High Court finds Trust in breach of contract

Dr MN v NHS Foundation Trust L [2025] EWHC 2023

The High Court has recently upheld the contractual rights of a senior consultant, Dr MN, in a dispute with his employing Trust, NHS Foundation Trust L. In a judgment delivered by Mr Justice Sheldon on 31 July 2025, the Court found that the Trust had breached its contractual obligations by failing to appoint the Medical Director as Case Manager in an internal disciplinary investigation, as required by its own policy, which mirrored the provisions of the national framework, Maintaining High Professional Standards in the Modern NHS (MHPS).  

The decision is likely to have important implications for how NHS Trusts manage internal investigations involving medical professionals, particularly where reputational, conduct and capability issues are involved. 

Background

The Trust commissioned an investigation into Dr MN's involvement in Lucy Letby's observational visits at Hospital X as well as a patient complaint.

The Trust argued that the matter concerned "trust and confidence" as opposed to matters of conduct or capability, such that they were not within the scope of the MHPS framework, nor the Trust's own disciplinary procedure. 

DWF Law LLP were instructed to represent Dr MN in connection with the investigation and sought assurances from the Trust that the investigation would be conducted in line with MHPS and the Trust's local MHPS policy. Specifically, it was argued that both procedures required the Trust's Medical Director to act as the Case Manager in all cases involving consultants and to be ultimately responsible for deciding on the steps to be taken once the investigation had concluded. 

Dr MN issued a claim for breach of contract and sought injunctive and declaratory relief.

Judgment

Dr MN succeeded in his claim, with the Court holding that:

• The Trust's local MHPS policy was incorporated into Dr MN's contract of employment;
• That policy was explicit in its requirement that the Medical Director must act as Case Manager in all cases involving consultants; and
• Delegation of the Case Manager role to the Director of Corporate Affairs, who was not a clinician, was a breach of contract unless exceptional circumstances applied, which they did not in this case.

The Court also addressed the Trust's attempt to reclassify the concerns as reputational rather than conduct or capability. It ruled that:

• The concerns outlined in the Terms of Reference were matters of conduct and / or capability, not merely reputational or managerial concerns. The Court clarified that impact, or potential impact, on patient safety would be sufficient to meet the threshold for applying MHPS. 
• The categorisation of allegations must be determined objectively and cannot be altered to bypass contractual procedures.
• The Trust's approach amounted to sidestepping the MHPS framework, which undermined procedural fairness and the implied duty of trust and confidence.

The judgment reinforces the principle that NHS employers must adhere to agreed disciplinary frameworks and cannot arbitrarily redefine the nature of concerns to suit alternative processes. The Court granted declaratory relief, confirming Dr MN's contractual rights under the MHPS and local policy. Ultimately, injunctive relief was not required in circumstances where the Trust confirmed to the Court that it would comply with any declaratory relief awarded by the Court. 

Comment 

This decision is expected to have significant implications for how NHS Trusts manage internal investigations involving medical professionals, particularly in cases where alleged reputational concerns may intersect with concerns relating to capability or conduct. It reinforces the importance of how Terms of Reference are drafted, as this will be determinative of whether MHPS must be followed, as well as the importance of another clinician making case management decisions where a senior clinician is under investigation.

This case is subject to reporting restrictions prohibiting the disclosure of the names and addresses of the parties or Dr MN's current workplace or any matters likely to identify the same.

Authors: Rosie Shapiro & Rukmanie Hodges