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MHPS (Maintaining High Professional Standards) is a framework all Northern Irish Trusts must use when formally investigating serious disciplinary or capability concerns about medical staff.
The formal process under the MHPS is intended for situations where there are serious allegations or concerns. Despite this, and the fact that the Policy clearly provides that less serious issues should be addressed informally, it is not uncommon for the formal MHPS procedure to be used widely by the NI Trusts, including for more minor issues.
The formal MHPS process provides for appointment of a Case Manager and Case Investigator to facilitate a formal investigation into the issues/concerns/allegations. The Policy provides that the investigation should complete within 4 weeks and thereafter a report should be issued to the Case Manager within 5 days to enable the Case Manager to make a decision on whether:
The Policy itself is exceptionally long and vague in a lot of areas. As a result, there does not appear to be a consistent approach to these investigations by Trusts (even within the same Trust). Further, the timescale to complete investigations within 4 weeks is rarely ever met. The processes often go on for long periods of time, in some instances for years.
In some cases during investigation, the employee is subjected to interim suspension or restrictions on their practice area and can experience considerable stress during a long-running unresolved formal investigation into their conduct or capability.
In many cases, interim suspension or restrictions are not justified or reasonable, however the employee is often reluctant to challenge this for fear of a negative outcome in the MHPS investigation or long-term implications for their employment within the relevant Trust.
However, whilst suspension or restrictions may not impact pay, given the implications they can have on the reputation and career development of those affected, there can be significant long-term financial and reputational damage in many cases.
As a result of the nature of the investigations, medical staff are often reluctant or unable to discuss them with other colleagues and often find themselves very isolated.
Following a long disciplinary procedure conducted by a London Trust resulting in a Summary Dismissal of him, Amin Abdulla sadly took his own life 2 days before his Appeal Hearing. A subsequent investigation found that the procedure against him was weak and unfair and the evidence did not provide an “honest and complete picture”.
Following Mr Abdulla’s death, the Chair issued correspondence in May 2019 entitled ‘Learning lessons to improve our people practices’. This correspondence outlined a number of recommendations for Trusts including;
Mr Al-Obaidi, a Senior Consultant, had initially been suspended from work for a 4-month period invoked at the outset of the investigation into allegations made against him. After that time he was returned to work but only on a part-time basis and on restricted duties. Whilst at this point the Trust had dismissed the more serious allegations against him, they refused to allow him to return to work full-time.
The Court granted the interim injunction stating the Trust had behaved irrationally. It also stated that restricting his duties had been demeaning and humiliating, affecting his emotional wellbeing.
There is no doubt the pandemic has only exacerbated the existing difficulties faced by many medical professionals dealing with these investigations as it has resulted in far more substantial delays in investigations as well as a very significant lack of resources.
I have a number of years’ experience advising many medical professionals on participating in Trust investigations and procedures, including MHPS investigations. Whilst having a great deal of knowledge on the Policies and Procedures themselves, I also have a good grasp of all relevant legal remedies available to clients which may include injunctive relief for return to work or to uplift restrictions on practice. Unfortunately, delaying in obtaining legal advice may affect the number of options available to clients or the strength of those options. It is therefore important legal advice is obtained at an early stage wherever possible.
Some clients may elect not to take any formal litigation however, many find that legal assistance provides them significant support and assists in bringing the matter to a conclusion at an earlier stage.
Please contact me in confidence if you think I may be able to assist you.
This article has been produced for general information purposes and further advice should be sought from a professional advisor. If you need any advice in relation to the issues raised above, please do not hesitate to contact our Employment team.