Raising Concerns

The Deanery is aware of the following:

• many Postgraduate Doctors and Dentists in Training (PGDiTs) feel they are not well informed about the process of raising concerns
• many experience barriers in the process
• the greatest perceived barriers are the impact of professional relationships and fear of repercussions

Many PGDiTs feel that a raised concern is not given due consideration and attention. Additionally few receive feedback on a raised concern and/or receive an update on the outcome.

The following information aims to provide PGDiT training with practical information in this area. However it is important to recognise this information is a guide.

 

What is a concern?

In this context a concern is anything that is compromising care, for example patient safety, staff health and staff, support, training, culture. It can relate to clinical practice but also involve the systems, policies and/or procedures of the organisations doctors and dentists work in. What is regarded as concern is a matter judgement for the healthcare worker and a concern can involve more than one aspect. Further information including videos can be found here.

 

When to raise a concern?

Concerns should always be raised in a timely fashion and not stored up to be reported in an annual training survey.

 

Support for raising a concern?

Raising a concern can be a daunting and challenging prospect. It can also have multiple consequences. The following resources can help provide support at this time:

• General Medical Council’s advice on ‘Speaking Up’
• the Professional Support Team at NHSE YH (offer personal and professional support including health and wellbeing issues)

The Deanery can always be contacted with concerns, communication is best done by email. The various contacts can be found here.

 

Raising concerns signposting chart

Issues relating to:

When raising concerns related to training, it may also be helpful to review the regional Yorkshire and Humber regional regarding postgraduate medical and dental training. These are available here.

 

Points of call

*Employment concerns are best raised with the points of call that are related to your employment, for example line manager, clinical lead etc. For employment concerns, educators such as your Educational Supervisor or Medical Education Teams may not be able to directly help with these issues but may be able to signpost to contacts related to your employment and/or other resources that can offer support.'

 

Please note:

• there will be variation among different schools and specialities
• always start by raising concerns locally at the first level and if the issue is not sorted, continue escalating upwards
• if you are unsure who to direct your concern to, speak to your Educational Supervisor. If you can’t speak to them, talk in confidence to someone you trust about the situation
• for information on what these roles entail, you can hover over the name for a brief description
• raising concerns can be professionally and personally challenging and so consider obtaining support. The Professional Support Team at NHSE YH can be a place to start

 

Brief Description of Different Roles and Organisations

Associate Dean: Supporting the dean in delivery of postgraduate education and training in several areas including improving patient care, enhancing learner safety and experience and achieving effective educational outcomes.

Clinical Director (Medical Director/Dental Director): Senior leader in a healthcare organisation who is responsible for clinical operations, patient care, regulatory compliance, staff management, finance and strategic planning.

Clinical Lead:  A senior healthcare professional who manages a clinical team and is responsible for the quality of patient care delivered by that team. Responsibilities include managing and supporting staff, implementing practices to meet clinical standards and overseeing the delivery of patient care.

Clinical Supervisor: A named trainer who is responsible for overseeing a specified trainee’s clinical work and providing constructive feedback during a training placement (National Health Service England: Workforce Training and Education Medical Hub 2022).

College Tutor: Responsible for co-ordinating and overseeing teaching of PGDiTs in a specific speciality/school.

Dean: Overall accountability for quality of postgraduate medical and dental education in their deanery ie overall responsibility for ensuring training environments meet training standards (General Medical  Council, 2015).

Director of Medical Education: Responsible person within the local education department for delivering the educational contract in that organisation. This includes mapping the curriculum,  developing and supporting the faculty and ensuring the quality of training in the organisation in line with local, regional and national standards.    

Educational Supervisor: A named trainer who is responsible for the overall supervision and management of a specified trainee’s educational progress during a training placement or series of placements (National Health Service England: Workforce Training and Education Medical Hub, 2022).

Freedom to Speak Up Guardian: Aim to protect patient safety and quality of care, improve the experience of workers and promote learning and improvement. Support employees to speak up by addressing the barriers that prevent employees from speaking up and fostering a positive culture of speaking up. Each employer will have at least one Freedom to Speak Up Guardian (National Guardian Freedom to Speak Up, 2018).

Guardian of Safe Working: Has responsibility for overseeing the safety of resident doctors’ working environments and hours. The guardian is independent of the management structure within  the employing organisation and is a senior person. Their role is to ensure issues of compliance relating to safe working hours are addressed with the employee and employer (National Health Service Employers, 2021).

Professional Regulator:  They have 4 key roles:

• Set standards of competence and conduct that healthcare professionals must meet Similarly, be registered and practice
• Maintain a register of healthcare professional
• Assess the quality of education and training courses to ensure learners leave with the knowledge and skills to practice safely and competently
• Investigate complaints of registrants and assess their fitness to practice.

The General Medical Council is the professional regulator for doctors in the UK and for dentists it is the General Dental Council. (Professional Standards Authority for Health & Social Care, 2024)

Trade Union: These are professional associations, and their aim is to promote the interests of their members (both individually and collectively). This includes negotiating employments rights and pay, supporting members at work and championing the profession they represent. The British Medical Association is the trade union for doctors in the UK. Similarly the British Dental Association the trade union for dentists in the UK.

Training Programme Director: Responsible for managing their specific training programme usually across different local education providers. They are responsible for recruitment, rotations and trainee progression.

 

References: 

General Medical Council. (2015). Promoting Excellence: Standards of Medical Education and Training. Available at:  https://www.gmc-uk.org/-/media/documents/promoting-excellence-standards-for-medical-education-and-training_pdf-108339649.pdf (Accessed on 18th Nov 2024)

National Guardian Freedom to Speak Up. (2024). Job Description. Available at: https://nationalguardian.org.uk/for-guardians/job-description/ (Accessed on 18th Nov 2024)

National Health Service England: Workforce Training and Education Medical Hub. (2022). Clinical and education supervision model guidelines. Available at: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialt.... (Accessed on 18th Nov 2024)

National Health Service  Employers. (2021). Information for guardians of safe working hours. Available at: https://www.nhsemployers.org/articles/information-guardians-safe-working-hours (Accessed on 18th Nov 2024)

Professional Standards Authority for Health and Social Care. (2024). About regulators. Available at: https://www.professionalstandards.org.uk/what-we-do/our-work-with-regulators/about-regulators Accessed on 18th Nov 2024)