Raising Concerns and Speaking Up in Healthcare

This raising concerns training is for anyone working in NHS or independent healthcare across the UK who has seen something worrying and is not sure what to do with it. It covers when you have a duty to speak up, which route to use, how to say it so that people listen, and how to respond when a colleague brings a concern to you. It is written for doctors, nurses, midwives, nursing associates, dental, pharmacy and allied health professionals, optometrists, osteopaths, chiropractors and social workers.

Inquiry after inquiry, from Mid Staffordshire to the maternity investigations at Morecambe Bay, Shrewsbury and Telford and East Kent, found the same pattern: staff saw the warning signs, some tried to raise them, and nobody acted. The course starts from that history and from a plain fact: most people who stay silent are not indifferent. They are held back by fear, futility, hierarchy, uncertainty or loyalty to a colleague. Each barrier is named, and the course gives you a practical way past it.

It takes approximately 2 hours, including reading, reflection points, a written reflective account and a 15-question assessment. It is self-paced, so you can start the day you need it. Healthcare Practise UK is an independent provider. We are not affiliated with any UK regulator or the NHS, and no regulator has reviewed this course. It supports your awareness and CPD; it does not replace your employer's own speaking up training, so check what your employer requires. Browse the course catalogue for related titles.

Module 2 sets out what each regulator expects. The shared message is that patient safety comes before loyalty to colleagues, worry about your own position or a wish to avoid conflict, and that an honest, reasonable belief is enough. You do not need proof.

Module 3 covers the law. In England, Wales and Scotland, protection for whistleblowers sits in Part IVA of the Employment Rights Act 1996; Northern Ireland has the Public Interest Disclosure (Northern Ireland) Order 1998. The course explains what makes a disclosure qualify, why a purely personal grievance usually does not, what detriment means, and which bodies count as prescribed persons, including the professional regulators and the CQC. It also explains why a settlement agreement or confidentiality clause cannot lawfully stop you making a protected disclosure.

The course has six modules, each ending with key points, a worked example and an "apply it" task.

1. Why speaking up matters. What raising a concern means and how it differs from a complaint or grievance, lessons from inquiries, why people stay silent, and speaking up as a learnable safety skill.
2. Your professional duty to speak up. What each regulator expects, the extra duties of managers and leaders, when the duty is triggered, and what happens to professionals who stay silent or discourage others.
3. The law and arrangements across the UK. Whistleblowing law, internal and external routes, Freedom to Speak Up in England (including the national changes in 2026), the National Whistleblowing Standards and Independent National Whistleblowing Officer in Scotland, the NHS Wales Speaking Up Safely Framework and Northern Ireland's HSC arrangements.
4. How to raise a concern well. Preparing the facts, an escalation ladder, SBAR, graded assertiveness, recording and following up, and the difference between confidential and anonymous concerns.
5. Receiving and acting on concerns. Listening well, investigating proportionately, protecting the person who spoke up from obvious and subtle detriment, and closing the loop.
6. Difficult situations and looking after yourself. Concerns about a colleague's health or conduct, sexual misconduct, harassment and bullying, what to do when nothing happens, small practices and locum work, and your own wellbeing.

The cases are drawn from real settings: a healthcare support worker noticing a drowsy patient with no fluid chart, a dental nurse stopping a tray that may have missed decontamination, a pharmacist in Scotland escalating incomplete controlled drug records, and a practice nurse whose concern is about the GP partner who owns the practice. A quick-reference guide and checklist close the course.

Throughout the course you stop to apply what you have read: finding your employer's speaking up policy and its named contacts, or drafting a three-line SBAR statement about a real or hypothetical concern. At the end you write a short reflective account to three prompts: a time you raised, or wish you had raised, a concern; which routes and protections apply in your workplace and nation; and what you will do differently when raising or receiving a concern.

The assessment has 15 scenario-based questions, such as what a student paramedic should do after seeing a crew member speak abusively to a patient, or how to respond to a settlement agreement that bars contact with a regulator. The pass mark is 12 (80%). If you fall short, you revisit the linked sections and try again. On completion you receive a certificate of completion from Healthcare Practise UK.

Record the time you actually spend as CPD. For nurses and midwives, self-directed online learning usually counts towards the NMC's individual CPD hours rather than the 20 participatory hours. Keep the certificate with your reflection.

For your own CPD and appraisal. The course gives you a structured reflection on speaking up, a topic every regulator now treats as core professionalism.

For teams. Module 5 is written for anyone who receives concerns, which in practice means most registrants and every manager. Ward managers, practice managers and clinical leads use it to agree a shared approach: thank, listen, act and feed back. See training for organisations for team access, and pair it with Building a Just and Learning Culture After Incidents for leaders.

Where a concern involves you. Fitness to practise panels treat failure to raise concerns, and discouraging others from raising them, as serious matters. If that is part of your situation, the course can help you understand the expectation and reflect on it honestly. It does not decide any outcome, and the course itself says that passing does not by itself demonstrate insight or remediation. Take advice from your defence organisation or union.

Speaking up overlaps with several other topics in the conduct and professional behaviour collection:

• Bullying, Harassment and Workplace Civility in Healthcare, for the behaviours that make people afraid to speak;
• Sexual Safety and Preventing Sexual Misconduct in Healthcare, which goes further on reporting sexual misconduct;
• Duty of Candour in Healthcare Practice, for openness with patients when something has gone wrong.

Not sure which title fits? The which course do I need tool asks four questions and suggests a short list.