Reported concerns not addressed

I have a concern about a fellow colleague's surgical outcomes. I have worked with this colleague for a number of years. More recently, I have observed a number of postoperative problems and have been called in to the hospital, when on call, to deal with post-operative emergencies arising out of his cases.

I have tried discussing the concerns with my colleague but this proved to be difficult as we have never really got on very well. I also feel that at directorate meetings previously, he was reluctant to accept advice and guidance.

Because my colleague would not take any notice of my concerns, I raised them with the clinical director but he did not appear to be interested. I then spoke in person to the medical director but he has not taken any action either. I am still seriously concerned that patients may be at risk. What should I do?

First and foremost, you have a duty to protect patients from harm. It was appropriate to voice concerns to the clinical and medical directors because the colleague in question would not discuss the matter with you. Although you may be anxious to avoid further disharmony in your department, you should consider setting out your concerns in writing to the medical director. Doctors are required to comply with GMC guidance, which requires doctors to take steps promptly if they have concerns about a colleague which could impact on the safety of patients, so that concerns are investigated and patients are protected if necessary. The GMC has published advice for all doctors in Raising and acting on concerns about patient safety (2012). Doctors who are managers have additional responsibilities set out in the GMC guidance Leadership and Management for all doctors (2012).

Keep a record of all correspondence on this matter. In the unlikely event that the medical director refused to investigate the concerns; or that a thorough investigation did not address the matter and you still believed patients were at risk, you might need to consider approaching the GMC yourself. But hopefully setting out your concerns in writing to the medical director should be enough for the matter to be properly investigated and, if it is necessary, for action to be taken to protect patients.