We are pleased to publish this joint guidance to support anyone delivering NHS services in Scotland to speak up about their concerns. It has been developed in partnership between the Scottish Public Services Ombudsman (Independent National Whistleblowing Officer) and Healthcare Improvement Scotland.
This work follows Healthcare Improvement Scotland’s NHS Greater Glasgow & Clyde Emergency Department Review (March 2025), which recommended the development of clear and unambiguous guidance on national processes for raising concerns under Whistleblowing and the Public Interest Disclosure Act, with the aim to help NHS boards strengthen their arrangements and improve staff understanding.
Speaking up is essential to safe, high-quality care. Staff, contractors, volunteers and students are often the first to notice when something may not be right. It is vital they feel confident, supported and clear about what to do next.
We know that awareness of how to raise concerns, and confidence in using existing processes, is not always consistent. For some, it can feel unclear or difficult to know where to go.
This guidance is designed to make speaking up simpler, clearer and easier to navigate. It sets out:
- what speaking up means
- when and how to raise a concern
- the different routes available for advice and action
Our aim is to remove uncertainty and make it easier for people to speak up.
Everyone who delivers NHS services in Scotland should feel assured that their voice matters, and that there are clear, confidential and supportive routes available to them.
“Speaking up plays a crucial role in keeping people safe and improving NHS services. We know it can feel difficult to raise a concern, particularly if you are unsure what will happen next.
We hear from people who want to do the right thing but are unsure how to raise a concern or what to expect. That tells us there is more we need to do to make the system clearer and more accessible.
This guidance is a practical step in that direction. It brings together the available routes and explains how they work, including the role of the Independent National Whistleblowing Officer.
I strongly encourage anyone who is unsure to use our free, confidential advice line. It offers a safe space to talk things through, understand your options, and get independent advice before deciding what to do next.
Speaking up matters, and everyone should feel supported to do so.”
Paul McFadden
Scottish Public Services Ombudsman
“We recognise that navigating different processes and organisations can feel complex, particularly when you are already concerned about something important.
This guidance is designed to make that easier. It provides clear, accessible information together in one place, helping people understand where to go and what to expect.
Healthcare Improvement Scotland will continue to listen to concerns raised with us and ensure they are considered carefully, with a focus on patient safety and care across the system. It reflects our shared commitment to openness, transparency, and continuous improvement across NHS Scotland.
By working in partnership, we are strengthening how we support people to raise concerns and how we learn from them.”
Robbie Pearson
Chief Executive
Healthcare Improvement Scotland
This publication reflects close collaboration between two national organisations with key roles in supporting and responding to concerns in Scotland.
By working together, we are helping to:
- improve awareness and access to advice
- strengthen understanding of the available routes
- support a more open and positive speaking up culture
We want everyone who delivers NHS services in Scotland to know:
- speaking up matters
- your voice is important
- support is available
- and there are clear, accessible and confidential routes to help you
By continuing to listen and improve how the system works, we aim to build trust, increase confidence, and support safer, better care for the people of Scotland.
Read the National guidance for NHS staff on speaking up in NHS Scotland