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Employer mini guide – Exclusion reviews

Healthcare professionals working in the NHS and private practices face the same employment challenges as other employees, however there are added layers  of Best Medical Practice, Patient Safety and other regulatory requirements. 

Navigating these are often confusing and sometimes anxious times for healthcare workers. MDS has compiled a series of simple guides regarding initial steps that can be taken to address these issues. 

Today we cover…Exclusion Reviews

Exclusion from work is rare and is a temporary removal from duty. It is one of the most serious actions an employer can take, and it should only be used when absolutely necessary. Being excluded from work is something none of us would welcome, however, particularly in healthcare settings, there are occasions where it’s necessary and part of a disciplinary, learning or other formal process.

As an employee it is important that you know your rights during any exclusion. You need to maintain your professionalism, engage with the process, and seek appropriate support. All of these will make a significant difference to both your wellbeing and the outcome.

When excluded from work, you do not attend work or the workplace (unless there are different arrangements, see below) and usually still receive your full salary.

 

It’s important to understand that exclusion from work:

  • It’s not a punishment, it is a neutral act (often a safety measure)
  • It is used to protect patients, staff or an investigation
  • It’s a risk based decision
  • Must be reviewed regularly.

 

There are alternatives to exclusions but these very much depend on the circumstances and reason for the exclusion. In some circumstances you may be requested to:

  • Work in another department
  • Undertake non clinical duties
  • Work under supervision.

Both exclusions and alternative ways or working must be reviewed on a regular basis.

 

Exclusion Review

An exclusion review ensures:

  • Whether the exclusion is still necessary
  • That patient and staff safety is maintained
  • That the restrictions are not excessive
  • That alternatives have or are being considered
  • That the review continues to follow the Trust policy under which the exclusion was deemed necessary (e.g. Maintaining High Professional Standards in the NHS -MHPS, or Infection Prevention and Control policies)

The timing of reviews very much depends on the reason for the exclusion. If the exclusion is due to a medical condition, then a weekly review may be appropriate.

If the exclusion is part of an MHPS investigation, then the standard policy states this should happen within 4 weeks of the exclusion date.

 

Depending on the context, the review is normally carried out by:

  • An MHPS case manager
  • A senior clinician
  • The Infection Prevention and Contract team
  • Occupational Health

And the main outcomes are whether the exclusion needs to continue or the subject can return to work, or if the exclusion needs to be amended (for example to include a return to the workplace on modified duties).

 

How we can help

MDS can guide you through this often long process and provide support and representation at any meetings held during the exclusion period or beyond depending on the circumstances.  Please call our team on 0300 30 32 442 if you are involved in a dispute at work so we can guide you through the best outcome.