Raising concerns

Has short staffing become a safety risk where you work?

Nursing staff have an important part to play in reporting threats to safety. If you feel inadequate staffing is affecting patient care in your workplace, follow these steps, drawn from our Raising Concerns publication

Before you start

Knowing if a situation should be raised as a concern can be difficult. Ask yourself whether it has caused harm or distress, or, if you let it continue, is it likely to result in harm or distress?

You don’t need hard evidence but your concern should be based on a reasonable belief which you can justify. The Nursing and Midwifery Council (NMC) Code is clear: you must “act without delay if you believe there is a risk to patient safety or public protection”.

Remember, too, that help is available. Raising concerns can be difficult and draining, but the RCN can support and advise you at every stage of the process.

Act early

Don’t wait for things to go wrong. If you feel you are being prevented from providing safe, compassionate care, read your local policy on raising concerns or whistleblowing and identify the person to speak to. You can raise issues verbally or in writing but make sure you’re clear about the nature of your concern.

Agency nurses should talk to the nurse in charge and their agency, while students should discuss safety concerns with their mentor first, then the nurse in charge. 

Keep records

From the start, take notes and keep records. They may be useful for future reference.


If you’re unable to talk to your line manager or your concerns are not adequately addressed, go to the next level of management. Alternatively, speak to your director of nursing or, in England, a local freedom to speak up guardian. Read more about freedom to speak up guardians.

Students who feel their concerns are not properly dealt with should contact their link lecturer who will speak to the nurse in charge.

Taking it further

If you are still concerned, go to the chief executive or equivalent of your employing organisation – but ensure your director of nursing is aware you are taking this step. 

Not satisfied

If you’ve exhausted all local policies and procedures, or you feel unable to raise your concern internally, you should consider going outside your organisation.

The government has produced a list of people and organisations to which you can make a disclosure. Take a look at the list.

Going to the media should always be a last resort. And remember, there may be confidentiality issues or employer policies that apply when raising a concern externally.

Caring for yourself

Most employers take concerns very seriously and you are protected in law from victimisation if you speak out. But even though you are right to raise concerns about threats to care – and are required to do so by the NMC – it takes courage and can be stressful.

RCN Member Support Services offer confidential counselling to any member facing challenging emotional issues, whether work-related or personal. To make an appointment, call the RCN on 0345 772 6100 between 8.30am and 8.30pm, seven days a week.

Remember the RCN is here for you at every stage of the raising concerns process. If you need support, call the number above or read our guidance on raising concerns.

Illustration by Jenny Robins

Read next...