How would you respond if asked for an example of speaking up but not being listened to? This is now a real interview question in the wake of the Lucy Letby case.
1. Introduction
Panels increasingly ask about escalation when concerns are ignored. These questions test your integrity and professionalism. Below is a worked example that shows a safe, structured response.
2. Why this comes up & frequency
High-profile failures in the NHS have shown the cost of not listening to clinicians. Interviewers want to know if you have the judgement and courage to escalate when required.
3. Analysing the question
The panel want to see accountability, knowledge of escalation pathways, and persistence in protecting patients. In our Members’ Area we provide extensive guidance on how to analyse these types of questions so your answers really resonate.
4. How to answer
Choose a clear example where you escalated concerns. Describe what you saw, what you did, and what happened. Conclude with how you now approach escalation in your current practice.
5. How to own and personalise
Use first person. Acknowledge colleagues who raised issues with you. Show how your leadership made a difference.
6. Worked example (≈ 260 words)
I noticed repeated unexplained deterioration in infants on our neonatal unit, often overnight. Staff raised concerns in handover but nothing changed. I gathered records of three such cases over two months, documented themes, and presented these to our Clinical Lead. When no action followed, I used the Trust’s serious incident policy and submitted evidence through Risk Management, also alerting the safeguarding lead. I supported junior colleagues by validating their concerns and reassuring them that formal processes existed. Within six weeks a multidisciplinary review was launched. Early warning criteria were introduced, monitoring improved, and feedback loops were set up with staff. The number of similar incidents decreased the following quarter.
This is how I now approach escalation in my practice. I proactively look for patterns of concern, act early with evidence, and ensure colleagues feel safe and supported when speaking up.
Want More?
In our Members’ Area, you will find detailed frameworks and broken-down examples that show exactly how to analyse and structure answers to consultant interview questions like this.
