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The Royal College of Psychiatrists Improving the lives of people with mental illness

Whistle-Blowing and Passing on Concerns

To contact the Psychiatrists' Support Service please telephone: 020 7245 0412  or e-mail: pss@rcpsych.ac.uk

What is Whistle-Blowing

When someone passes on information about actions in the workplace that are possibly unsafe or illegal this is often called ‘whistle-blowing’. The General Medical Council (GMC) refers to this as ‘passing on concerns’.



Duties

The GMC’s core guidance in Good Medical Practice states that:

 

  • You must protect patients from risk of harm posed by another colleague’s conduct, performance or health.
  • If you have good reason to think that patient safety is or may be seriously compromised by inadequate premises, equipment, or other resources, policies or systems, you should put the matter right if that is possible.
  • If they do not take adequate action, you should seek independent advice on how to escalate the issue.

Record your concerns and the steps you have taken to try and resolve them.

 


Difficulties

Difficulties in taking action commonly include:

 

  • Reluctance to directly criticise or get a colleague into trouble,
  • Fear of personal or organisational retaliation,
  • The possibility of legal action for slander or libel,
  • Assuming other people have already noticed and dealt with the issue.

 

These difficulties are compounded when:

 

  • There is a considerable difference in seniority,
  • There is a culture of collusion,
  • Your job is not secure.

Putting patients’ interests first must override personal and professional loyalties. The Public Interest Disclosure Act 1998 provides legal protection against victimisation or dismissal for individuals who disclose information in order to raise genuine concerns and expose malpractice in the workplace.

 


The Public Interest Disclosure Act

Health Service Circular 1999/198 states that every National Health Service (NHS) trust and health authority should have in place policies and procedures which comply with the Public Interest Disclosure Act and includes as a minimum:

 

  • Guidance to help staff who have concerns about malpractice raise these reasonably and responsibly with the right parties.
  • A senior manager or non-executive director with specific responsibility for addressing concerns which need to be handled outside the usual management chain.
  • A clear commitment that staff concerns will be taken seriously and investigated.
  • An unequivocal guarantee that staff who raise concerns responsibly and reasonably will be protected against victimisation.

 

 

What to do?

Public Concern at Work advises that you should:

  • Keep calm and ask for advice,
  • Think about the risks and outcomes before you act,
  • Remember you are a witness, not a complainant.

Don’t:

 

  • Forget there may be an innocent or good explanation,
  • Use a whistle-blowing procedure to pursue a personal grievance.


In the NHS

Effective reporting is part of good clinical governance. Your role is to bring concerns to the attention of the people responsible for investigating and taking action. You should:

 

  • Refer to the trust’s whistle-blowing policy or equivalent.
  • Talk things over with a trusted colleague.
  • Generally, discussion with your own manager is advisable unless they are the source of your concern.
  • Keep records of all your observations and actions.
  • Follow local policies such as adverse incident reporting.
  • If necessary, go to a higher level of management, possibly the medical director.
  • If the concern is about another health professional, the appropriate routes are usually the employer first, then the regulator (the GMC for doctors).

Subsequently, you may not hear about the details of action taken, but you can ask for appropriate feedback.

 

If the concern is wider, for instance about a trust’s decision, and you are considering going to the media, obtain expert advice and ensure your actions are in line with your employer’s policy.

 

 

FAQs

Who can I ask for advice?

 

  • Talk to a trusted colleague, who may be able to provide you with formal and informal information about your organisation, and give you space for reflection.
  • Consult your defence organisation, or union (such as the British Medical Association or the Hospital Consultants and Specialists Association) before taking any action.
  • The College Psychiatrists’ Support Service can provide information, advice and support.
  • Public Concern at Work is a charitable legal advice centre primarily concerned with this issue. You can contact them through their helpline: 020 7404 6609

 

Do I have to be able to prove it?

No. You are acting as an alerting mechanism. But you should be able to show that you have acted reasonably and in good faith. Keeping records of both observations, actions and discussion is strongly recommended.

 

Who should I tell and how?

Firstly, clarify who is the appropriate person to approach is within your organisation for the problem or issue. For senior, doctors the medical director is likely to be appropriate. For doctors in training, a tutor or dean may be appropriate.

 

Can it be confidential?

Check this at the outset. It is helpful if you can be as open as possible, that is, not to report anonymously, and be prepared later to give evidence if necessary. Ideally, there should be a first stage confidential system, where your name is not passed on without your consent.

 

How can I avoid antagonism?

Try to avoid isolation on the issue by keeping others involved and informed and do not let it appear to be a personal ‘campaign’ or vendetta. Consider using an independent mentor for support.

 

Sources of further help and support please contact British Medical Association, the General Medical Council or the Care Quality Commission.  Details can be found here.

 

Acknowledgements to the General Medical Council and Public Concern at Work.

The information should be used as a guide only and is not a substitute for professional advice. If you need further advice and support, please contact the Psychiatrists’ Support Service.

 

© Royal College of Psychiatrists 2016


If you require advice and support about a particular issue then please contact the Psychiatrists' Support Service at the Royal College of Psychiatrists on 0207 245 0412 or email

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