Of 470 doctors polled by the MDU, 259 (55%) thought that doctors were more willing to raise concerns nowadays, while over half of respondents (53%) had raised concerns, such as about the conduct of a colleague or inadequate resources. Of the doctors who had raised concerns, over a third (40%) reported that the matter was not dealt with to their satisfaction (100 of 247 cases). Reasons for this included that the doctor was ignored, told nothing could be done or not taken seriously.
Just 14% of respondents (68/470) said they had encountered barriers to reporting concerns. These included pressure from colleagues or management, concerns that their career might be adversely affected, or just generally feeling isolated and unsupported.
Dr Sally Old, MDU medico-legal adviser said:
“Much media attention in the wake of the Francis report into Mid Staffordshire hospital has focussed on the willingness of healthcare staff to raise concerns about poor standards of care. It is encouraging that only a small minority of doctors in our survey reported any barriers to reporting issues.
"This reflects our experience from the many calls we receive to our advice line from doctors at all stages of their careers. We find they take their responsibility to protect patients very seriously and don’t just ignore any problems they encounter. Calls often centre on patient safety incidents and working practices, including inadequate training, cover or handover arrangements, individual or team workloads, and employers not replacing medical colleagues who leave or retire.
"It is vital that, when they do raise concerns, doctors feel supported and that they will not suffer personally or professionally as a result. The challenge for employers is to create a culture of openness in which all healthcare staff are able to act in patient's interests without fear of adverse repercussions."
The MDU's advice to doctors on raising concerns includes:
• Report a concern immediately; don't sit on it until it reaches a critical point.
• Follow your employer’s policy.
• Put your concerns in writing and ask for a written reply.
• Keep a record of the steps you have taken to resolve them.
• If colleagues are affected, consider sending a joint letter of concern, which may have more impact.
• Raise concerns locally in the first instance, with a senior colleague, your CCG or medical director.
• If no action is taken and patients may be harmed as a result, you may need to take it further, such as informing the GMC.
• Get advice from your medical defence organisation or professional organisation. Other sources of help include the NHS whistleblowing helpline, the GMC's confidential patient safety helpline, or the charity Public Concern at Work.
Further results from the survey included:
• 31% of respondents were GPs, 25% were consultants and 44% were hospital doctors, including training grades.
• Over half of doctors (54%) had raised one or two concerns over the previous five years, while 30% had raised three to five concerns and 16% had raised more than six.
• Common reasons for raising concerns were lack of resources or equipment (66%), problems with policies or systems (47%), poor
conduct or performance of a colleague (46%) and inadequate premises or resources (45%).
• 55% of respondents had raised concerns jointly with colleagues, while the rest had raised concerns alone.