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Maintaining High Professional Standards, morally, ethically and fairly: what doctors need to know right now
  1. Ifat Ataullah1,
  2. Alexandra Livesey2
  1. 1 Retired Medical Practitioner, Writer, UK
  2. 2 Surrey and Borders NHS Foundation Trust, UK
  1. Correspondence to Ifat Ataullah, 48 Palace Road, East Molesey, Surrey KT8 9DW, UK; ifatataullah{at}


Facing an investigation into performance concerns can be one of the most traumatic events in a doctor’s career, and badly handled investigations can lead to severe distress. Yet there is no systematic way for National Health Service (NHS) Trusts to record the frequency of investigations, and extremely little data on the long-term outcomes of such action for the doctors. The document—Maintaining High Professional Standards in the Modern NHS (a framework for the initial investigation of concerns about doctors and dentists in the NHS)—should protect doctors from facing unfair or mismanaged performance management procedures, which include conduct, capability and health. Equally, it provides NHS Trusts with a framework that must be adhered to when managing performance concerns regarding doctors. Yet, very few doctors have even heard of it or know about the provisions it contains for their protection, and the implementation of the framework appears to be very variable across NHS Trusts. By empowering all doctors with the knowledge of what performance management procedures exist and how best practice should be implemented, we aim to ensure that they are informed participants in any investigation should it occur.

  • Health services administration & management
  • Health policy
  • Medical education & training
  • Medical law
  • Human resource management
  • Protocols & guidelines

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  • Contributors IA is a retired consultant obstetrician and gynaecologist. She has an interest in promoting the complex framework for managing doctors’ performance within the NHS. After retirement, she chose to address the knowledge gap, intent on educating doctors and found that there is nothing practical and accessible written for the doctors in published journals, hence the idea for this article. The investigation and literature search took the form of collating guidance from governmental and NHS agencies, speaking to senior staff at NHS Resolution, i.e., Denise Chaffer: director of Safety and Learning at NHS Resolution, Karen Wadman: lead adviser at Practitioner Performance Advice, experts Professor Narinder Kapur, Professor Aneez Esmail, Roger Kline, feedback from a focus group of junior and senior doctors and medical managers. AL is a highly specialist clinical psychologist with over 14 years of experience working in a variety of settings within the NHS. She is also an experienced and published researcher. She has published on a broad range of topics within clinical psychology, neuropsychology, industrial/organisational psychology and other healthcare areas. Her contribution to the paper was primarily to assist IA with formulating and preparing the original idea for the article into a publishable format. Her expertise in publishing interesting and accessible articles for healthcare professionals was also used.

  • Funding For signposting, support, advice see ACAS PPA Below is a link and contact details of medical defence organisations, mental health support, financial support services:

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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