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
University NHS Foundation Trust
36 cases
36
cases
Alder Hey Children's NHS Foundation Trust
36 cases
36
cases
Salisbury NHS Foundation Trust
36 cases
36
cases
Midlands Partnership University NHS Foundation Trust
36 cases
36
cases
Rotherham Doncaster and South Humber NHS Foundation Trust
35 cases
35
cases
Royal Papworth Hospital NHS Foundation Trust
35 cases
35
cases
North London NHS Foundation Trust
34 cases
34
cases
South Tyneside and Sunderland NHS Foundation Trust
34 cases
34
cases
Lincolnshire Partnership NHS Foundation Trust
33 cases
33
cases
London North West University Healthcare NHS Trust
33 cases
33
cases
Sheffield Teaching Hospitals NHS Foundation Trust
33 cases
33
cases
Sussex Partnership NHS Trust
33 cases
33
cases
University Hospitals Bristol and Weston NHS Foundation Trust
32 cases
32
cases
Worcestershire NHS Trust
31 cases
31
cases
Gateshead Health NHS Trust
31 cases
31
cases
Kingston and Richmond NHS Foundation Trust
31 cases
31
cases
Royal Devon University Healthcare Foundation Trust
30 cases
30
cases
Stockport NHS Foundation Trust
30 cases
30
cases
Central and North West London NHS Foundation Trust
30 cases
30
cases
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
29 cases
29
cases
South London and Maudsley NHS Foundation Trust
29 cases
29
cases
Oxleas NHS Foundation Trust
29 cases
29
cases
Epsom and St Helier University Hospitals NHS Trust
29 cases
29
cases
Hertfordshire Partnership University NHS Foundation Trust
29 cases
29
cases
West Midlands Ambulance Service University NHS Foundation Trust
29 cases
29
cases
North West Ambulance Service NHS Trust
29 cases
29
cases
Derbyshire Community Health Services
28 cases
28
cases
University Hospitals Coventry and Warwickshire NHS Trust
28 cases
28
cases
Sussex Community NHS Foundation Trust
27 cases
27
cases
North Staffordshire Combined Healthcare NHS Trust
27 cases
27
cases
Sandwell and West Birmingham Hospitals NHS Trust
27 cases
27
cases
Calderdale and Huddersfield NHS Foundation Trust
26 cases
26
cases
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
26 cases
26
cases
Royal Berkshire NHS Foundation Trust
25 cases
25
cases
Whittington Health NHS Trust
25 cases
25
cases
St George's University Hospitals NHS Foundation Trust
25 cases
25
cases
Lancashire Teaching Hospitals NHS Foundation Trust
25 cases
25
cases
Central London Community Healthcare NHS Trust
24 cases
24
cases
South West Yorkshire Partnership NHS Foundation Trust
24 cases
24
cases
MID Cheshire Hospitals NHS Foundation Trust
24 cases
24
cases
Lancashire and South Cumbria NHS Foundation Trust
23 cases
23
cases
Imperial College Healthcare NHS Trust
23 cases
23
cases
Northamptonshire Healthcare NHS Trust
23 cases
23
cases
Kent and Medway Mental Health NHS Trust
22 cases
22
cases
Kettering General Hospital NHS Foundation Trust
22 cases
22
cases
Northern Care Alliance NHS Foundation Trust
22 cases
22
cases
Milton Keynes University Hospital NHS Foundation Trust
22 cases
22
cases
Warrington and Halton Teaching Hospitals NHS Foundation Trust
21 cases
21
cases
Lincolnshire Community Health Service NHS Trust
20 cases
20
cases
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
20 cases
20
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.