Practical Guidance on Whistleblowing in the NHS from Public Concern at Work


Week in and week out doctors blow the whistle across the NHS. Few of these doctors will think of themselves as whistleblowers, insisting that they are just doing their job. This is understandable as, for many, the perceived characteristic of whistleblowing remains that the message is not heard, the messenger gets crucified and it all ends in tears. Essentially what this means is that only when the message is unwelcome is it considered to be whistleblowing.

However, the culture is changing and people up and down the NHS are much more aware today that they may have to account for their actions. This helps inject an element of self-discipline and circumspection when people are presented with difficult choices. Recent initiatives mean that many, if not most, NHS Trusts are committed to promoting responsible whistleblowing as an essential aspect of good clinical governance. Whistleblowing in today’s NHS need not end in tears.

While the Bristol Inquiry cautioned that it was possible that such poor practices and tragic outcomes might be occurring elsewhere in the NHS, we think it is impossible that today when the whistle is blown, senior managers or Health Department officials would again wish such a problem away.

Should you have a concern about something you feel ought to be addressed, your efforts should be directed to trying to ensure that you don’t raise the issue in such a way that confuses the message with the messenger. Drawing on the experience of our confidential helpline and our work with employers in and out of the NHS, we set out below some questions to bear in mind if you are unsure whether or how to raise a concern:

  1. Is someone (e.g. a patient) unaware that they are being exposed to a risk that you would not take or expose your loved ones to?
  2. Do you believe any of your colleagues or your team would answer the question the same way?
  3. If the tables were turned and someone had a concern about your clinical practices, how would you want them to raise the issue?
  4. How can the risk be addressed so that the least damage is caused to the colleague involved?
  5. Have you talked to your colleagues or your team? (If not, why not?)
  6. Can you find a solution within your team?
  7. If not, does your Trust have a whistleblowing policy which tells you who to talk to?
  8. If not, who in the hospital will be dealing with the fallout if your concern is not raised and it proves well founded?
  9. In any event, is there a trusted senior colleague or friend you can discuss the issue with first? Did you know you can ring Public Concern at Work in confidence on 020 7404 6609 to discuss whether or how to raise the concern?

Some other questions you may sensibly ask yourself are:

  • If you’ve known of the risk for some time, why are you minded to raise the issue now?
  • What do you think would be a satisfactory outcome?
  • What obstacles are there to it?
  • What is your motivation?

Before you blow the whistle, it’s always a good idea to be very clear about the limits of your own responsibility. First, a whistleblower is a witness, not a complainant. Secondly, a likely consequence of not blowing the whistle is the Chief Executive or Chair saying “Why didn’t anybody tell us?” or “If only we had known…” The treatment, then, should be to let the facts speak for themselves and allow those responsible to take an informed decision.