Speaking up
Speaking up, raising concerns, whistleblowing. However you describe it, we know it can be daunting.
On these pages you'll find advice and tools to help you follow the processes set out in our guidance.
Disclaimer
This ethical hub topic shows ways in which our professional standards can be applied in this area of care and signposts to relevant resources. It does not set new professional standards and is not intended to replace the formal guidance. Page last reviewed: 31 Oct 2022.
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Speak up in your organisation
Important
If patients are, or may be, at risk of death or serious harm, don’t delay. Act as best you can to make the situation safe and report your concerns immediately.Speak up in your organisation
Set up
- What's the nature of the problem? And can you put it right? If you can, do it.
- Talk to colleagues to see if they share your concerns. Together, think about the bigger picture and any action you can take - potentially as a group.
- Understand and follow your organisation's internal policies and procedures.
- Consider whether to seek advice from someone independent of the situation early on.
- Keep a written record of your concerns and the actions you're taking. Include relevant emails and meeting notes.
Speak up
- If you're not able to fix the problem, find the right person to talk to. This might be your supervisor, the department or practice clinical lead, site manager or another named person in your local policy.
- Consider reaching out to staff networks for support.
- Plan the best way to raise your concern to make sure you're listened to. It might sound obvious, but how, where and when you choose to speak up can make a big difference.
- Make your points as clearly as you can and stick to the facts. If possible, identify potential solutions.
- Agree next steps, timescales and how you'll keep in touch. Keep a written record.
Follow up
- Check if the concern has been dealt with. If not, and you're still worried, it's important to escalate it. This could be to the medical director, clinical governance lead or the board of your organisation.
- If you need additional support, contact your Freedom to Speak Up Guardian, Whistleblowing Champion or a similar organisation representative. If you're a trainee, you can also contact your Educational Supervisor or postgraduate organisation.
- If you're still dissatisfied with how your concern is being handled, raise it with the relevant regulator or organisation with authority to intervene, also known as a 'prescribed person'.
Change up
- Feedback about what did and didn't work for you during the process and areas for improvement. Your experience is important for getting things right in the future.
- Share your learning with colleagues, especially the outcomes. Your story can help to inspire others to take action too, and you may be able to offer them support.
Organisations who can support you
Organisations who can support you
Support from the GMC
- You can call our confidential helpline on 0161 923 6399 Monday to Friday, 9am - 5pm. We will provide advice and guidance on any concerns you may be struggling with.
- Our liaison and outreach teams work at the local level across the UK and offer training and support on speaking up and raising concerns.
- You can also read our full guidance on Raising and acting on concerns about patient safety.
Support from others
- Protect are a UK wide whistleblowing charity that advises and supports individuals and encourages safe whistleblowing.
- The BMA offer advice to their members.
- BMA members in Scotland can access a local adviser to confidentially discuss any issues around bullying, harassment, discrimination or dignity at work by contacting respectatwork@bma.org.uk.
- In England, you can contact your local Freedom to Speak Up Guardian. The website also contains further advice and resources on speaking up.
- In Scotland, you can contact your confidential contact who can provide support and relevant information on policies and procedures.
- The NHS Speak up helpline, available in England and Wales, offers legally compliant, unbiased support and guidance.
- Secondary care doctors in Wales can follow the procedure for NHS Staff to raise concerns. Doctors can also use Healthcare Inspectorate Wales’s (HIW) guidance for healthcare workers on raising concerns about healthcare in Wales.
- The Independent National Whistleblowing Officer (INWO), available in Scotland provides information, advice and support on raising concerns and the application of the National Whistleblowing Standards (the procedure for raising concerns for all NHS services in Scotland). The INWO provides an independent, final review stage for concerns raised through the National Whistleblowing Standards.
- In England, you can report a concern to the Care Quality Commission (CQC) if you’re a member of staff. Although, they can’t investigate individual complaints, they have a role in looking at workforce equality in regulation, and reporting can help them build a picture of the service provider.
- Your defence union will also be able to offer you advice.
Wellbeing support
- The BMA have a range of sources of support for your wellbeing. You don't have to be a member to access their free counselling and peer support services.
- NHS England have several support services – this includes a confidential text support service.
- In Wales, Canopi offers a free, confidential service that provides NHS and social staff with access to various levels of mental health support including counselling and peer support. Health Education and Improvement Wales (HEIW) have a range of resources available via their Professional Support Unit.
- In Scotland, the National Wellbeing Hub provides access to support resources for staff – this includes information about services available at both a national and local level.
- In Northern Ireland, the Public Health Agency have resources for staff health and wellbeing, which includes helplines open to staff working within Trusts, GP practices and Independent Care Providers.
Practical tools and advice to help you
Practical tools and advice to help you
'Say what needs to be said, and hear what needs to be heard' - practical tools for speaking and listening up
Professor Megan Reitz and John Higgins have carried out wide ranging studies across healthcare and other industries on effective speaking up and listening up practices. They've developed a pragmatic framework and supporting resources, based on insights from their research.
Effective listening and speaking up
Respect protects: tools to help you address unprofessional behaviour
Here you can find resources to give you the skills and confidence to deal with unprofessional behaviour. We’ve developed them in collaboration with the Royal College of Physicians, the Royal College of Surgeons of Edinburgh and the Royal College of Obstetricians and Gynaecologists.
Respect protects - tools to help you address unprofessional behaviour
Reflections and advice from the front line
Dr Tina Chrysochou, consultant nephrologist and established Freedom to Speak Up Guardian, shares her learnings and advice based on her experiences in supporting colleagues to speak up at Salford Royal NHS Foundation Trust.
Speaking up - a Freedom to Speak Up Guardian's experience
In this real-life case study, a doctor in training escalated concerns within their organisation with the help of their local Freedom to Speak Up Guardian. Read about what they did and what they learned.
Raising concerns externally
Raising concerns externally
If you feel unable to raise your concerns locally, or adequate action hasn't been taken when escalated locally then you can contact the appropriate regulatory body or prescribed person. Prescribed persons are people and bodies, set out in law, that you can raise a 'protected' disclosure to, rather than your employer. You can view them on the UK Government's website along with further guidance.
The GMC is a prescribed person and we can deal with concerns raised with us in relation to any of our statutory functions:
- Registration and licensing
- Medical education
- Professional standards
- Fitness to practise.
Where a concern falls outside of our statutory remit, we will signpost you to the appropriate body, or we may pass the information along to those who can take direct action.
You can also call our confidential helpline on 0161 923 6399 for help and advice. The helpline is available Monday to Friday between 9am and 5pm. Alternatively, you can use our online concerns form.
Protected disclosures
A 'protected disclosure' is defined in the Public Interest Disclosure Act 1998 (PIDA) and The Public Interest Disclosure (Northern Ireland) Order 1998. This legislation allows certain categories of worker to lodge a claim with an employment tribunal if they suffer as a result of speaking up.
As the legislation is complex, it's important to seek advice, for example from your defence body or Protect, about making a protected disclosure.
Going public with a concern
You can also consider making your concerns public where you have done all you can to deal with the issues locally or with the appropriate prescribed person. Again, it's important to seek advice before going public with a concern, especially if you intend to go to the press.
You can read more about PIDA and the legal protections available for whistleblowers.
How we safeguard doctors who raise concerns in our processes
In recent years, we've introduced a number of safeguards into our fitness to practise and revalidation processes to help make sure these aren't misused against doctors who raise concerns.
Quick visual guide
Quick visual guide
Follow the diagram below to help you decide how to raise your concern and get the right support. You can also download the Raising concerns diagram as a PDF.
Our professional standards
You can find our professional standards, including our guidance on Raising and acting on concerns, in the professional standards section.
