Last July, the Dash review on patient safety recommended that the responsibilities of the National Guardian’s Office (“NGO”) should be undertaken by healthcare providers, with some national activities delivered by NHS England.
In line with these recommendations, the NGO will close in June. From 1 July 2026, NHS England will take on certain activities currently undertaken by the NGO. Healthcare providers will also have greater responsibility for embedding Freedom to Speak Up arrangements.
What are the main changes?
From 1 July 2026, healthcare providers will need to:
- Ensure their Freedom to Speak Up guardians complete mandatory guardian foundation training before starting their role and support their continued professional development.
- Ensure appropriate psychological support is available for their guardians – particularly important given the closure of the national Employee Assistance Programme on 31 December 2026.
- Publish information about how to contact their guardians and ensure this information is kept accurate, is publicly available and accessible.
- Routinely submit their Freedom to Speak Up data through NHS England’s national data collection system (for 2026/27, this will only apply to Trusts and ICBs). NHSE will collect this data nationally and share insights with guardian networks.
From 1 July 2026, NHS England has committed to supporting existing guardian networks and individual guardians. One step will be to manage general enquiries via a national contact centre and escalate specialist queries to NHSE’s Freedom to Speak Up team. They have also committed to providing and maintaining the platform for free online guardian foundation training, as well as reviewing policy and guidance across all sectors.
What do providers need to think about?
There are several steps which healthcare providers can take to prepare for these changes. These include:
- Ensuring that your guardians have completed the mandatory foundation training and discussing what further training and support they require in their role.
- Discussing with your guardian what types of wellbeing and psychological support they would like and would benefit them the most. Given the types of matter they are exposed to, it is important for guardians receive useful wellbeing support, tailored to their specific needs. A helpline they can call may not provide the best support in all situations.
- Review how you collect Freedom to Speak Up data and update any systems as necessary to allow for routine reporting to NHSE.
To help strengthen the Speak Up culture, healthcare providers could also consider an alternative reporting mechanism for guardians if they do not have confidence in the current arrangements and accountability for board members to take action once a complaint is received.
Whistleblowing concerns are complex, particularly when there are overlapping issues, such as grievance and disciplinary allegations. Providers should note that sexual harassment is now specified as a relevant whistleblowing failure in the legislation. Speak to us if you require any advice or guidance on whistleblowing matters and best practice in building a culture to support the raising of concerns openly and transparently.
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