The High Court granted an interim injunction to a doctor which obliged his employer trust to lift the restrictions it had placed on his practice.

Injunctions and restrictions

If an exclusion process is carried out incorrectly in relation to a doctor, there is always the potential threat of an injunction. Where the extent of restrictions, in practice, amount to an exclusion, this can be challenged in the same way. However this recent decision, although made on an interim basis, suggests that injunctions can potentially be obtained in situations where the restrictions imposed are at a lower level than such as to be indistinguishable from exclusions.

Factual background

Dr Al-Obaidi was initially excluded by the trust on the basis of potentially serious allegations, including allegedly discouraging reporting of serious incidents and alleged intimidating behaviour. One of the reasons given for this exclusion was ‘potential interference with the investigation’. The investigation showed that there was no potential case of gross misconduct. The trust then lifted the exclusion but imposed restrictions on practice. The doctor challenged the restrictions but the trust decided they had to remain in place until the disciplinary process concluded. At an interim hearing the High Court obliged the trust to lift the restrictions and determined that the decision to impose them showed that the original decision to exclude (exclusion was described as a ’nuclear weapon’) was flawed.

The High Court determined that the fact that the situation could be dealt with by restrictions only showed that the urgent requirement to exclude on grounds of patient safety had not been met. They also found that the issues related to the personality of the doctor rather than being matters of patient safety.

Implications

This is an interim decision only. It is possible that a different decision will be reached at a full hearing. However it shows that injunction proceedings are a realistic threat where extensive restrictions are imposed and illustrates the Court’s careful analysis of the justification for such decisions.

Trusts are often faced with difficult situations where personality problems are potentially serious enough to give rise to patient safety issues and this case emphasises the importance of a clear rationale in these cases. The High Court’s clear determination that they considered the restrictions were ‘demeaning and humiliating’ for a senior doctor mean trusts need to consider very carefully in every situation where restrictions are in place whether they are definitely justified on the grounds of patient safety. Finally, the High Court was very scathing about ‘potential interference with an investigation’ and again this case is a timely reminder that although this is one of the grounds in Maintaining High Professional Standards (MHPS) that justify an exclusion, it should only be used when there is actual evidence of a potential risk of interference, and not otherwise.

This case highlights the need to have a clear rationale at every stage of the process and to make sure that all decisions can be linked back to the principle of patient safety.