2 Why don’t people raise a concern, and why does this matter?
So far, you’ve learned about some of the reasons the public expresses concern to regulators. You will now read our findings on why some people are unwilling to report concerns and the repercussions of not raising issues with health and social care regulators.
Activity: reflection point
Watch the animation below and decide whether you agree with the reasons people gave for raising or not raising a concern.
If you’d like to, make some notes in the text box below. Your notes will only be visible to you.
Transcript
SPEAKER 1: From social workers to nurses to child protection officers, health and social care workers play a vital role in care, protection, and advocacy for a wide range of communities.
SPEAKER 2: But in these positions, there will be occasions when professionals fail to meet the standards expected of them.
SPEAKER 1: In such cases, members of the public may raise concerns about them, which will lead to a fitness to practice investigation and hearing.
SPEAKER 2: The Open University lead a team with four other universities who conducted in-depth research to understand the experiences of people who raised these concerns.
SPEAKER 1: One of the key areas they investigated was the reasons people do and don’t express concerns to regulators.
SPEAKER 2: So let’s get a sense of what they discovered. First of all, why do people raise concerns?
SPEAKER 3: I wanted to make sure no one would go through the same distress and trauma as I did from my treatment. I wanted the public to know so, hopefully, it will never happen again.
SPEAKER 4: I wanted to face the person who did this to me. It’s not like I wanted revenge or to ruin their career. I wanted them to reflect, to really think about what they’d done.
SPEAKER 2: So, to recap, some of the key reasons people raised concerns included raising awareness of issues to prevent them happening again--
SPEAKER 1: --and to make the person involved reflect on what they had done and why it was wrong.
SPEAKER 2: So, why don’t people raise concerns? What’s stopping them from even beginning the witness to harm process?
SPEAKER 5: I didn’t know where to go. I did look, but it was just really hard. I don’t think enough people know about the General Dental Council or any of the other regulators. They’re just not visible. They need to advertise more.
SPEAKER 6: I felt trapped. I was too embarrassed to even mention it. It was something so shocking and difficult to prove that it felt easier to keep quiet. I’d also heard that complaining about a GP could make it difficult to find another one. That was a real worry.
SPEAKER 2: So, to recap, one of the key reasons people didn’t raise concerns was the process was just too difficult. It was hard to find where to report a problem. And even if you did, the process was arduous, with many pages to read and zero assistance.
SPEAKER 1: People also felt they couldn’t speak up because the issues were difficult to prove. They found that the misconduct itself had an isolating effect.
SPEAKER 2: Some people also feared the negative consequences involved in raising a concern-- difficulty finding a new dentist, for instance.
[DRAMATIC MUSIC]
Discussion
This study revealed a number of reasons why people are willing to and reluctant to express concerns; some people believe that raising a concern will have no impact. Some people try to handle their concerns locally with the organisation rather than filing a formal concern with regulators under the Fitness to Practise procedure, as there are several ways people can raise a concern.
When some people wish to lodge concerns with regulators, the complex process deters them, and they may feel it’s a challenge when they are already distressed by practitioners’ conduct. One thing for sure is that to make people comfortable raising concerns, information needs to be easily available and accessible.
Given that the majority of UK citizens look for information online and that the majority of information is available there, research participants believed that how information is presented online is critical; too much information can overwhelm individuals, and too little will not provide them with enough information to make informed decisions.
Activity: reflection point
Reflect on the following question and make some notes in the text box below:
- If you needed to raise a concern with a regulator and found that there is a limit on the number of words you can write or that you cannot upload existing documents, would you still fill out the form and submit it? Note down the reasons why you responded in this way.
Discussion
We discovered that restrictions like this could discourage people from voicing concerns. Similarly, they become irritated and lose interest if they are given difficult and jargonistic material. We identified that most of the online information linked to the Fitness to Practice of 13 regulators is inaccessible to those with limited literacy skills. If the public does not express concerns to regulators, changing poor practice in health and social care will be impossible.
We also found that some people do not want to speak up about issues that are difficult to prove due to the poor practice, itself having an isolating effect:
