Speaking Up When Reporting Is Blocked

Reporting can be blocked by time pressure, hierarchy, fear of blame, loyalty, embarrassment or the belief that "nothing happened". GDC Principle 8 requires dental professionals to raise concerns promptly when patients may be at risk.

When the concern involves a dentist, owner or senior colleague, the nurse may face a power imbalance. Useful, professional phrases include: "I am concerned this needs reporting", "Can we check the incident process?", "I am worried patients could be at risk if this is not reviewed", and "If we cannot resolve it locally, I need advice on the next route."

Escalate further when

• The concern is serious, repeated or unresolved.
• You are told not to report a patient safety issue.
• Records are being altered, concealed or made misleading.
• The source of the concern is the person you would normally tell.
• You fear victimisation or deliberate concealment.
• Patients or the public may need protection from a registrant.

Escalation might involve a senior nurse, manager, owner, clinical lead, commissioner, local regulator, safeguarding route, defence organisation, professional association or the GDC. Use urgent routes first if there is an immediate danger to patients.

GDC escalation

If reporting is blocked, the reporting problem itself becomes a patient safety issue. Dental nurses have a professional duty to escalate unresolved risk.