- You must raise concerns about patient care and safety, including any practitioner’s fitness to practise.
- Raising a concern is also known as whistleblowing.
- In some circumstances you are protected in law when you raise a concern.
- You should act quickly.
- You should keep a record of any concerns.
- You must protect patient confidentiality.
- You should record adverse incidents centrally, for example in your practice’s system or in the practice Accident Book.
- You should report near misses involving NHS-funded patients in England and Wales to the National Reporting and Learning System and to the equivalent bodies in the other UK countries, in Scotland to your local health board, and in Northern Ireland to the Northern Ireland Adverse Incident Centre.
- what might the outcome be in the short- or longer-term if I do not raise my concern?
- how could I justify not raising the concern?
- very poor treatment
- failure to gain patient consent to treatment
- cross-infection problems, for example use of dirty equipment
- sexual assault or abuse. See section on Maintaining boundaries
- practising under the influence of drink or drugs
- fraud or theft
- inadequate malpractice insurance.
- act quickly
- keep a record of the concerns you have raised, and actions you have taken. The record should be as detailed as possible, and not influenced by your personal feelings or opinions. The record should be verifiable or auditable, and you should keep a time line record of any communications.
References
206 General Optical Council (2016) Standards of practice for optometrists and dispensing opticians para 11.3 [Accessed 20 Nov 2020]207 The Public Interest Disclosure Act 1998 [Accessed 20 Nov 2020]
208 The Public Interest Disclosure (Northern Ireland) Order 1998 [Accessed 20 Nov 2020]
209 Public Concern at Work [Accessed 20 Nov 2020]
- apologise to the patient
- explain what has happened
- explain any remedial action.
This is what is meant by the duty of candour.
- investigate the adverse incident
- take the appropriate action
- keep a written record.
- in England and Wales to the National Reporting and Learning System (NRLS). This does not collect any patient or practitioner identifiable information210
- in Scotland to your local health board211
- in Northern Ireland to the Northern Ireland Adverse Incident Centre.212
References
210 Learning from patient safety incidents [Accessed 20 Nov 2020]211 Northern Ireland Adverse Incident Centre (NIAIC). Reporting an adverse incident [Accessed20 Nov 2020]
212 MHRA Yellow Card Scheme [Accessed 19 Nov 2020]
213 Learning from adverse events through reporting and review. A national framework for Scotland: December 2019 [Accessed 22 Sept 2020]
214 MHRA. Report a problem with a medicine or medical device [Accessed 19 Nov 2020]
British Medical Association. Raising concerns [Accessed 20 Nov 2020]
Care Quality Commission. Raising a concern with CQC. A quick guide for health and care staff about whistleblowing [Accessed 19 Nov 2020]
Department of Health, Northern Ireland (2017) Your right to raise a concern (whistleblowing) HSC framework and model policy [Accessed 20 Nov 2020]
General Optical Council (2019) Standards for Optical Businesses, Standard 1.1 [Accessed 20 Nov 2020]
General Optical Council (2016) Raising concerns with the GOC (whistleblowing) policy [Accessed 20 Nov 2020]
National Advisory Group on the Safety of Patients in England (2013) A promise to learn – a commitment to act. Improving the safety of patients in England [Accessed 19 Nov 2020]
National Guardian’s Office [Accessed 20 Nov 2020]
NHS Improvement. Patient safety [Accessed 16 Aug 2021]
NHS Improvement (2021) Freedom to speak up: raising concerns (whistleblowing) policy for the NHS [Accessed 16 Aug 2021]
NHS Scotland Confidential Alert Line: 0800 008 6112 [Accessed 20 Nov 2020]
NHS Scotland Partnership Information Network policy on whistleblowing arrangements [Accessed 20 Nov 2020]
Protect [Accessed 20 Nov 2020]
Public Health Wales (2013) All Wales Raising Concerns (Whistleblowing) Policy [Accessed 20 Nov 2020]
Speakup Helpline 08000 724 725 [Accessed 20 Nov 2020]
Whistleblowing for employees [Accessed 19 Nov 2020]