Landmark Ruling for Safety-Critical Role

PatientsCann UK®  ·  Employment & Rights  ·  12 May 2026

By Mohammad Wasway, Founder & Managing Director, PatientsCann UK®

A medical cannabis patient who was banned from the rail industry for five years after testing positive for THC from his prescribed medication has won a significant victory at the Employment Appeal Tribunal. This ruling changes the legal landscape for every prescribed cannabis patient in safety-critical employment in the UK.

On 1 May 2026, Mr Justice Soole handed down judgment in Truman v SPL Powerlines UK Ltd & Others [2026] EAT 54. At PatientsCann UK, we believe this is one of the most significant employment law decisions for medical cannabis patients since prescribing became legal in 2018.

The case began in July 2022 when Mr Truman, a rail industry professional with a long and successful career, was offered a safety-critical planning role with SPL Powerlines. Mr Truman had been prescribed Adven EMT1 and EMT2 by a Harley Street specialist to manage chronic pain caused by genetic haemochromatosis, an incurable condition. All three organisations named in the case accepted that his condition left him disabled within the meaning of the Equality Act 2010.

Mr Truman disclosed his prescription at the pre-employment medical. His urine sample tested positive for cannabis metabolites, which was entirely expected given his medication. The Medical Review Officer (MRO) at Express Medicals then did something that would prove critical to the case: without contacting Mr Truman at all, the doctors recorded a fail. Network Rail’s Sentinel system was updated automatically, triggering a mandatory five-year ban on all safety-critical rail work. The job offer was withdrawn the next day.

The Employment Tribunal in Sheffield found, based on unchallenged expert evidence, that the THC levels in Mr Truman’s urine were entirely consistent with his declared prescribed use, and that he could have worked safely in the role with a risk assessment, self-reporting obligations, and normal managerial oversight. It also found that if Network Rail’s own policy had been correctly applied, Mr Truman’s result should have been recorded as a pass. And yet the Employment Tribunal dismissed all his claims. The Employment Appeal Tribunal has now corrected part of that picture.

What the Appeal Tribunal Decided

Why This Matters for Patients

This is the first Employment Appeal Tribunal judgment to directly address the position of a medical cannabis patient in safety-critical employment. The implications reach well beyond the rail industry.

Industry certification bodies are bound by equality law

The most significant legal development in this judgment is the confirmation that Network Rail, as operator of the Sentinel scheme, is a qualifications body under the Equality Act 2010. In plain terms, this means the organisation controlling access to an industry certification card must comply with equality law, including the duty to consider reasonable adjustments, just as any employer would. It is not enough to say that testing was handled by someone else.

This principle extends beyond the rail industry. Any industry body that controls access to a certification, licence, or accreditation needed to work in a particular occupation may be covered by the same principle. If you hold a prescribed cannabis medicine and that certification is refused or revoked on the basis of a drug test result, you may be able to bring a claim directly against the certifying body, regardless of who employs you.

The MRO must follow their own policy on prescribed medication

Network Rail’s policy included a clear step: if laboratory analysis reveals a substance consistent with declared medication, the Medical Review Officer must satisfy themselves that there is a legitimate medical need for the quantity found before recording a fail. The MRO at Express Medicals never contacted Mr Truman. They never asked. They never satisfied themselves of anything, because they did not try.

The Employment Tribunal found that if the policy had been correctly applied, the fail should have been recorded as a pass. The Appeal Tribunal did not change that finding. The message for every prescribed patient in a safety-critical role is important: always disclose your prescription in writing at every stage, keep copies of everything, and be aware that an MRO who does not contact you before recording a fail may not have correctly followed the required process.

Expert evidence can show that you are able to work safely

An independent forensic expert, Mrs V. Jenkins of the Chartered Society of Forensic Sciences, prepared a joint report that was agreed by all parties. She found that the concentration of cannabis metabolites in Mr Truman’s urine was consistent with his declared prescribed use; that any adverse effects would be less severe because he took his medication at night; and that by the time he woke each morning, he was no longer impaired.

The tribunal went further and concluded that Mr Truman could have worked safely with a risk assessment, a requirement to self-report any adverse effects, and normal day-to-day management oversight. This is the proportionate, evidence-based approach that employers should be taking, not an automatic ban.

You cannot outsource your legal responsibility

Network Rail argued, in effect, that it was not responsible for what Express Medicals did. It simply received the uploaded result and acted on it automatically. The Appeal Tribunal rejected that position. Network Rail sets the policy. Network Rail controls the Sentinel scheme. Network Rail imposes the ban. The fact that it chose to have testing carried out by a third party does not change who is ultimately responsible for the outcome.

This has direct implications for any employer or certification body that contracts out its occupational health and drug testing. Outsourcing the work does not outsource the legal responsibility.

What the Original Tribunal Had Already Said

It is worth pausing on what the original Employment Tribunal in Sheffield said when it dismissed all of Mr Truman’s claims. The opening paragraph of its judgment is unusual and, we think, says everything:

A tribunal that dismissed all the claims still believed the claimant had suffered an injustice and that he should be able to work. The Appeal Tribunal has now given him a route to pursue that. His reasonable adjustments claim against Network Rail will be heard again.

The Comparison with Other Prescribed Medicines

The tribunal’s reference to opiates is not a throwaway remark. It reflects a double standard that PatientsCann UK has consistently highlighted. Workers taking prescribed opiates, which are also Schedule 2 controlled drugs, also psychoactive, and also capable of causing impairment, are routinely accommodated through occupational health assessment and individual risk management. Workers prescribed cannabis are often automatically excluded without any such process.

The Rail Safety and Standards Board’s own guidance makes this point directly, stating that existing policies can be applied to prescribed cannabis “just as they would be in the case of other medicines that are also drugs of abuse, for example opiates.” The RSSB also acknowledges that simply banning the use of medicines that may cause some impairment “may amount to disability discrimination.” These are not our words. They are the rail industry’s own regulatory body.

What This Ruling Does Not Decide

We want to be honest with our community about the limits of this ruling.

Mr Truman’s reasonable adjustments claim against Network Rail has been sent back to the Employment Tribunal for a fresh hearing. It has not been won. The Appeal Tribunal found that the original tribunal had not properly explained its reasoning on whether Mr Truman was placed at a substantial disadvantage compared to someone without his disability. The question of whether Network Rail treated Mr Truman unlawfully will be answered at that fresh hearing.

The separate discrimination claim Mr Truman brought, based on the direct consequences of his disability, was not revived for him or for his claim against SPL Powerlines. Those routes are closed based on how the case was argued at the original hearing.

Express Medicals is not liable under the specific legal provisions of the Equality Act that cover those who assist discrimination. This does not mean their conduct was unproblematic. It means the specific provisions relied upon did not apply to them in these circumstances.

Our Position at PatientsCann UK

Mr Truman built a career in the rail industry from the age of 18 and held his Sentinel card continuously since 2009. When he developed a painful, incurable condition and was prescribed medication to manage it, he did everything right. He disclosed his prescription. He took his medication responsibly. He did not drive or operate heavy machinery when he had any concern about impairment. The independent expert evidence confirmed he could have worked safely. The very tribunal that heard his case believed he had suffered an injustice.

He was nonetheless banned from his industry for five years.

This ruling does not undo that. But it does change the legal framework within which prescribed cannabis patients and safety-critical employers now operate. Certification bodies cannot shield themselves from equality law by pointing to third-party testing. Medical Review Officers must follow their own policies on prescribed medication. Employers must carry out a genuine, evidence-based assessment before deciding that a prescribed patient cannot work safely.

We are a patient-led Community Interest Company and we do not have the resources to bring litigation ourselves. But we can publish the law, explain what it means in plain language, and make it harder for discriminatory practices to continue through ignorance. [2026] EAT 54 is now part of that work, and we will be incorporating it into our employment guidance, our Know Your Journey education platform, and the briefings we share with employers and HR teams.

We are grateful to Susan Chan, who represented Mr Truman without charge, instructed by Morris Legal (Solicitors) Ltd. Cases like this do not reach the Employment Appeal Tribunal without advocates who are prepared to take them on.