Major study into how healthcare middle managers experience and manage the speaking up process launched by Kingston University London
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Major study into how healthcare middle managers experience and manage the speaking up process launched by Kingston University London

04.02.2026 Kingston University

Kingston University London has announced the launch of a landmark two-year research project investigating how healthcare middle managers experience and manage the speaking up process in both the public and private healthcare sectors.

The study, funded by The MPS Foundation and adopted by the NIHR, is led by Professor Ann Ooms and Dr Celayne Heaton-Shrestha at Kingston University.

The project comes against staff perceptions that their concerns relating to bullying, harassment and patient safety are not adequately addressed. Reports and media portrayals suggest that middle managers are often seen as a barrier in the speaking up process. However, little is known about how middle managers experience staff approaching them with a concern, how they decide to respond, what enables or hinders follow-up and how the process might affect their wellbeing.

The research project aims to expand knowledge about how NHS middle managers, who manage frontline healthcare staff, experience and manage the speaking up process and how that affects their wellbeing. Speaking up is defined as communicating anything that hinders patient care and patient safety such as unsafe practice, or that affects staff wellbeing such as bullying or harassment and is crucial to patient care, patient safety and staff wellbeing.

The study will investigate two key areas:
  • How middle managers manage the speaking up process
  • How managing the speaking up process impacts middle managers’ wellbeing.
Researchers will work with two NHS Foundation Trusts, conducting interviews with middle managers, frontline staff, senior leaders, and wellbeing guardians. An anonymous online survey will also capture wider experiences, offering an opportunity for all middle-managers to share their perspectives.

Professor Ooms emphasised the importance of addressing the unique challenges faced by middle-managers: “They are likely to experience isolation and dilemmas, trying to address the expectations of frontline staff and senior management simultaneously, whilst maintaining positive relationships with both.”

By shining a light on the pressures faced by middle managers, the project aims to generate new insights into how healthcare organisations can better support staff, strengthen the speaking up process and ultimately improve patient safety and staff wellbeing.
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04.02.2026 Kingston University
Regions: Europe, United Kingdom
Keywords: Health, People in health research, Well being, Public Dialogue - health, Business, Universities & research

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