A guide to clinical handovers, delegation and referral

One of the key areas in the updated Good medical practice guidance from January 2024  centres on creating respectful, fair and compassionate workplaces where people feel valued and empowered to do their jobs. This is because a positive work culture ultimately leads to higher standards of patient care and safety.  

Culture is determined by the shared values and behaviours of a group of people. In the workplace, a positive culture is characterised by a supportive, inclusive, and productive environment where employees feel valued, motivated, and engaged. It fosters collaboration, communication and trust among team members, leading to higher levels of job satisfaction, morale and overall wellbeing.  

The updated GMC guidance emphasises the need to foster a positive workplace culture in all healthcare settings. It states that while doctors have an ongoing duty to work effectively with colleagues in the interests of patients, they are also obliged to work towards achieving a culture of courtesy, respect and self-reflection. The updated guidance places a duty on doctors to work civilly and professionally with all parties in the interests of patient safety.  

Doctors must be conscious of their impact on others and do what they can to create civil and compassionate cultures where colleagues can ask questions, talk about errors and raise concerns without judgement. 

Strong teamwork is at the heart of any successful workplace, and this can be achieved by: 

• listening to colleagues 
• communicating clearly, politely and considerately 
• recognising and showing respect for colleagues’ skills and contributions 
• working collaboratively with colleagues and being willing to lead or follow as the circumstances require. 

Doctors with formal leadership or managerial roles have a responsibility to make sure that everyone in the team feels heard and validated. In line with Good medical practice (paragraph 76) they must “take active steps to create an environment in which people can talk about errors and concerns safely. This includes making sure that any concerns raised with you are dealt with promptly and adequately, in line with your workplace policy.”  

Developing self-awareness and respecting cultural differences

All doctors have a professional obligation to develop their self-awareness. They must regularly reflect on their standards of practice and think about how their own life experience, culture and beliefs may influence their interactions with others as well as impact their decisions and actions.  

The updated guidance emphasises the importance of treating colleagues with respect and not unfairly discriminating against them.  

The GMC states that doctors “must not abuse, discriminate against, bully or harass anyone based on their personal characteristics, or for any other reason”, including someone’s appearance, lifestyle, culture, social or economic status or any characteristics protected by legislation.  

Challenging negative or unsafe behaviour

Good medical practice also sets out how doctors should act if they witness any abuse, discrimination or harassment of colleagues. The GMC places a positive duty on doctors to act to prevent these behaviours from continuing and contributing to a negative or unsafe environment.  

Actions you might take if you witness abuse, discrimination or harassment include:  

• checking in and offering support to those targeted or affected by the behaviour, and letting them know that you feel the behaviour was unacceptable
• challenging the behaviour by speaking to the person responsible – either at the time, if safe to do so, or at an appropriate time and place 
• reporting the behaviour in line with your workplace policy and the GMC’s more detailed guidance on Raising and acting on concerns about patient safety. Before you do, make sure the person who was targeted is aware of and supports your intention to report it.  

It can be challenging to speak up, but everyone has a responsibility – to themselves and their colleagues – to do something to stop negative behaviours from continuing.  

Ultimately, a positive workplace culture is essential for attracting and retaining talented healthcare professionals, fostering employee engagement and loyalty, and maintaining high standards of patient care and safety. It creates a supportive and empowering environment where colleagues thrive, collaborate effectively, and contribute to positive outcomes for all patients.  

The MDDUS medical team will be happy to speak to you about any queries you have in relation to your professional obligations.  

Please contact MDDUS to discuss a particular case or query. Email us on advice@mddus.com or have a look at our medio-legal advice pages for more information.

Get in touch

You might also be interested in the following MDDUS articles relating to workplace culture:  

Ten behaviours that reduce team risk (primary care)  

Ten behaviours that reduce team risk (secondary care)  

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.