NHS INTERVIEW GUIDE

Raising Concerns Interview Questions in the NHS: Speaking Up and Whistleblowing

How to answer NHS interview questions about raising concerns, speaking up and whistleblowing, with the usual escalation route, regulator expectations, 12 practice questions, a worked STAR answer and a preparation plan.

Last updated 24 October 2026 · Created by a practising NHS doctor · Independent of the NHS

Quick answer

How do I answer a raising concerns question in an NHS interview?

Show you would act promptly to protect patients, deal with any immediate risk, then raise the concern factually with the person in charge or your manager. Record what you saw and escalate through your organisation's speaking up route, such as a Freedom to Speak Up guardian in England, if it is not resolved. Stay fair to colleagues, follow local policy and back your answer with a real example.

Key takeaways

Deal with immediate risk to patients first.
Use internal routes first and escalate if nothing changes.
Record facts and follow up on your concern.
Know the difference between a concern, a grievance and safeguarding.
Speaking up routes differ by UK nation, so check local policy.

To answer a raising concerns question in an NHS interview, show that you would act promptly to protect patients, starting with the person in charge or your line manager, and escalate further through your organisation's speaking up route if the concern is not resolved. Say you would record the facts, stay respectful and follow local policy, and that you know other routes exist, such as a Freedom to Speak Up guardian in England or external bodies as a last resort. Back it with a short, real example.

Panels ask about speaking up for almost every role, from porters and receptionists to nurses, doctors and directors, because staff who raise concerns early prevent harm. This guide covers what raising concerns means, how speaking up arrangements work at principle level, the difference between concerns, complaints and whistleblowing, regulator expectations, a step-by-step answer, practice questions, a worked example and common mistakes. Concerns about abuse or neglect of a person follow safeguarding procedures, which are covered in a separate safeguarding guide.

In this guide

What does raising concerns mean in an NHS interview?
Why do NHS interview panels ask about speaking up?
What is Freedom to Speak Up and how do speaking up routes work?
What is the difference between raising a concern, whistleblowing and making a complaint?
What do regulators say about raising concerns?
How do I answer "What would you do if you had concerns about a colleague?"
What are common raising concerns interview questions?
What is a good STAR answer to a raising concerns question?
What do panels look for in raising concerns answers?
What are common mistakes when answering raising concerns questions?
How should I prepare for raising concerns interview questions?

What does raising concerns mean in an NHS interview?

Raising concerns means speaking up about anything that puts patients, staff or the service at risk. Panels want to know you would notice, act and escalate, rather than stay silent or go straight outside the organisation.

Patient safety: unsafe care, errors, missed observations or poor infection control.
Colleague practice or conduct: a colleague cutting corners, behaving unprofessionally, or appearing under the influence.
Systems and environment: faulty equipment, unsafe staffing, unclear processes.
Workplace culture: bullying, harassment or discrimination.
Governance and probity: falsified records, fraud or breaches of confidentiality.

Why do NHS interview panels ask about speaking up?

Panels ask because a culture where staff speak up is one of the strongest protections for patients. Many national reviews of failings in care have found that staff had concerns that were not raised or not acted on.

It also tests judgement: whether you would speak up, choose a sensible route and stay respectful. For managers, it tests whether you would listen to and protect staff who raise concerns.

What is Freedom to Speak Up and how do speaking up routes work?

Freedom to Speak Up is the approach in the NHS in England that encourages and supports staff to raise concerns, including through Freedom to Speak Up guardians who offer a confidential route outside the usual management line. Arrangements changed in 2026, with national functions moving to NHS England and local organisations taking more responsibility, while local guardians remain. Check your employer's current policy.

Scotland, Wales and Northern Ireland have their own arrangements. In Scotland, for example, there are national whistleblowing standards with an independent national officer for unresolved concerns about NHS services. At interview, describe the principle and say you would use your employer's policy.

First route: the person in charge, your supervisor or line manager.
Next route: a more senior manager, matron, clinical lead or head of department.
Confidential support: a speaking up guardian, champion or equivalent named in local policy.
Other internal routes: governance or patient safety teams, a non-executive lead, or human resources for conduct issues.
Support: trade unions such as Unison, the RCN or the BMA, and independent advice lines.
External routes: regulators and other bodies named in law, usually if internal routes fail or are inappropriate.

What is the difference between raising a concern, whistleblowing and making a complaint?

A concern is about a risk to others, such as patients or the public, while a grievance or complaint is usually about how you personally have been treated. Whistleblowing is the term often used when a concern in the public interest is raised formally, especially outside the normal line of management.

Raising a concern: informal or formal, about risk, wrongdoing or harm to others.
Whistleblowing: workers who make a qualifying disclosure in the public interest have legal protection from detriment under UK employment law, including the Public Interest Disclosure Act 1998.
Grievance: a personal employment matter, handled through HR policy.
Patient complaint: made by patients or families through the complaints process.
At interview: show you know the difference, and that the aim is to fix the risk, not to win an argument.

What do regulators say about raising concerns?

Professional regulators expect registrants to raise concerns about patient safety promptly and to act on concerns raised with them. Not raising a serious concern can itself be a fitness to practise issue.

NMC: the Code and the NMC's raising concerns guidance expect nurses, midwives and nursing associates to raise and escalate concerns about safety without delay.
GMC: guidance on raising and acting on concerns about patient safety says doctors must act when patient safety is at risk, and senior doctors must make sure concerns are dealt with.
HCPC and other regulators: standards for allied health professionals, pharmacists and dental professionals include similar duties to report concerns.
Unregistered staff: employer policies and codes of conduct expect everyone to speak up, and the same protections apply.

How do I answer "What would you do if you had concerns about a colleague?"

Answer in clear steps: protect anyone at immediate risk, gather the facts, raise it with the right person, record it and escalate if nothing changes. Keep the tone fair and supportive, because the colleague may be struggling.

1. Act on immediate risk: if a patient is in danger, make them safe and get help straight away.
2. Check the facts: be clear about what you saw or heard, without assumptions.
3. Consider speaking to the colleague: where it is safe and appropriate, a private, supportive conversation can resolve minor issues.
4. Raise it with the person in charge or your manager: promptly, factually, and in line with policy.
5. Record it: note dates, times and what was said, and complete an incident report if needed.
6. Escalate if unresolved: to a senior manager, speaking up guardian or equivalent, then external routes if needed.
7. Look after yourself: seek support from your union, mentor or occupational health.

What are common raising concerns interview questions?

These are typical practice themes for speaking up questions, not real questions from any interview.

Tell me about a time you raised a concern. Use STAR and show the outcome and learning.
What would you do if you saw a colleague being rude to a patient? Intervene safely, then report.
What would you do if you thought a colleague smelt of alcohol at work? Patient safety first, inform the person in charge promptly.
How would you raise a concern about unsafe staffing? Escalate, record it and use incident reporting.
What is whistleblowing? Define it and mention legal protection.
What is a Freedom to Speak Up guardian? A confidential route to raise concerns in England.
What would you do if your manager did not act on your concern? Escalate through the next route.
A senior colleague asks you to ignore poor practice. What do you do? Stay polite but raise it.
How would you respond if a junior colleague raised a concern with you? Listen, thank them, act and feed back.
How would you create a culture where staff feel safe to speak up? For leaders: visibility, no blame and acting on concerns.
What stops staff from speaking up? Fear, hierarchy and futility, and how to overcome them.
When would you raise a concern outside your organisation? Only when internal routes fail or are not appropriate.

What is a good STAR answer to a raising concerns question?

A good answer shows a real concern raised through the right route, with your actions clear and a positive change at the end. This example suits a healthcare assistant or nursing associate, and works for many other roles.

Example answer: faulty equipment on a ward (healthcare assistant)

Situation: On a night shift, I noticed that one of the ward's hoists had a frayed sling and a loose attachment. It was still in use because the second hoist was out for repair.

Task: I was worried a patient could fall during a transfer, so I needed to stop it being used and make sure the issue was fixed.

Action: I took the sling out of use, labelled it clearly and told the nurse in charge straight away, explaining exactly what I had seen. We agreed a safe plan for transfers that night using the alternative equipment available. I completed an incident report and emailed the ward manager in the morning. When a replacement had not arrived a week later, I raised it again with the ward manager and asked if it should go on the ward risk register, which she agreed to.

Result: New slings arrived and the ward introduced a weekly equipment check, which I helped set up. No patient was harmed. I learned that speaking up once is not always enough, and that following up politely and recording each step makes sure a concern is acted on.

What do panels look for in raising concerns answers?

Panels look for courage balanced with judgement: you act quickly, use the right route and treat colleagues fairly.

Patient safety first: immediate risk handled before anything else.
Prompt action: no waiting to see if it happens again.
Correct, proportionate route: internal first, escalating if needed.
Facts, not gossip: clear, objective and documented.
Fairness to colleagues: supportive tone, no blame.
Persistence: following up if nothing changes.
Knowledge of policy and protection: speaking up routes and whistleblowing protection.
For leaders: how you respond to and protect people who raise concerns.

What are common mistakes when answering raising concerns questions?

The most common mistakes are going too far too fast, such as contacting the media or regulator first, or not going far enough, such as only talking to colleagues.

Going external first: panels expect internal routes unless they are unsafe or have failed.
Doing nothing or waiting: silence is never the right answer.
Confronting aggressively: stay calm and professional.
Mixing it with safeguarding: abuse or neglect concerns follow safeguarding procedures.
No follow-up: show you would check the concern was acted on.
Breaching confidentiality: no names or identifying details.

How should I prepare for raising concerns interview questions?

Read your target employer's speaking up policy, your regulator's guidance and one or two real examples of your own. Then practise aloud.

Free help is available from NHS Jobs interview advice, careers services, unions, professional bodies and mentors. Healthcare Interview Prep is one self-study option, with 40 original practice questions and written model answers for each of 471 NHS roles. It is independent, not affiliated with the NHS, and does not offer live coaching or mock interviews.

Step 1: Find the speaking up or whistleblowing policy for the employer, often on their website.
Step 2: Read your regulator's raising concerns guidance if you are registered.
Step 3: Learn the escalation steps so you can list them confidently.
Step 4: Write one STAR example of raising a concern, including follow-up.
Step 5: Practise two scenarios: a colleague's conduct and unsafe staffing.
Step 6: Get feedback from a mentor, union rep or trusted colleague.

Frequently asked questions

What is a Freedom to Speak Up guardian?

A Freedom to Speak Up guardian is a member of staff in an NHS organisation in England who supports colleagues to raise concerns, offering a confidential route outside the usual management line. They listen, signpost, help escalate and check that concerns are handled properly. National arrangements changed in 2026 but local guardians remain. Other UK nations have their own speaking up arrangements, so check local policy.

Am I protected if I blow the whistle in the NHS?

Workers who make a qualifying disclosure in the public interest, through the routes set out in law, are protected from being treated unfairly because of it under UK employment law. The rules are detailed, so at interview just show you know protection exists. In real life, seek advice from your union or an independent whistleblowing advice service before raising a concern externally.

What should I do if my manager ignores my concern?

Record what you raised and when, then escalate through the next route in your organisation's policy, such as a more senior manager, a speaking up guardian or a governance team. If internal routes have been tried and failed, or are not appropriate, external routes such as a regulator may be considered. Stay factual and seek support from your union or a mentor.

Is raising a concern the same as making a safeguarding referral?

No, although they overlap. Concerns about abuse or neglect of a child or adult at risk should follow safeguarding procedures, usually through your safeguarding lead and local safeguarding arrangements. Wider concerns about safety, practice, staffing or conduct go through speaking up routes. In interviews, show that you know which route fits which situation, and that you would act promptly in either case.

Do healthcare assistants and admin staff need to answer speaking up questions?

Yes. Every member of NHS staff is expected to speak up, whatever their role. Porters, receptionists, domestic staff and healthcare assistants often notice risks first, such as broken equipment, unsafe behaviour or patients in distress. Give an example of noticing something, telling the person in charge or your supervisor, recording it if appropriate and following up, and link it to patient safety.

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