Claimant v NHS England (formerly Health Education England)

The tribunal accepted that requiring the claimant to undertake additional F1 training after a 5-month cancer-related absence was unfavourable treatment. However, it was found to be a proportionate means of achieving the legitimate aims of ensuring patient safety and adequately preparing the claimant for the increased responsibility and autonomy of F2 practice. Given the significant period away from clinical practice, the differences between F1 and F2 (including full registration and reduced supervision), and the fact that F2 has no regulated length so the claimant could still progress with peers, the tribunal concluded the treatment was justified.

The tribunal found three PCPs: the time-based requirement of F1 training, the requirement to remain in F1 after 1 year if absence exceeded 20 days, and the practice of triggering a review after 20 days absence. These put the claimant at substantial disadvantage by delaying her F2 progression while peers moved on, and preventing her from applying for anaesthetic specialty training. However, allowing immediate progression to F2 without additional F1 time was not a reasonable adjustment. The claimant had been absent for April-July (the whole of her final F1 months) creating a risk of skills drift. F2 involves full registration, less supervision, and authority to do locum work in unfamiliar settings. Given the continuous absence, lack of day-to-day clinical experience her peers had gained, and paramount importance of patient safety, requiring some additional F1 time was reasonable. The claimant only had to complete 3 additional months (September-November 2021) before progressing to F2.