Disciplinary panel can proceed against doctor who discussed patient’s details on train, say judges

The current issue of the British Medical Journal has an article by Clare Dyer on disciplinary proceedings involving a psychiatrist who discussed a patient’s case on a crowded train.

The NHS trust that runs Broadmoor secure hospital can go ahead with disciplinary action against a consultant forensic psychiatrist who discussed a patient’s medical report with a colleague on a crowded train, three Court of Appeal judges have ruled.

The judges quashed a High Court injunction stopping West London Mental Health NHS Trust from convening a disciplinary panel to hear allegations of breach of confidence against Dr. Chhabra.

Judge Jeremy McMullen granted the injunction in the High Court last June after ruling that it would be a breach of Chhabra’s contract to allow the disciplinary panel to be convened.

The case investigator appointed by the trust had accepted Chhabra’s explanation that she had not appreciated that her actions, which also included dictating two patient reports on the train, had breached patient confidentiality.

[…]

The appeal judges heard that the main allegation was that Chhabra had the patient’s report on her lap and was discussing it with a colleague when the two doctors were passengers on a train from Sunningdale in Berkshire to Waterloo in London in November 2010.

Opposite them happened to be sitting the head of secure services policy at the Department of Health, Jo Leech.

Chhabra admitted reading the patient’s notes on the train but said that she had not realised that his name could be seen.

After a secretary expressed concern about train noises on a dictation tape, she also admitted dictating two reports on the train in one week when she had felt pressured by work, but she said that she believed she had ensured no other passengers were close by.

Read more on BMJ  (subscription required)

Personally, I have a tough time believing that the psychiatrist did not appreciate that her actions were a breach of confidentiality. Mental health professionals are generally especially attuned to the need to protect confidentiality. Discussing cases on a train or dictating reports on a train strikes me as even worse than the scenario where healthcare professionals discuss cases in a hospital elevator. It also creates a terrible impression for the public who may fear that at some point, their own conditions or cases might be discussed in public spaces.

via Dr. Ken Pope

Edited August 4, 2014 to remove Dr. Chhabra’s first name from post, consistent with what the original source has done in response to a request concerning the doctor’s personal safety.

Update: This case ultimately went to the UK’s Supreme Court, who ordered the Trust not to pursue any of the confidentiality concerns contained in the Trust’s letter of 12 August 2011 as matters of gross misconduct; and not to pursue any confidentiality concerns without first re-starting and completing an investigation under its policy D4A.

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