05/05/2026
The High Court has handed down judgment in the case of Nirmal v Birmingham Women's and Children's Hospital NHS Foundation Trust [2026] EWHC 723.
The decision will be of interest to NHS organisations managing conduct concerns involving doctors in recognised training grades under the MHPS process.
Dr Nirmal sought an injunction at the High Court to prevent the Trust from holding a disciplinary hearing, on the basis that the national MHPS framework requires allegations of misconduct relating to doctors in training to be dealt with initially as a training issue.
The High Court refused the injunction, finding that MHPS did not constrain the Trust in that way. The Court determined that some types of gross misconduct (such as sexual harassment) are likely to be inappropriate to be dealt with via a training route and should be considered via a disciplinary route.
Background
Dr Nirmal is employed as an ST5 doctor in training.
Following two complaints by members of staff about Dr Nirmal’s behaviour, an initial fact-find was undertaken. The Trust's Practitioner Advisory Group ("PAG") reviewed the information gathered and consulted Health Education England (“HEE”, now part of NHS England), who advised that if the allegations were conduct issues, it was for the Trust to investigate using their own procedures and keep HEE updated.
The PAG decided that a formal investigation process should commence and, following a review of the investigation report, the Trust invited Dr Nirmal to a disciplinary hearing to consider allegations of potential gross misconduct (sexual harassment).
Dr Nirmal sought an interim injunction to restrain the Trust from holding a disciplinary hearing. Dr Nirmal argued that under MHPS, concerns relating to doctors in recognised training grades should be treated initially as a “training issue”. Dr Nirmal sought to rely on Part III of MHPS, paragraph 6, which states: “Any allegation of misconduct against a doctor or dentist in recognised training grades should be considered initially as a training issue and dealt with via the educational supervisor and college or clinical tutor with close involvement of the postgraduate dean from the outset.”
The Trust maintained that it did initially consider the allegations as training issues with HEE, but decided they were better suited to be dealt with under their own procedures, and, in any event, potential gross misconduct allegations were not appropriate to be dealt with as a training issue.
The High Court Decision
The High Court refused Dr Nirmal’s injunction and held that:
- It is likely to be inappropriate to deal with some types of gross misconduct allegations (such as sexual harassment) using the training route and it is likely to be more appropriate to deal with them via the disciplinary route
- HEE would have had practical difficulty interviewing the complainants/witnesses if they had dealt with it as a training issue
- In Part III of MHPS, paragraph 6, there is no mandatory requirement for Trusts to deal with conduct concerns against doctors in training as a training issue. Although MHPS says that an employer "should initially" treat conduct concerns as a training issue it did not say that it must. The Court described this as “slim pickings for the Claimant to hang his whole claim upon”.
- In commendably clear and common-sense language, the Court noted that medical training and supervision is focused on training the doctor to be a good doctor - knowledgeable, capable and skilful - and is less concerned with wider conduct or behaviours that are unrelated to anything medical. It pondered “why medical training would be the correct course for a doctor to understand the boundaries between: (1) asking a person out for a date once (and being declined) and (2) persistently pestering a person for sex or a date or harassing them with sexualised questions”
Legal Analysis
This is an important Judgment for NHS Trusts dealing with conduct concerns involving doctors in training, and particularly serious allegations of sexual misconduct. It provides clarity and guidance on the scope of the requirements under the MHPS Framework.
The wording in Part III MHPS does not operate as a bar to disciplinary action in cases of alleged gross misconduct. Where the nature of the allegations is more akin to general misconduct / behaviour - particularly conduct that goes beyond what could sensibly be addressed through educational supervision - Trusts retain the discretion to proceed via the disciplinary route, provided the process is fair and reasonable. The Court's confirmation that "should initially" does not mean "must" is also helpful.
The judgment is particularly helpful for NHS organisations managing conduct concerns of a sexual nature involving doctors in training, in light of the strengthened statutory framework now governing employer obligations to prevent sexual harassment. The Employment Rights Act 2025 will strengthen this obligation further from October 2026, amending the duty so that employers must now take all reasonable steps to prevent sexual harassment - a materially higher standard.
How We Can Help
Our specialist healthcare employment team has leading experts who advise NHS organisations nationally on issues relating to the MHPS framework and doctors’ and dentists’ cases. We regularly support clients in navigating these processes and, where challenged, in defending injunctions brought in the High Court. We also regularly provide training on MHPS processes, including to case managers, case investigators, NHS Executive teams and Non-Executive Directors.
If you would like to discuss the implications of this judgment in more detail, or we can help you with any other doctor (or dentist) related issues, please contact Joanna Burrows, Partner or Andy Uttley, Partner.
