Big drop in trainee whistleblowing amidst anonymity fears

THE number of trainee doctors raising concerns about patient safety has fallen sharply this year after the General Medical Council warned it could not guarantee anonymity.

In its 2014 National training survey of almost 50,000 doctors, only 0.8 per cent of respondents (404) submitted patient safety comments, compared to 5.2 per cent (2,746) last year and 4.7 per cent (2,444) in 2012.

Part of the drop was attributed to changes made to the way the survey is carried out, and to a greater emphasis on encouraging trainees to report concerns locally.

But the GMC said confidentiality was another contributing factor, stating: “We told respondents frankly that their anonymity in this part of the survey could not be guaranteed, since the safety of patients must come first and they may be called upon to assist in further investigations. However, we assured them that we would do everything in our power to support them through this process.”

The regulator welcomed this year’s drop in patient safety comments “if it means that doctors in training are not reporting issues that we are already aware of, or if local reporting systems are dealing with more issues on the ground.”

It added: “However, it is a concern if doctors in training don’t feel confident to report a concern either to us or locally.”

The regulator said it had gathered feedback on the issue of confidentiality and found “the prospect of foregoing complete anonymity has been off-putting for some doctors in certain circumstances.”

Among the concerns raised by trainees in the survey, 60 per cent were either previously unknown or were known about but provided evidence to active issues.

The top area of concern in 2014 (as in 2013) was lack of staffing/resources, with 65 per cent of comments relating to this. In second place was problems with processes of care (33 per cent), which refers to any concern about the individual treatment of patients.

Problems with patient management (the ways in which patients are organised in a particular system and how they move through it) and problems with work expected of trainees both made up 19 per cent of concerns.

Niall Dickson, chief executive of the GMC said: “We are working with those responsible for postgraduate education at local level to respond to this feedback from doctors in training. We need to develop a supportive culture that actively encourages doctors in training to feel confident in raising concerns at an earlier stage.”