Jain v Manchester University NHS Foundation Trust

MHPS procedures were not incorporated into the consultant’s contract by the Secretary of State’s directions, custom and practice, or the contractual reference to disciplinary and capability procedures. However, once the Trust chose to address concerns under MHPS Part IV, the procedure became a central consideration when assessing compliance with the implied obligation of mutual trust and confidence. The Trust was entitled to adopt a precautionary restriction where patient-safety concerns were reasonably judged significant. It could also change its approach over time, including addressing working relationships before retraining, provided its conduct did not seriously damage trust and confidence. A reintegration plan was a practical route map, not a freestanding contract, and mediation confidentiality was limited by its purpose. The claim therefore failed, although the Trust remained obliged to follow a fair procedure in deciding what to do next.

The claimant was employed as a consultant radiologist by the defendant NHS Foundation Trust. His duties included breast radiology and general radiology. Following longstanding concerns about clinical performance, professional relationships and capability, the Trust restricted his breast radiology work, commenced an MHPS Part IV investigation, attempted a reintegration plan and arranged mediation.

The reintegration plan was suspended after the mediation indicated a serious breakdown in working relationships. The Trust then commissioned an independent inquiry into those relationships and potential patient-safety consequences. The claimant alleged breaches of contract, including breaches of the implied obligation of mutual trust and confidence, the use of mediation material, failure to follow MHPS, and failure to implement an alternative retraining plan.

The central issues were whether MHPS formed part of the contract, whether the Trust’s changing procedures and restrictions were contractually permissible, whether the reintegration plan created enforceable obligations, and whether the mediation report could be used in the later inquiry.

1. Claim dismissed. None of the alleged individual or cumulative breaches of contract was established.
2. MHPS was not expressly incorporated into the claimant’s contract. Nor was incorporation established through custom and practice or the Secretary of State’s 2005 Direction. The statutory direction required the relevant NHS body to comply with and implement MHPS as a matter of public law, but did not authorise or require unilateral variation of employment contracts.
3. The Trust nevertheless had to treat MHPS as a directly and centrally relevant consideration when assessing compliance with the implied obligation of mutual trust and confidence. Having elected in 2015 to address capability concerns under MHPS Part IV, it was ordinarily required to follow that procedure unless there was a justifiable reason not to do so. That did not make every departure a breach of contract.
4. The restrictions imposed in 2015 and continued in 2017 were restrictions of practice, not exclusions from work. The first restriction was a precautionary response to significant patient-safety concerns and was taken in good faith. The later suspension of the reintegration plan was also permissible, given the limited return to breast film reading and evidence that colleagues would not work with the claimant.
5. The Trust did not breach mutual trust and confidence by proceeding with mediation while capability concerns remained. Its concurrent approach to capability and working relationships was reasonable at the time and had to be assessed without hindsight. The later decision to address working relationships before retraining was likewise a justified attempt to balance the claimant’s interests with patient safety and the Trust’s wider responsibilities.
6. The March 2017 reintegration plan was not a separate legally enforceable agreement. It recorded agreed practical actions whose success depended on contingencies outside the parties’ control and which were intended to be capable of modification.
7. The mediation was private and confidential only to the extent necessary to encourage participation and limit dissemination of participants’ views. In the absence of an express agreement, that confidentiality did not prevent the Trust from providing the mediator’s report to the investigator for the purpose of considering further steps concerning the claimant’s return to work.
8. The judgment did not determine the fair procedure to be followed after the independent inquiry. The Trust remained required to adopt a fair process in deciding what to do next.

First-instance decision. No prior or subsequent appellate decision is stated in the judgment.