'Supporting the welfare, rights and inclusion of chronically ill and physically disabled doctors and medical students'
How to cope when being challenged
This page gives general advice on how to cope and deal with “episodes” of suspected discrimination by colleagues and employers, including possible harassment and bullying which may be related to disability
Discrimination may be experienced in different contexts, e.g. during a recruitment process for a job; within an existing employment; inappropriate statements in a reference; inappropriate criticism by supervisors, managers and colleagues on aspects of your performance which relate to your disability.
How you might deal with it depends on the specifics of the situation, personal circumstances and the outcome you wish to achieve. The following advice is aimed at helping you gain clarity and to signpost you to sources of further support
Work through the following steps to help guide your judgement and decisions:
- Step 1: Identifying harassment, discrimination and bullying. Documenting evidence and assessing the situation
- Step 2: Deciding on an appropriate course of action
- Throughout: looking after yourself
Step 1: Is this harassment, discrimination or bullying? Documenting evidence and assessing the situation
Discrimination, harassment and bullying can really undermine your confidence and you may not even realise that this is happening or has happened until you talk it through with an independent adviser. Talk to a trusted friend, colleague or mentor to reflect on the situation
If you suspect you have been discriminated against, or you are being bullied or harassed, ask yourself what makes you think that this is the case. What makes your friend or mentor think that this is bullying or harassment? What evidence have you got that supports this impression objectively?
Collect the evidence- this is very important
If you feel there might have been discrimination, e.g. in a job recruitment process or interview, get copies of all paperwork that was used as part of the selection process including copies of score sheets and references. Be prepared for unpleasant surprises and make sure you have support to deal with it.
If you feel harassed or bullied by a colleague, keep a record or diary of any incidences including how these have made you feel and how it has affected you (e.g. performance and attitude to coming into work etc..)
Verify if your experiences are in-keeping with the legal definitions of discrimination, harassment or bullying. It helps to discuss the situation and evidence with knowledgeable, independent advisors in confidence. It may be all you need for getting your concerns validated and move on.
Step 1 - Resources
Good resources for both online support and telephone advice are listed here. The Equality and Human Rights Commission (EHRC) advise on disability discrimination and discrimination at work. They also advise about collecting evidence. The Equality and Advisory Support Service (ESSA) also have particular relevance
Consider funding a once off private session with a good employment lawyer to get an opinion about whether you have a case and what may be achieved by taking legal action
The BMA website provides advice and guidance on identifying bullying and harassment
This document discusses preventing workplace harassment and gives useful advice about how to identify it
Your NHS trusts will have policies in place on harassment and bullying and the procedure on how to report and challenge it
Step 2: Deciding on an appropriate course of action
What action you take, will depend on the severity of the “offense”, the evidence you have to prove wrong-doing, what outcome you are looking for and your personal risk-benefit assessment including considering the resources you have emotionally, physically and financially
Deciding to take no action
This may be appropriate for you. If you feel that taking action would make matters worse for you either in terms of your physical or mental health, your professional progression or financial security then this may be the best decision for you personally. If, after gaining specialist advice, you do not have a case for taking action or it is felt unlikely that you would achieve the desired outcome, then this may also be the best decision to make
Deciding to take action with focus on changing process and education rather than legal regress
This may be appropriate as a first step for many situations, especially if you want to maintain amicable workable relationships with involved colleagues in the future. If you are a member of the BMA, they may be able support you in this and may attend meetings with you. It is very important to have support at any informal or formal meetings and to have meetings recorded either physically or in writing. It is also imperative that you review any meeting minutes to make sure they are accurate and that you concur
There are a number of ways this could be achieved:
1. Approaching the “offending” individual directly, e.g. if you feel harassed or bullied by a particular individual you could let them know how this leaves you feeling and that their behavior could be regarded as discriminatory, harassment or bullying. They may simply not be aware. This would give them a chance to apologise and change their behavior and then remove the need for escalation. It is important to remember that your conversation with the individual involved should always be witnessed to keep you safe from reproach or, one would hope far more rarely physical violence or threats. If you are going to choose this option, there are helpful preparation tools in ‘Crucial Conversations’ listed below in resources
2. Local escalation which would involve following the organisations policy on harassment and bullying, which would be on their intranet or should be available from human resources
3. Approaching the organisation directly. You can give feedback and see how they respond (e.g. if you feel a recruitment process has not been in keeping with equality legislation). Have a plan in place in case your concerns are dismissed without appropriate attention. If you are a BMA member, you should be able to get advice from them on how to proceed
4. Challenging a discriminatory reference would require approaching the Human Resources department of the organisation you have worked for rather than the individual doctor who wrote the reference. Again, if you are a BMA member you can also get help with this from the BMA employment advisors
Deciding to take legal action
Aside from private employment law firms there are organisations which can advise and help you with this process (see resources below). Before a case will be heard at an employment tribunal, there is a requirement to first go through a reconciliation process via The Advisory, Conciliation and Arbitration Service (ACAS). ACAS provides excellent advice on this. You may not need legal representation to go through their process. It is worth asking if and how you can represent yourself in this, if you wish to do so or have no other option financially
Only when reconciliation fails, can a case be taken to employment tribunal
The decision of taking something to employment tribunal again depends on individual circumstances and how much is at stake. The BMA legal team have set thresholds when assessing if to take a challenge on
It is important to understand that tribunal proceedings also include an assessment as to whether your condition is defined as a disability under the Equality Act. For this purpose, your medical records are likely to be made part of the proceedings and might be disclosed in full to the other party.
You may wish to obtain good quality legal advice and representation before deciding to take your case to tribunal
Highlighting the issue by other means
If there has been a breach of pre-employment Health Questions Section 60, the Equality Act 2010
e.g. discriminatory advert, questions about your health asked before or during interview, you can report this to the Equality Human Rights Commission (EHRC) via the Equality Advisory Support Service (EASS).The EHRC will follow this up initially in an advisory role and feedback to you. This is an elegant way of raising concerns and ensuring organisations pay attention to their duties and can be done independently of taking legal action. The service keeps a record of such reports and can take further action if an organisation breaches the act repeatedly
Reporting to the professional Regulator
If the perpetrator of discrimination, harassment or bullying is a doctor, then this may be raised as an issue with the GMC. Disclosure of health or disability related information in a reference may be discriminatory and/or in breach of professional guidance on confidentiality and reference writing. Making critical comments on aspects of performance which is known to be affected by a disability may also be in breach of guidance and this could also be reported to the GMC. Getting advice from the confidential GMC helpline might be helpful in deciding how to challenge this.
Equality and Advisory Support Service (EASS) is an advice service aimed at individuals who need expert information, advice and support on discrimination and human rights issues and the applicable law, particularly when this is more than other advice agencies and local organisations can provide. It is possible to speak to an adviser and discuss your situation for advice. You can also report certain types of breaches of the Equality Act 2010 by organisations to the Equality Commission via their website link “let us know”
Disability Law service (DLS) provides free advice via information, factsheets, training courses and telephone and written advice on employment and discrimination law
Equality and Human Rights Commission (EHRC) provides a wealth of written resources. They have a useful section on identifying disability discrimination and one on dealing with discrimination in work and how to challenges it in a step by step advice section
The Advisory, Conciliation and Arbitration Service (ACAS) is a Crown non-departmental public body of the Government of the United Kingdom. You can call the ACAS helpline for free and impartial advice and clear and confidential guidance about any kind of dispute or query that you have about relationship issues within the workplace. The ACAS helpline number is 0300 123 1100 and is available Monday to Friday 8am-6pm.
British Medical Association (BMA) members can get free employment advice and possibly legal representation. However, the threshold to take action may be higher than that of private law firms
Even if you are not considering taking legal action, it can be helpful to fund a meeting with private law firm who specialises in employment law. This may allow you to get verification and potential validation on your experience and concerns. We are not able to advise on any specific companies but a simple internet search will provide you with the details of a number of firms that will provide these services.
Step 2 - Resources
Throughout: Look after yourself
Working as a doctor is demanding. Doctors with a chronic health issue/disability have additional demands and vulnerabilities to manage
Experiences of discrimination, harassment and bullying can have a big impact upon emotional well-being and professional and personal confidence and the rejection simply hurts. Challenging organisations/individuals on their “wrong doing” can leave you feeling even more isolated and vulnerable. Those experiences can easily destabilise an existing physical condition
It is of upmost importance that you take care of yourself through such difficult situations for your own sake and your patients’ sake. Consider the following to help you through the challenges
Understand you are (sadly) not on your own- do not suffer alone!
Try not to take it as a personal insult. It is more a cultural issue and not one of individuals
Get the emotional support you need, be it via friends and family, close colleagues or confidential helplines
Talk to your GP or specialist teams and see if more formal medical support can/needs to be offered
Consider review by Occupational Health and added support/adjustments whilst issues are getting addressed
Consider taking time out or reducing workload/adjusting deadlines for projects whilst dealing with these added challenges
Use the resources as listed below to help you work through this
Make sure you take time out from dealing and thinking about the issue and do something you enjoy regularly!
Use some form of mindfulness/mediation practice
General Medical Council Confidential helpline: 0161 923 6399
BMA counselling: For help, counselling and peer support just call 0330 123 1245 (24/7hours available) These services are available to all doctors and medical students
Practitioner Health Programme: Access the service by emailing us or by calling 0300 0303 300. The service is available 8am – 8pm Monday – Friday and 8am – 2pm Saturday and is for all NHS doctors & dentists in England
Headspace guided meditation app
Book “Crucial Conversations” by Patterson-Grenny-Mcmillan-Switzler, this gives tools for dialogue in high stakes situations, to help transform anger and hurt feelings into powerful dialogue
Look after yourself - Resources
Section author - Dr Heike Haffmans