Disciplinary issues arise when problems of conduct are identified by the employer. All employers should have a disciplinary procedure for dealing with such issues.

Issues of straightforward misconduct or gross misconduct by doctors or dentists, should be dealt with through the local NHS employer's internal disciplinary procedures.

All such disciplinary procedures should be based firmly on the principles of fairness and designed to both protect patients and practitioners themselves. Where the penalty imposed is dismissal, the employee has a right, as with all employees, not to be unfairly dismissed. An otherwise fair dismissal may be found to be unfair if there is procedural unfairness.

Dismissal will also need to be justifiable as a reasonable response and employers need to be aware of the risk of the unfairly disciplined employee resigning and claiming constructive dismissal.

These disciplinary procedures should be augmented by additional disciplinary procedures for dealing specifically with doctors and dentists' professional conduct or capability issues.

An NHS organisation is required to develop a co-ordinated approach to handling disciplinary concerns about doctors and dentists. Whatever the source of information, the response must be the same – to quickly establish the facts, ascertain the extent of any risk or validity of any concern and take immediate appropriate action.

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