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30 July 2019, 15:24 | Updated: 30 July 2019, 15:26
The NHS faces having to pay out millions of pounds to junior doctors following a Court of Appeal ruling over rest breaks.
In a test case of significance across the NHS, senior judges concluded that Derby Hospitals NHS Foundation Trust's arrangements for monitoring breaks were in breach of trainee medics' contracts and "irrational".
The appeal was brought by Dr Sarah Hallett, who underwent training at the Royal Derby Hospital, with the support of the British Medical Association (BMA) after she lost a High Court challenge in April last year.
Dr Hallett, deputy chairwoman of the BMA's junior doctor committee, also brought her case on behalf of 20 other doctors who trained with her.
The trust could now have to pay Dr Hallett and her fellow trainees a total of £250,000 in extra pay they missed out on over an eight-month period, after the court made a number of declarations regarding the contracts.
Lord Justice Bean, sitting with two other senior judges, said the wider cost to the NHS is "potentially substantial".
The judge said lawyers for Health Secretary Matt Hancock previously told the court the financial implications of Dr Hallett's appeal succeeding would be "considerable".
Lawyers for Dr Hallett argued patients could be at risk and doctors might quit the profession because trusts were failing to monitor trainee medics and make arrangements for them to take breaks in line with their contracts.
They said trusts have a responsibility to make sure trainees take a 30-minute break for every four hours they work, and are contractually bound to pay junior doctors more if they do not comply with the rules.
Lord Justice Bean said Derby Hospitals NHS Foundation Trust's method for ensuring it was complying with the terms of the contract was flawed because it used data from rotas drawn up in advance.
Giving a ruling on Tuesday, he said: "I therefore accept the claimant's argument that the assessment of natural breaks compliance should have been calculated using actual recorded data for each duty period during the monitoring round as opposed to the expected data shown on the rota."
The judge added: "The defendant's method of calculation is both in breach of the contract on its proper interpretation and also irrational."
Lord Justice Bean said the court refused to allow Mr Hancock to intervene in the appeal after an application was made just two weeks before the hearing in June.
He said the main points Mr Hancock sought to put before the court were that the contract in question was in "widespread use" throughout the NHS and that if Dr Hallett's appeal was successful the cost implications would be "considerable".
However the judge said the first point was not in dispute and the second could not "affect the proper interpretation" of the contract.
Dr Hallett's case related to a period in 2013 during a rotation in general surgery at the Royal Derby Hospital, when she was in her first foundation year after leaving medical school.
She accepted she was able to take all of the breaks she was entitled to, but claimed the trust's monitoring process should have shown her training group as a whole did not get enough rest periods and therefore should have been paid more.