Campaign Against Unnecessary Suspensions & Exclusions in the NHS (CAUSE)


So what should you do, now that you have been suspended?

(With many thanks to Craig who wrote the first guide)

Positively managing your suspension/exclusion will require a lot of thinking and reading and statement writing at the time when you are in a state of shock and distress, so it will be a huge challenge.

1.Tell your family and/or trusted friends because you need all the support you can get. If your family live abroad that is much more difficult but telling them at least some of the truth will lift some of the burden from you.

Go to see your GP to get medical help.  It is not uncommon for people to suffer psychological damage as well as conditions such as high blood pressure.

2.Recognise that you are in shock so pace yourself.  Absorbing information will be difficult.  Take your time and don’t be surprised if it takes several reads before you understand what is written.  It is very important to try and get some sleep and to eat even small meals to help you.  (See Effects of suspension and Coping)

  1. Contact your union rep. Keep trying. Make them deliver on their advertised services.

If you don’t feel the rep is helpful, ask for a replacement.  Often people have had to do that to find someone they believe is fighting their corner.  

  • If you don’t belong to a union or your membership has lapsed, sadly they rarely help people. You could promise to sign up for 5 years to see if that makes any difference.  They are unlikely to help you retrospectively but will advise you now hopefully.  But check that and put it in an email to them so that you have written witness to what you understand.
  • Still no help? Sam Stone at has a lot of information on his website and is also contactable.
  • We have the help of  Robin Oliver who is happy to give free telephone advice, and initial help on a pro bono basis.
    Robin has practised law as an adviser and advocate for over 30 years, 15 of those as a practising solicitor.
    Robin will also undertake representation and advocacy services in the Employment Tribunals or professional Regulatory proceedings, such as the NMC, at reasonable cost, including “no win-no fee” agreements in appropriate cases. He has a wealth of experience in these matters.
    Please send an email at or contact him directly by phone: 07854514480 or 01255 719354  
  • We have been told of independent human resources advice, a helpful service provided by Charlotte Coupe at See her website for information and charges which are very reasonable compared to solicitors fees.  She will be able to help with letters and appeals and will be able to quote what your employers should be doing.  She is very insightful about malfunctioning NHS managers.
  • Other sources of legal help – Acas helpline – see their website too, TUC website, your local Citizens Advice Bureau, a free half hour with an employment solicitor. (Sadly employment solicitors don’t understand the punitive culture of the NHS and may not be very helpful.  They are limited too by employment law as to what help they can give in the early stages.)
  • See also
  • How to pay – check your household insurance to see if you have paid for legal cover. You may have to persevere before they agree to pay.  (See Legal expenses insurance information.)

4.Suspension meeting.  It is not uncommon for you to be called to a meeting suddenly with no explanation or invitation to bring a colleague or a union representative, which is the procedure that should be used. The whole situation is still a terrible shock to you.

It is not uncommon for you not to know why you have been suspended or to be given only a vague explanation.

Your employer should send you the allegation(s) in writing within 5 working days.

It is not uncommon for that not to happen and to be kept waiting much longer.  Of course it is not right and you can ask your union rep to put in a grievance for you, or write one yourself.  See the Acas website section: Raising a grievance at work.  See also Sam Stone at for a template and advice.

A Human Resources staff member should have given you a copy of your employer’s disciplinary policy.  It is quite common that they haven’t. It might be on your employer’s website.

If you can’t find a copy, email HR for a copy and copy one of the managers into your email to show that you haven’t been given the information you need.

Also look on the Acas website for best practices which your employer should be following.

  1. Write a full statement as soon as possible while events are still fresh in your mind.

See Written statement prompt in resources section second from last

6.See the Acas website, Advice and guidance section, scroll down to the following to see how your employer should be proceeding now.

Discipline and grievances at work: The Acas guide

Discipline and grievance – Acas Code of Practice

Disciplining staff

Managing discipline – Investigation to possible dismissal: A guide


If your employer is not following these processes, write and ask why.  Remember that the manager who has suspended you unnecessarily, now has to justify his/her action.

Very often they are younger than you and have poor people skills.

Your commitment to your patients and your colleagues and your practice is possibly superior to theirs too.

7.Communication with your employer.  Do NOT have any telephone conversations.  Everything needs to be by email, copied to the HR staff member so that your concerns cannot be ignored. (Information in telephone conversations can subsequently be denied.)

If you write, use recorded delivery for the same reason.

When you write an email, let some time elapse before you send it, to check that what you are trying to say is clear and unemotional.

You can also question why you were suspended, why such extreme action has been taken.

Why were alternatives not used?

  1. Email regularly requesting a time frame for the investigation. Sadly, employers have no idea of the distress being caused by the suspension and many employers fail to treat the suspension as an emergency needing an urgent response unlike managers in the business world where time is money and suspension is understood to be distressing. In the NHS it feels as though you are in someone’s ‘pending tray’.

See Acas again: Conducting workplace investigations, section 7: If an investigation is necessary, then an employer should act promptly. 

Unnecessary delay may cause memories to fade or give the perception of an unfair process. Importantly, an informal resolution of the matter should still be considered as an option at any stage of the process.

Use the Acas guide to quote back to your employer.

9.Start filing your emails and letters, those you send and those you receive.

Start an index for them. You will be surprised how quickly they mount up. Always keep a copy of everything you write and receive in case important

10.Decide what action you need to take now to prepare your defence.  Think about what is wrong with the allegations.  You have to think like a detective.

How can you demonstrate that the allegations are wrong?

If you have made a mistake and are being disciplined for it, for example by making a drug error and owning to it as soon as you realised, with no history of poor practice, look at what mitigating circumstances there were, how the mistake happened (systems failure), how you will prevent it happening again by changing your practice.  What training you will undertake.

Importantly express regret.  Show insight into the seriousness of the mistake and the possible impact on the patient.  Never minimise it, for example by saying that no harm was caused suggesting that therefore it was not serious.

11.Write clearly. If you are describing a situation as you saw it, remember the investigator  wasn’t there.  What was the room like, where were you standing, who was there too etc.  Use who, what, why where, when.

12.Setting it out: Number paragraphs. Prepare a summary sheet.  Put large amounts of information in appendices.  (The people reading your defence/explanation are short of time.  Help them read quickly in summary form, what you are saying.)

13.Be careful what you write. Make sure it is clear and cannot be misunderstood.  Ask a friend or family member to read it for you, to see if it is clear to them.

Keep reference to your emotions out of what you are writing.  Be factual.

14.Were you a whistleblower without realising it?  Think about what might have contributed to becoming a target for the action taken against you.  Were you regularly reporting critical incidents, shortage of staff, concerns about the lack of skills to deal with patients with complex conditions?

See ‘Raising concerns at work’ ( to read or download a copy.) a document published in 2014 by the whistleblowing helpline. The Secretary of State for Health, Jeremy Hunt, wrote in the Foreword,

‘Staff should be supported and protected when they raise concerns, as well as praised for their courage and thanked by management as a key part of the effort to build a safe, effective and compassionate culture that patients, service users, the public and the overwhelming majority of staff across health and social services expect.’

In that document you will find very helpful information plus a list of agencies to help you to be protected through the Public Interest Disclosure Act (PIDA).

  1. Taking care of yourself

Being suspended will affect you physically, mentally, emotionally, spiritually, socially.  It will affect your family and friends too. (You should not be affected financially unless your contract says otherwise.)

See ‘Effects of suspension’  for a fuller description.

16.Return to work. If there is no case to answer, request a Return to Work plan. Ensure your employer recognises that you need updating and support because of the trauma experienced.

(I can only remember a few people receiving a written apology or any information to colleagues about their time away.  How is it to be explained?  You can ask for clarification.)

17.If you are dismissed, consider appealing.  See the Acas website for your rights to appeal and earlier notes in the Help and resources section.  See the Acas website or your employer’s disciplinary policy for the time allowed for appeal, which may be 5 working days.

Acas have just released new guidelines about references employers may provide that will be helpful to you, to know what they are legally allowed to write.  See

18.Referral to the Nursing and Midwifery Council. As well as the trauma and distress, you will probably be referred to the Nursing and Midwifery Council regarding your Fitness to Practice. See the Fitness to Practice section for their procedures.  They say that it demonstrates insight if you contact them yourself to report what has happened and ask what they want you to do.

There is currently a support and information closed group on Facebook called The Case against the NMC: (Home of NMC Watch: Registrant Care.)  They are very supportive to referred registrants.                                     


19.Remember to sign on at your local Job Centre as soon as the outcome has been finally decided if the dismissal stands – not a foregone conclusion because sometimes a manager outside the situation with fresh eyes, sees what has been happening and overturns the decision.

Some general thoughts:

Being assertive rather than aggressive in a very troubled situation is not easy but more productive.

People are often worried about causing further damage to their case by being assertive. But remember you are trying to redeem your professional reputation and may even be fighting for your career.

Try and go for a win win outcome with your employers. In some situations this may not be possible where managers are trying to cover up poor practice.

The whole wasteful process is a huge challenge and often a grave injustice.  Sadly the idea that the ‘truth will out’ regularly fails to happen.

It is always helpful to hear outcomes if you have the energy by the end of this very difficult situation.

Your story

We are always grateful for people’s stories when they get to the end of it all.  Sometimes it is helpful to people.  Sometimes, people start writing and then find it too painful and have to stop.

The process: If you are able to write, when you send it to me, I will make sure you cannot be identified, return it to you to check that you agree with any changes, and then publish it on the website, with grateful thanks.

Some Good News

People are now setting up groups to fight back. These are some of them.

Betrayed By Their Trust is a Worcestershire based group, focusing on support and justice for bullied staff in the Worcestershire trusts. So far it makes for depressing reading as the group reports grave injustices that have not been remedied.

If you have been referred to the NMC Fitness to Practice, there is a very active support and information confidential closed group on Facebook called NMC Watch: Registrant Care  They are campaigning and also crowdfunding so they can help with some legal support for registrants who have none.  Documents are under the NMC Watch heading, including how to appeal being struck off.

Friends of NMC Watch is also a closed group set up for supporters and those who fear a referral to the NMC.  Go to

Campaign Co-ordinator for NMC Watch Registrant Care:  Cathryn Watters


But also spare a thought for the families of patients who have suffered at the hands of poor care given, often resulting in death, who have been unable to get any justice too. Look up Toms Anguish on Twitter , James Titcombe at and Eileen Chubb for three very sad examples amongst many.