From 1 July, there will be an important shift in how Freedom to Speak Up (FTSU) is supported across the NHS. NHS England will take on responsibilities previously held by the National Guardian’s Office (NGO), which is due to close in June following the Dash review into patient safety.
For GP partners and practice managers, this isn’t just a national update — it’s a timely opportunity to reflect on how well your own speaking up culture is working in practice.
What’s changing?
- The National Guardian’s Office will close in June
- NHS England will assume key FTSU responsibilities from 1 July
- This follows the Dash review, focused on improving patient safety across health and care
While national structures are evolving, expectations at practice level remain unchanged: your team must feel safe, supported, and confident to speak up.
What this means for your practice
You should be able to demonstrate that:
- Staff know how to raise concerns
- There is a clear and trusted route to speak up
- Concerns are listened to, acted on, and fed back
- Your approach supports psychological safety, not just policy compliance
In smaller GP settings, there may not always be a formal Freedom to Speak Up Guardian role in place — making it even more important to consider accessible external support options that give staff a safe and independent route to raise concerns.
Moving beyond policy: creating a system that works
One of the common challenges in general practice is not a lack of intention, but a lack of consistent, accessible mechanisms for speaking up — especially when concerns feel difficult to raise internally.
This is where having a practical, visible system in place becomes essential.
Introducing the Harmony Pulse Hotline
The Harmony Pulse Hotline is an independent, confidential reporting service designed to support a genuinely open and transparent culture within your practice.
It gives your team:
- A safe, accessible space to raise concerns
- An option when they don’t feel comfortable speaking internally
- Confidence that their voice will be heard and acted on
Using a simple call system:
- Team members leave a recorded message
- The message is securely transcribed
- It is shared with leadership for review and appropriate action
Importantly, the service:
- Protects anonymity where needed
- Enables you to gather clear, meaningful insight
- Helps ensure concerns are not lost, missed, or avoided
Why this matters in light of the FTSU changes
With NHS England taking on a greater role, there will be continued focus on how organisations:
- Demonstrate a genuine commitment to Freedom to Speak Up
- Evidence a culture, not just a policy
- Respond to concerns effectively
The Harmony Pulse Hotline supports this by helping you:
- Build trust and psychological safety
- Surface concerns early, before escalation
- Create a consistent and trackable approach
- Gather evidence aligned to CQC expectations
Alongside tools like the Harmony Pulse weekly check-in, it creates a simple but powerful system to listen, respond, and improve continuously.
Practical steps for your practice
- Ask your team: “Would you feel comfortable speaking up here?”
- Review whether your current approach is accessible and trusted
- Ensure there is more than one route to raise concerns
- Make support systems visible — posters, reminders, conversations
Accessing the Harmony Pulse Hotline
The Harmony Pulse Hotline is available as part of Simple Path — giving you not just a policy, but a complete, practical system to evidence and embed a strong speaking up culture.
👉 To get access and start embedding this within your practice, visit:
https://hcqc.co.uk/simplepath
and you will get:
- Access to the Harmony Pulse Hotline
- The weekly Pulse check-in
- Structured support to help you build, evidence, and sustain CQC confidence