How criminal record checks work in the NHS
Lots of people.

Criminal record checks are one of the most important steps to take before employing someone in healthcare, but what do you need to do?

A medical setting should be a place of trust, professionalism and safety for both staff and patients. But there have been incidences where staff have violated this trust, and put the well-being of their patients at risk.

For example, in November last year, a former NHS secretary was found guilty of illegally accessing the medical records of over 150 people. 

The perpetrator was required to access clinical and personal information of patients within the ophthalmology department. However, the individuals whose records were accessed had no medical conditions relating to that area and she viewed the medical records of people who lived near her.

The possibility of this happening to patients is frightening, especially with criminal record checks in place that are supposed to protect all individuals.

So what criminal record checks are needed to ensure the wrong people are prevented from entering the workforce and gaining access to often vulnerable individuals?

We look at best practice for these checks, and the importance of carrying them out correctly.  

The basics 

In 2002, the Department of Health and Social Care issued a mandate outlining the primary checks which all NHS organisations within England must undertake when appointing individuals into NHS positions.

There are different levels and different kinds of checks that must be conducted by the NHS before someone can start work. Their purpose is to help employers seek the necessary assurance that individuals are of good character and have the appropriate experience, qualifications, skills and competency to do the job properly.

There is a lot to be said for making sure these screening checks are carried out by one department to make sure they are carried out fairly.

The first of these is checking identification documents. Employees will be asked to provide proof that they have the right to work in the UK. This means they will need to produce either a document or a combination of documents. For example, a passport, a visa or immigration documents if they are non-national.

If the role requires a particular professional registration, the employer must carry out a check with the appropriate regulatory body and secure confirmation of the appropriate registration. Where a check has been made, employers will not be required to verify their professional qualifications separately.

Where a licence is a requirement, confirmation will be sought from the relevant regulatory body as well.

What are criminal record checks? Criminal background checks are arguably the most crucial aspect of the NHS’ employment checks.

To put it simply, it is a process used by employers to screen potential employees for criminal records, past convictions and any other relevant information that could affect their suitability.

These checks are crucial to workplace and patient safety because they prevent unsuitable people from entering healthcare settings.

In most cases, a check will include criminal convictions, cautions and other similar offences, such as traffic offences for speeding and drink-driving. They can be accessed through the Disclosure and Barring Service (DBS) in England and Wales, but this differs for Scotland and Northern Ireland. 

Types of criminal record check 

There are six types of criminal record checks that can be completed by the NHS before someone is employed.

Firstly, there are the basic checks which provide information only on unspent convictions (when someone is in their rehabilitation period following conviction).

Once the rehabilitation period has passed and if the individual has not been reconvicted at any time during this period, they will not be required to declare these offences, nor are employers permitted to consider this type of information in their assessment of suitability for the role.

The next step up is the standard check which must be completed for positions which are listed as exempt under the Rehabilitation of Offenders Act 1974. It details information on spent and unspent convictions and cautions. 

To meet eligibility for a standard check, the role must require the individual in that role to be involved in the provision of a health service which would also give them access to persons in receipt of health services as part of their normal duties.

Enhanced checks without barred list information are the third type of criminal record check, and are usually used for positions where the employee will work with adults and/or children. 

The enhanced check will provide the same information as a standard check. In addition, it will include any other relevant information that may be held on local police databases which the chief officer reasonably believes should be disclosed and considered by an employer. Including cautions or convictions that may be protected by the DBS filtering rules.

Next are enhanced checks with barred list information, which is carried out for positions involving a regulated activity as stipulated within the Safeguarding Vulnerable Groups Act 2006 (amended by Protection of Freedoms Act in 2012).

Additionally, using the DBS Adult First Service enables employers to obtain a fast-track check against the adults barred list. This check does not remove the need to obtain a full enhanced disclosure, but it can help to mitigate risk where any delay to recruitment would have a significant impact on the provision of services and/or patient safety. For example, this might be during the winter period when there is an increased pressure on NHS services.

If the check confirms that the individual is not barred from working with adults, and all other recruitment criteria have been met, employers can allow them to start work under supervision while waiting for the outcome of the full enhanced disclosure.

The final step you can complete for a criminal record check is the DBS update service, which is available for potential and current employees to subscribe to when an application for a DBS check is made.

Subscription to the service allows for standard or enhanced certificates to be updated and allows employers to mitigate risk by carrying out a quick check online instead of requiring individuals to have a new DBS check each time they change roles and where the new role does not alter the type or level of check required.

Of course, these checks do not completely ensure that an employee is not unsuitable. But putting these systems in place can significantly reduce the chances of this kind of person being employed by the NHS.