"There were minor points upon which she succumbed – only for short time – to the temptation to put a favourable gloss on events, but in our judgment she did not do so to a greater extent than would most people charged with an offence that could end their professional careers. She is not generally untruthful."
"The Trust (though not Dr Khair) notified the NMC of the dismissal of Mrs Westwood. In cases where nurses have been dismissed for gross misconduct, the NMC has power to withdraw from them permission to practice. It is likely that the NMC is awaiting the outcome of the Tribunal proceedings before deciding on its course of action."
"It also showed the patient's crotch area to be wet, and a damp patch next to the patient's head, and this led him [Mr P Finch the Security Officer] to think that the patient had vomited."
"The evidence before the panel (like that before the tribunal) was that any vomiting had been before she was seen by the doctor and discharged. There was no evidence to suggest that any incontinence took place during the short period of transit of the trolley from cubicle to outside A&E."
"The patient was later discharged by an A&E doctor. The doctor's note records that the patient had vomited, but was 'alert and orientated' and had a GCS score of 15/15. GCS is a description of a patient's level of consciousness. 3/15 is comatose. 15/15 is 'fully alert'."
"However Ms Stanford continued through this area towards the exit doors, and it was only then that Mrs Westwood realised that she intended to take the patient outside. Mrs Westwood said 'You can't do this'. She herself had never wheeled a patient outside on a trolley, and had never known it to be done, though we accept her evidence and that of Ms Randall that it is not unknown for a patient who is unwilling to leave to be pushed outside in a wheelchair then invited to get up and go. Certainly, Mrs Westwood recognised at the time that what was being done was irregular and wrong. However, Ms Stanford assured her that she had done this before with this particular patient, and this was the best way of encouraging her to leave; it was her responsibility. The journey from cubicle to outside the hospital took less than 10 seconds, and from waiting area to outside 3 or 4 seconds. Mrs Westwood was confused and uncertain, and she was outside before she had had time to think or to object again. She was, in fact, swept along by the tide of events."
" … the allegation that on12 May 2007 you failed to provide appropriate care and treatment to patient … . You did so by deciding with a colleague, Ms Ann Stanford, Staff Nurse, to take the patient on a trolley and place her outside the A&E Department in the middle of the night… "
"It was substantiated that you, along with SN Ann Stanford took the patient outside the A&E department on a trolley …"
" made it clear that it had been her … [Ms Stanford's] … idea to push the trolley outside, and that she had recruited Ms Westwood to help her. "
"To encourage the patient to get off the trolley Mrs Westwood lowered the cot side, on the side away from the wall. Mrs Westwood spent some time trying to persuade the patient to get off the trolley. The patient told her to 'fuck off', and did not move."
"The Trust says that the CCTV shows that the two nurses walked back into A&E together."
"However it was clearly visible on the CCTV footage that you both walked into the department together."
"Mrs Westwood says that the CCTV footage shows that Ms Stanford followed her back into the hospital but remained in the 'majors' office while Mrs Westwood went to the triage reception desk to call security. Mrs Westwood then turned and was surprised to see Ms Stanford in front of her. Having viewed the CCTV footage, the Tribunal finds that Mrs Westwood went back inside the building but was followed after a couple of seconds by Ms Stanford, and that the gap between them narrowed as Mrs Westwood approached the desk, but that Mrs Westwood was preoccupied by the need to call security, and did not notice Ms Stanford had followed her until she had made her call."
"At this point Mrs Westwood noticed that Ms Stanford was there. She said 'Steve is on the way'. Ms Stanford said 'Thank you' and walked out of the triage door and in the direction of the hospital entrance. Mrs Westwood assumed that she was returning to look after the patient until security arrived. In fact, Ms Stanford did not return to the patient."
"Although you claim that you were alarmed to discover that SN Stanford had not remained with the patient whilst you called security, it was apparent that you did not make any attempt after making the telephone call to go back outside to the patient or to ask SN Stanford to return to the patient"
"The Trust points out that since the cot side had been left down, the patient could have rolled off the trolley. Even in the early hours of the morning, there are passers-by. Many patients and visitors come through A&E late at night, and some are under the influence of drink and drugs. One of them could have wheeled the patient into the road or the canal. The CCTV showed a number of men passing the trolley and standing near to it."
"KM What were the potential risks? DRi She was obstructive perhaps but she was not violent or anything like that. She could have fallen off the trolley. I would be concerned about the image to the profession. I suppose that would have been my overriding concern. But I suppose life is full of risks."
"Your actions during the evening of12 May 2007 as outlined in the representation of the management's case were dangerous, negligent and a serious infringement of Trust policy. The panel consider that your conduct during this incident was an act of gross misconduct. As a registered nurse you are accountable for your practice and are answerable for any actions and omissions, regardless of advice or direction obtained from another professional. Although it was noted that you claimed to have acknowledged that you had acted inappropriately and had since reflected and learned from this experience; the panel were of the view that your actions were of such a serious nature that they could not be condoned. Your actions had the potential to not only damage the reputation of this organisation but also that of your profession. Accordingly it was the panel's view that the management's case was upheld. In addition the panel felt that your actions and their consequences resulted in a serious breakdown in trust and confidence between you and the Trust as your employer."
"The panel unanimously decided that the actions of Mrs Westwood had the potential to damage the reputation of the Trust and that of Mrs Westwood's profession. It determined that her actions had amounted to gross misconduct which had led to the breakdown of trust and confidence, and that summary dismissal was the appropriate sanction."
"The panel considered that the Trust had a duty to provide safe and high quality care to its patients, and that staff are under a duty to work in such a way as to minimise risk. Although Dr Khair said he found the case a difficult one, and the panel took into account the mitigation advanced by Mrs Westwood, he entirely agreed with Mr Gillespie that there was no difference at all in degree of culpability between Mrs Westwood and Ms Stanford. Both had equal responsibility for the patient, and both were equally to blame for having put her at risk. Mrs Westwood could have challenged Ms Stanford at several points along the way. Even to take the patient on the trolley to persuade her to get off was wrong. Taking her outside was quite unacceptable: in all his 35 year career in medicine he had never known anything like it."
"She herself had never wheeled a patient outside on a trolley and had never known it to be done, though we accept her evidence and that of Ms Randall that it is not unknown for a patient who is unwilling to leave to be pushed outside in a wheelchair then invited to get up and go."
" … When the patient would not go, Mrs Westwood at once went back into A&E and called security … this was at least one acceptable way of dealing with the position in which she was placed."
"You presented no witnesses in support of your case. It was also noted that supporting documentation; namely character witness statements from Lorraine Randall, Senior Sister and Barry Thomasson, Charge Nurse submitted on your behalf were not supported by the presence of these individuals, neither were they referred to as part of the staff slide presentation."
"Her lapse was a momentary one, in the heat of the moment, by an otherwise exemplary nurse."
"It is not our practice to allow appeals by consent without our being satisfied that there is a good reason for making the order sought. SeePractice Direction 13 (4) and J Sainsbury plc v Moger[1994] ICR 800 ."
"It must be recalled also that the Employment Tribunal is now specifically required by the Employment Tribunal Rules, rule 30 (6), to set out the findings of fact which it makes relevant to the issues which it has to decide. In this case, the Tribunal had set out that there were agreed facts and there were disputed facts. It follows if there are disputed facts, as identified by the Tribunal following submissions of Counsel, it is under an obligation to determine them if they are relevant to the decision, as they were. In this case, there were issues as to the grounds upon which the Respondent formed its belief, whether that belief was genuine, whether there was a reasonable investigation informing that belief, and whether on this material it was reasonable to dismiss. In addition, were allegations conduct and contribution (sic)."
"The parties agree that the legal principles on conduct dismissals are those set out by the EAT 30 years ago in its judgment in British Home Stores Ltd v. Burchall[1978] IRLR 379 and affirmed by this court in Post Office v. Foley2000 ICR 1283 . The essential terms of enquiry for the ET were whether, in all the circumstances, the Trust carried out a reasonable investigation and, at the time of dismissal, genuinely believed on reasonable grounds that Mr Small was guilty of misconduct. If satisfied of the Trust's fair conduct of the dismissal in those respects, the ET then had to decide whether the dismissal of Mr Small was a reasonable response to the misconduct."
"The questions of law on this appeal relate to the ET's application of the legal principles when, as is often the case, there are related issues, in this case contributory fault and breach of contract. In quite a few cases the related issues will include constructive dismissal and, increasingly, discrimination in, or associated with, the dismissal. The additional issues require findings of fact. The additional facts are not the same facts as relate to the issue of the fairness of the dismissal."
" ... that the ET made findings of fact about conduct issues that were in dispute in the disciplinary proceedings. It then wrongly used its factual findings, which were based on the evidence that it had heard, in order to substitute its own decision on Mr Small's conduct dismissal for that of the Trust. Mr Reynold cited the decision of this court in Morgan v. Electrolux Ltd[1991] ICR 369 for the proposition that it was an error of law for the employment tribunal to substitute its own evaluation of the witness or of the evidence for that of the employer. The ET must consider the reasonableness of the employer's conduct. In judging that the ET was not to substitute its view as to what was the right course to adopt for that of the employer. 31. On the issue of liability, as distinct from the issues of contributory fault, the ET was not, as the EAT thought, bound to make the findings of fact that it used in deciding whether the dismissal was fair."
" B. Substitution and misapplication … 41. On the liability issue the ET ought to have confined its consideration to facts relating to the Trust's handling of Mr Small's dismissal: the genuineness of the Trust's belief and the reasonableness of the grounds of its belief about the conduct of Mr Small at the time of the dismissal. Instead, the ET introduced its own findings of fact about the conduct of Mr Small, including aspects of it that had been disputed at the disciplinary hearing. For example, the ET found that the daughter, who did not give evidence to the ET, had not told Mr Small that her mother was hypertensive and diabetic. Further, on the point whether Mr Small had done a risk assessment before asking the patient to walk, the ET held that there was no evidence that he had failed to carry out a risk assessment, but Mr Suter gave evidence to the ET that the critical issue before the disciplinary panel was that Mr Small had not carried out a proper patient assessment, before the decision was made. 42. The ET used its findings of fact to support its conclusion that, at the time dismissal, the Trust had no reasonable grounds to its belief about Mr Small's conduct and therefore no genuine belief about it. By this process of reasoning the ET found that the dismissal was unfair. In my judgment, this amounted to the ET substituting itself and its findings for the Trust's decision maker in relation to Mr Small's dismissal. 43. It is all too easy, even for an experienced ET, to slip into the substitution mindset. In conduct cases the claimant often comes to the ET with more evidence and with an understandable determination to clear his name and to prove to the ET that he is innocent of the charges made against him by his employer. He has lost his job in circumstances that may make it difficult for him to get another job. He may well gain the sympathy of the ET so that it is carried along the acquittal route and away from the real question - whether the employer acted fairly and reasonably in all the circumstances at the time of the dismissal. C. Separate and gradual fact-finding 44. I agree with the EAT that the ET was bound to make findings of fact about Mr Small's conduct for the purpose of deciding the extent to which Mr Small's conduct contributed to his dismissal. That was a different issues from whether the Trust unfairly dismissed Mr Small for misconduct. Contributory fault only arose for decision, if it was established that the dismissal was unfair. The contributory fault decision was one for the ET to make on the evidence that it had heard. It was never a decision for the Trust to make. That makes it different from the decision to dismiss, which was for the Trust to make. It was not the role of the ET to conduct a re-hearing of the facts which formed the basis of the Trust's decision to dismiss. The ET's proper role was objectively to review the fairness of Mr Small's decision by the Trust. 45. I am unable to agree with the EAT that the ET kept the issues and the relevant facts separate or that it avoided the error of substituting its own judgment about dismissal. Although the ET rightly warned itself against substitution and thought that it was not falling into that error, my reading of the reasons is that its findings of fact about Mr Small's conduct seeped into its reasoning about the unfairness of the dismissal. 46. Mr Marsh [Counsel for the Respondent, Mr Small] spoke of his experience that ETs often structure their reasons by setting out all findings of fact in one place and then drawing on the findings at the later stages of applying the law to the relevant facts. It is not the function of appeal courts to tell trial tribunals and courts how to write their judgments. As a general rule, however, it might be better practice in an unfair dismissal case for the ET to keep its findings on that particular issue separate from its findings on disputed facts that are relevant to other issues, such as contributory fault, constructive dismissal and, increasingly, discrimination and victimisation claims. Of course, some facts will be relevant to more than one issue, but the legal elements of the different issues, the role of the ET and the relevant facts are not necessarily all the same. Separate and sequential findings of fact on discrete issues may help to avoid errors of law, such as substitution, even if it may lead to some duplication. "
"As soon as the trolley was outside A&E, Mrs Westwood bent her efforts to persuading the patient to get up and leave. Again, if she had done so, it is difficult to believe that anyone would have taken a serious view of what had happened."
" … parts of the CCTV material which were not before the panel might have corroborated Mrs Westwood's account of her movements and those of MS Stanford after they had returned to A&E. He said that would have made no difference to the outcome: in the mind of the panel, what mattered was the fact that the patient had been taken outside. In any event, he did not consider that Mrs Westwood had taken effective action to protect the patient by calling security: they were not the appropriate people to have contacted. "
"We accept the submission for the respondent that as she did not get off the trolley and leave, in one particular respect she was more vulnerable than she would have been in that scenario; she was for about 5 minutes outside the hospital, flat on her back on a trolley. A female patient in that situation was plainly vulnerable to assault, and to the risk of falling of the trolley and suffering injury."
"Now what will justify an instant dismissal? - something done by the employee which impliedly or expressly is a repudiation of the fundamental terms of the contract" and at page 433 where he cites Russell LJ in Pepper ( page 518) that the conduct "must be taken as conduct repudiatory of the contract justifying summary dismissal."
"the disobedience must at least have the quality that it is 'wilful': it does (in other words) connote a deliberate flouting of the essential contractual conditions."