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
Pennine Care NHS Foundation Trust
20 cases
20
cases
George Eliot Hospital
18 cases
18
cases
Leeds and York Partnership NHS Foundation Trust
18 cases
18
cases
Great Western Hospitals NHS Foundation Trust
18 cases
18
cases
Croydon Health Services NHS Trust
17 cases
17
cases
North East Ambulance Service NHS Foundation Trust
17 cases
17
cases
Royal Orthopaedic Hospital NHS Foundation Trust
17 cases
17
cases
University Hospital Southampton NHS Foundation Trust
17 cases
17
cases
Wirral University Teaching Hospital NHS Foundation Trust
17 cases
17
cases
Royal Cornwall Hospitals NHS Trust
17 cases
17
cases
North Middlesex University Hospital NHS Trust
15 cases
15
cases
Sheffield Children's NHS Foundation Trust
15 cases
15
cases
Wirral Community Health and Care NHS Foundation Trust
15 cases
15
cases
Berkshire Healthcare NHS Foundation Trust
14 cases
14
cases
Royal Free London NHS Foundation Trust
14 cases
14
cases
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
14 cases
14
cases
James Paget University Hospitals NHS Foundation Trust
14 cases
14
cases
Coventry and Warwickshire Partnership NHS Trust
13 cases
13
cases
Portsmouth Hospitals NHS Trust
13 cases
13
cases
North Tees and Hartlepool NHS Foundation Trust
13 cases
13
cases
The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
13 cases
13
cases
Clatterbridge Cancer Centre
12 cases
12
cases
Rotherham NHS Foundation Trust
12 cases
12
cases
West London NHS Trust
12 cases
12
cases
The Walton Centre NHS Foundation Trust
12 cases
12
cases
Norfolk Community Health and Care NHS Trust
12 cases
12
cases
Airedale NHS Foundation Trust
11 cases
11
cases
Bridgewater Community Healthcare NHS Trust
11 cases
11
cases
Cheshire and Wirral Partnership NHS Foundation Trust
11 cases
11
cases
The Christie NHS Foundation Trust
11 cases
11
cases
East Cheshire NHS Trust
10 cases
10
cases
Royal Surrey NHS Foundation Trust
10 cases
10
cases
Queen Victoria NHS Trust
9 cases
9
cases
Yorkshire Ambulance Service NHS Trust
9 cases
9
cases
Chelsea and Westminster Hospital NHS Foundation Trust
9 cases
9
cases
Hertfordshire Community NHS Trust
9 cases
9
cases
Humber Teaching NHS Foundation Trust
8 cases
8
cases
Dartford and Gravesham NHS Trust
8 cases
8
cases
Liverpool Women's NHS Foundation Trust
8 cases
8
cases
Royal National Orthopaedic Hospital NHS Trust
8 cases
8
cases
The Hillingdon Hospitals NHS Foundation Trust
8 cases
8
cases
West Hertfordshire Teaching Hospitals NHS Trust
8 cases
8
cases
Tavistock and Portman NHS Foundation Trust
7 cases
7
cases
Liverpool Heart and Chest Hospital NHS Foundation Trust
7 cases
7
cases
Cambridgeshire Community Services NHS Trust
4 cases
4
cases
Harrogate and District NHS Foundation Trust
4 cases
4
cases
East Kent Hospitals University NHS Foundation Trust
0 cases
0
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.