Recommendations where a doctor has raised public interest concerns
Where a licensed doctor has raised public interest concerns (PICs), commonly known as 'whistleblowing’, we have some additional requirements as part of the revalidation process. This is to give us assurance that revalidation recommendations have been made appropriately.
Where a doctor has raised PICs you should follow your organisation’s local policies and processes for managing these situations. However, when making revalidation recommendations for a doctor who has raised PICs you must also follow the guidance below.
What we mean by public interest concerns (PICS)
The term ‘public interest concern’ is used to refer to instances where a doctor has raised concerns in the public interest (sometimes referred to as ‘whistleblowing’), usually relating to patient safety, and not merely for personal reasons. This type of concern is distinct from a grievance or private complaint, for example a dispute about the employee’s own employment position that has no public interest element.
Discussing the situation with your ELA
Where you are aware that a doctor has raised PICs you should contact your Employer Liaison Adviser (ELA) to discuss the situation before making any non-engagement or consecutive deferral recommendations for the doctor. You can discuss this with your ELA at any time and don’t need to wait until you are due to submit your recommendation.
The discussion with your ELA will include:
- the nature of the doctor’s PICs, including how they was raised and how they are being handled locally
- any potential conflict of interest between you and the doctor and whether advice should be sought from your higher-level or second tier responsible officer
- whether any ongoing processes relating to the doctor’s PICs are creating challenges for you or the doctor in engaging with revalidation process.
The discussion will be recorded and the ELA will feed the information back to our revalidation team.
We understand that you may not always be aware that a doctor has raised PICs and so you will not be able to discuss this with us. We don’t expect you to create extra systems for obtaining this information, but you may want to review existing systems to check you would be routinely informed of any PICs raised by your doctors.
In addition to your normal record keeping for your recommendations you should keep a record of any information relating to PICs raised by the doctor, such as:
- When the doctor raised their PICs with your organisation and how they did this
- When you were informed about the doctor’s PICs
- Any local processes or actions to respond to the PICs and specifically how they were handled in the context of the doctor engaging in revalidation
- Any identified conflict of interest between you and the doctor and whether the option of an alternative responsible officer or suitable person was considered, offered and granted
- Details of when you informed the doctor of your recommendation
- Details of any conversations or emails between you (or your support team) and the doctor about their revalidation, your recommendation and them having raised PICs.
You may find it helpful to have this information to hand when discussing these cases with your ELA.
Submitting your recommendation
You should submit your recommendation for the doctor in the usual way and do not need to provide any additional information, as you should have already discussed the situation with your ELA.
You will be required to confirm that you have had this discussion, and that the fact that the doctor has raised PICs has had no bearing on your recommendation.
Other information we might need
Where a doctor informs us that they have raised PICs and you were unaware of this, we will ask the doctor to tell us:
- how they believe this has impacted on their ability to engage with clinical governance and appraisal as part of revalidation, and
- whether they believe it has had a bearing on the recommendation you have submitted.
We may then need you to provide further information to help us understand the context of the doctor’s PICs and whether it has affected their ability to meet the requirements for revalidation. We are not requesting this information to investigate, intervene or resolve the doctor’s PICs locally.
Examples of additional information we may ask you for
- Correspondence between your organisation and the doctor about their appraisal and revalidation
- Correspondence between your organisation and the doctor about any identified conflict of interest between you and the doctor, or about any request by the doctor for an alternative responsible officer or suitable person
- Details of the doctor’s outstanding revalidation requirements and why you believe these have not been met.
If new information comes to light after you have made your recommendation
If you become aware that a doctor has raised PICs after you have made your recommendation you should contact our revalidation team or your ELA to discuss this.
How we respond to a recommendation where a doctor has raised PICs
Recommendation to defer
If the doctor has raised PICs and you need to make a subsequent consecutive deferral recommendation (see recommendations to defer), you should discuss the situation with your ELA. We may seek further information from you about any on-going local process before processing the recommendation.
Recommendation of non-engagement
If you make a recommendation of non-engagement (see recommendations of non-engagement), the doctor will be given the opportunity to respond to this before we make a decision about whether to withdraw their licence.
If they tell us that they have raised PICs and this has affected their ability to engage with revalidation we will usually share the doctor’s response with you and, if required, ask you for further information. Any information you give us will be shared with the doctor.
Once we have all the required information we will make a decision about the doctor’s revalidation. We may decide to withdraw the doctor’s licence, to defer their revalidation to give them more time to meet the requirements, or to revalidate them.
More advice and information about whistleblowing
- The whistleblowing charity Protect can offer advice on the relevant law and the protection it gives to workers who raise PICs.
- The national freedom to speak up guardian (NHS, England only) and local guardians can offer advice on your local processes for managing concerns.
- Further information and support for doctors who have raised PICs is available from the BMA and we also have guidance for doctors who are whistleblowers.