Concerns about a senior colleague

A newly qualified consultant's professional dilemma about raising a concern

The scene

A newly qualified consultant physician started work in her new role at a trust she had not worked in before. Within a few months, she became concerned about the clinical practice of one of her senior colleagues in the department. In particular, she was worried about the standard of care that he was providing to patients and that he was using management plans now considered outdated.

The doctor called the MDU for advice. She was unsure how to tackle this problem as, despite being seriously concerned, she felt awkward in raising an issue about a senior colleague, especially when she had only just started working in the trust.

MDU advice

The MDU adviser asked the doctor if she was concerned about patient safety as a result of her colleague's clinical practice. The doctor confirmed that she was and that in fact a patient had been admitted the previous week which, in the doctor's opinion, was as a result of a sub-optimal treatment plan instituted by her colleague.

The safety of patients must come first at all times and in its guidance Raising and acting on concerns about patient safety (2012) the GMC states that all doctors have a duty to act when they believe that patient safety is at risk or that patient care or dignity is being compromised. This duty overrides any personal or professional loyalties.

The guidance goes on to explain that if the doctor is unable to put the matter right, then they should raise the concern with an appropriate person in their employing organisation. The doctor does not need to wait for proof and can justify raising a concern if it is done honestly, on the basis of reasonable belief and via the appropriate channels, even if the doctor is mistaken.

The adviser suggested that the doctor may wish to report her concerns to her clinical or medical director without delay and that she should be clear, open and honest about her concerns, keeping the focus on patient safety. She was advised to keep a record of the steps she had taken.


The doctor discussed the matter with her medical director. He took the concerns seriously and thanked the doctor for raising them with him. The trust dealt with the concerns appropriately through their local procedures.

Doctors who have concerns that the clinical practice of another healthcare professional might be putting patients at risk are obliged to act upon those concerns but should be careful to do so through the proper channels and in a factual, unbiased way. As this is an area that can be fraught with difficulties, MDU members with such concerns who are unsure how to proceed are encouraged to contact us for advice to ensure that their actions in raising the concerns are not subsequently subject to criticism.

Dr Judith Clark
Medico-legal adviser

This page was correct at publication on 10/01/2014. 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.