NMC Code Section 8: Work Cooperatively

Section 8 of the Code covers how registrants work with each other.

“Work cooperatively.”

Sub-clauses:

• 8.1 Respect the skills, expertise and contributions of your colleagues, referring matters to them when appropriate.
• 8.2 Maintain effective communication with colleagues.
• 8.3 Keep colleagues informed when you are sharing the care of individuals with other healthcare professionals and staff.
• 8.4 Work with colleagues to evaluate the quality of your work and that of the team.
• 8.5 Work with colleagues to preserve the safety of those receiving care.
• 8.6 Share information to identify and reduce risk.
• 8.7 Be supportive of colleagues who are encountering health or performance problems.

Section 8 is wider than its name suggests. It covers professional respect, information sharing, team safety, and how registrants treat colleagues facing difficulty.

What it means in practice

Cooperative working has three layers:

Respectful behaviour. Recognising the expertise of other professions, not undermining colleagues in front of patients, taking concerns seriously rather than dismissing them.

Practical coordination. Knowing when to refer, when to ask for input, when to share information across the team, when to escalate. The MDT functions when each member knows their role and the limits of it.

Mutual support. Supporting colleagues with health or performance problems (8.7) is explicit: looking out for the colleague who’s struggling rather than just observing.

The hardest of these in practice is 8.7. Calling out concern for a colleague’s wellbeing or competence requires courage and risks the relationship. The Code makes it a professional duty rather than a personal choice.

Common breaches

Section 8 breaches in fitness-to-practise cases:

• Bullying or undermining of colleagues: often the substance of fitness-to-practise referrals from peers or managers.
• Failure to share information that another team member needed for safe care.
• Failure to support a struggling colleague, particularly when the colleague’s struggle led to harm.
• Hierarchical dismissal of concerns from junior staff or other professions.
• Public disagreement with colleagues in front of patients.

The Mid Staffordshire inquiry and several other major incident reviews identified cooperative-working failures as significant contributors to systemic patient harm.

CPD that maps to Section 8

• MDT communication training.
• Conflict resolution and difficult conversations.
• Leadership development at all levels.
• Team dynamics (Belbin, Tuckman frameworks).
• Clinical supervision, both as supervisor and supervisee.
• Schwartz rounds, increasingly common in NHS trusts.

Common reflective account themes

Strong Section 8 accounts describe:

• A team handover where the cooperation between professions produced a better outcome than any one could have produced alone.
• A moment when you raised a concern about a colleague’s wellbeing or practice.
• A conflict you helped resolve in a way that maintained the team’s effectiveness.
• A piece of information you shared (or wished you’d shared earlier) that affected patient outcomes.

The accounts that work show the registrant doing the harder side of cooperation: calling out concern, supporting a struggling colleague, bridging a professional boundary.

Where Section 8 connects to other sections

• Section 11 (delegation): delegation is cooperative working.
• Section 16 (raise concerns): concerns about colleagues’ practice connect both sections.
• Section 25 (leadership): modelling cooperative working is leadership.

The next chapter covers Code Section 9: sharing skills, experience and knowledge.