New National Guardian appointed to lead the NHS in speaking up freely and safely




The Medical Director for NHS England’s North Central and East London region and practising GP, Dr Henrietta Hughes has been appointed as the new National Guardian for speaking up freely and safely within the NHS.

Dr Hughes is a practising GP with over twenty years of experience across primary, secondary and community healthcare. She has been Medical Director for NHS England’s North Central and East London region since April 2013, in which she provides system leadership across 12 clinical commissioning groups and 12 NHS trusts, and she is the Responsible Officer for nearly 3,000 GPs.

Dr Hughes’s selection for appointment was made by a panel consisting of representatives of CQC, NHS England and NHS Improvement, as co-sponsors for the National Guardian’s Office, as well as the Patients Association and Sir Robert Francis QC, whose independent review from February 2015 into ‘whistleblowing’ across the NHS instigated the creation of the National Guardian role.

As the National Guardian, Dr Hughes will help to lead a cultural change within NHS trusts and NHS foundation trusts, so that healthcare staff feel confident and supported to raise concerns about patient care at all times.

This will include leading, advising and supporting the growing network of ‘Freedom to Speak Up’ Guardians within NHS trusts who are responsible for developing a culture of openness within their hospitals. Also, as the National Guardian, she will share and advise on good practice in responding to staff concerns, and provide challenge and support for the system so that it has a truly safe and open culture.

Dr Hughes is expected to take up the role in October 2016. She will be supported by a small office of staff, which is already in operation with an interim team.

Commenting on the appointment, David Behan, Chief Executive of the Care Quality Commission, said: “I am very pleased that Henrietta has accepted the position of National Guardian.

“The need for the NHS to have a positive reporting culture, which encourages and supports its staff to raise concerns about care without fear of reprimand has been stressed time and time again and now must become common practice.

“Leading the healthcare system on this journey alongside the Freedom to Speak Up Guardians within NHS trusts will be a core aim of the National Guardian and her office, so that ultimately, patients can get the safe, high-quality and compassionate care they deserve.

“The role requires strong leadership, trust and a clear understanding of the NHS and the challenges its staff face in raising concerns. I am confident Henrietta will bring all of these qualities in abundance as the National Guardian and I look forward to working with her in this capacity.”

Dr Henrietta Hughes, incoming National Guardian for the NHS said: “I am very excited to be appointed as the National Guardian and recognise that supporting and protecting staff across the NHS who wish to speak up is a huge and tremendously important responsibility.

“It requires a great deal of courage, honesty, and selflessness to ‘blow the whistle’. People should never feel that they are at risk of punishment when advocating better and safer care for patients.

“As a practising GP and with my experience in the NHS, both on the frontline and at leadership levels, I understand the challenges that lie ahead.

“Together with my office, the growing network of Freedom to Speak Up Guardians in NHS trusts, our national partners, and anyone else who has an interest in supporting and protecting staff who wish to speak up, I look forward to driving forward this agenda of openness.

“I want staff to always feel listened to regardless of where they work within the NHS, so that we can see real improvements in patient safety and staff experience. This is a real opportunity to work towards making that a reality.”

Health Secretary, Jeremy Hunt said: “The appointment of Dr Henrietta Hughes as National Guardian is an important step in our ambition to create a more open and honest culture in the NHS.

“Dr Hughes will support staff so they can raise concerns without fear of discrimination and ensure the NHS is one of the safest healthcare systems in the world.”

Sir Robert Francis, CQC board member and author of the ‘Freedom to Speak Up’ review, said: “No service can be effective without listening to and acting on the concerns raised by its staff, let alone one which employs such skilled and dedicated people as the NHS. They are the lifeblood of the service, and the lifeline for their patients.

“However, the evidence clearly shows that many staff are fearful of speaking up. It is important that every part of the NHS develops a culture in which it is entirely normal to raise issues about safety, quality and effectiveness of the service, for those issues to be addressed and for those who raise them to be protected from any adverse consequences arising out of their disclosures.

“I believe that the National Guardian, her office and the network of Freedom to Speak Up Guardians all have an invaluable role to play in supporting these changes.

“I would like to congratulate Henrietta for her appointment as National Guardian. She displays a genuine commitment to want to make a real difference to the lives of NHS staff and their patients. With her leadership, I am confident that she and her office can make great strides in achieving that.”

Ruth May, Executive Director of Nursing at NHS Improvement, said: “I would like to welcome Dr Henrietta Hughes as the new National Guardian. Her extensive clinical experience and expertise means she has the know-how to encourage the growth of the Freedom to Speak up Guardian’s network. Alongside the guardians, I am sure she will provide the leadership to ensure that a culture of openness within NHS trusts flourishes.

“Whistleblowers can play a crucial role in making sure that the NHS delivers the highest standard of care to patients day in, day out. If we all continue to do our part to safeguard the freedom to speak out, NHS staff will feel more confident to share vital information that can prevent the risks of harm to patients.

“I look forward to working closely with Dr Hughes, and our partners, to help NHS staff feel free and safe to speak out.”

Professor Jane Cummings, Chief Nursing Officer of NHS England, said: “I welcome the appointment of Dr Henrietta Hughes as the new National Guardian and look forward to working with her. The experience she brings to this role will be key in delivering an open and transparent health service. Providing all staff with the confidence and means to speak up is an essential part of providing high quality care to all.”

Katherine Murphy, Chief Executive of the Patients Association, said: “The Patients Association endorses Henrietta’s vision for NHS where staff feel valued and supported and where patients are treated safely and with dignity. Through our national helpline we not only hear from patients but also increasingly professionals working within services who feel they have nowhere else to turn. We welcome Henrietta’s appointment to this important national role and look forward to working closely with her to help deliver her vision.”


For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. 

Also, follow the team on Twitter for the latest national announcements: @CQCPressOffice.

Journalists wishing to speak to the press office outside of office hours can find out how to contact the team . (Please note: the duty press officer is unable to advise members of the public on health or social care matters). 

For general enquiries, please call 03000 61 61 61.

Notes to Editors

1. For further information about the National Guardian’s office, please visit:

2. Biography: Dr Henrietta Hughes is Medical Director for North Central and East London at NHS England and a practising GP. Her role at NHS England is a commissioning and assurance role as Responsible Officer for nearly 3,000 GPs, with 12 clinical commissioning groups and 12 acute, specialist and mental health providers. She is the clinical lead for mental health for London region in NHS England. Prior to that, Dr Hughes was the Acting Medical Director in the North Central London Cluster, the Associate Editor of the Journal of Family Planning and Reproductive Healthcare, and the Lead Appraiser at Camden Primary Care Trust. She has experience in hospital and community roles as well as in primary care.  Dr Hughes is passionate about improving the quality of care for people in England by disseminating good practice, improving the skills and reflection of staff and by managing variation in quality. She has experience of working with individuals and organisations in difficulty and brings a formative, learning and reflective approach which helps to create a sense of calm and purpose to support staff morale and bring improvement. She has published articles on a wide range of health related issues and written chapters in two books.

3. Dr Henrietta Hughes will serve as National Guardian for four days a week, primarily from the office in London and she will continue to work as a GP and GP appraiser. Her salary as National Guardian will be £105,040 per annum.  She replaces Dame Eileen Sills who stood down as National Guardian in March 2016.

4. The need for an independent National Guardian for the NHS was highlighted in Sir Robert Francis’s ‘Freedom to Speak Up’ review in February 2015, which found that patients could be put at risk of harm because vital information about mistakes and concerns was not being raised by NHS staff routinely. The review found that reporting systems were either insufficient or not used or because healthcare professionals did not feel able to speak up. The creation of the National Guardian was one of the key recommendations from this; an arrangement which the Secretary of State for Health confirmed in July 2015. For further information about Sir Robert Francis’s Freedom to Speak Up review, please visit:

5. There are 57 NHS trusts across England that have appointed Freedom to Speak Up Guardians. For further information, please visit NHS Employer’s website:




One thought on “New National Guardian appointed to lead the NHS in speaking up freely and safely

  1. Pingback: NHS whistleblowing articles in 2016: TWO years post Francis Review with NO change | sharmilachowdhury

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