Raising and escalating concerns:Guidance for nurses and midwives

Raising and escalating concerns

Guidance to support nurses and midwives who wish to raise or escalate concerns about the safety or wellbeing of people in their care, and their families

What do we mean by guidance?

Rules and standards• Nurses and midwives must comply

Guidance• Best practice that nurses

and midwives should follow

Advice• Supports nurses and midwives in practice

The purpose of the guidance

The guidance supports nurses and midwives who wish to raise concerns about the wellbeing of people in their care, and:• explains the processes you should follow• provides information about relevant

legislation• identifies sources of confidential support

and advice

Who is this guidance for?• All nurses and midwives • Pre-registration nursing and

midwifery students• Applicable to all practice environments• The principles apply to all healthcare

professionals

Your role in raising concerns• The code (NMC, 2008)

sets out the core standards that we expect of nurses and midwives and to which we hold them accountable

The code: Managing risk• You must act without delay if you believe

that you, a colleague or anyone else may be putting someone at risk

• You must inform someone in authority if you experience problems that prevent you working within this code or other nationally agreed standards

The code: Managing risk• You must report your concerns in writing

if problems in the environment of care are putting people at risk

• As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions

Raising a concern ormaking a complaint?

Raising a concern• Worried about an issue, wrongdoing or risk• Witnessed, observed, or been made aware

of a risk or unsatisfactory situation

Making a compliant• Complaint about your personal treatment,

and seeking resolution for yourself

If you are unsure, seek advice

Concerns may include• Delivery of care • Risks to health and safety• Environment of care • Fitness to practise• Misuse or unavailability of clinical equipment

What examples can you thinkof in your workplace?

Raising concerns: A staged process

Raise your concern with your line manager

Raise your concern internally with a designated person

Escalate your concern internally to a higher level

Escalate your concern to a regulatory organisation

Key principles• Put the interests of patients and clients first• Take immediate or prompt action• ‘Doing nothing’ is not an option• Refer to local policies and safeguarding

procedures• Don’t go it alone – seek independent,

confidential advice• Keep an accurate record

Use the guidance to help safeguard the public• Actively promote and discuss this

guidance in your workplace• Look at the case studies and team

discussion notes in your team• [Insert other ideas on how your workplace

can use the guidance]• [Insert name and contact details of the

nominated contact person in your workplace]

Use the guidance to help safeguard the public

Visit www.nmc-uk.org/raisingconcerns to: • provide us with feedback on how the

guidance is received and working in practice

• order copies of the guidance and poster for your workplace or team

• download case studies and discussion notes for your workplace or team

Thank you

Your nominated contact is:[insert contact details of nominated person in yourorganisation]