Draw the line - managers' toolkit for raising concerns

Draw the Line

Our 'Draw the line' resources help facilitate engagement between managers and the board, senior teams, wider management teams and staff about the importance of raising concerns. They highlight some key considerations for managers when they are dealing with concerns raised by staff, and showcase different approaches undertaken by other NHS organisations.  

The extensive research and engagement we carried during development demonstrated that there are differing levels of understanding across the NHS about how to raise and escalate a concern. Managers told us that they need more support and practical guidance to help them deal with concerns raised by staff, and that they need support to improve engagement with their boards and senior teams on this issue.

The campaign is designed to support, guide and empower managers to have open conversations about raising concerns at a local level and has been produced by NHS Employers.


"Nurses, midwives and other care staff are very well placed to know when the quality of services and patient care need to improve. The Freedom to Speak Up report calls for better support for those who raise legitimate concerns. The report also calls for changes to be made system-wide to help foster a healthy, open, no blame culture where staff feel empowered to speak up, know that they will be listened to, and issues raised are acted on. The report prompts the need for urgent action based on learning and reflection to embed a culture of openness and transparency. I believe that the new resources of the staff facing ‘Draw the line’ campaign being delivered by NHS Employers help to address this need. The campaign is part of a wider programme of work from the Compassion in Practice strategy." Jane Cummings, Chief Nursing Officer England

"The self-assessment tool is a really good barometer for employers to check how they are progressing with their whistleblowing arrangements. We are planning to use it as part of a review of our current approach to whistleblowing. I also think that this will be a great tool to include in the report for the next staff survey, linked to the local whistleblowing questions we include." Barry Mortimer, Senior HR Advisor, Calderdale & Huddersfield Foundation Trust 

"This resource will be a valuable aid for staff and managers where there are concerns that affect patient safety. Staff raising concerns should be supported at all times." Lorraine Wright, Communities of Excellence, Digital Expert NHS England

Campaign resources

Draw the line, raising concerns: together we can make a difference logo

The logo is the face of our campaign. Use it in your communications and any local planned activity to help raise the profile of raising concerns.

Self-assessment tool

Our raising concerns self-assessment tool contains a set of questions for HR/or other designated officer responsible for assessing the effectiveness of local raising concerns policies and procedures.

Designed to be completed by HR or an individual in the organisation with responsibility for raising concerns, the tool can be used to check where your organisation is in relation to raising concerns. The tool can help evidence strengths and areas that need improvement along with any actions needed.

Manager's guide to raising (whistleblowing) concerns

Our manager's guide for raising (whistleblowing) concerns provides clarity on the role of a manager when a concern is raised, tips for handling concerns positively, the benefits of effective staff engagement and signposts where to go for further support.

Other raising concerns tools and resources

NHS Employers has a suite of existing resources to support employers with raising concerns. Visit our dedicated tools and resources section where you will find a model process flowchart, downloadable posters, guidance and shared learning examples. Other useful resources can be found by visiting our Improving staff experience section.


Following the Mid Staffordshire inquiry, recommendations, analysis and reports, raising concerns remains an issue in the NHS. Within the Compassion in Practice Strategy was a set of implementation plans, one in which focussed on improving the staff experience in the workplace. NHS Employers delivered this campaign on behalf of NHS England.

Read the NHS Employers response to the DH consultation on the implementation of recommendations, principles and actions set out in the Freedom to Speak Up report. Our response was informed through strong engagement with employers, particularly the Draw the line event held in April 2015.

We would like to hear from you

We are keen to hear from you on the effectiveness of these resources when published. Send drawtheline@nhsemployers.org your feedback.


If you use Twitter, join the raising concerns conversation using #nhsdrawtheline.

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