak Up Guardians. This presents a stark picture:
- There remains huge variation in how the Guardian role is implemented
- Guardians are frequently placed in a conflicted position
- The role has a negative impact on health and wellbeing
Previous reports have made similar observations. It is disappointing therefore that the recommendations in the report (largely advocating for more time and other resources) also repeat previous recommendations. Doing more of the same in the hope that it will generate different results will not work. Asking for more without evidence that it will generate better results at a time when every penny counts is out-of-touch with the real struggles providers face. This underlines the points made by Dr Penny Dash in her “Review of patient safety across the health and care landscape” (July 2025):
- Recommendations continue to be made without an attempt to look at the balance between costs and benefit:
- “A very high number of recommendations have been made to the NHS, most of which lack any cost-benefit analysis” – p 8
- The focus is on input rather than outcome:
- “Recommendations are often focused on inputs, rather than outputs or outcomes, and fail to recognise the balance of risks within organisations and across systems.” – p 8
- Recommendations are made in isolation without taking into account the realities of providing health and care services:
- “the current hosting of the National Guardian's Office within CQC results in the role being distant to the people it needs to support and influence.” – p 11