Working with doctors Working for patients

Steps to raise a concern

11. You must follow the procedure where you work for reporting near misses and incidents. This is because routinely identifying incidents or near misses at an early stage, can allow issues to be tackled, problems to be put right and lessons to be learnt.

12. If you have reason to believe that patients are, or may be, at risk of death or serious harm for any reason, you should report your concern to the appropriate person or organisation immediately. Do not delay doing so because you yourself are not in a position to put the matter right.

13. Wherever possible, you should first raise your concern with your manager or an appropriate officer of the organisation you have a contract with or which employs you – such as the consultant in charge of the team, the clinical or medical director or a practice partner. If your concern is about a partner, it may be appropriate to raise it outside the practice – for example, with the medical director or clinical governance lead responsible for your organisation. If you are a doctor in training, it may be appropriate to raise your concerns with a named person in the deanery – for example, the postgraduate dean or director of postgraduate general practice education.

14. You must be clear, honest and objective about the reason for your concern. You should acknowledge any personal grievance that may arise from the situation, but focus on the issue of patient safety.

15. You should also keep a record of your concern and any steps that you have taken to deal with it.

Raising a concern with a regulator

16. You should contact a regulatory body such as the General Medical Council (GMC)5 or another body with authority to investigate the issue (such as those listed at the end of this guidance) in the following circumstances.

a. If you cannot raise the issue with the responsible person or body locally because you believe them to be part of the problem.

b. If you have raised your concern through local channels but are not satisfied that the responsible person or body has taken adequate action.

c. If there is an immediate serious risk to patients, and a regulator or other external body has responsibility to act or intervene.

Making a concern public

17. You can consider making your concerns public if you:

a. have done all you can to deal with any concern by raising it within the organisation in which you work or which you have a contract with, or with the appropriate external body, and

b. have good reason to believe that patients are still at risk of harm, and

c. do not breach patient confidentiality.

But, you should get advice (see paragraph 18 below) before making a decision of this kind.

Help and advice

18. If you are not sure whether, or how, to raise your concern, you should get advice from:

a. a senior member of staff or other impartial colleague

b. one of the GMC’s employer liaison advisers

c. your medical defence body, your royal college or a professional association such as the British Medical Association (BMA)

d. the GMC, the appropriate regulatory body listed at the end of this guidance if your concern relates to a colleague in another profession, or other relevant systems regulators if your concern relates to systems or organisations rather than individuals

e. Public Concern at Work – a charity which provides free, confidential legal advice to people who are concerned about wrongdoing at work and are not sure whether, or how, to raise their concern.