Raising concerns England General practitioner Practice manager

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Guidance on raising concerns for primary care providers

NHS England produced guidance on raising concerns for primary care providers following the report of the Freedom to Speak Up review chaired by Sir Robert Francis QC.

Read the NHS England guidance


Whistleblowing policy

The guidance provides a version for primary care of the standard NHS whistleblowing policy which was produced following the Francis review. Primary care providers should ensure their local policies and procedures align with this policy.


Freedom to Speak Up Guardian

The BMA response to the consultation on the draft guidance stressed that, in view of the diversity of primary care organisations, there would have to be flexibility about the processes to be used so that different solutions could be adopted in different contexts. In particular, whilst we agreed that the functions of a Freedom to Speak Up Guardian should be performed in primary care organisations, we were concerned by the number of roles that individuals in small organisations were being required to perform.

The final version of the guidance nevertheless includes the following requirement: “Each NHS primary care provider should name an individual who is independent of the line management chain and is not the direct employer as the Freedom to Speak Up Guardian, who can ensure that policies are in place and that staff know who to contact if they have a concern.”

Primary care providers will now have to implement this requirement. GP practices might like to be aware, however, that there are a range of options available to them in ensuring that they have a named individual as Freedom to Speak Up Guardian. The following options are listed in the guidance:

  • arrangement with another local provider
  • assigned staff role within a larger provider federation/network
  • arrangement with the local hospital trust Freedom to Speak Up Guardian
  • nominated member of the local Clinical Commissioning Group (CCG)
  • regional manager in larger provider organisations
  • NHS England Responsible Officers.

The BMA believes that the success of the guidance will depend on the cultural lead given by the NHS in ensuring that the raising of concerns is normalised in healthcare services.


Contact us

We would welcome feedback from our members on their implementation of the guidance and any problems they encounter. Any feedback should be sent to [email protected]