This information guide is intended for a psychiatrist concerned
about whistle-blowing. The information can 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 or one of the organisations listed at the end of
the information guide.
Definition of whistle-blowing
someone passes on to others 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’.
The GMC’s core guidance in
Good Medical Practice
- 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.
- In all other cases you should draw the matter to
the attention of your employing or contracting body.
- If they do not take adequate action, you should
take independent advice on how to take the matter further.
- You must record your concerns and the steps you
have taken to try to resolve them.
Difficulties in taking action commonly
- reluctance to speak directly in criticism
- fear of retaliation, whether personal or
- uncertainty about who else to refer to
- unwillingness to get a colleague into
- the possibility of legal action for slander or
- assuming other people have already noticed and
decided whether or not to take action.
- These difficulties are compounded when:
- there is a considerable power differential, for
- there is a culture of collusion
- your job is not secure.
However, your duty to put patients’ interests
first and act to protect them 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
ActHealth 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, as a minimum, include:
- Guidance to help staff who have concerns about
malpractice raise these reasonably and responsibly with the right
- The designation of a senior manager or
non-executive director with specific responsibility for addressing
concerns which need to be handled outside the usual management
- 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
What to do
Public Concern at Work advises that you
- keep calm
- think about the risks and outcomes before you
- remember you are a witness, not a
- ask for advice.
- forget there may be an innocent or good
- become a private detective
- use a whistle-blowing procedure to pursue a
- expect thanks.
In the NHSEffective reporting is part
of good clinical governance.
- Obtain and consult the
trust’s whistle-blowing policy or equivalent.
- Talk things over with a
- Aim at improving the
situation with the least possible damage to the individual.
- Generally, discussion with
your own manager is advisable unless they are the source of your
concern; they may be aware of others’ concerns and be able to
approach the individual’s manager.
- Keep records of all your observations and
- Follow local policies such as adverse incident
- If necessary go to a higher level of management,
probably the medical director.
- If the concern is about
another health professional, then the appropriate routes are
usually the employer first, then the regulator (the GMC for
- Your role is to bring concerns to the attention
of the people responsible for investigating and taking action.
- When writing, copy in the responsible manager’s
manager, but do not send multiple copies.
- Subsequently, you may not hear about the details
of the action, but ask for some form of 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 as far as possible your
actions are in line with your employer’s policy.
Similar points apply within
the private sector, especially for large organisations. It is more
difficult with individuals in private practice.
Frequently asked questions
When someone passes on to
others information about actions in the workplace that are possibly
unsafe or illegal this is often called ‘whistle-blowing’.
Who can I ask for
- First consult with a trusted
colleague, who may be able to provide you with formal and informal
information about your organisation, and give you space for
- It would be wise to 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 at their helpline: 020 7404 6609.
Is whistle-blowing the same as making a
This type of reporting of concern is about
something that affects others (patients, for instance) rather than
Do I have to be able to prove
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 and of later actions and discussion is strongly
Who should I tell and
First clarify within your
organisation for the problem or issue who would be the right person
to go to. For senior doctors the medical director is likely to be
appropriate. For doctors in training a tutor or dean may be
Can it be
It is advisable to 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
What happens to
Cultures are changing, but
there have undoubtedly been difficulties in the past. However, the
term ‘whistle-blowing’ is often not used when concerns are raised
and appropriately dealt with, so ‘successes’ usually go
How can I avoid
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
BMA House, Tavistock
London WC1H 9JP
Tel: 020 7387 4499
St James Buildings, 79 Oxford
Manchester M1 6FQ
Tel: 0845 357 8001
CQC National Customer Service
Newcastle upon Tyne
Telephone: 03000 616161
Hospital Consultants and Specialists
1 Kingsclere Road,Overton,
Hants RG25 3JA
Tel: 012 5677 1777
Medical and Dental Defence Union
Mackintosh House, 120
Glasgow G2 4EA
Tel: 0141 221 5858
230 Blackfriars Road
London SE1 8PJ
Tel: 020 7202 1500
33 Cavendish Square
London W1G 0PS
Tel: 020 7637 0541
National Clinical Assessment
1st Floor, Market Towers, 1 Nine
London SW8 5NQ
Tel: England and Northern Ireland 020 7062 1655,
Wales 029 2044 7540, Scotland 013 1220 8060, 24-hour emergency
contact 020 7062 1655
National Patient Safety
4–8 Maple Street
London W1T 5HD
Tel: 020 7927 9500
Royal College of Psychiatrists
17 Belgrave Square, London SW1X 8PG
Tel: 020 7245 0412
Public Concern at
Suite 301, 16 Baldwins
London EC1N 7RJ
Tel: 020 7404 6609
Acknowledgements to the General Medical Council
and Public Concern at Work.
© Royal College of Psychiatrists 2008
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