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  • Be sure of the facts before whistleblowing.
  • Do not confuse isolated facts with systematic issues.

Doctors are often well-placed to be aware of poor practice, and to report this through their usual management train so that improvements can be made. If changes are not made, however, doctors may feel they have a duty to their patients and or to the tax-payer to escalate their concerns outwith their usual management chain. This is what is usually referred to as whistleblowing.

Whistleblowing can backfire.[1][2] Managers may be defensive, and seek to discredit the whistleblower rather than make the changes they should have made earlier (which they may view as admission of fault); or they may claim that the whistleblower is seeking to discredit the organisation. This means that whistleblowing has considerable potential to cause stress, and to harm doctors' careers[3]. The problem is not unique to medicine or the health service[4] (or, indeed, to the public services). The UK laws to protect whistleblowers are inadequate, with the Public Interest Disclosure Act 1988 failing to meet international standards.[5]

Guidance has been published on how to be a whistleblower.[6][7] NHS staff who feel they need advice can also call the @WhistleUK helpline on 020 7404 6609 which is run by the charity Public concern at work and covered by legal privilege.

The GMC also has a phoneline to call for such things: 0161 923 6399.

It is possible that employers will have gagging clauses in employment contracts.[8][9] These would appear to conflict with any concept of "duty of candour" - but perhaps the duty of candour only applies to the footsoldier healthcare workers, and not to their managers.

It is unclear how enforceable gagging agreements are when they interact with potential issues around patient safety but breaking one will be very stressful.

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