Health campaigners and former clinicians are strongly advocating for NHS England to implement an "Amin's rule", an independent, external second opinion process, before any healthcare professional's dismissal is finalised. This push, which gained traction in early 2026, stems from concerns that the current internal disciplinary system leaves staff susceptible to unfair treatment, negatively impacting workforce morale and patient safety.
The proposed rule is named in memory of Amin Abdullah, a nurse who died by suicide in 2016 following his dismissal from Imperial College Healthcare NHS Trust. An independent inquiry later determined his treatment by management was unfair. Dr. Narinder Kapur, an NHS whistleblower, champions the idea as a necessary safeguard against future tragedies.
Under Dr. Kapur's "Amin's rule," an independent expert panel would review and assess the fairness and justification of any dismissal before an NHS trust finalises it. This includes dismissals under disciplinary procedures or the broader "some other substantial reason" (SOSR) mechanism. Supporters argue this external oversight would prevent the misuse of internal disciplinary processes and protect staff, especially those who raise safety concerns.
Campaigners highlight a systemic issue where Black and minority ethnic (BME) staff face disproportionately higher rates of disciplinary action. Dr. Kapur notes that staff of colour are statistically more likely to face disciplinary action and fear retaliation for raising patient safety concerns, a pattern that external protection could help to mitigate.
Furthermore, proponents seek to expand existing staff protection frameworks, such as the Maintaining High Professional Standards (MHPS) framework, which currently governs professional conduct for doctors and dentists, to encompass all healthcare professionals. The goal is to standardise fairness and disciplinary processes across all disciplines.
The push for "Amin's rule" is part of a broader reform agenda that includes a proposed restructuring of the Care Quality Commission (CQC). This reform would see one part of the CQC focus on patient safety while the other specifically scrutinises staff treatment and the handling of disciplinary actions, thereby enhancing independent oversight.
Supporters' Concerns: Critics of the current system describe internal disciplinary procedures as often opaque and intimidating, which deters staff from speaking up, particularly amidst high workplace stress, workforce shortages, and restructuring. For staff who have experienced or witnessed unfair dismissal, a neutral second opinion symbolises fairness and psychological safety, key to staff retention.
NHS England's Response and Opponents' View: NHS England has acknowledged the concerns and stated it is working with the Department of Health and Social Care (DHSC) to strengthen whistleblower protections and improve internal support, highlighting the role of Freedom to Speak Up Guardians. Opponents of the external rule caution that adding formal review steps could unduly slow down necessary dismissals and increase procedural complexity. They argue that improvements should focus on better training, clearer policies, and robust internal appeal processes instead of a blanket external requirement.
As the debate unfolds throughout 2026, the focus will remain on whether policymakers adopt structural changes, such as the independent review, or opt for incremental improvements within the existing internal systems.
