What is MHPS?
MHPS stands for ‘maintaining high professional standards’ which is a framework produced by the Department of Health to assess the performance of doctors and dentists. When dealing with performance concerns, NHS managers will utilise this national framework along with local processes and support as part of an external MHPS investigation.
There are several aims of the MHPS framework including improving patient care, encouraging collaboration, promoting continuous improvement and increasing efficiency. MHPS is therefore an important approach because it feeds into the primary objective of the NHS which is to continuously improve patient care.
MHPS in healthcare
As an experienced healthcare consultancy we understand that maintaining high performance standards is a challenging endeavour. If you’re responsible for managing doctors, how do you deal with their performance problems? This can be one of the most difficult issues that healthcare managers face.
It is especially difficult due to inhibitions about the special status of doctors, the lack of knowledge managers have with clinical skills and performance standards, and the reluctance to raise concerns over poor practise.
Post-Pandemic Operational Realities
Covid has added another layer of complication to this, of course. The after-effects including backlogs, workforce burnout, and recruitment pressures have changed how MHPS is used. While the pandemic-era NHS guidance was a reactive necessity, the current reality for NHS managers is navigating the long-term impact of those years. Specifically, how to manage practitioner performance when the system is under extreme, persistent strain.
Applying MHPS Fairly
While the MHPS framework provides the formal structure for managing performance, the national data reveals significant challenges in its application. Recent insights from NHS Resolution indicate an average of 93.6 formal exclusion episodes per financial year.
Perhaps more concerning is the trend suggesting that practitioners from ethnic minority groups remain more likely to be excluded than their white counterparts. These figures highlight the importance of healthcare providers promoting a Just Culture, where investigations are not merely administrative hurdles, but exercises in objectivity and fairness that protect both the patient and the professional.
MHPS needs prompt action
In our experience healthcare managers carry out MHPS processes only as a last resort due to concerns about how long and complicated the process can be. To avoid going down the route of MHPS, identifying performance issues as they arise is key. Addressing those issues rather than ignoring them will help to prevent them persisting.
Understanding how to manage performance issues is important to ensure the doctor is clearly aware of the problem, the required standards, and how it might affect their team members and patients. Explaining the steps involved to better their performance is necessary for standards to improve.
Raising the issue promptly and constructively may be enough in itself to drive change but sometimes an MHPS case is needed.
Avoid unnecessary time and costs involved
The big concern that most managers have about MHPS is about the time it might take. The issue of “process paralysis” and the damaging consequences of delayed intervention is illustrated well by the situation at Addenbrooke’s Hospital (Cambridge University Hospitals NHS Foundation Trust), reported by ITV News in July 2026.
Despite initial reports, the surgeon continued to practice until an external review was finally launched in March 2024. An eight-year gap between initial concern and the independent investigation conducted by Verita. This highlights the vital importance of the ‘prompt action’ principles within the MHPS framework. When managers treat formal investigations as a last resort to be delayed or avoided, they inadvertently create the very conditions that allow concerns to escalate into crises.
Modern investigations are pressured to be faster to protect both patient safety and the mental wellbeing of the clinician. Partnering with external, objective investigators is now more critical than ever.
MHPS support
At Verita, we have supported the MHPS process of many cases by carrying out the investigation. In our experience, complex cases like this one do indeed need to be handled carefully.
If you would like to know more about MHPS and Verita’s MHPS investigation services, please book a free consultation or contact Ed Marsden on 020 7494 5670 or [email protected].
