The scene

An MDU member and trainee in paediatrics had been out to dinner with some non-medics and afterwards went on to a club recommended by her friends. At the club she recognised a fellow trainee in anaesthetics at the other end of the bar, who appeared to be quite drunk. She mentioned to her friends that he seemed to be drinking heavily, and her friend replied that he was a frequent visitor to the club and always drank heavily, as well as occasionally taking cocaine and other recreational drugs.

They left the club in the early hours and the anaesthetist was still there drinking. The paediatric trainee was not working for the next two days, but on her return found that one of her patients had deteriorated in the early hours of the morning after the dinner and had to be intubated.

She was shocked to learn that the person who had done the intubation was the anaesthetist she had seen at the club. Considering the amount he had been drinking at the club, she could not believe he would have been fit to intubate a small child just a few hours later. She called the MDU advice line to explain her dilemma and ask what she should do, as although she was concerned she would not wish to see him struck off.

MDU advice

The MDU adviser explained that as per GMC guidance in 'Good medical practice' (2024) and Raising and Acting on concerns about patient safety (2012), if the trainee is concerned that the anaesthetist could be putting patients at risk, she should raise a concern.

The trainee does not need to have proof of the excess drinking or the drug-taking, it is enough to have a reasonable belief. She should follow processes in place at the trust; it would be reasonable to start by discussing her concerns with her own supervising consultant. The consultant would likely then escalate the concern from there.

The adviser explained that if the anaesthetist was found to have a problem with drugs and alcohol then he could approach NHS Practitioner Health and also engage with self-help groups for help. The hospital would likely support him by involving occupational health and ensuring that he sought appropriate treatment.

The adviser assured her that if he was referred to the GMC it would not strike a doctor off (erase from the register) for health concerns alone, but would usually be offered health assessments and may restrict his practice to ensure patient safety.

Outcome

After speaking with the MDU, the member did inform her consultant, who took up the matter with the anaesthetic department. The anaesthetic trainee was offered an occupational health appointment and referral to the NHS Practitioner Health programme.

Conclusion

It is difficult to raise concerns about a colleague's health because of worries it could cause problems for them. However, patient safety is paramount, and if you believe a colleague's health may put this at risk, you should take steps to protect the patients.

In many cases reporting health concerns can result in the colleague being offered the help and support they will need to practice safely in the future.

MDU medico-legal adviser Dr Sally Old discusses sources of support available to doctors in this short video. Check out more sources of support here.

Raising concerns about a colleague

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