Dr David Naylor

This website captures what I now know about speaking up, being ‘constructively awkward’ and resisting being silenced. Knowledge based on my time at The King’s Fund (KF) where I was a senior fellow in leadership development (2001 – 2009) and a senior consultant (2014 – 2020); and a secondment to the Sign up to Safety Campaign, during my second stint at the KF.  A campaign, set up by the then secretary of state, Jermey Hunt, to harness the commitment of staff across the NHS in England to make care safer. 

Along with the Sign Up Campaign, two programmes at the KF had real impact on my thinking about ‘speaking up’. The Top Managers Programme (TMP) and the KF’s support for charity leaders, working to improve communities and people’s health and wellbeing (GSK IMPACT Awards). Each led to conversations with people struggling to find and keep their voice. Conversations about being punished for not ‘speaking up’ even when it was obvious others didn’t want to listen. Conversations about the cacophony of demands, based on inadequate understanding and vested interests, telling them of their duty of ‘candour’. 

For a while at the KF I bought into the assumption that my focus should be on the one failing to speak up. An assumption that I realised retrospectively, silenced a question – why do we not talk about why we can find it so hard to listen to some people? It was Dr Fleetwood who got me to think differently. 

I met Dr Fleetwood in 2006 as I progressed my professional doctorate at Middlesex University. I wanted to research people – clinicians, community activists, NHS managers – who had a reputation for being ‘constructively awkward’[1]. People who spoke up and were hard to silence. People who wanted to build relationships with people they disagreed with, who believed in hearing different voices to keep in mind the people and issues at risk of being silenced and ignored. 

I explained to Dr Fleetwood, that my methodology was anchored in my Tavistock, psychodynamic training. I would focus on intra and interpersonal explanations. Dr Fleetwood listened and then just said, ‘what else?’ An invitation to face my bias and the gaps in my thinking. 

He knew I had confused what I knew how to notice and measure, with all there was to know about my subject. I didn’t know what I didn’t know. I was caught in the ‘epistemic fallacy’. Where ‘what exists disappears from the analytic field as it is collapsed in knowledge of what exists’[2].  A neat mirroring of the challenges I was to hear later in the Sign up Campaign. People close to patients, finding others in authority, reluctant to listen. As if what they currently understood about keeping people safe, was all there was to know about this critical shared task. 

Dr Fleetwood’s constructive and awkward intervention made me think about the wider contextual layers of speaking up. To look beyond the characteristics of individuals. To think about the effects of interpersonal relationships; the culture and capabilities of teams and professions; the values and norms embedded in the organisational and wider culture. All help determine who gets heard, who gets silenced and how safe it feels to question what others take for granted around here.

My doctorate and all these conversations informed my book published in 2023 – Speaking up in a culture of silence[3]. This website offers easy to use, practical tools, to people wanting to say more, who want to help others to speak, and explore how to approach those moments when ‘communication fails’ or someone is bullied into silence, and you don’t want to fall into your own epistemic fallacy or let others do so.