The issues existing in the race inequality agenda are ingrained, multifactorial and complex, needing many different, innovative and creative solutions for us to employ in order to ultimately reach the goal of a fully inclusive and fair NHS for all our staff…

A fair experience for all: Closing the ethnicity gap in rates of disciplinary action across the NHS workforce    NHS England

The case studies in this guide give examples of strategies used to close the disciplinary gap. They emphasise the need for multiple interventions, long-term as well as short-term, a commitment to continuous improvement, and effective leadership and culture. 

The good practice models set out in A fair experience for all also provide a useful starting point for NHS organisations.  

They are: 

  1. Decision tree checklist - a structured set of questions to guide managers in deciding if formal disciplinary action is necessary or if alternatives may be feasible. This keeps responsibility with managers while providing an evidence-based framework. 
  2. Post-action audit - formal disciplinary decisions reviewed quarterly/biannually to identify any biases or systemic issues. This keeps responsibility with managers and can help embed better practices. 
  3. Pre-formal action check by a director level member of staff and/or a panel - an executive board member or panel reviews cases before formal action to ensure consistency. This reduces manager responsibility but increases objectivity. 
  4. Pre-formal action check by a trained lay member - a trained lay member reviews cases before formal action to reduce bias and increase objectivity. This adds independent scrutiny but may raise confidentiality risks and needs to be managed carefully.