Consultant ophthalmologist dismissed after on-call dispute: breakdown in trust was fair
An NHS consultant who stopped on-call duties and refused to engage with his clinical lead was fairly dismissed for a breakdown in trust and confidence, the tribunal has ruled.
1 min read · Last updated 19 May 2026
Case details
- #consultant-ophthalmologist
- #on-call-duties
- #breakdown-in-trust
- #refusal-to-engage-with-clinical-lead
- #protected-disclosures
- #disability-not-proved
Key facts
- The claimant worked as a consultant ophthalmologist from 4 November 2013 until dismissal on 13 June 2021.
- The claimant stopped undertaking on-call duties from January 2020, citing safety concerns.
- The respondent offered a six-month trial of a two-tier on-call arrangement, which the claimant declined.
- The claimant refused to engage with his clinical lead, Dr Lakshmi Patil.
- The respondent dismissed the claimant for some other substantial reason due to breakdown in trust and confidence.
- The tribunal found the claimant did not prove he had a disability at the relevant time.
Timeline
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Employment started
Claimant began work as a consultant ophthalmologist for the respondent.
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Letter about on-call safety
Claimant and three other consultants signed a letter to the Trust raising concerns about the safety of the on-call rota.
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Email about private patients
Claimant emailed Christine Shrimpton raising concerns about private patients being booked among NHS patients.
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Email about patient backlog
Claimant emailed about a backlog of patients needing injections, stating it was a patient safety issue.
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Claimant ceased on-call duties
Claimant emailed stating he had reached a dangerous level of stress and would no longer undertake on-call duties.
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Ill health absence started
Claimant commenced a period of ill health absence, with fit notes citing stress at work.
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Offer of two-tier on-call
Respondent offered claimant a six-month trial with an SAS colleague as first on-call; claimant declined.
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Return to work
Claimant returned to work but did not undertake out-of-hours on-call, instead taking sick leave on those days.
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SOSR hearing (first day)
A lengthy hearing was held to consider dismissal for some other substantial reason.
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Dismissal letter
Claimant was dismissed for some other substantial reason due to breakdown in trust and confidence.
The legal issue
The tribunal had to decide whether the consultant was automatically unfairly dismissed for making protected disclosures, or ordinarily unfairly dismissed, and whether he was discriminated against on grounds of race, religion, or disability.
The outcome
The tribunal dismissed all claims. It found that although the consultant had made protected disclosures, the principal reason for dismissal was not those disclosures but a breakdown in trust and confidence caused by his refusal to undertake on-call duties and to engage with his clinical lead. The dismissal for some other substantial reason was fair. The tribunal also rejected claims of race and religion discrimination, and found that the consultant had not proved he had a disability at the relevant time.
No compensation was awarded as the claims were unsuccessful.
Lessons & takeaways
- Refusing to engage with management or accept reasonable compromises can lead to a fair dismissal for breakdown in trust, even if you have previously raised legitimate concerns.
- Making protected disclosures does not automatically protect you from dismissal if the employer can show a separate, substantial reason for the decision.
- To bring a disability discrimination claim, you must provide medical evidence that you meet the legal definition of disability at the time of the alleged discrimination.
When a breakdown in trust becomes a fair reason to dismiss
This case shows how a long-running dispute over working arrangements can lead to a fair dismissal, even where the employee has previously raised genuine safety concerns. The consultant, an ophthalmologist with eight years' service, stopped undertaking on-call duties in January 2020, citing stress and safety worries. The NHS Trust offered a six-month trial of a two-tier on-call system, but the consultant declined and refused to engage with his clinical lead. The tribunal found that this refusal, rather than the protected disclosures he had made, was the real reason for dismissal.
What the employer did right
The Trust followed a proper process, including a lengthy hearing before deciding to dismiss. It offered a reasonable alternative to the on-call dispute, which the consultant rejected. The tribunal noted that the consultant's refusal to communicate with his clinical lead made the working relationship untenable. For employers, this case reinforces the importance of documenting efforts to resolve disputes and offering reasonable compromises before resorting to dismissal.
Why the result matters
This decision highlights that employees who raise concerns about safety or other issues are not immune from dismissal if their conduct causes a genuine breakdown in trust. The tribunal carefully separated the protected disclosures from the conduct that led to dismissal. It also serves as a reminder that disability discrimination claims require solid medical evidence of a disability at the relevant time — the consultant's claim failed because he could not prove he met the legal definition.
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