Intended for healthcare professionals


Hospital trust prosecuted for not supervising junior doctors

BMJ 2006; 332 doi: (Published 19 January 2006) Cite this as: BMJ 2006;332:135
  1. Clare Dyer, legal correspondent
  1. BMJ

    A UK hospital trust faces a potentially large fine after pleading guilty to failing to properly supervise two junior doctors whose gross negligence led to a patient's death. The judge over-seeing the case, thought to be the first of its kind, said that it had implications for the whole NHS.

    Southampton University Hospitals NHS Trust admitted that it had not adequately managed two senior house officers, Amit Misra and Rajeev Srivastava, who were working at Southampton General Hospital in June 2000 when Sean Phillips, aged 31, died of staphylococcal toxic shock syndrome.

    A spokesman for the Crown Prosecution Service (CPS) said that he believed it was the first time that an NHS trust had been prosecuted under the Health and Safety Act for the way junior doctors were managed.

    Mr Phillips, who had been admitted for a routine knee operation, developed a bacterial infection, which the two doctors failed to diagnose and treat. They were working in the trauma and orthopaedic department.

    The two were convicted of gross negligence manslaughter at Winchester Crown Court in 2003 and given 18 month prison sentences suspended for two years. In 2005, the General Medical Council suspended Dr Misra, now 35, for a year and Dr Srivastava, aged 40, for six months.

    Last week at Winchester Crown Court, the trust pleaded guilty to an amended charge concentrating only on the supervision of the doctors, in a plea bargain which avoided a costly six week trial. The prosecution agreed to drop other allegations of failing to take up a reference for Dr Misra, failing to implement a system of ward rounds, failing to have proper handover meetings for staff, and failing to encourage nursing staff to report concerns.

    Embedded Image

    It is the responsibility of consultants to ensure that trainees only work within their own level of competence, said a spokesman for the National Confidential Enquiry into Patient Outcome and Death

    Credit: ADAM GAULT/SPL

    Judge Michael Brodrick said that the case had implications for the whole NHS. Sentencing will take place on April 10.

    Ian Martin, lead clinical coordinator for the National Confidential Enquiry into Patient Outcome and Death (NCE-POD), said, “Not all patients need to be seen by a consultant, but it is the responsibility of the consultant to ensure that trainees only work within their own level of competence and know when to seek the advice of a senior colleague.

    “These problems cannot be addressed by individual doctors, but require careful planning by clinical teams, trusts, and in some cases strategic health authorities.”


    • Embedded Image Longer versions of these articles are on

    View Abstract

    Log in

    Log in through your institution


    * For online subscription