In Qasim v Central Manchester Hospitals NHS Foundation Trust (2009) the High Court was asked to consider an application for an injunction lifting the exclusion of Dr Qasim from the trust pending an investigation into allegations that she was responsible for a complete breakdown in working relationships and presented as a risk to patients.

Dr Qasim was employed as a consultant nephrologist at the trust and her contract of employment largely incorporated the exclusion terms of "Maintaining High Professional Standards" which can be accessed here, and which provides that exclusion is very much a matter of last resort. Dr Qasim argued that her exclusion breached her contract of employment and mutual trust and confidence and that it ought to be lifted. The trust in its defence relied on several reports which highlighted serious issues with Dr Qasim's clinical practice, behaviour and conduct.

The High Court held in favour of the trust and decided that it had not acted in breach of contract or in breach of mutual trust and confidence. The High Court considered the potential damage and disruption if Dr Qasim was to return to the workplace and refused the injunction sought.

This case highlights the importance of fully considering incidents and evidencing concerns, involving NCAS and ensuring that full reasons are provided to the doctor or dentist concerned and his/her representative when reaching a decision to exclude.