Creating space to speak up: What all leaders can learn about empathy from the silent crisis in healthcare

Imagine you're in a hospital. Maybe you're a patient, feeling a bit lost and uncertain. You have a question, a little worry about your treatment, or maybe even a concern about something that doesn't feel quite right. But you look at the busy doctor or the hurried nurse and you hold back. You don’t ask. You stay silent.

I’ve been that person, feeling that something isn’t right. Despite my background in healthcare and my work helping people to communicate effectively, and teaching skills around how to have difficult or challenging conversations, I still didn’t want to say anything. Fortunately, my doctor gave me an open opportunity, and in that moment I was able to raise my concerns which led to a healthy outcome.

Or perhaps you're a new member of the team in a healthcare setting. You've noticed a tiny detail that could prevent a future problem, but the traditional hierarchy feels so big and overwhelming. You think to yourself, "Is it my place to speak up?" and in that moment, the answer feels like no.

That moment of quiet hesitation - the choice to stay silent - is a story we hear far too often. But here’s the thing: it’s not just a hospital problem. This same issue is playing out in boardrooms, offices, and even in your own teams. Leaders in every industry face the same challenge: creating an environment where people feel safe enough to speak up. It’s about more than just having an "open door" policy; it's about building genuine trust.

When being factual leaves a cold feeling

In healthcare, leaders are trained to be factual and precise. Their world is one of data, diagnoses, and life-or-death decisions. This focus on objective facts is essential for clinical excellence. But if a leader's approach is only factual and lacks empathy, it can come across as cold and unapproachable. The very mindset that makes someone a brilliant surgeon can make them a less-than-brilliant communicator.

The data backs this up in a way that’s pretty hard to ignore. We know that many NHS staff want to speak up. In fact, more than six out of ten staff members say they feel safe to raise concerns about things in their organisation. That's a good starting point. But then you hit what we like to call the ‘action gap’. Look a little closer at the numbers: only about half of those same staff members - just 50.48% - are confident that their organisation will actually act on their concerns.

Think about that for a second. The channel for feedback is there, but the trust that it will lead to meaningful change has completely eroded. When a culture of blame and a fear of retaliation takes root, people learn that the safest option is to say nothing at all. They choose silence over the risk of looking foolish, damaging their reputation, or facing consequences for simply trying to help.

The corporate mirror: Same problem, different uniform

You don't need to be in a hospital to see this play out, and at Green Shed Talent we see it across a number of sectors with our clients. It’s The CEO who lives by the numbers and dismisses an employee’s emotional feedback as “not data-driven.” The manager who makes it clear that mistakes will not be tolerated because they impact the bottom line. It's the same story, just with a different uniform.

This ‘factual-first’ mindset, left unchecked, creates an invisible barrier. Just like in the NHS, employees may have official channels for feedback, but they don't believe their voice will be heard. They fill out that annual survey, they click the anonymous feedback link, but they hold back their best ideas and most crucial concerns. Why? Because they've learned it’s easier to be quiet than to be wrong. This isn't about people being bad or lazy; it’s about a system that makes speaking up feel like a risk rather than a responsibility.

The cost of silence: Stifled creativity and lost ideas

When people feel unable to speak up, it’s not just about stopping a problem from getting worse; it’s also about preventing good things from happening in the first place. A workplace that lacks psychological safety is one where brilliant ideas die quiet deaths. It's a place where innovation gets squashed because no one feels brave enough to challenge the status quo. Different points of view are kept to ourselves, and we miss out on a whole world of diverse thought and wider knowledge that can make a team so much more well-rounded and cohesive. Think about it this way: how many times has a junior employee had a fantastic idea but didn't share it because they feared being dismissed or told, "That's not how we do things here"? When we create a safe space, we’re not just encouraging people to report what’s wrong; we’re giving them permission to be creative, to be curious, and to contribute their very best selves.

A blueprint for leaders: More human, less corporate

So, what’s the fix? How do we build teams where open communication is the default?

The answer isn’t to abandon your factual side. It's to become more human. The research tells us that compassionate leadership is the foundation for psychological safety. This isn’t some fluffy, touchy-feely concept; it's a pragmatic, evidence-based approach that makes teams more resilient and more effective.

Here’s where we get to the really practical stuff. This is what we talk about with our clients. Leaders can start right now by doing three things:

• Model vulnerability. A leader has to go first. By openly admitting your own mistakes - like, "Hey, I messed that one up, but here's what I learned" - you send a powerful message. It shows your team that it’s okay to be imperfect and that mistakes are for learning, not for punishing.
• Listen with curiosity. When someone on your team brings up a concern, your first job is to understand, not to defend. Ask open-ended questions like, "Tell me more about that," or "What are you seeing that I'm not?". This simple act of curiosity shows that you truly value their perspective and that every voice matters.
• Embrace a ‘just and learning culture.’ Based on an organisational model in healthcare, a ‘just and learning culture’ looks to learn from concerns and errors rather than seeking to blame. When something goes wrong, a compassionate leader doesn't immediately ask, “Who did it?” They ask, “What happened and why did it happen?”. By focusing on the system instead of the individual, you free your team to report issues without fear of blame. This is how you catch problems before they become crises.

And here’s the really tricky part. As leaders, we often focus on the words we use - making sure our language is clear and our messages are positive. But so much of what we communicate is unspoken. Our body language, our reactions, and the small, everyday behaviours we don't even think about often say more than the language we use. Are we sitting back with our arms crossed, or are we leaning in with genuine interest? Do our eyes glaze over as soon as someone shares a concern? This is where leadership development can really make an impact, helping leaders become more self-aware so they can truly walk the talk and it’s what we love doing at Green Shed Talent.

The Bottom Line

The stories of silence in UK healthcare are a tough reminder of a universal truth. The very skills that make a leader effective can also create a climate where people are afraid to speak up. But the fix isn't complicated. It's about being a better human, not just a better leader.

At Green Shed Talent, we believe that creating a safe space for every voice isn’t just a nice idea - it’s a powerful competitive advantage. Organisations that prioritise psychological safety aren't just kinder; they’re more innovative, more productive, and more successful. And we're here to help you get there.