Malpractice season 2 ending explained: What happens to James?

The second instalment of anthology series Malpractice has arrived on ITV, an important drama written by former NHS Doctor, Grace Ofori-Attah. Focussing on the aftermath of a medical error, the show highlights the overworked and underfunded conditions healthcare professionals work under, and how this can contribute to catastrophic mistakes.

Niamh Algar took the helm for season 1, as a doctor at the centre of a fictional malpractice allegation made against a hospital when a patient dies following an overdose. For season 2, Tom Hughes takes the role of psychiatric registrar Dr James Ford, who becomes caught between an anxious new mother’s postnatal check-up, the sectioning of a psychotic patient, and the ensuing tragic outcome.

It's both a complex case and difficult viewing that can raise questions. We break down everything that happens during the season finale and take a look at what happens to James at the end of his malpractice hearing.

Malpractice ending explained

At the end of Malpractice, the Medical Investigation Unit (MIU) found senior members of the trust to be at fault. In this instance, Eric Sawers was one of the leaders involved - his corruption and manipulation began the whole chain of events.

With the trust on the brink of bankruptcy, Eric Sawers and Arun Mansoor had been brought on board to turn the failing hospital around. Their job was seemingly made incredibly difficult by the ingrained culture of bullying and cover-ups, in which staff were too scared to report cover-ups.

With incident reporting far lower than the real number of real near misses taking place, the hospital appeared safer than it actually was according to government figures.

However, George stumbled across plans written by the architectural firm where his girlfriend Gina worked, outlining how more money could be saved by closing the psychiatric unit altogether. The plan was the convert the unit into luxury flats once closed.

It transpires the trust had been given over £6 million to improve the psychiatric unit, but the repairs never happened and the money was instead spent on the maternity unit.

This was deliberate move to run the unit down to the point it was not fit for purpose and would have to close. The site could then be sold for housing redevelopment for a profit.

To hasten the process of closing the unit, investigations were carried out into staff members such as James, in the hope less time would be wasted until it was deemed unfit for purpose.

It then came to light that Eric would personally profit from the land being turned into housing. The architecture firm putting in the bid to redevelop the unit was owned by himself and his brother. Unsurprisingly, Eric was arrested.

What happens to James?

During the hearing, James said he'd have made different clinical judgments in Rosie's case if he had access to all the correct data - something he didn't at the time. He did however admit his behaviour regarding Felicity Templeton had been irresponsible.

James urged those present at the hearing to take into account how much the stress of the investigation would've clouded his judgment. He was found to have demonstrated failure to keep Rosie safe, and when it came to Felicity, his fitness to practice had been impaired.

James wasn't struck off on account of the findings, but suspended for 12 months instead. Following this period, he could return to his job depending on the results of a review.

James had also been in a secret relationship with Kate, who'd been offered a job by Eric to keep her on side. Eric took back the job offer when she was no longer useful, offering the excuse he could no longer employ her because of the relationship with James - he'd actually been the one to report their relationship to the MIU.

By the end of the series finale, James and Kate's relationship is over and she's has been summoned to attend her own MIU hearing, although viewers don't get to see the outcome of this.

What happens to Sophia?

Because of Sophia and her whistleblowing, the MIU were able to build a strong case against Eric and the trust. However, because she'd had to implicate herself in malpractice, she was ultimately struck off.

She was forced to leave her job behind, but bravely knew this would be the price she paid for coming forward. Sophia wanted justice and accountability, and was willing to sacrifice her career for this outcome.