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How to escalate your concerns


You need to report poor practice with confidence - it’s part of your professional and moral duty. We give you a quick guide to escalating concerns

The day you start your nursing degree is the day you have to start abiding by the Nursing and Midwifery Council’s (NMC) professional code of conduct. The regulator for nurses and midwives in the UK and the islands sets out standards that it expects all nurses to adhere to in order to protect the public. And those ethics and principles should be instilled in every student from the start of their experience.

The NMC Code, and its four guiding principles are spelt out in full on its website at But while students may be taught well on how to uphold their own standards and ethics, they can find one of the most difficult aspects of upholding the code is knowing what to do when they see a lecturer or mentor failing to uphold the code.

If you see behaviour or care that you think is below par, what do you do?

“Definitely don’t challenge on your own, get support”

Carmel Lloyd, NMC assistant director, Standards (Midwifery and  Health Visiting), advises students who are having problems to talk to their mentor first. “They may have a different perspective and so it’s worth seeking out their point of view,” she says. Another key person she recommends chatting to is the student’s personal tutor. But she says that whatever you do, you must not keep any concerns to yourself. “It’s important to speak to someone and challenge practices if you think they are wrong,” she says. “But we recognise it is not easy for the student, so they should seek the help of someone else.”

The other people to approach, she says, can be a union representative - either a nursing union rep or a student union rep. “Definitely don’t challenge on your own,” says Ms Lloyd. “Get support.”

In fact, she says concerns about practice from students and tutors are rarely raised with the NMC, which suggests to her that such issues are being dealt with well at ground level. She believes that most good universities have a policy on this.

The NMC website does contain a toolkit for raising and escalating concerns, and Carmel says this can be useful for both student and tutor if they have been approached with concerns. These contain case studies and lots of “what if” style scenarios. They are really useful for those students who are worried that no one has ever been in their shoes, and are seeking reassurance, as well as giving ideas on how to handle the situation.



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Readers' comments (2)

  • Adam Roxby

    Very good point, despite all this I still think that there is a fear among students when it comes to escalation.

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  • I have tried escalating concerns previously about problems on placement and found that I was not listened to when bringing issues forward to placement supervisors and University.

    I would struggle to feel confident in escalating concerns again, especially as a student.

    I hope that not everybody has the same experiences that I did and feel more confident in escalating concerns.

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