Providing comments on a colleagues conduct

The scene

An F2 doctor was asked by her consultant to provide a statement as part of an investigation into a complaint. A patient had alleged that the consultant had been rude and dismissive during a consultation at which the F2 doctor had been present. The complainant went on to allege that the consultant's poor communication skills and bullying attitude had led to a failure to reach the correct diagnosis. The F2 considered that the patient's complaint was justified, and had raised concerns about the correct diagnosis at the time, only to be put down in front of the patient. The consultant had also been rude to her and other colleagues on several other occasions during his placement. She rang the MDU for advice on how to respond.

Our advice

It is becoming increasingly common to be asked to provide comments on a colleague's conduct or performance. Often this is by way of a 360° appraisal, which every doctor must undergo during a five year revalidation cycle. However, there are other situations, such as disciplinary hearings, investigations by the GMC or when a report is needed, where it is necessary to provide an account of another doctor's actions. The majority of doctors might feel comfortable in providing feedback through a 360° appraisal, which involves a tick box form submitted via an independent company so that the appraiser remains anonymous. However, many would be uncomfortable or concerned about providing a report that is critical of a senior colleague. 

It is understandable not to want to say anything negative about a colleague, but doctors might also be anxious about counter-accusations or jeopardising their career prospects. The GMC states that doctors have an obligation to act if they think that patients are being put at risk by a colleague's performance, conduct or health. The booklet Raising and acting on concerns about patient safety (2012) provides additional detail, and while acknowledging that there may be obstacles to raising concerns there is 'a duty to put patients' interests first and act to protect them, which overrides personal and professional loyalties'.

Hospitals are obliged to have a policy on raising concerns at work. The policy will usually include an option of being able to raise concerns anonymously. While this may seem an attractive option, doctors should be aware that raising concerns anonymously can hamper an investigation and also deny the doctor concerned the opportunity of responding adequately to the concerns. There are also times when the concerns raised are of sufficient severity that anonymity cannot be protected.

In summary, the same principles apply whether a doctor is providing feedback anonymously via 360° appraisal or a written statement as part of formal proceedings. The doctor must be honest and fair to all concerned and not be afraid of providing a truthful account through fear of reprisals.

Outcome

In this case, we helped the F2 doctor to write a statement setting out what she had observed during the consultation, which did include corroboration of the patient's account of the incident. The adviser also suggested that the F2 speak to colleagues with a view to jointly approaching her Foundation Programme Director or Education Supervisor about the consultant's attitude towards her junior colleagues.

Learning points

  • Keep any statement factual and avoid opinion.
  • Be specific – include dates, times etc.
  • Identify other witnesses/colleagues by name.
  • Include patient identifiers if confidentiality allows.
  • Contact the MDU for advice.
  • Be discreet.
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This page was correct at publication on . 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.

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