An acute trust where three senior managers remain suspended over waiting-list irregularities, and which has been forced to close its accident and emergency department twice during the past two weeks, is now facing an employment tribunal case brought by its A&E clinical director.

Stoke Mandeville Hospital trust is facing a tribunal case brought by Dr Alison Gammon following a breakdown in relations between her and another senior member of staff over recent years.

The situation led to grievances procedures being taken out by other staff in A&E, and both the British Medical Association and the Royal College of Nursing have been involved in trying to resolve problems in the department.

An independent consultancy was also brought in last year to advise on staffing issues, but the situation remains unresolved.

Dr Gammon has been on sick leave since January, and the case is not due to be heard until January 2002. It was unclear whether she would be returning to work in the near future, as HSJ went to press.

Local MP David Lidington told HSJ that several constituents had contacted him with concerns about the department, and he had sought assurances that patient safety had not been compromised.

He said: 'Constituents have made complaints and allegations that were serious. There were a number of specific allegations of specific incidents that added up to concerns about patient safety. I have been told by the trust that they have thoroughly investigated any claims with regard to the quality of clinical care, and they are satisfied standards are being observed. I was given a very firm assurance that patient safety was not at risk.'

Trust interim chief executive Fiona Wise, who has been in post since April, said that although she could not comment on the staffing problems because of the forthcoming tribunal, she was satisfied that safety had not been compromised.

She added that, given the situation when she arrived, 'I believe I have handled it appropriately'.

But Aylesbury community health council chief officer Jenny Hunt said the CHC was concerned about what impact the situation was having on patient care. She said: 'We are looking for the situation not to be affecting patient care. It is a situation that needs to be resolved.'

The trust was forced to close its A&E unit for several hours on two occasions in the past two weeks for the first time in its history, when it could not find beds for patients using the service.

Ms Wise said: 'We had a significant number of patients in the department that required admission and no beds, and it really wasn't sensible to admit more patients. I did it with great reluctance and it is the last resort. I do not want to do it again.'

A review of the A&E department, commissioned by the trust last year and considered by the board at its meeting in August, identified several problem areas on which work had already been done. These included communications within the unit and training on personnel policies.

But the review also identified out-of-hours protocols and medical staffing requirements as issues of concern, and an action plan was due to address these concerns. A report back is due at the December board meeting.

Ms Wise is running the trust while chief executive Sue Nicholls and two other senior managers remain suspended while waitinglist irregularities are investigated.