The framework comprises 5 parts:
- Part 1: Investigations
- Part 2: Exclusion from work
- Part 3: Conduct hearings and disciplinary matters
- Part 4: Procedures for dealing with issues of capability
- Part 5: Handling concerns about a practitioner’s health
These sections should have been integrated into the local procedures of all NHS trusts in England by 1 June 2005.
What is the document?
Entitled "High professional standards in the modern NHS; a framework for the initial handling of concerns about doctors and dentists in the NHS", it covers disciplinary procedures for doctors and dentists.
It was developed nationally by the Department of Health with NHS Employers, the BMA and the BDA.
What are the key changes for employers?
It abolishes the distinction between personal and professional misconduct. NHS doctors and dentists will be disciplined for misconduct under the same locally-based procedures as any other member of staff.
For employers, it makes it easier to resolve issues – there should no longer be protracted challenges over whether misconduct is professional or personal. Guidance is available in the National Clinical Assessment Authority (NCAA) employers toolkit or in the National Patient Safety Agency’s Incident Decision Tree. It gives a single process for handling capability issues regarding a practitioner’s professional competence, closely linked to the work of the NCAA. Employers can draw on the expertise of the NCAA for guidance and support in the early resolution of concerns.
Health issues are routinely dealt with through the occupational health service. Employers are encouraged to find alternatives to disciplinary action when dealing with individuals with health problems. For further guidance, see The healthy workplaces handbook.
The employing trust is responsible for disciplining its medical and dental staff. Employers can tackle and resolve problems before they become a dismissal issue, which helps to retain staff and improve standards.
There is scope to bring in expert advice for panels considering capability issues. This helps panels make more informed decisions, and the process is fairer for both the employer and employee.
The capability panel is handled by an independent chair, which safeguards employer and employee. The same disciplinary procedures apply to all doctors and dentists employed in the NHS. Employers and employees now have a simpler and more consistent way of handling disciplinary issues for these staff.
What does it replace?
It replaces the previous disciplinary procedures in circular HC(90)9, HC(82)13 and HM(61)112 (currently applies only to salaried primary care dental staff). It abolishes the right of appeal to the Secretary of State held by certain practitioners under paragraph 190 of the terms and conditions of service. The framework has been issued to NHS foundation trusts as advice.
Who does it cover?
It applies to the NHS in England. It covers medical and dental employees, excluding those who perform PCT medical services as far as they are covered by the primary care list system.