Ex-Portsmouth doctor wins unfair dismissal case after being sacked for reporting colleagues at Queen Alexandra Hospital over new technique she claimed was dangerous

Consultant Dr Jasna Macanovic is in line for compensation after being fired for blowing the whistle on the procedure which she believed was putting patients at risk.

The 'extremely gifted' kidney specialist 'strongly opposed' the method adopted by other doctors at the renal unit at Queen Alexandra Hospital where she worked after learning that recipients of it had suffered complications including excessive bleeding, clotting and even death.

Colleagues had hoped that the new ‘buttonholing’ procedure - which involves the insertion of needles to aid dialysis - would help in the treatment of kidney patients.

But an employment tribunal heard Dr Macanovic was so concerned she blew the whistle to the Care Quality Commission, before reporting her fellow consultants to the GMC.

The move prompted ‘outrage’ among her colleagues with Unit head, Dr Robert Lewis, finding it ‘defamatory’, the tribunal heard.

Following this, Dr Macanovic was sacked for serious misconduct after her employers found she had been ‘aggressive’, ‘intimidating’, and had accused colleagues of lying.

However, she has now successfully sued the hospital after the tribunal found she was unfairly dismissed for whistleblowing, with the panel ruling she had done so not to 'intimidate' but to 'demonstrate the seriousness of the situation'.

The hearing in Southampton, heard that Dr Macanovic - who has over 20 years of ‘excellent service’ with the NHS - joined Portsmouth Hospital NHS Trust in 2001 and was made a consultant nephrologist (a kidney specialist) in 2005.

The panel was told she and Dr Lewis had fallen out soon after she joined and that they barely spoke.

‘She attached a high priority to honesty and integrity and where she felt this was lacking she was unafraid to say so, if necessarily loudly and publicly,’ the tribunal heard.

‘Nor was she prepared to be fobbed off. Dr Lewis, on the other hand, while no less honest, was principally concerned with the reputation of the renal unit, and harmonious relations among the staff.

‘He explained to us that the unit had gone through a difficult period and he 'did not want it to spill out into the outside world.'

‘So, while Dr Macanovic was perfectly prepared to rock the boat, Dr Lewis was at the helm, trying above all to keep it steady.’

The tribunal heard that in 2016, she resigned from the Renal Transplant Team after discovering two serious clinical failings had occurred but were not reported by either of the surgeons involved.

She did not however resign privately, instead she gave her reasons very publicly in a meeting, the panel heard, which upset her colleagues.

An investigation into this was then carried out under whistleblowing policy and she raised concerns about the buttonholing technique which had been in use since 2014.

Following a presentation on the technique, Dr Macanovic had immediate concerns which were also held by a 'substantial number of others', the tribunal was told.

She said it was dangerous and against national guidance and in a later meeting, some colleagues agreed they would not support it, the panel heard.

The hearing was told: ‘Even those who supported it...accepted there was a lack of evidence about its effects but were keen to innovate.’

It was then agreed that patients would be warned about the risks and would only carry on if their consultant agreed, and that a research study would be carried out.

Dr Macanovic was however not content with that and she alleged that patients had died from the technique.

The tribunal heard she wrote in an email: ‘The practice was considered inappropriate by the vast majority of experts in the field and that no other renal unit in the country was doing it...

‘Patients had been told the outcomes were excellent, whereas of the 14 patients using it, two had died, two had developed serious complications, and she had not had time to review the other ten.’

During one subsequent meeting discussing buttonholing, the panel heard five consultants were described as behaving like a 'pack of wolves' towards Dr Macanovic.

‘She was trying to hold her ground so much that the rest of us were gobsmacked at the atmosphere – it was just awful,’ one witness told the hearing.Ultimately her complaints about the procedure failed and she resorted to reporting the matter to NHS standards regulator, the CQC. However, it was happy for the practice to continue.

Then in May 2017, Dr Macanovic reported her colleagues to the GMC, accusing them of a cover-up, of lying and dishonesty.

Numerous colleagues had by this point complained about her behaviour.

The tribunal was told at another consultants' meeting, Dr Lewis read out the GMC referral - with Dr Macanovic present - which the panel found was 'stoking anger against her' and 'seeking to isolate her from her colleagues'.

She was then investigated and partially excluded as the Trust felt she had become 'unmanageable', with her work relations 'poisoned', the panel heard.

Following a disciplinary investigation, she was sacked in March 2018 for serious misconduct, with the tribunal noting her dismissal letter gave the reason 'expressly' that she had reported colleagues to the GMC, amongst others.

An external review found that buttonholing could not be recommended as routine practice but there had been no 'infective complications', the panel heard.

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Dr Macanovic - who now works in Oxford - then went before an employment tribunal where the trust argued she was not sacked for making the disclosures but for 'the manner in which she did so'.

However, the panel found this 'distinction' was not apparent in her dismissal letter and ruled she had been unfairly dismissed.

The panel - headed by employment Judge Eoin Fowell - said: ‘The plain fact is that after over 20 years of excellent service in the NHS, Dr Macanovic was dismissed from her post shortly after raising a series of protected disclosures about this one issue.

‘It is no answer to a claim of whistleblowing to say that feelings ran so high that working relationships broke down completely, and sothe whistleblower had to be dismissed.

‘We can only conclude they all lost sight of the important principle that this was a protected disclosure and as such it was wrong to pressure her into withdrawing it.

‘Taking all this together, we conclude the reason for dismissal was the breakdown in working relationships caused by the buttonholing controversy.

‘This is turn resulted mainly from fear that Dr Macanovic would report colleagues to the GMC and a sense of outrage that she actually did so.

‘It has to be remembered this was an innovative procedure and a substantial number of others shared her concerns."

The level of compensation will be decided following another hearing at a later date.

A message from the Editor, Mark Waldron

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