Creating psychological safety for our staff

Principal consultant Anna Barnes reflects on an unfortunate flashback

Yesterday was a pretty normal day here at GGi: lots of work with clients, a bit of writing, some planning, online chats with a few colleagues. So far, so good- but then the dreaded message from one of my managers:

“Can we have a quick chat?”

For reasons connected to past work experiences, this led me down a rabbit hole of anxiety. Had I unwittingly been rude to a client? Was my report writing under par? Had I looked scruffy on a Teams call and someone had complained about me? Did someone know I had been out to check on my new lawn between calls yesterday?

This spiral had its roots in brutal NHS environments, where in two notable instances, a quick chat had led to me feeling I had no option but to change jobs in a hurry.

These ‘quick chats’ had left me feeling bullied, and led to off-the-record accusations of poor performance, feelings of being unsupported by my managers, one grievance and one Freedom to Speak up consultation. On both occasions, I rapidly changed job rather than stay and use the recommended avenues to address the problems. It is an OD cliché to say that employees don’t leave jobs, they leave managers,[1] [2] and these experiences have left me with a very low tolerance for informal, off-the-record feedback.

The experience yesterday was not helped by the ‘quick chat’ being delayed several times, which increased my anxiety and paranoia. However, when we did chat, it was, to my surprise and relief, just a check-in following my recent bereavement. It was actually lovely, and not scary or intimidating at all. Checking the lawn had not led to any sanctions after all.

It did get me thinking though. I can’t be the only employee who has emotional baggage from experiencing bullying and toxic management, and many people have psychological vulnerabilities, especially in a time where there is widespread uncertainty in the job market. Certain groups of employees are especially vulnerable: new parents back from maternity or paternity leave, newly promoted managers, ethnic minority employees who may feel they need to try hard to fit in and suffer imposter syndrome[3] [4].

How can employers ensure psychological safety in the workplace?

There are a few basic rules, based on organisational development principles, and from my own experience of having worked in high-pressure, high-stress NHS environments over the past 30 years:

• Nobody comes into work to do a bad job; we may need coaching and support, but most of us in public-purpose organisations want to do our best and make a positive difference to people’s lives.[5]
• Supervision and support are best provided in regular, planned and mandatory supervision sessions which are in both diaries from the outset and not subject to cancellation. The rule of no surprises holds true; difficult feedback should be given as soon as possible, not saved up for supervision sessions.
• Supervision is therefore supportive, and learning/reflective sessions for both parties are opportunities for growth, not just performance management. [6][NC2] [AB3]
• A safe and supportive culture creates conditions for informal feedback between colleagues, the online equivalent of water cooler and corridor conversations. These are difficult to create when people are working remotely, but they are necessary to prevent paranoia creeping in.
• Formal mechanisms such as Freedom to Speak Up are better than nothing, but they are often used quite late in the day when damage between employer and employee has already begun.
• As an employer, you may not know what is going on for your employees that might affect performance; someone may have caring responsibilities, they may be going through IVF, or, for example, they may (like me) have experienced bullying at another job and are thus liable to overreact in times of stress.

In the week the NHS staff survey results for 2025 were published, we have seen a deterioration in staff satisfaction metrics – specifically, staff looking forward to coming in to work – at many trusts. The causes are multifactorial but include an increase in incidences of violence and aggression which seem to have increased with waiting times, for example. We know low morale has an impact on the services provided to patients which, ultimately, will feed into performance metrics and board reports.

At GGi we are experienced at undertaking well-led reviews and CQC preparation. We have noticed increasing attention being paid to staff survey metrics, via board reports and, during our in-depth stakeholder engagement processes, are adept at getting under the skin of these metrics to help boards understand what is really going on. For example:

• How do staff with protected characteristics gain support from their managers and are they able to develop their careers the way other staff do, as evidenced by metrics such as recruitment/promotion and the existence of gender pay gaps?
• What is the timescale for the resolution of grievances and employment tribunals; how does this compare to other trusts of a similar size?
• Are staff offered development opportunities beyond statutory and mandatory training?
• How real is staff engagement beyond the establishment of staff networks?

Happy staff = better service

Staff feedback and the metrics associated with staff wellbeing are increasingly being used as a proxy measure of whether an organisation is well led[7]. This is because there is a direct and evidence-based correlation between staff satisfaction/wellbeing and better patient care[8].

People teams have a crucial role in supporting staff as well as ensuring that the organisation gets what it needs from staff in terms of performance. Unfortunately, staff sometimes perceive HR as being more concerned with the latter than the former.

Organisations seeking to improve the service they offer and also to reduce staff turnover and sickness should pay attention to psychological safety and ensure that staff are able to perform at their best and feel able to openly express concerns and ideas. This, in turn will improve the services we offer to patients.

[1] Popularised from Gallup research and the book First, Break All the Rules (Buckingham & Coffman, 1999).

[2] https://andiroberts.com/leader...

[3] Gould, J. 2024, ‘“Maybe I was never meant to be in science”: how imposter syndrome seizes scientist mothers’, Nature, 1 April. Available at: https://www.nature.com/article... [linkedin.com]

[4] Husbands, D., Linceviciute, S. & Yetkili, O. 2024, ‘The impostor phenomenon among racially minoritised university students: “who knows how to get rid of this?”’, Race Ethnicity and Education. Available at: https://www.tandfonline.com/do... [blog.hptbydts.com]

[5] Review of employee turnover

[6] Edmondson, A. C. (2018) The fearless organization: Creating psychological safety in the workplace for learning, innovation and growth. Hoboken, NJ: Wiley.

[7] https://www.cqc.org.uk/guidanc...

[8] 1. People Management in the NHS: NHS Staff Management and Health Service Quality Authors: Michael West, Jeremy Dawson, Lul Admasachew & Anna Topakas Published by: Department of Health / GOV.UK Year: 2011. Link: https://assets.publishing.serv...