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Providing references about colleagues: the role of the regulator

10 Feb 2009 | Professional Standards Authority
  • Policy Advice

February 2009 advice to the Secretary of State considers whether specific guidelines should be written by the regulatory bodies on writing references about colleagues.


In the Government’s response to the recommendations of the Shipman Inquiry’s fifth report and to the recommendations of the Ayling, Neale and Kerr/Haslam Inquiries, Safeguarding Patients, the Government stated that it would invite the Professional Standards Authority (then CHRE) to ensure that there is guidance on the ethical responsibility on health professionals to provide objective and transparent references:

Neale Inquiry recommendation 12: The Panel Chairman should be responsible for ensuring that referees are contacted by telephone and content of the references should be confirmed at or around the time of appointment.

Recommendation 14: Employing authorities/medical colleagues should not give a reference which is capable of being misleading by omission.

Kerr/Haslam Inquiry p24: One of the referees in any job application should be the consultant who conducts the applicant’s appraisal, their Clinical Director, or their Medical Director.

p25: When appointments to the NHS are considered, references should be obtained from the three most recent employers and those references should be properly checked.

Existing GMC and NHS guidance already covers the ethical responsibility on health professionals to provide, and interviewing panels to look for, objective and transparent references; the Government will invite the Council for Healthcare Regulatory Excellence (CHRE) to ensure that there is similar guidance for the other healthcare professions. The Government agrees that panel chairmen should always be alert to the possibility of misleading references, including references from a much earlier part of the candidate’s career, and will ask NHS Employers to consider how this principle could be reflected in updated guidance.


Health professionals may be asked to provide references for their colleagues when they move between jobs. In one high profile case, problems had been identified with the references provided and the needs of patients were not considered as highly as they should have been.

This report considers whether specific guidelines should be written by the regulatory bodies to help in this situation. Specific guidance on writing references is available from the GMC, and other organisations also provide support, for example, NHS organisations, professional groups and other bodies such as the Information Commissioner. The regulators stress the importance of being honest and acting in patients’ interests throughout their codes and standards. We could not find further evidence that dedicated guidance on writing references was necessary at this stage.