Lesson 4.7: Colleague Concerns and Professionalism
UK standard: patient safety always comes before professional loyalty. The GMC states explicitly: 'You must act without delay if you have good reason to believe that a doctor, or any other healthcare professional, is putting patients at risk.' Failing to act is itself a breach of your professional obligations.
A Structured Approach for Colleague Scenarios
Use this framework when a colleague is struggling, distressed, or has been involved in a complaint or error. It keeps you structured, empathetic, and professional, without overstepping your FY2 role.
| Step | What to Do | Example |
|---|---|---|
| 1. Set the stage | Open gently in a private space. Acknowledge what they've been through. | "You've just come out of a tough situation. Is now a good time to have a quick chat?" |
| 2. Understand their side | Let them speak without interruption. Do not jump to solutions. | "Would you like to tell me what happened from your point of view?" |
| 3. Probe for causes | Gently explore root causes — workload, health, personal difficulties. | "Have you been under extra pressure lately? Is there anything else going on?" |
| 4. Provide empathy | Validate their experience without condoning unsafe practice. | "It's completely understandable to feel that way. I can see how much you care." |
| 5. Offer solutions | Practical, appropriate options within your FY2 remit, not commands. | "Would it help to speak with your supervisor or occupational health? Both are confidential." |
| 6. Reassure | One difficult situation does not define their ability as a doctor. | "You've done the right thing by speaking up. This shows insight, not failure." |
| 7. Take forward together | Agree clear shared steps. Follow up. | "Let's speak to [name] together after this. I'll check in with you tomorrow." |
Types of Colleague Concerns — What to Do
| Situation | Immediate Action | Escalation If Unresolved |
|---|---|---|
| Colleague appears impaired (alcohol, illness) | Speak to them directly and ask them to step aside. Do not ignore it. | Escalate immediately to registrar/consultant. Complete an incident report. |
| Clinical errors — witnessed in the moment | Intervene immediately, even if the colleague is senior: 'I just want to double-check this dose before it's given.' | If recurrent: inform clinical supervisor formally. |
| Colleague requesting you cover up an error | Decline clearly: 'I'm sorry, I can't agree to that, we need to document this accurately.' Then escalate. | Inform senior or patient safety lead. Apply duty of candour to the patient. |
| Inappropriate social media/confidentiality breach | Gather evidence (screenshot). Speak to colleague directly. Escalate to senior and informatics/governance team. | Data Protection Act 2018 breach. Fitness to practise concern. |
| Recurrent absence or unreliability | Speak to the colleague supportively first: 'I've noticed you've been late a few times, just checking in. Are you okay?' | Escalate to clinical or educational supervisor if pattern continues. |
Escalation Pathway
| Level of Concern | Pathway |
|---|---|
| Immediate patient safety risk | Act now, do not wait. Inform your senior immediately. |
| Concern about clinical practice | Speak to the colleague first. If no change: clinical supervisor. |
| Fitness to practise concern (impairment, substance misuse) | Clinical supervisor → Medical Director → Occupational Health → GMC if required. |
| Cannot raise concerns locally (senior is the problem) | Freedom to Speak Up Guardian (every NHS trust has one) → GMC confidential helpline. |
You are never expected to manage a concern about a colleague entirely alone. Seeking advice from a senior, the BMA, or the GMC's confidential helpline is the right thing to do, and whistleblowing protections apply.
Supporting a Struggling Colleague
Not every concern is disciplinary. Many doctors struggle with mental health, burnout, or personal difficulties. As an FY2:
- Offer a private, non-judgmental conversation: 'I've noticed you seem tired lately. How are you doing?'
- Signpost: Practitioner Health (confidential NHS service for doctors), BMA Doctors for Doctors helpline, or trust occupational health.
- Support them in disclosing to their supervisor, if they agree.
- Do not enable dangerous practice in the name of loyalty. That is not support, it abandons both the colleague and the patients.