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’.
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 in taking action commonly
- Reluctance to directly criticise or
get a colleague into trouble,
- Fear of personal or organisational
- The possibility of legal action for slander
- 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
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
The Public Interest Disclosure Act
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
- 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 and ask for advice,
- Think about the risks and outcomes before you
- Remember you are a witness, not a
- Forget there may be an innocent or good
- Use a whistle-blowing procedure to pursue a
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
- Refer to the trust’s whistle-blowing policy
- Talk things over with a trusted
- Generally, discussion with your own manager
is advisable unless they are the source of your concern.
- Keep records of all your observations and
- 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
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.
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
- Consult your defence
organisation, or union (such as the British Medical Association or
the Hospital Consultants and Specialists Association) before taking
- The College
Psychiatrists’ Support Service can provide information, advice and
- 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
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
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
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
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’
© 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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