Doctors who fail to raise concerns about sub- standard patient care could be struck off, according to whistle-blowing guidance published yesterday.
The General Medical Council (GMC) has also banned doctors from signing "gagging clauses" that stops them raising patient safety issues amid increasing reports about trusts using pay-off agreements to silence health professionals.
The GMC yesterday said that the interests of the patient must "trump everything" and doctors must not sign such contracts, which risk their own careers and the health of patients.
Medical managers also face a regulatory clampdown if they fail to properly deal with concerns raised by more junior colleagues.
The new guidance, which comes into force from March, comes only weeks before the final report into the scandal at Mid Staffordshire hospitals, where up to 1,200 people died unnecessarily.
It makes clear that doctors should first raise concerns in their workplace, but then go to the GMC or the Care Quality Commission (CQC). Doctors can then go public if patients are still at risk.
The CQC has asked at least six employees since 2009 to sign confidentiality agreements that stop them from publicly criticising the organisation, it was revealed yesterday.