Putting patient safety first

Where patient safety is being put at risk, no matter what the reason, doctors have an obligation to raise concerns to prevent harm. The prospect of speaking up can be very daunting, especially for a junior doctor and especially when the concerns may relate to a senior colleague or systems which are in place in their employing hospital.

There has been a noticeable increase in the number of calls from doctors, of all grades, to the MDU advice line, where they are concerned about patient safety. As well as concerns about individual colleagues, this can also relate to more widespread problems such as staffing in terms of numbers and cover. Experience and senior cover can also be a factor as well as working excessive hours. 

Guides and resources

The GMC produced guidance for doctors which came into effect in March 2012, setting out the duties all doctors have, regardless of their grade. We all have a moral obligation to protect patients and our colleagues. We can’t assume someone else will address the problem or take any action to resolve it. Once you qualify as a doctor you will have a professional obligation to raise concerns.

The GMC also recognises that medical students, may witness or be involved in something in training which impacts on patient safety, dignity or comfort. It has produced specific guidance for students, Achieving good medical practice (paragraphs 18 -22). The GMC advises you to raise such concerns promptly, usually following your medical school’s procedures, and to contribute honestly and openly to the process.

Speak Up Month

As part of Speak Up Month which was led by the National Guardian’s Office in England, the GMC released practical advice to help doctors who feel they need to raise concerns and what to do if someone shares concerns with them. Importantly, the guidance provides tips on how to create an environment where speaking up is encouraged.


The GMC recognises doctors may not feel confident speaking up or may feel unsupported when they do so. As well as raising concerns, the GMC is encouraging doctors to bring solutions and engage colleagues to do the same, so they can raise concerns as a team, avoiding any feelings of isolation. This is also good advice for students, where they are aware of, or witness something, that concerns them. The Speaking up hub linked above provides tools and advice, including experiences of front line staff.

Student members of the MDU can also speak to one of our experienced medico-legal advisers for advice, if they have concerns about raising concerns where they are worried about patient safety or the behaviour or conduct of a fellow student or qualified colleague. 

This page was correct at publication on 04/11/2019. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Dr Kathryn Leask

Medico-legal adviser


Kathryn has been a medico-legal adviser with the MDU since 2007 and is a team leader, trainer and mentor in the medical advisory department. Before joining the MDU, she worked in paediatrics gaining her MRCPCH in 2002 and did her specialty training in clinical genetics. She has an MA in Health Care Ethics and Law, a Bachelor of Law and a Professional Doctorate in Medical Ethics. She is also a fellow of the Faculty of Forensic and Legal Medicine and has previously been an examiner and deputy chief examiner for the faculty. Kathryn is currently a member of the faculty’s training and education subcommittee and a member of the Royal College of Pathologists (medical examiner).

See more by Dr Kathryn Leask