Speaking up is vital for ensuring patient safety and quality services. The Employment Rights Act 1996, amended by the Public Interest Disclosure Act 1998, gives legal protection to all workers who speak up whether in private or public. In addition, the Government established an independent National Guardian to drive cultural change across the National Health Service so that speaking up becomes business as usual. Legislation and cultural change are designed to create an environment of trust and we have seen some progress. The National Guardian’s latest Freedom to Speak Up Index showed that 82% of trusts had made it easier to speak up since 2015. If NHS workers feel uncomfortable raising concerns through their line management or clinical lead, they can speak to their Freedom to Speak Up Guardian or to regulators. NHS workers should be thanked for speaking up and never face detriment for doing so.