The solution

Disciplinary investigations can be one of the most challenging professional experiences a doctor can have in their career. At Medical Protection, we support over 400 members a year in England who are involved in a disciplinary and we witness first-hand the range of pressures they experience, particularly when due process is not followed.

Based on our experience of assisting doctors, and from feedback from members, we have identified four themes for ensuring a ‘good’ disciplinary process. Within each of these themes we have identified specific areas where changes should be made. We hope these will act as a call to action and kickstart the debate that is needed to drive improvements.

Theme 1: Efficient

1. Proportionate
   Trusts must consider whether a matter may be dealt with in a less formal manner before proceeding to an MHPS investigation. Any move to exclude the doctor from their duties must also be proportionate to the nature of the investigation.
2. Timely
   When a doctor is put through a disciplinary process, it should begin and conclude in a timely manner.

Theme 2: Fair

1. Fair treatment for all parties
   The doctor and their representatives should receive fair treatment during proceedings, with due process followed and all necessary disclosures made. NHS staff involved in carrying out the disciplinary processes should also receive adequate, specialised training; Trusts should not be relying on competence or experience. Dedicated time should be ring-fenced for those involved in an investigation to ensure that MHPS deadlines can be met.
2. Free from bias and discrimination
   Steps must be taken to ensure discrimination and bias are not factors that can initiate a disciplinary investigation. Information about the importance of defence organisation and union membership should be highlighted at each induction to maximise the chances of a doctor being able to access appropriate support during an investigation.

Theme 3: Compassionate

1. Considerate
   The wellbeing of the doctor subject to investigation should be considered at all times, and active steps taken to offer support and mentorship.
2. Well communicated
   The disciplinary process should be communicated clearly and in plain language at the outset, and frequent communication should continue throughout, so doctors are aware of the status of the investigation and any delays.

Theme 4: Accountable

1. Accountability of employers
   When a Trust or another employer is found to have behaved in a seriously wrong way during proceedings, a clear method needs to be established to hold them to account.
2. Scrutiny
   Senior managers and Trust Boards should have greater knowledge and scrutiny of disciplinary processes. Standardised reporting and data collection, such as the inclusion of disciplinary processes in governance audits, should be rolled out.