FOI 2024-151

1.       Please confirm has your Trust adopted the Just Learning Culture in handling of concerns following receipt of Dido Harding’s letter that was sent to all Chairs and Chief Executives of NHS Trusts and NHS Foundation Trusts dated 23 May 2019.

This has been fully adopted and outlined in Trust policy HR39 Responding to Concerns around Clinical Practice – the Dido Harding recommendations can be found in appendix 1 of this policy.

See attached.

2.       Does your MHPS Procedure set out an informal process to deal with concerns pertaining to conduct/ capability of medical and dental staff, if so please provide details.

Yes, section A of the above policy outlines Trust approaches relating to supportive action, coaching conversations and remediation.

3.       Please provide details of what training and support is provided by your Trust to Case Investigators and Case Managers when dealing with MHPS cases.

Case Managers and Case Investigators are required to have attended the case manager and case investigator training from NHS Resolution.

4.       Please can you confirm if your Trust has a Decision-Making Group and if so please can you confirm who sits on this group/how this is constituted and its remit?

We do not have a decision making group, but we do have our monthly Professional Standards Group (PSG) which provide multi-disciplinary support and guidance to the Case Manager, who is the decision maker.  Any decision to proceed to a formal MHPS investigation would first be discussed with PSG, PPAS and the Responsible Officer (if different to the case manager).

Please provide a breakdown of the requested information below for the period from May 2019 to date:

5.       The number of cases of medical and dental staff that were handled and resolved via a Just Culture approach and informal process.

Not all of these are captured as they have been resolved locally with a supportive coaching conversation.  However, of the cases that have reached PSG, there have been 48 that have been managed under “section A” of the HR39 and not reached a formal MHPS process.  I have classified bank workers as LtFT.  Due to the small numbers and the breakdown of information required, I have provided generic info of the country of graduation rather than specific countries for some cases.  

6.       The number of cases of medical and dental staff that were subjected to a formal MHPS investigation.

There have been 14 undergo formal MHPS investigation.

7.       The number of medical and dental staff that have been formally excluded under MHPS and the duration of the exclusion.

No doctors or dental staff have been excluded from March 2019-date.

8.       Where medical and dental staff have been formally excluded under MHPS please provide a breakdown of whether this was on grounds of a) a need to protect the interests of patients or other staff pending the outcome of a full investigation, and/or b) the presence of the practitioner in the workplace was likely to impede the gathering of evidence during the investigation?

N/A

9.       How many medical and dental staff have been the subject of a formal process in relation to concerns over conduct and performance after they have made a protected disclosure (whistleblowing) following concerns over patient safety or other issues?

None, but <5 has been subject to informal performance management support – they were also whistle blowers.

10.   Please provide the number of medical and dental staff that were placed on restricted duties and the duration of these restrictions.

There have been 7 doctors with restrictions on their practice with a duration ranging from 3 months to 18 months.

11.   Please provide a breakdown of how many of these formal MHPS investigations were:

a.       Resolved with no further action due to the concerns not being upheld - <5

b.       Resolved via an agreement to proceed through a disciplinary fast track process which avoided the need to proceed to a formal hearing - <5 (with first written warning issued)

c.       Proceeded to a formal hearing – conduct or capability (provide breakdown) - <5 all conducted

d.       Other outcome - provide details - 5

12.   Of the cases that proceeded to a formal hearing please confirm how many of these resulted in:

a.       No disciplinary sanction - because the allegation/concerns were not upheld - NIL

b.       No disciplinary sanction - but ended with a recommendation for additional training/remediation/support - NIL

c.       A disciplinary sanction – please confirm the level of this sanction (e.g. written warning/final written warning/dismissal) - <5 first written warning, and <5 final written warning

d.       Number of medical staff who appealed the disciplinary sanction and the outcome - <5

e.       Other outcome - provide details - N/A

13.   Please provide length of time from start to finish of each MHPS case.

Please be advised that this represents management of the case from initiation of a formal MHPS process to closure of the case, which includes any subsequent hearing and if any conditions are applied, captures the number of days until restrictions/conditions/undertakings are lifted and the case is closed and no longer under the formal MHPS performance management process.  For example, one doctor received a warning and the hearing panel requested a PPAS behavioural assessment and they remained under the MHPS process during that time before the case manager closed the case.  Other reasons for prolonged cases included issues with arranging face to face hearing panels during Covid for doctors who rejected the option of a virtual panel.  Another prolonged case was due to the doctor taking a prolonged period of sick leave during the process which paused the investigation until they returned.

Time periods in days are as follows:

268, 225, 406, 144, 74, 94, 59, 185, 63, 81, 29, 238, 20, 125

14.   Please can you provide an overall breakdown of the make-up of your medical and dental staff.

Please note, we do not have access to this data for rotational doctors in training who are appointed by HENW and employed by Lead Employer.