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Dilemma: Dealing with a difficult reference request

A former member of staff with performance shortcomings asks you for a reference. How should you proceed?

dr edward farnan square

Medicolegal view: Be fair to both parties

Prospective employers use references to help them assess an applicant’s suitability. This can put you in a difficult position if you feel that you cannot provide as positive a reference as the candidate might hope.

If you feel that the person had professional shortcomings, you may be tempted to focus instead on any positive attributes and to gloss over the negative, saying just enough about these to allow the prospective employer to read between the lines. Alternatively, you might decide to decline to provide the reference, and suggest your former colleague nominates someone else. There are problems with both of these approaches.

The GMC’s Good medical practice says that ‘you must be honest and objective when writing references, and when appraising or assessing the performance of colleagues, including locums and students’, and that references ‘must include all information relevant to your colleagues’ competence, performance and conduct’.1 An inaccurate or incomplete reference could result in the wrong candidate being successful, which could jeopardise patient safety.

Specific GMC guidance on writing references says that ‘you should usually provide a reference if you are the person best placed to do so’, which may make it difficult for you to decline.2

The best approach may be to provide a reference written in a way that is fair to both the candidate and their prospective employer. If your reference is not entirely positive, you may wish to make your former colleague aware of this, perhaps by providing them with a copy, although you are not required to do so.

If in doubt, talk to your medical defence organisation.

Dr Edward Farnan is a medicolegal adviser for the MDU


Dr Daniel James

Dr Daniel James: Provide evidence of significant concerns

Producing a reference for a former staff member with performance problems is likely to be anxiety provoking. If they are able to demonstrate damage as a consequence of a negative reference and take exception to its veracity or intention then it leaves the former employer open to litigation.

Conversely, a glowing reference for a staff member who goes on to perform poorly may leave the reference writer vulnerable to legal challenge from the new employer.

It is important to note that there is no legal requirement for an employer to provide a reference. Common practice, however, is to furnish ex-employees with something brief and factual; many practices take the policy decision that this will confirm only the job performed and the dates of employment.

Some add detail about any complaints, sick days or warnings given, but this may be open to challenge by the employee. More advice can be found online from the UK government website and the Advice, Conciliation and Arbitration Service.3,4

If professional or ethical considerations compel you to share any specific detail about this staff member’s conduct then you must do so. Indeed the GMC may take a dim view of a doctor not passing on significant concerns regarding another doctor’s fitness to practice.1

Former employees may only challenge the content of a reference if the content is damaging (for example, it has resulted in them being turned down for a job) and is inaccurate or misleading.

Any detail should be backed up by evidence, such as written warnings. If you are planning on anything other than a very brief factual reference or a refusal then this should be done with the support of your partners. It may be prudent to seek legal advice.

Dr Daniel James is a GP in Suffolk


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Dr Trevor Thompson: Use measured honesty

If a former employee who struggled with performance issues asks for a reference, they are either desperate or deluded. Desperate because a would-be employer has made this specific request or deluded because they never quite grasped there were problems.

There are various parties to consider. You are at reputational risk from a falsely optimistic or unnecessarily damning reference. Things may have been difficult, but you won’t wish to harm someone’s chances of a fresh start. You have a duty to save other employers the heartache of a problem employee and to protect patients from clinical incompetence.1

Which line to take depends on the nature of the prior issues and the specifications of the new role. If, for example, a member of staff had blatantly manipulated the sick-leave system, you might simply decline the request – which should ring alarm bells. This way you may prevent further unwelcome and possibly litigious action. Another option here is a barebones reference.

In less pressing circumstances, you can respond with general positives (‘she was punctual and polite’) while alluding obliquely to difficulties (‘he had an active interest in Social Media’ or ‘scheduling was perhaps not her strongest suit’). Most HR people can read between the lines.

The final option would be measured honesty, probably the best policy. State the positives and explain the problems in reasonable detail. If possible, contact the applicant and share your intentions. This gives them a chance to withdraw their request or get prepared. They may show how they’ve fixed an issue or explain how it will not be relevant in the new role.

Always share what you’ve written with a trusted colleague, and in sensitive cases talk to your defence organisation.

Dr Trevor Thompson is a GP in Bristol


1. GMC – Good medical practice; 3: 41. 2013.

2. GMC – Writing references. 2012.

3. UK Government – References: Workers’ rights

4. ACAS – References for employment