Disciplinary Findings Against Nurse Quashed on Appeal

A Registered Mental Health Nurse (RMN) who worked in that capacity since 2011 successfully appealed to the High Court against findings of misconduct and a 12 month Conditions of Practice Order made by a Fitness to Practise Committee of the Nursing & Midwifery Council: Ibrahim, R (On the Application Of) v Nursing and Midwifery Council [2024] EWHC 2991 (Admin) (26 November 2024)  Richard Kimblin KC (sitting as a Deputy Judge of the High Court)

The nurse advanced two grounds of appeal (i) that the Panel’s conclusions at the Factual and Misconduct Stages failed to mention or engage with his submissions on the facts; (ii) that at the Impairment Stage the Panel placed too great an emphasis on, and drew impermissible inferences from, what they wrongly considered to be lack of insight.

His Lordship found that the nurse’s case on both misconduct and impairment was largely omitted by the Panel in coming to its conclusions. In each respect that case was underpinned by material, evidence and facts which raised serious issues about the situation which the nurse had to deal with in the early hours of 28 November 2017. The nurse was unable to understand from the Panel’s reasons why his case was rejected.

The appeal succeeded on both grounds.

The court heard submissions on the appropriate order. The court’s powers included allowing the appeal and quashing the decisions, substituting the decisions appealed against with any other decision which the NMC could have made, and remitting the case with directions.

In a regulatory appeal for a health and care professional, the primary focus was the public interest and trust as recognised by the NMC in articulating the role of the profession. The competence of the regulatory body to judge professional standards lay with the regulatory body, not the court. The court must accord due deference to the evaluation of a panel composed of medical professions who were obviously better placed to make a peer judgment: Meadow v GMC [2006] EWCA Civ 1390; [2007] QB 462

The judge found that the Panel was wrong to omit to make findings which related to the nurse’s case, to fail to integrate such findings on the issue of misconduct and to omit important factors in finding impairment. That judgment was not based on the evidence of witnesses but on the basis of the same documents as were before the Panel. The circumstances faced by the nurse on 28 November 2017 were clear and detailed and were easy for the court to see and understand. To that extent the court was as well placed to assess that material as the Panel. The court was similarly competent as the two lay members of the Panel but did not have the expertise of the registrant member of the Panel.

If the Panel had taken the nurse’s case properly into account when it reached its decisions on misconduct, impairment and sanction, it would have reached different and less serious findings. It would either have found that misconduct was not made out, or that it was misconduct of a lesser degree. The same applied to impairment. The sanction would necessarily have been a lesser sanction or no sanction at all.

An interim order was made and had been effective during the period of the appeal. It had now lapsed. The court had not been told there was any factor or fact which related to events and the nurse’s practice post 2017 which warranted his return before the Committee. It was therefore clear that if the case were returned to Panel, or a differently constituted Panel, then no sanction could properly and fairly be imposed because the sanction had already served its purpose in the public interest.

In his Lordship’s judgment, the public interest included the question of whether a full rehearing of the case would be proportionate. It would not be.

The appeal was allowed. The factual findings, the findings of misconduct and impairment, the sanction and resulting orders were quashed.

The Respondents were ordered to pay the nurse’s costs assessed in the sum of £8,809.