Why should I raise a concern?
It's in everybody’s interests (patients, staff and managers) to identify when something isn’t right and to make improvements. Speaking up or raising concerns should form part of your normal clinical practice. Get in touch with us at the early stages and we can guide you through this process.
You should not become a target for poor treatment because you raised a concern. If you do, we can help you.
You have a professional duty, under Good medical practice (paragraph 25), to raise concerns about anything that impacts patient safety or could impact patient safety.
What types of concern should I raise?
It can sometimes be hard to know whether you should raise a concern. You should be guided by this question: if you let the situation carry on is it likely to result in harm to others?
If in doubt, you should always err on the side of caution and raise your concern following your employer’s policy.
Issues you might have concerns about could include:
- unsafe patient care or conditions
- unsafe working conditions
- inadequate induction or training for staff
- inadequate response to a reported patient safety incident
- suspicions of fraud
- bullying towards patients or colleagues, or a bullying culture.
You can use the GMC's raising and acting on concerns flowchart to help you decide whether to raise a concern.
How to raise a concern
Report what has happened
You should use formal reporting methods, like Datix. Doing this can be essential to protecting yourself legally. It may also make it more likely that your concerns will be taken seriously.
There may be other methods for incident reporting depending on which nation you are in and your branch of practice.
If you don't feel comfortable raising a concern via your employer, concerns relating to health and safety matters can also be made to the Health and Safety Executive via its online concerns form. Your anonymity will be maintained by the HSE if you make this clear on the form.
Read your employer’s raising concerns policy
You should be able to find this on your employer’s website. It may also be called speaking up or whistleblowing. See what a model policy should look like in:
Follow the policy and raise your concern
When you have identified the right person to approach, you can raise your concern either verbally or in writing. You should:
- include key information eg details of what happened, where and when it happened, and who was involved
- include any relevant documentation or evidence you may have, don’t worry if you do not have evidence, it is not up to you to prove that something has happened
- think about and, if possible, be clear about the outcome you would like to see
- frame your concern as an opportunity for improvement and helping to address a shared problem
- use the right tone and remain professional.
Make a record
It’s important to keep a written record of raising your concern so you can refer to this later.
You can either put it in writing in the first instance or, if you raised your concern verbally, make a dated note of what you said.
What happens next?
The person you have spoken to:
- should thank you for speaking up and listen carefully
- may need to investigate your concern
- will decide on the most appropriate action to take
- tell you what they are going to do.
You should not be subjected to detrimental treatment, such as unwarranted criticism, disapproval or disciplinary action as a result of raising the concern.
Your legal protection
We have agreed legally binding protections with relevant bodies in England and Scotland for junior doctors to ensure they are protected when they raise concerns and are then get treated detrimentally.
We are in the process of agreeing a similar arrangement to provide protection for junior doctors in Wales.
Refusing to work
Remember, you should not refuse to work even if you believe staffing levels or your working environment (eg IT failure, lack of support staff) means conditions for patients are unsafe.
You would be in breach of your contract of employment and risk GMC action.
If you are a consultant, read our guidance on working under pressure.
The BMA can provide individual support – we can guide you through the process, help you to set out your concerns, review and advise on all correspondence and if necessary, accompany you to meetings with your employer.
Our Wellbeing support services can offer support for the emotional aspect of any dispute you may be going through. Call them on 0330 123 1245.