Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)
There Is A Question In NHS Interviews In 2026 That Was Not There 18 Months Ago. Most IMGs Do Not Know It Is A Scored Competency. It Is Ending Interviews That Were Going Well.
It sounds like a values question.
It sounds like something you answer briefly and move past.
But since the NHS Patient Safety Incident Response Framework (PSIRF) replaced the Serious Incident Framework in 2022, and since the Freedom to Speak Up framework was embedded across all NHS Trusts following the Ockenden Report and other major patient safety reviews — this question is now scored.
Formally. Against a criterion. With a number.
The question is: "What would you do if you had a concern about a colleague's clinical practice?"
Or: "Tell us about a time you raised a concern about practice standards or patient safety."
Or: "How would you respond if you observed something that did not meet the clinical standards you would expect?"
And the internationally trained healthcare professional — conditioned by years of practice in hierarchical systems where raising a concern about a senior colleague was professionally dangerous — gives an answer that scores a 1.
Not because the answer is wrong.
Because the answer protects the hierarchy rather than the patient.
"I would speak to my senior." — 1.
"I would observe the situation carefully before deciding whether to act." — 0. "I would reflect on whether I had sufficient evidence before raising a concern." — 1.
Here is what a 4 looks like:
"If I had a concern about a colleague's practice that affected patient safety, my first step would be to speak to that colleague directly if it was safe to do so — which is in line with Good Medical Practice / the NMC Code / HCPC standards.
If the concern was serious or if the direct conversation was not appropriate, I would escalate to the senior clinician and document my concern through the Trust's incident reporting system.
I am aware that every NHS Trust has a named Freedom to Speak Up Guardian — and that there is also the option of raising a concern with my professional regulator.
My obligation is to patient safety — and that obligation exists regardless of the seniority of the colleague involved."
That answer names three frameworks. It demonstrates professional courage. And it shows the panel that you understand your personal accountability.
DM me "SPEAK" and I will send you the complete Freedom to Speak Up interview framework for your profession.
Post 5 drops at 5:00 PM — and it is the post I have been building to all week.
#Freedomtospeakup #NHSInterview2026 #IMGDoctor #InternationalNurses #PhysiotherapistUK #AHPsUK #PatientSafety #PSIRF #GoodMedicalPractice #NMCCode #HCPCStandards #NHSJobs2026 #NHSRecruitment #clinicalgovernance #TrustGradeSHO #ClinicalFellow #SovereignHealthcareAdvisoryGroup #NHSBand6 #Whistleblowing #NHSValues
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