Table 1

Key documents for doctors

Document titleContent
Maintaining High Professional Standards in the Modern NHS (MHPS): Department of Health, 20032 A key document and part of all NHS doctor’s and dentist’s contract of employment, NHS Trusts are all required to have MHPS compliant procedures in place. MHPS consists of five parts: (1) action when a concern arises; (2) restriction of practice and exclusion; (3) conduct of hearings and disciplinary matters; (4) procedures for dealing with issues of capability; and (5) handling concerns about the health of a practitioner.
MHPS is the most important framework outlining how concerns about all doctors are to be handled. The key word here is framework. Every NHS Trust has used it to develop their own policies, which has resulted in considerable variation in the interpretation and implementation of MHPS.
MHPS was developed in a climate of protracted unresolved exclusions from work resulting in financial and professional loss for the NHS. MHPS stipulates that procedures must allow for informal resolution of less serious problems. When a concern is considered to be serious, MHPS defines clear roles and responsibilities for individuals investigating and managing the outcomes of a concern. MHPS also states that unfounded or malicious allegations must be addressed at the time a concern is raised, as it is acknowledged that these can cause lasting damage to the reputation and career of a doctor.
The content of the original MHPS in itself, is not something that most doctors need to be versed in. What is most relevant, is each NHS Trust’s current MHPS policy and other policies that may be relevant such as Code of Conduct, Disciplinary, Sickness and Absence. If other policies are used and there is any conflict, MHPS overrides them.
Baroness Dido Harding’s Letter to all Trusts, 201911 This is perhaps the next most important document for doctors to be aware of. It makes essential recommendations above and beyond MHPS in regards best practice, but is not mandatory. Harding includes an appendix of seven sets of measures to minimise unfairness by adhering to a rigorous decision-making methodology, ensuring staff are fully trained and competent to carry out their role, assigning sufficient resources and safeguarding people’s health and well-being, as well as board-level oversight.
A practical guide for responding to concerns about medical practice, 20193 This document was disseminated in 2019 to responsible officers. It is useful because it contains sections not found in MHPS such as the general principles of a good investigation based on the GMC’s ‘principles of good investigation’, the need to support and engage the doctor as a partner during the investigation, the role of others such as occupational health and HR as well as organisational learning and quality assurance of process. It contains a template summarising how a responsible officer might advise a doctor who is asked to respond to a concern about their practice. Appendix E: Guidance for the doctor about how to respond, may be especially helpful.
Advisory, Conciliation and Arbitration Service (ACAS) Code of conduct, 201512 This document is relevant to both employers and employees. ACAS is a publicly funded, independent organisation that aims to promote better relations between employers and employees in disciplinary matters and grievances. It is applicable to all professions. The document outlines the keys to handling disciplinary issues and grievances in the workplace.
  • GMC, General Medical Council; HR, human resources; NHS, National Health Service.