Dr Rebecca Marsh v NHS England — 2025

The claimant was a postgraduate doctor in anaesthetics training. The respondent accepted that she was disabled by reason of Russell Silver Syndrome and Moyamoya syndrome and that it knew of her disability. The case concerned an ARCP panel's decision on 18 February 2022 to issue Outcome 4, which released her from the training programme, after periods of COVID-related shielding, restricted duties and sickness absence.

The tribunal found that the claimant's sickness absence did not arise in consequence of her disabilities, but accepted that her requirement to shield did. It found that her performance, clinical skills and confidence had deteriorated and that disability-related shielding, including restricted duties, was a material factor in the decision to issue Outcome 4. The later successful appeal did not prevent the Outcome 4 from being unfavourable treatment.

The respondent's legitimate aims were accepted, but the tribunal found Outcome 4 was not proportionate. It placed weight on the career impact of the decision, the exceptional disruption caused by the COVID pandemic, the availability of Outcome 10.2 or an N-coded outcome, and the short period of full practice assessed after the claimant's return from shielding.

For the reasonable adjustments complaint, the tribunal found that the requirement to complete training within a specified or reasonable timeframe placed the claimant at a substantial disadvantage, and that the respondent knew or could reasonably have been expected to know this. It found there was some prospect that alternative outcomes or allowing a period of at least six months in full practice before assessment would have avoided the disadvantage. Remedy was left to a further hearing.