Show simple item record

dc.contributor.authorMartin, Grahamen
dc.contributor.authorChew, Sarahen
dc.contributor.authorDixon-Woods, Maryen
dc.date.accessioned2019-12-20T00:30:14Z
dc.date.available2019-12-20T00:30:14Z
dc.date.issued2020-01-27en
dc.identifier.issn1363-4593
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/300144
dc.description.abstractEmployee voice is an important source of organizational intelligence about possible problems in quality and patient safety, but effective systems for encouraging and supporting those who seek to speak up have remained elusive. In the English NHS, a novel role known as the ‘Freedom to Speak Up Guardian’ has been introduced to address this problem. We critically examine the role and its realization in practice, drawing on semi-structured interviews with 51 key individuals, including Guardians, clinicians, managers, policymakers, regulators and others. Operationalizing the new role in organizations was not straightforward, since it had to sit in a complex set of existing systems and processes. One response was to seek to bound the scope of Guardians, casting them in a signposting or coordinating role in relation to quality and safety concerns. However, the role proved hard to delimit, not least because the concerns most frequently voiced in practice differed in character from those anticipated in the role’s development. Guardians were tasked with making sense of and dealing with issues that could not always straightforwardly be classified, deflected to the right system, or escalated to the appropriate authority. Our analysis suggests that the role’s potential contribution might be understood less as supporting whistleblowers who bear witness to clear-cut wrongdoing, and more as helping those with lower-level worries to construct their concerns and what to do with them. These findings have implications for how voice is understood, imagined, and addressed in healthcare organizations.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherSAGE
dc.rightsAll rights reserved
dc.rights.uri
dc.titleUncovering, creating or constructing problems? Enacting a new role to support staff who raise concerns about quality and safety in the English National Health Service.en
dc.typeArticle
prism.publicationDate2020en
prism.publicationNameHealth (London, England : 1997)en
prism.startingPage1363459319901296
dc.identifier.doi10.17863/CAM.47215
dcterms.dateAccepted2019-12-17en
rioxxterms.versionofrecord10.1177/1363459319901296en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-01-27en
dc.contributor.orcidMartin, Graham [0000-0003-1979-7577]
dc.contributor.orcidDixon-Woods, Mary [0000-0002-5915-0041]
dc.identifier.eissn1461-7196
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idNational Institute for Health Research (NIHR) (via University of Leicester) (RM62G0760)
cam.orpheus.successTue Mar 31 10:38:31 BST 2020 - Embargo updated*
cam.orpheus.counter2*
rioxxterms.freetoread.startdate2020-01-27


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record