Doctor who worked consecutive 12 hour shifts without telling employers is suspended for four months
BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4619 (Published 09 July 2019) Cite this as: BMJ 2019;366:l4619
A specialist doctor in an urgent treatment unit who worked back-to-back 12 hour shifts at different hospitals without telling his employers has been suspended from the UK medical register for four months.
Bevan Hyder, 47, left his job at Crawley Hospital early on four occasions in 2014 to work locum shifts elsewhere.
He did not tell his employers at Crawley about his other work or seek formal permission to leave early. Instead, he told the medical practitioners tribunal, he would message the nurse in charge on the day and ask to leave early without giving a reason. The earliest he left was 102 minutes before his shift was due to end.
The allegations against Hyder did not include a charge related to risk of patient harm resulting from fatigue. But he was accused of dishonestly failing to complete his shifts at Crawley.
Hyder told the tribunal that he had left Crawley only when he was sure that the urgent treatment centre there was “quiet.” But Julian Weinberg, chairing the hearing, said that the tribunal found “implausible” Hyder’s insistence that leaving the Crawley shifts early had posed no risk of harm to patients.
“He would have been unaware of patients’ needs or the demands of the unit after he had left to go to his locum shifts,” said Weinberg.
Contradictory evidence
Hyder presented the tribunal with a reflective statement taking full responsibility for his actions, but this was undermined, said Weinberg, by the doctor’s contradictory oral evidence during the hearing. He was a “less credible and reliable witness,” partly because “his reflective statement was inconsistent in a number of respects with the robust and unequivocal evidence” that he gave in person.
In his reflective statement Hyder wrote that “the primary purpose of the extra work was that my family was growing and we needed extra space. I was in the process of extending our house.” He was “trying to have more funds available to help my family so they would be proud of me, as any father should,” he wrote.
“However, in his evidence,” said Weinberg, “Dr Hyder forcefully and repeatedly stated that his motivation for working the locum shifts was not financial but was for altruistic reasons.”
The reflective statement acknowledged the potential risk to patients from a doctor who failed to take breaks. “However,” said Weinberg, “in his oral evidence, Dr Hyder was adamant and unequivocal in insisting that in not taking breaks, his behaviour posed no risk of harm to patients” because of his “strict fitness regime that meant that he would not have suffered any fatigue.”
Hyder’s counsel, Matthew Barnes, told the hearing that stress may have affected his client in giving evidence.
Counsel for the General Medical Council asked for a suspension, and the tribunal agreed. Four months “would reflect the gravity of his conduct and send out a clear signal to Dr Hyder, the profession and the wider public,” said Weinberg. It would give Hyder time to develop more insight, while not depriving the public of a competent doctor for longer than necessary.
Hyder, who resigned from Crawley Hospital in 2015 and has been working as a locum consultant in Ipswich, will be expected to attend a review hearing before being allowed to resume work.