GPAtlasWhat it covers
What speaking up means in a GP practice, what it can be about, and how it differs from a complaint, a grievance and the duty of candour. The routes inside and outside the practice, including the Freedom to Speak Up guardian, and how to respond when a colleague speaks up to you. The legal protection for whistleblowers, the fears that keep small teams quiet, and what CQC looks for in a well-led practice.
Who it is for
Everyone who works in the practice: reception and administration, secretaries, healthcare assistants, nurses, pharmacists, GPs, trainees, locums, practice managers and partners. The listening lessons matter most to anyone who manages or employs others.
By the end you will be able to
- Say what speaking up is, who can do it, and what it can be about.
- Tell speaking up apart from a complaint, a grievance and the duty of candour.
- Raise a concern inside or outside the practice, openly, confidentially or anonymously.
- Thank, listen and follow up when a colleague speaks up to you.
- Explain the legal protection for whistleblowers and the prescribed bodies, such as CQC.
- Recognise fear and futility in small teams, and what CQC looks for.
Modules
- What speaking up covers
- Raising a concern
- When someone speaks up to you
- Protection in law
- Barriers and a well-led practice
Your practice's own speak up policy names the people and routes where you work; this course explains the national rules it is built on. The National Guardian's Office closed on 30 June 2026, and NHS England took on part of its work from 1 July.
Content mapped to NHS England's Freedom to Speak Up policy for the NHS (version 2, June 2022), the National Guardian's Office guidelines on Freedom to Speak Up training (2019) and Part IVA of the Employment Rights Act 1996. Law named: Employment Rights Act 1996, Part IVA (protected disclosures), inserted by the Public Interest Disclosure Act 1998.
Sources
- Freedom to Speak Up policy for the NHS, version 2, June 2022 (NHS England, PAR1245_i): the national policy for primary and secondary care
- The future of Freedom to Speak Up (NHS England, 16 April 2026, PRN02339): closure of the National Guardian's Office and revised responsibilities (read from the web archive copy; the live site blocks automated reading)
- Closure of the National Guardian's Office, home page notice (National Guardian's Office, 2026)
- Adoption of the national Freedom to Speak Up policy and access to a guardian for primary care workers (NHS England letter to ICBs, 2 October 2024, PRN01370)
- Integrated care boards, integrated care systems and Freedom to Speak Up (NHS England)
- Primary care patient safety strategy (NHS England, 26 September 2024, PRN01039): ICBs to ensure access to guardians independent of the practice
- Speaking up to NHS England (NHS England, updated 26 March 2026; read from the web archive copy)
- Freedom to speak up in primary care: guidance to primary care providers on supporting whistleblowing in the NHS (NHS England, 11 November 2016)
- National guidelines on Freedom to Speak Up training in the health sector in England (National Guardian's Office, August 2019)
- Freedom to Speak Up training: Speak Up, Listen Up, Follow Up (National Guardian's Office with Health Education England)
- Speak Up: core training for all workers, session outline (elearning for healthcare)
- What is speaking up? (National Guardian's Office)
- How to speak up (National Guardian's Office)
- Principles for responding to speaking up (National Guardian's Office)
- Freedom to Speak Up training for all workers launched (National Guardian's Office, 27 October 2020)
- Listening to Guardians: Freedom to Speak Up Guardian Survey 2023 (National Guardian's Office, July 2023): fear and futility
- National Guardian's Office annual report, April 2025 to March 2026: case themes and speak up reviews (its 61.5% Staff Survey figure is the 2022 result; the course uses the survey's own 2025 figure)
- Sir Robert Francis' Freedom to Speak Up review (GOV.UK, 11 February 2015)
- Employment Rights Act 1996, section 43B: disclosures qualifying for protection (sexual harassment added from 6 April 2026)
- Employment Rights Act 1996, section 43C: disclosure to employer or other responsible person
- Employment Rights Act 1996, section 43D: disclosure to legal adviser
- Employment Rights Act 1996, section 43F: disclosure to prescribed person
- Employment Rights Act 1996, sections 43G and 43H: disclosure in other cases
- Employment Rights Act 1996, section 43J: contractual duties of confidentiality
- Employment Rights Act 1996, section 43K: extended meaning of worker
- Employment Rights Act 1996, section 47B: protected disclosures, detriment by employer and co-workers
- Employment Rights Act 1996, section 48: complaints to employment tribunals (three months, six for acts on or after 1 October 2026)
- Employment Rights Act 1996, section 103A: dismissal for a protected disclosure
- Employment Rights Act 1996, section 108: qualifying period, not applied to section 103A
- Whistleblowing for employees (GOV.UK)
- Whistleblowing: list of prescribed people and bodies (GOV.UK, updated 15 September 2026)
- GP mythbuster 87: Freedom to Speak Up (Care Quality Commission, updated 23 December 2022)
- Freedom to speak up, well-led quality statement (Care Quality Commission, updated 25 June 2024)
- Draft primary care and community services assessment framework, v6.0, and consultation page (Care Quality Commission, 2026)
- Our initial response to our public consultation: Better regulation, better care (Care Quality Commission, 25 March 2026)
- Report a concern if you are a member of staff (Care Quality Commission)
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 20: duty of candour
- Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, regulation 5: who may complain
- Acas Code of Practice on disciplinary and grievance procedures
- The Code, standard 16: act without delay if you believe that there is a risk to patient safety or public protection (Nursing and Midwifery Council)
- Standards for pharmacy professionals, standard 8: speak up when things go wrong (General Pharmaceutical Council)
- Report NHS fraud (NHS Counter Fraud Authority): freephone 0800 028 4060, available 24/7, and online form
- Protect, the whistleblowing charity: free confidential advice line 0203 117 2520
- Speak Up Direct: free, independent, confidential advice on the speaking up process
- Freedom to Speak Up (FTSU) guidance for practices (Londonwide LMCs)
- The Employment Rights Act 2025 (Commencement No. 5 and Transitional Provisions) (Amendment) Regulations 2026 (SI 2026/954): section 152 and Schedule 12, tribunal time limits from three to six months, in force 1 October 2026 for acts on or after that date
- Employment Rights Act 2025, Schedule 12: increase in time limits (sections 48 and 111 of the 1996 Act)
- Employment Rights Act 2025: what has changed and when (Acas): sexual harassment a qualifying disclosure from 6 April 2026; tribunal time limits six months from 1 October 2026
- 2025 NHS Staff Survey national results briefing (March 2026): q25e 60.29% feel safe to speak up about anything, q25f 47.59% confident it would be addressed; trusts only
- Temporary Workers, Permanent Voices: a speak up review (National Guardian's Office, March 2026): 60.4% of 384 respondents said temporary staff have no voice
- Listening and Learning: Amplifying the Voices of Overseas-Trained Workers (National Guardian's Office speak up review, May 2025): visa and immigration worries as a barrier to speaking up
- Good medical practice 2024, domain 3, paragraph 76: doctors with a leadership or management role (General Medical Council; read from the web archive copy)
- Whistleblowing for employees, whole guide (GOV.UK): media disclosures usually lose protection; anonymous reports make unfair treatment harder to link
- Volunteers, interns and trainees (Protect): no whistleblowing protection for volunteers under employment law (read from the web archive copy)
GPAtlas is not accredited, verified or endorsed by Skills for Health or NHS England. Acceptance of this training is at the discretion of your employer, who remains responsible for confirming it meets local requirements. Your employer may require more frequent refreshers than the guidance period; the practice's own policy applies. Some pictures and films in our courses, and the film narration, are made with AI tools. We check every one for accuracy before we publish it.