GMC survey on raising concerns


The GMC's National Training Survey (2013) revealed that junior doctors are more likely to raise concerns. Professor Sir Peter Rubin, Chair of the GMC, expands on these findings.

In his report on the failings at Mid-Staffordshire NHS Foundation Trust, Robert Francis QC made it clear that all doctors have a duty to protect patients and that doctors in training are invaluable 'eyes and ears' for what is happening at the front line of patient care.

Patient safety is our top priority at the GMC and we believe all doctors, regardless of their seniority, should feel supported in improving the standards of care for their patients. The very best organisations have a culture of openness where mistakes and near-misses are promptly and widely reported and lessons for improvement quickly learned.

Junior doctors are in an ideal position not only to draw attention to potential problems in their training environment but also to highlight any concerns they have about patient safety.

We know from our latest National Training Survey that doctors nearer the beginning of their training are more likely to raise concerns, as are doctors whose primary medical qualification is from the UK.


More than 2,000 doctors in training (5.2%) raised a concern about patient safety through the survey in 2013 - more than half of which related to lack of staffing or resources. Most of these trainees told us they had also raised the issue locally.

We believe that doctors in training should raise their concerns through local channels where possible. However, the important point is that the concern is raised, so we'd encourage trainees to use the survey if they feel more comfortable reporting a concern in that way. We can then liaise with the Postgraduate Dean to check that the matter is followed up.


The survey also revealed that nearly one in five doctors in training has witnessed someone being bullied in their current post. More than one in four has experienced undermining behaviour themselves and 13.2% said they had experienced bullying at work. This is unacceptable and clearly more needs to be done to support junior doctors to build the positive, supportive culture that is essential to patient safety.

We know that the best care is always given by professionals who are supported and encouraged. We strongly support openness and transparency and we feel that doctors in training should be able to raise their concerns, without fear of reprisal or being disadvantaged in some way.

Reassuringly, 5,863 respondents (11.1%) said they had been concerned about patient safety, and their concerns had been raised and addressed locally. This, and other examples of good practice from the survey, shows how organisations which had experienced problems managed them positively and effectively.

Employers will want to reflect on these results and engage with doctors in training, using their experiences to help change the culture of their organisations.

The survey highlights the importance of listening to young doctors working on the front line of clinical care. The significance of their views cannot, and should not, be underestimated.

The National Training Survey runs again this year until 8 May. I'd encourage all doctors in training to take part, to ensure their views and any concerns they raise are taken forward and to play their part in improving postgraduate medical education in the UK.

This article originally appeared in the printed edition of wardround April 2014 entitled "Junior doctors have their say".

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