Raising concerns: guidance for RCN representatives
How to help RCN members raise a workplace related concern
As an RCN rep, you have an important part to play in helping members raise concerns about care in their workplace. This page gives you the information you need to do this.
Raising and Escalating Concerns
This resource, aimed at NHS and independent sector nursing staff and student nurses, will support you to raise concerns wherever you work. It includes a decision making flowchart to help staff and students decide whether to raise a concern and when to escalate a concern.
As an RCN rep, you need to be aware of the RCN guidance for members on raising concerns. You should use this guidance in addition to the employer's policy on raising concerns when members seek your advice.
Information for all RCN reps
Raise concerns early
We don't want members to wait for a problem to develop. While concerns may not have an immediate impact on patient care, there may be long term effects.
By raising concerns early, before there is any impact on patient care, reps can offer support in finding pragmatic and workable solutions.
Be prepared to support members
If a member approaches you with a concern ask:
"Has the situation caused harm or distress or if you let the situation carry on is it likely to result in harm or distress?"
If the answer is “yes” or “I’m not sure” then the concern will need to be taken forward.
Members may choose to discuss concerns with any RCN rep or activist, but stewards are primarily responsible for supporting them. Safety and learning reps should refer members to the local RCN steward, who will meet with them to discuss their concerns. Stewards will also represent members if speaking out affects their terms and conditions of employment.
If there is no local RCN steward, refer the member to the RCN so a member of RCN staff can support them.
Help the member to access and read the RCN's guidance on raising concerns to prepare for their meeting and reassure them that the RCN will support them throughout the process.
Information for RCN stewards
Meet the member to discuss their concern
Stewards should arrange to meet the member in a comfortable and safe environment to discuss their concerns.
Ask the member:
- when did the issue causing concern happen?
- where did it happen?
- who was involved?
- what happened?
- how did it happen?
- what evidence (if any) do you have?
Make notes and then go through the story with the member for clarification and to make sure you have captured all their concerns.
Then use the Principles of Nursing Practice to illustrate where care is, or is in danger of, falling below standard. You can also use the Principles of Nursing Practice mapping form to clearly set out where the member’s concerns show that this may be happening.
Based on what they’ve told you, the member can now write a statement to their employer highlighting their concern. Ask them to send you a copy, as you will need to complete the paperwork or open a file on the RCN case management system.
You will be able to discuss the case with your mentor during your mentorship/case supervision meeting, but don’t hesitate to contact them at any time if you need extra support or to document further developments.
Use your mentorship record to capture your involvement in supporting a member to raise concerns. This will provide you and the RCN with an audit trail of our efforts on behalf of the member.
You should also discuss the concern with any other RCN reps in your organisation and/or other trade union reps as appropriate, so you can co-ordinate further actions.
Support the member to escalate a concern
If the concern is not being acted upon or taken seriously, you will need to support the member to escalate it.
In the first instance use your mentorship session to review the case and explore your next steps. These could involve further actions locally or formally handing the case to the RCN regional office to raise at a higher level within your organisation.
If you pass the case on to the regional office, inform the member in writing you have done this and who will be supporting them from then on.
You should use your mentorship record to document the next steps. If further information comes to light, or you are finding the process challenging, don’t wait for your next mentorship session, contact your mentor at the earliest opportunity.
The health care regulator will investigate any concerns voiced by a member, rep or the RCN as an organisation. If you don’t see a positive response from the employer, you should discuss with your mentor how best to escalate the issue, including raising with the regulator. This can be done anonymously and the regulator will always feed back its findings.
As a nursing professional and an RCN rep, you may find you feel conflicted. You may wish to raise the concern yourself as an accountable practitioner, for example by alerting the regulator. The RCN supports all members to raise concerns so please make sure we are aware you have done so.
Use the action journal, accessed through the RCN case management system, to capture the key actions agreed and to remind yourself of the next steps. The member and the RCN will expect you to feed back any actions taken. Ask the member to keep you informed of what is happening in the workplace.
Information for RCN safety reps
As a safety rep, you should direct members with concerns to a local RCN steward. You should also arrange a workplace inspection of that area, preferably with other trade union safety reps.
You should discuss this activity with your mentor, and the steward representing the member should be kept informed of any developments. If any further concerns about employment practice are raised you should also discuss these with the steward.
The RCN handbook for safety representatives will help you.
You may also want to discuss the situation with other trade union safety reps and raise any concerns together, but you must be mindful not to disclose details of individual members.