Dr Calisha Allen, National Student Ambassador for the Doubleday Centre, discusses how doctors and medical students can raise issues of concern, reflecting on a recent event with Helené Donnelly OBE.

We all have a responsibility to speak up when we have concerns about patient safety and identify opportunities to improve patient care.

This responsibility extends to us at all points in our career, from the early clinical experiences to having the bravery to speak up in our first years as a doctor, and the strength to be catalysts for change as senior consultants.

Freedom to Speak Up Guardians can support us within our workplaces to raise our concerns. In 2019/20, 16,199 cases were raised. 23% of cases included an element of patient safety/quality and 36% included an element of bullying/harassment.

Speaking up is all about changing the status quo, and this can be hard. When you see something that concerns you, think about:

• What needs to be changed?
• What needs to be improved?
• What are the risks?
• Who can I go to for help or to raise the concern?
• What can we learn?

As a student, what can your next steps be?

If there is an immediate patient safety concern, think about how you can intervene. If you think a treatment or diagnosis is wrong, ask a question to prompt the clinician to re-think their decision.

In theatres or emergency situations, speak up straight away. All voices are equally respected.

Where you are concerned about an underlying culture or behaviour, collect information. This can be in the form of a log or diary. You can then use this as evidence to help explain your concerns, as these cultural or behavioural concerns are sometimes less tangible and harder to explain.

Talk to someone, whilst maintaining confidentiality (this might be your supervisor, your tutor or another trusted member of hospital or medical school staff).

Alternatively, for students at The University of Manchester, use the Education Alert app; press the education alert button on your iPad and complete the form.

Speaking up is not about punitive measures or getting anyone in trouble. It is about improving our work and improving patient care.

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