This case has recently been reported in the BMJ which I found interesting because I don’t know about you but I often hear conversations on trains which sound confidential to me. The link to the case is
http://www.bailii.org/uk/cases/UKSC/2013/80.html but the summary is below.
A consultant forensic psychiatrist at Broadmoor high security hospital who while on a crowded train discussed a medical report on a patient has won a ruling from the UK Supreme Court stopping her employers from convening a hearing that could result in her dismissal for gross misconduct.1
The UK's highest court ordered West London Mental Health NHS Trust not to pursue allegations of breaches of confidentiality against Preeti Chhabra as matters of gross misconduct, potentially grounds for dismissal.
The court also barred the trust from pursuing any confidentiality concerns against her without first restarting and completing an independent investigation. The five judges unanimously concluded that there were several irregularities in the trust's proceedings against Chhabra "that cumulatively render the convening of the conduct panel unlawful as a material breach of her contract of employment."
The judgment overturns a decision by the Court of Appeal last January that the trust was entitled to go ahead with the hearing.2The High Court had originally granted an injunction stopping it.
Chhabra was alleged to have read through a medical report and discussed an incident involving a patient with a colleague during a journey on a packed commuter train in November 2010. She was unaware that sitting opposite her was Jo Leech, head of secure services policy at the Department of Health. Leech reported her to Broadmoor, saying that the patient's name and the section of the Mental Health Act under which he was detained were visible on the report.
The trust's medical director commissioned Amanda Taylor, a consultant forensic psychiatrist from another trust, to investigate the allegation along with other concerns, to find out whether there was a prima facie case to put before a conduct panel. This was in line with the trust's own procedures, based on the Maintaining High Professional Standards policy framework for conduct and capability concerns about NHS doctors and dentists, which formed part of Chhabra's employment contract.
Characterising the allegations, which also included dictating two reports on a train, as gross misconduct was in itself sufficient ground for an injunction, said the judges.
The trust was entitled to treat the allegations as serious misconduct, but gross misconduct was defined in the trust's own policy as conduct so serious "as to potentially make any further relationship and trust between the trust and the employee impossible."
The judges said that the breaches were "qualitatively different from a deliberate breach of confidentiality such as speaking to the media about a patient." Chhabra told Taylor that she had not appreciated that her actions compromised confidentiality.
In addition, despite an undertaking to Chhabra that the trust's human resources associate director, Alan Wishart, would take no part in the investigation, Taylor had been in contact with Wishart during the investigation and had sent him her draft report. He had suggested amendments stiffening her criticism of Chhabra, some of which she had included in the final report.
The trust's disregard of its undertaking amounted to "a breach of the obligation of good faith in the contract of employment," the judges said.