Speaking up has a bad rap but it's a big deal.

Report after report, inquiry after inquiry, all say the same thing: "this could have been avoided if only people spoke up". We also know that small improvements, made regularly can lead to dramatic leaps in performance, safety and the experience people have of our health system - both as service users and as care professionals.

Freedom to Speak Up is a great step in the right direction, but it's not nearly enough - it's too formal and too heavy. And while managers should know how to hear reports and suggestions, without judgement or agenda, few are trained to do so properly. Tell Florence is here to bridge that gap.

If you share a genuine experience with Tell Florence, we promise:

1. To ensure it is shared with someone who can do something about it.
2. To protect your identity, if you've asked us to do.

If in doubt, share what you think. Even small suggestions and reports can add up to make a difference.

If you've seen something that presents an imminent threat of harm, and you can't do anything alone, speak to someone who can, in person or on the phone, and as soon as possible. This is not the domain of internet-based reporting.

To report incidents or near misses, please use your Trust's formal process. If you don't know what this is, or how to access it, report the issue here and we'll make sure it gets to the right place.

And if you trust your manager to hear your concerns and respond accordingly, then please don't let us get in the way.

For anything else, Tell Florence.

If you've seen something that presents an imminent threat of harm, please report it to any member of staff. All care personnel have a duty of care and should be able to help in such urgent situations.

If you have a good relationship with a member of your care team, please talk to them in the first instance.

And if in doubt, or if other attempts have not worked, by all means, Tell Florence and we'll find the right place for your concern.