A plastic surgeon who left a Yorkshire hospital to accept a high-paying sabbatical position in Abu Dhabi has successfully challenged his dismissal by the NHS at an employment tribunal. Augustine Akali, a consultant plastic surgeon at Hull University Teaching Hospitals NHS Trust, was dismissed after taking a two-year contract in the United Arab Emirates without formal approval from his employer.

Akali, 61, joined the trust in 2008 and was recognised for his expertise in microsurgical breast reconstruction. In 2023, he sought a sabbatical to work at Tawam Hospital in Abu Dhabi, where he was offered a tax-free salary of approximately £21,000 per month, equivalent to nearly £250,000 annually. While sabbaticals can be granted within the NHS, the trust declined his request, citing policies that discourage breaks taken primarily for financial gain.

During the tribunal hearing in Hull, it emerged that Akali had discussed his intentions with senior trust figures, including clinical manager Ashutosh Kotwal and medical director Colin Vize. Akali emphasized his desire to rejuvenate his career, develop a microsurgical reconstruction service untapped in the region, and contribute to medical work in developing countries, particularly in Africa. Vize reportedly expressed concerns that the financial aspect of Akali’s sabbatical might conflict with NHS guidelines.

The tribunal revealed confusion over the approval process, with uncertainties about who had the authority to grant the sabbatical and whether Akali had effectively resigned. Despite this ambiguity, Akali relocated to Abu Dhabi before receiving formal permission. The trust subsequently terminated his employment, citing that he had effectively abandoned his post by taking an unauthorised sabbatical.

Employment tribunal judge Ian Miller ruled that Akali’s dismissal was unfair, noting that the trust failed to follow proper procedures and that Akali never formally resigned. However, the judge also acknowledged significant failings on both sides during the dispute. While Akali’s unfair dismissal claim was upheld, the tribunal decided he would not receive compensation, reasoning that he had, in practice, abandoned his duties at the NHS trust.

Akali had been based at Castle Hill Hospital in Cottingham, East Riding of Yorkshire, and maintained a successful private practice alongside his NHS work. The British Medical Association estimates that NHS consultants with over 14 years of service typically earn around £150,000 per year, substantially less than Akali’s Abu Dhabi contract.

The case underscores ongoing challenges within NHS policies regarding sabbaticals and overseas work, particularly when financial incentives are involved, as well as the complexities of communication and procedural clarity between doctors and trust management.