Freedom to Speak Up

Quarterly data from the National Guardian's Office showing how many speaking up cases each NHS trust receives. Covers patient safety concerns, bullying and harassment, and other workplace issues raised by staff through Freedom to Speak Up Guardians.

8,615
Cases raised (Q4 2024/2025)
197
NHS trusts reporting
43.7
Avg per trust
0.0%
Patient safety

Key figures — Q4 2024/2025

8,615
Total cases raised
0
Patient safety
0
Bullying / harassment
43.7
Avg cases per trust

Source: National Guardian's Office. Higher case numbers may indicate a healthier speaking up culture, not necessarily more problems.

National Trend

Total cases raised across all NHS trusts by quarter

Total cases raised Patient safety concerns Bullying / harassment

Trusts with most cases — Q4 2024/2025

Top 15 trusts by total FTSU cases. Higher numbers may reflect stronger speaking up cultures.

197 trusts — Q4 2024/2025

Most cases Patient safety Bullying A–Z
King's College Hospital NHS Foundation Trust
55 cases
55
cases
South Central Ambulance Service NHS Foundation Trust
55 cases
55
cases
East Sussex Healthcare NHS Trust
54 cases
54
cases
London Ambulance Service NHS Trust
53 cases
53
cases
South East Coast Ambulance Service NHS Foundation Trust
53 cases
53
cases
MID Yorkshire Teaching NHS Trust
53 cases
53
cases
Avon and Wiltshire NHS Trust
52 cases
52
cases
Hampshire Hospitals NHS Foundation Trust
52 cases
52
cases
Leeds Community Healthcare NHS Trust
52 cases
52
cases
County Durham and Darlington NHS Foundation Trust
51 cases
51
cases
Frimley Health NHS Foundation Trust
51 cases
51
cases
West Suffolk NHS Foundation Trust
51 cases
51
cases
Wye Valley NHS Trust
51 cases
51
cases
Devon Partnership NHS Trust
50 cases
50
cases
Norfolk and Norwich University Hospitals
50 cases
50
cases
North Cumbria Integrated Care NHS Foundation Trust
50 cases
50
cases
Barts Health NHS Trust
49 cases
49
cases
Bolton NHS Trust
49 cases
49
cases
East Midlands Ambulance Service NHS Trust
49 cases
49
cases
Great Ormond Street Hospital NHS Trust
48 cases
48
cases
The Princess Alexandra Hospital NHS Trust
47 cases
47
cases
Buckinghamshire Healthcare NHS Trust
47 cases
47
cases
Shrewsbury and Telford NHS Trust
47 cases
47
cases
South West London and St George's Mental Health NHS Trust
46 cases
46
cases
Maidstone and Tunbridge Wells NHS Trust
45 cases
45
cases
North East London NHS Foundation Trust
45 cases
45
cases
University Hospitals of Morecambe Bay NHS Foundation Trust
44 cases
44
cases
South Tees Hospitals NHS Foundation Trust
44 cases
44
cases
NORTHAMPTON GENERAL HOSPITAL NHS TRUST
44 cases
44
cases
Barking, Havering and Redbridge University Hospitals NHS Trust
44 cases
44
cases
East London NHS Foundation Trust
43 cases
43
cases
Cornwall Partnership Foundation Trust
42 cases
42
cases
Moorfields Eye Hospital NHS Foundation Trust
42 cases
42
cases
Sherwood Forest Hospitals NHS Foundation Trust
42 cases
42
cases
The Royal Marsden NHS Foundation Trust
42 cases
42
cases
Chester Hospital NHS Trust
41 cases
41
cases
Lewisham and Greenwich NHS Trust
41 cases
41
cases
Mersey and West Lancashire Teaching Hospitals NHS Trust
41 cases
41
cases
Tameside and Glossop Integrated Care NHS Foundation Trust
40 cases
40
cases
Torbay and South Devon NHS Foundation Trust
40 cases
40
cases
University College London Hospitals NHS Foundation Trust
39 cases
39
cases
Leicestershire Partnership NHS Trust
38 cases
38
cases
Medway NHS Foundation Trust
38 cases
38
cases
Surrey and Borders Partnership NHS Foundation Trust
38 cases
38
cases
The Dudley Group NHS Foundation Trust
38 cases
38
cases
Bristol NHS Trust
37 cases
37
cases
Gloucestershire Health and Care NHS Foundation Trust
37 cases
37
cases
Royal United Hospitals Bath NHS Foundation Trust
37 cases
37
cases
Surrey and Sussex Healthcare NHS Trust
37 cases
37
cases
Bradford Teaching Hospitals NHS Foundation Trust
37 cases
37
cases
Data from the National Guardian's Office. Freedom to Speak Up was established following Sir Robert Francis QC's 2015 review into creating an open and honest reporting culture in the NHS. Every NHS trust in England has a Freedom to Speak Up Guardian.