I recently had the privilege of chairing a forum on duty of candour, an experience which allowed me to interact with many people with an interest in patient safety.

One of the lasting impressions the event left on me, however, was the realisation that, while one of the most critical factors to transparency in medicine is that of psychological safety, it remains an issue that is not talked about enough.

Whether it is in our workplaces or in the BMA, the ability to feel safe and secure enough to express our views and concerns is fundamentally critical to our own wellbeing and ultimately to that of our patients.

As the association’s representative body chair, it is my responsibility to ensure that the voices and views of the BMA’s more than 170,000 members are heard and adequately reflected, particularly at formal policymaking events such as the annual representative meeting.

It is only natural that differences of opinion will arise and while points of view that are discriminatory will never be tolerated, it should also never be the case that those holding a minority view feel unsafe and afraid to speak out. As RB chair, I am always eager to hear from you about ideas and suggestions that would allow the ARM to become a more inclusive event that encourages debate and openness by increasing everyone’s sense of psychological safety.

I believe that doing this will not only make our ARM fairer, but actually help to produce policy that is more representative and beneficial.

The ability to feel safe and secure in the workplace is clearly one of huge importance, particularly when personal or patient wellbeing is concerned.

Important strides have been made in recent years across the NHS, most notably in the form of the introduction of Freedom to Speak Up guardians across trusts in England.

Despite such welcome changes, there is considerable evidence to suggest many doctors, from those in the early stages of their careers to even senior consultants, do not feel confident in making their feelings and concerns about important issues known.

To my mind, this speaks volumes about the extent to which many of us do not feel psychologically safe in our places of work. The obvious question therefore is what are trusts neglecting to do that might enhance their staff’s sense of security?

The presence of speaking up guardians is clearly an advance, but these individuals are not a silver bullet, and their efficacy can depend on a number of factors, including whether they were appointed solely by management or in conjunction with staff.

Other considerations include whether staff in these roles are visible and known within their workplaces? Have they made the effort to introduce themselves, walk around the wards and get to know those they advocate for on first name terms?

To doctors – ask about your speak up guardian; they’re there for you. To those in leadership positions – get to know your frontline staff, listen to them, they’re the experts. If you would like to get in touch to share your ideas or views please write to me at [email protected]

Dr Latifa Patel is chair of the BMA representative body