United Lincolnshire Hospitals NHS Trust v Farren

14 November 2016. JUDGE EADY QC delivered the following judgment of the appeal tribunal.

1 This is our unanimous judgment, in which we refer to the parties as the claimant and the trust. We are concerned with the trust’s appeal against a judgment of the Lincoln employment tribunal (Employment Judge Faulkner, sitting alone on 29 February 2016) sent to the parties on 6 April 2016, by which the tribunal ordered that the claimant was to be re-engaged by the trust, the tribunal having earlier found that she had been unfairly dismissed. Representation before the employment tribunal was as it has been on this appeal.

2 The claimant had been employed by the trust since 1992 and as a staff nurse since September 2006, employed in that capacity at the trust’s Grantham & District Hospital. Over a night shift on 16 and 17 May 2014, an incident occurred which ultimately led to the claimant’s summary dismissal on 24 October 2014. That incident, and the way in which matters came to be progressed to a disciplinary investigation, are described by the tribunal in its liability judgment:

“11. The background to this matter can be stated briefly, being tragic events which occurred on the night of 16 and 17 May 2014. The claimant, employed by the [trust] since July 1992 and as a staff nurse since September 2006, was on duty in A & E. A young boy was brought to the hospital apparently having suffered a cardiac arrest; despite the efforts of hospital staff, he sadly died. As can be imagined, his adult family members were distraught, at least one collapsing and others damaging property. It is alleged that at some point later in the night the claimant administered the drug diazepam to four of the family members without prescription from a doctor and therefore in an unauthorised manner. The claimant does not dispute that if she did so it was contrary to the [trust’s] policy for medicines management … and the Nursing & Midwifery Council [‘NMC’] ‘Standards for medicines management’ … It is also alleged that the claimant failed to complete the required patient records, again contrary to the medicines management policy … and to the NMC’s ‘Record keeping, guidance for nurses and midwives’ …

“12. Whilst in large part the claimant accepts that her record-keeping was on this occasion wholly inadequate, she does not accept that she administered the drugs without prescription. Her case is that the drugs were prescribed by Dr Naqvi. The matter came to the trust’s attention when Dr Naqvi informed an A & E speciality meeting on 20 May 2014 that she had been asked by the claimant to complete prescriptions when the claimant had already given the drug to the patients, Dr Naqvi signing the prescriptions thereafter. The claimant was not present at that meeting.

“13. Ms Shepherd [a sister at the hospital] evidently reported the matter to Ms Charles [matron for medicine], who e-mailed Ms Shepherd on 21 May … outlining what she understood from their discussion, including the comment, ‘This medication was not prescribed at the time of administration’. Mr Prydderch [deputy director of operations] was copied into that e-mail, having stated in an e-mail to Ms Charles the day before, ‘Sounds like someone,? “Joyce” [the claimant] decided to give someone in the family diazepam, then told Naqvi to write it up later. Naqvi hadn’t even seen the patient but wrote it up anyway. Jeez.’ On 22 May … he e-mailed other colleagues, stating that Dr Naqvi ‘was just performing tasks under duress, from someone who it sounds is quite difficult and overwhelming’. The claimant takes that as a reference to her; it seems to me more likely than not that it was.

“14. It was decided that the claimant should carry out non-clinical work whilst the matter was investigated, rather than being suspended. On 23 May, Ms Charles prepared a short report for Mr Prydderch, headed ‘Preliminary investigation’ … The report stated that Dr Naqvi had informed the meeting on 20 May that the claimant had asked her to complete the prescriptions for patients she had given the drug to ‘and there was no need for the doctor to see the patients’. The report appears...