Colleagues and culture: respect, fairness, leadership and support

How does GMP translate culture, respect, discrimination, leadership, supervision and support into individual professional duties at every level of seniority?

Teaches professional behaviours and interfaces with equality/employment law. A later Leadership programme will go deeper into organisational design and leadership methods.

• Treat colleagues with kindness, courtesy and respect and recognise the impact of personal behaviour.
• Recognise bias, discrimination, bullying, harassment and sexual misconduct as professional and safety issues.
• Act appropriately when unacceptable behaviour is witnessed or reported.
• Demonstrate leadership behaviours whether leading or following, with extra duties in formal leadership roles.
• Support colleagues fairly, including those new to UK practice, returning to practice or with limited access to support.

GMP 2024 makes respectful, fair, supportive and compassionate workplace culture an explicit professional concern. Colleagues includes anyone a doctor works with, not only doctors or registered professionals.

Teamwork requires listening, clear and considerate communication, recognition of others’ skills and willingness to lead or follow according to circumstances. Seniority does not create a permanent right to lead every decision.

Bias awareness is a professional skill. Doctors should consider how culture, beliefs and experience can influence interactions and decisions; this is not an instruction to erase judgement but to test it for unsupported assumptions.

Bullying, harassment and discrimination can damage individuals, team functioning and patient safety. Doctors who witness unacceptable behaviour may need to support affected colleagues, challenge behaviour where safe, or report it through appropriate routes.

Formal leaders have additional duties to act on unacceptable behaviour, ensure support and escalate appropriately. Leadership accountability therefore increases with actual role and authority, not merely job title.

References, appraisals and assessments must be accurate, fair and objective and should not omit information relevant to competence, performance and conduct. This is an important probity interface because unfairly positive or negative references can harm patients and colleagues.

Access to training, development and employment opportunities should be fair. In Great Britain equality law may provide additional protections; Northern Ireland has separate equality legislation. Local recruitment and HR processes add further rules.

Support for colleagues with performance or health problems should be compassionate, but patient safety remains central. Support and accountability are not opposites: a fair system can provide remediation while setting clear limits and escalation.

1. Observe the behaviour or cultural problem accurately: what happened, who was affected and what was the safety impact?
2. Check your own assumptions and bias, and distinguish evidence from interpretation.
3. Address immediate harm or unacceptable behaviour where safe.
4. Support affected colleagues and use appropriate reporting/escalation routes.
5. If you hold formal authority, act on the concern, ensure fairness and document decisions.
6. Keep references, assessments and development opportunities accurate, objective and equitable.
7. Review whether team systems make it safe to ask questions and speak up.

Scenario 1. A senior clinician repeatedly humiliates junior staff during ward rounds; patient information is missed because staff stop asking questions.

Reasoning prompt: identify immediate risk; identify the professional source; check any separate legal/local framework; act, communicate, document and escalate proportionately.

Scenario 2. An appraiser omits known relevant performance concerns from a reference to avoid conflict.

Reasoning prompt: identify immediate risk; identify the professional source; check any separate legal/local framework; act, communicate, document and escalate proportionately.

Scenario 3. A doctor returning from long absence is denied support because “you are senior enough”.

Reasoning prompt: identify immediate risk; identify the professional source; check any separate legal/local framework; act, communicate, document and escalate proportionately.

• Culture is an HR issue, not a patient-safety issue.
• Only managers have leadership duties.
• If conduct is not unlawful discrimination it cannot breach professional standards.
• Compassion means avoiding difficult performance conversations.
• A positive reference can omit relevant concerns to help a colleague.

• Am I contributing to a respectful and psychologically safe culture?
• Have I checked bias or unsupported assumptions?
• Does behaviour require challenge, support or escalation?
• If I am a leader, have I acted rather than merely recorded the concern?
• Are references and assessments accurate and objective?
• Are opportunities being allocated fairly?

Optional reflection

Do not enter identifiable patient, colleague or employer information.

• What team behaviour makes it easier - or harder - for colleagues to ask questions or speak up?
• How do you ensure references and assessments remain fair when you know a colleague well?

• Colleagues includes non-medical staff.
• Doctors may need to lead or follow depending on circumstances.
• Respectful culture is a professional standard.
• Bias awareness should inform decisions.
• Formal leaders must act on serious unacceptable behaviour brought to them.
• References/appraisals must be accurate, fair and objective.
• Development opportunities should be allocated fairly.
• Equality Act 2010 does not apply in Northern Ireland.
• Support and patient-safety accountability can coexist.
• Workplace behaviour can have patient-safety consequences.

These sources underpin the module. Check current versions for time-sensitive decisions.

• GMC-05 - General Medical Council / Domain 3: Colleagues, culture and safetyOpen official sourceUK / Professional standards. Teamwork; culture; leadership; continuity; safety; health
• GMC-20 - General Medical Council / Leadership and management for all doctorsOpen official sourceUK / More detailed guidance. Leadership, systems and management responsibilities
• LAW-03 - UK Parliament / Equality Act 2010Open official sourceGreat Britain / Primary legislation. Equality/discrimination/reasonable adjustments; does not apply in NI
• POL-07 - Equality Commission for Northern Ireland / Equality laws in Northern IrelandOpen official sourceNorthern Ireland / Official equality guidance. NI has separate equality/discrimination laws; Equality Act 2010 does not apply
• POL-10 - GOV.UK / Reasonable adjustments for workers with disabilities or health conditionsOpen official sourceGreat Britain / Government guidance. Employer reasonable-adjustment duties; separate NI route
• POL-09 - Acas / Whistleblowing at work - what someone can whistleblow aboutOpen official sourceGreat Britain / Employment guidance. Sexual harassment qualifying disclosure from 6 Apr 2026; public-interest condition