There are moments in every healthcare security officer’s career when something simply does not feel right.
Perhaps a secure door has been left open for the third time that week. A patient is behaving differently from usual. A visitor keeps testing the boundaries of restricted areas. A colleague mentions something that does not fit with the rest of the picture.
None of those observations automatically proves that something is wrong.
But experience teaches us that small concerns matter, particularly when they repeat, connect with other information, or involve somebody who may be vulnerable.
The publication of the Thirlwall Inquiry report on 15 September 2026 has brought renewed attention to how healthcare organisations receive, assess, and respond to concerns. The Inquiry examined events at the Countess of Chester Hospital and identified serious failures of management, governance, and safeguarding. Its findings arise from an exceptional and deeply serious case, and should not be reduced to a generic security lesson.
There is, however, a principle that applies across healthcare roles: a concern cannot be considered if nobody is willing or able to raise it.
For healthcare security teams, speaking up is part of professional practice. It means noticing, recording, asking, escalating, and following the correct route without exaggeration or accusation.
Speaking up is not the same as being certain
One of the biggest barriers to raising a concern is the belief that you need proof before saying anything.
Most security officers will not have the complete picture. They may hold one observation, one report, or one part of a developing pattern. Their responsibility is not to conduct an investigation on the spot or reach a final conclusion.
It is to communicate information that may matter.
A concern may later have a reasonable explanation. That does not make raising it improper. Decisions can only be made using the information available, and silence removes information from that process.
Speaking up professionally means being clear about the difference between:
- What you directly saw or heard.
- What somebody else reported to you.
- What appears unusual or inconsistent.
- What you do not yet know.
- Why you believe another person should review it.
That distinction allows the recipient to assess the concern without treating an observation as a proven fact.
Professional curiosity without premature conclusions
Professional curiosity is the willingness to look beyond the first explanation and ask whether more information is needed.
Useful questions include:
- Is this normal for this person, place, or time?
- Has something similar happened before?
- Does this connect with another incident or report?
- Who else may hold relevant information?
- Is there an immediate safety or safeguarding concern?
- Who has responsibility for reviewing this?
Curiosity is not suspicion for its own sake. It is not an invitation to speculate, interrogate people, or treat an unfamiliar situation as evidence of wrongdoing.
The strongest officers remain open-minded. They notice what is unusual, gather information within their role, and communicate it to somebody with the authority or expertise to decide what happens next.
Security often sees what departments see separately
Healthcare security teams occupy an unusual position. Officers move between departments, work across shift changes, monitor shared spaces, review CCTV, respond to incidents, and speak with clinical and non-clinical colleagues.
One department may see one unsecured door. Another may report an unfamiliar visitor. The control room may notice repeated movement around a restricted area. A night officer may have logged similar behaviour the previous week.
Viewed separately, each observation may appear minor. Together, they may justify closer attention.
This wider view is one of healthcare security’s strengths, but only if information is recorded and shared. The article The Small Things Become Big Things explores how repeated defects and exceptions can become normal when nobody closes the loop.
The cost of assuming somebody else will act
Hospitals are busy, complex organisations. People work under pressure, information changes quickly, and ownership can become unclear.
It is easy to think:
- Somebody must already know.
- It is probably nothing.
- It belongs to another department.
- I do not want to make a fuss.
- I raised something similar before and nothing happened.
Those thoughts are understandable. They are also how concerns can disappear into gaps between teams.
Speaking up does not mean treating every issue as an emergency. It means taking reasonable ownership of the information you hold: use the appropriate route, make the concern understandable, and escalate again if the risk remains and the response is inadequate.
Choose the right route
Not every concern requires the same process. Depending on the issue and local policy, the appropriate route may include:
- Immediate radio escalation or emergency action where somebody faces imminent harm.
- Notification to a supervisor, control room, clinical lead, safeguarding team, or site manager.
- An incident, defect, intelligence, or security report.
- A confidential reporting route.
- The organisation’s Freedom to Speak Up Guardian or speaking-up process.
- Police, counter-fraud, regulatory, or other specialist referral where required.
Routine reporting and Freedom to Speak Up are not interchangeable. Many operational concerns can and should be resolved through normal management, incident, safeguarding, or maintenance routes. Freedom to Speak Up provides an additional route when a worker has a concern about something affecting patient care or working life, particularly where ordinary routes feel unavailable, unsafe, or ineffective.
Officers should know their employer’s current policy rather than rely on a generic internet description. NHS England’s Freedom to Speak Up policy sets a national framework, but local contacts and processes matter.
Speak up with facts, not accusations
The way a concern is communicated can determine whether it is understood.
A useful report usually explains:
- What was observed, heard, or reported.
- When and where it happened.
- Who was present or may hold further information.
- Whether it has happened before.
- What immediate action was taken.
- What risk remains.
- What review or response is being requested.
Compare these two statements:
“Nobody cares that this door is always insecure.”
“The staff entrance was found unsecured at 20:10 on Monday, 19:35 on Wednesday, and 21:05 today. Each occasion has been logged. The lock is still not securing consistently, so access remains uncontrolled outside normal hours. Please confirm the temporary control and repair owner.”
The second version is more useful because it separates evidence, risk, and requested action. It does not need dramatic language to show why the issue matters.
Clear records are particularly important if the concern later forms part of a safeguarding review, complaint, investigation, or organisational learning process. Our article on what makes a healthcare security incident report useful explains the same fact-led approach in more detail.
Escalation is not disloyalty
Some staff hesitate because they worry that speaking up will be seen as criticism of a colleague, team, or organisation.
Professional loyalty does not mean protecting an organisation from uncomfortable information. It means helping the organisation identify and address risk before more harm occurs.
That does not justify careless allegations, gossip, or bypassing fair processes. Concerns should be raised in good faith, through appropriate channels, and with respect for confidentiality.
It does mean that hierarchy, familiarity, or fear of embarrassment should not prevent a genuine concern from being heard.
Leaders must make speaking up safe
Responsibility does not sit only with the person raising the concern.
Supervisors, managers, and senior officers shape whether staff will speak up again. A dismissive response, public criticism, or silence after a report teaches the team that raising concerns carries risk but little value.
A constructive response includes:
- Listening without immediately becoming defensive.
- Clarifying the facts and immediate risk.
- Explaining what will happen next.
- Protecting confidentiality where possible.
- Recording ownership and timescales.
- Providing feedback, even when details must remain restricted.
- Making clear that retaliation or mistreatment is unacceptable.
The Thirlwall Inquiry’s chapter on Speak Out Safely discusses why policies alone are not enough. Staff must believe that concerns will be received fairly and acted upon appropriately.
What if the first response is not enough?
An officer may raise a concern and receive no visible action. Sometimes there are legitimate reasons why information cannot be shared back. Sometimes another team is reviewing the matter out of sight.
But a continuing risk should not be mistaken for a completed action simply because an email was sent or a log entry was made.
If the concern remains, the officer should:
- Check whether it reached the intended person.
- Restate any continuing or increased risk.
- Use the next escalation level set out in local policy.
- Keep a factual record of what was raised, when, and with whom.
- Seek advice from a supervisor, safeguarding lead, union representative, or Freedom to Speak Up Guardian as appropriate.
Persistent, proportionate follow-up is not the same as demanding a preferred conclusion. It is asking for assurance that the concern has been considered by somebody able to respond.
Final thoughts
Healthcare security officers are not expected to solve every problem they encounter.
They are expected to observe, communicate, and act within their role when something may affect safety, security, safeguarding, or professional standards.
Sometimes speaking up means challenging an unsafe practice. Sometimes it means connecting several minor reports. Sometimes it means telling a supervisor that an explanation does not resolve the risk. Sometimes it means using a confidential route because ordinary channels have failed.
The goal is not to be proved right.
The goal is to make sure a reasonable concern is not lost because everybody assumed somebody else would raise it.
Protecting people does not always begin with intervention. Often, it begins with one person having the professional courage to start a conversation.
For a related look at how listening and escalation support patients and relatives, read Martha’s Rule Isn’t Just for Clinicians.
