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 providing important guidance to Trusts on the scope of the requirement in Maintaining High Professional Standards in the Modern NHS (MHPS) for concerns about doctors in recognised training grades to be considered as a training issue.
Background
Dr Nirmal is employed as an ST5 doctor in training. Initial complaints were raised by a member of staff about Dr Nirmal’s behaviour which made the complainant feel unsafe. Informal advice was given to Dr Nirmal to allow him to learn from the incident. By January 2025, another complaint had been raised and this led to an initial fact find. The Trust’s Practitioner Advisory Group (PAG) considered the information and consulted NHS England (NHSE). NHSE advised the Trust that if the allegations were conduct issues, it was for the Trust to investigate and to keep NHSE in the picture. The PAG decided that a formal process should be instigated and an investigation was undertaken. Following a review of the investigation report, Dr Nirmal was invited to a disciplinary hearing to consider allegations of potential gross misconduct.
In a without notice application for an interim injunction, Dr Nirmal sought to restrain the Trust from convening the hearing. He argued that the Trust was required to treat the allegations as a “training issue” having regard to the MHPS framework which provides (in Part III) that: “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 High Court’s Decision
Mr Justice Ritchie handed down judgment on 25th March 2026. In rejecting Dr Nirmal’s submission that the allegations had to be treated as a training issue, and accepting that there was no serious issue to be tried, Mr Justice Ritchie stated at [39]-
…I agree with the Defendant that some types of gross misconduct allegations are likely to be inappropriate for the training route. They are more likely to be considered in the disciplinary route. This is so for many reasons. One reason appears to me to be that medical training and supervision is likely to be more focussed on how to train the Claimant to be a good doctor, knowledgeable, capable and skilful, interacting well with patients and colleagues, and less about how to behave properly more widely (for instance not providing training about not committing crimes or how to drive carefully). Another reason would be the practicality of interviewing witnesses. The Defendant employs them all, not HEE… Finally, the national MHPS, which the Claimant relies upon, does not say “must”, it says “should initially”. That phrase is slim pickings for the Claimant to hang his whole claim upon.
In an obiter passage, the Court also reminded NHS employers that the question of whether it would be necessary to call witnesses remained a question of fairness and reasonableness in misconduct procedures and that it was not for the Court to “micromanage” the process going forward.
You can read the full judgment here.
Betsan Criddle KC and Oliver Isaacs represented the Defendant instructed by Jonathan Lewis at Capsticks, successfully securing the discharge of the interim injunction.
This article was written by Oliver Isaacs.
