Recent appeals
Health and Care Professions Council (HCPC)
Appeal against an HCPC decision in the case of a radiographer who behaved inappropriately towards colleagues, on social media and failed to respect a patient’s dignity
This was an appeal against an HCPC panel decision to impose a 24-month conditions of practice order with a review in respect of a radiographer who, between 15 June 2020 and 13 August 2020, and while on a six months’ probationary period, failed to respect a patient’s dignity, posted inappropriate content on social media; displayed inappropriate behaviour towards colleagues and failed to accept guidance from training leads. We were concerned that the panel’s reasons for imposing conditions were irrational and the radiographer had not engaged with the HCPC since 2022. There was also nothing to suggest that he would comply and undertake meaningful remediation, and no evidence that he was unable to engage with the process. We considered that it was wrong for the panel to conclude that it was possible to formulate conditions, and that the registrant did not pose a risk of harm by being subject to conditions. Further, the panel departed from the relevant sanctions guidance without giving sufficient reasons. The panel also failed to consider whether conditions would be sufficient to maintain and uphold the public interest, and the most serious aspects of the misconduct were not considered.
The appeal has been upheld and the panel’s original sanction decision is substituted with a 12-month suspension order.
Nursing and Midwifery Council (NMC)
Appeal against an NMC decision about a senior nurse’s handling of two patient telephone consultations and where he subsequently acted dishonestly
This was an appeal against an NMC panel decision imposing a 12-month suspension order with a review. The fitness to practise case involved a senior nurse and Clinical Team Leader where concerns were raised about his telephone consultation with two patients whilst working for the out-of-hours primary care service for Nottingham Emergency Medical Services. The registrant incorrectly advised the mother of Patient A, a child with symptoms consistent with sepsis, to attend a pharmacy rather than to A and E, giving wrong clinical information and his record of the telephone consultation being deliberately inaccurate. Further, in relation to another patient, Patient B, an adult showing high potassium levels in their blood, the registrant told them to attend for a repeat blood test when they should have been referred to A&E immediately. The registrant failed to complete an accurate record of his conversation and was dishonest during the local investigation.
This appeal was settled by way of a Consent Order upholding the appeal. The original sanction decision has been quashed and is substituted with a striking off order. This means that the nurse has been removed from the NMC’s register.
Appeal against an NMC decision involving a nurse who mocked a vulnerable patient, was rude, off-hand and did not offer the level of care expected
This was an appeal against an NMC panel decision to impose a 12-month suspension order with review in respect of a nurse who did not introduce themselves to a patient or their relative, spoke to their relative in a rude manner, and did not ensure that appropriate and timely pain relief was provided. Further, the registrant did not allocate sufficient staff to cover patients who required enhanced care, did not allocate a patient with severe diarrhoea to a room with a toilet, and on multiple occasions failed to work cooperatively with colleagues, displaying patronising and unsupportive behaviour.
Our concerns around this panel decision were that:
- The case was under-prosecuted – there was other relevant evidence that the panel should have had sight of involving the registrant mocking a vulnerable patient.
- The panel’s finding that the registrant’s failure to allocate a patient with severe diarrhoea to a room with a toilet did not amount to misconduct was wrong, and the reasoning provided was insufficient.
- The panel’s decision on sanction was wrong. The panel had relied on irrelevant factors to mitigate against a striking off order, and had failed to have proper regard to the sanctions guidance, and it came to an irrational conclusion that a suspension order was appropriate.
A consent order has been agreed. This means that the appeal has been upheld and the panel’s original sanction decision is substituted with a striking of order.
Appeal against an NMC decision in the case of a nurse who breached professional boundaries
This was an appeal against an NMC panel decision imposing a 12-month conditions of practice order involving a nurse who breached professional boundaries. The nurse sent sexual messages and photos to a patient without clinical justification. We had concerns that the panel failed to consider the full seriousness of the misconduct, failed to properly identify aggravating and mitigating factors, placed excessive weight on some mitigating factors, and the sanction was insufficient to protect the public.
A consent order was agreed. This means the appeal has been upheld and the panel’s original sanction decision has been substituted with a 12-month suspension order with a review.
Appeal against an NMC decision involving a nurse who intimidated and stole money from an elderly patient
This was an appeal against an NMC panel decision to impose a 12-month suspension order with a review in respect of an agency nurse who intimidated and stole money from an elderly patient while they took them to the bathroom during the night. When challenged by a colleague after the patient reported the incident, the nurse initially denied that the money belonged to the patient before returning the money when challenged. We had concerns that the panel failed to consider the full seriousness of the misconduct, failed to properly identify and give appropriate weight to relevant aggravating factors, placed excessive weight on some mitigating factors, failed to apply the sanctions guidance, failed to provide adequate reasons, and the sanction was insufficient to protect the public and to uphold and maintain the public interest.
A consent order was agreed. This means the appeal has been upheld and the panel’s original sanction decision is substituted with a striking off order.
Appeal involving an NMC decision in the case of a school nurse who had a history of accessing medical records when there was no clinical need to do so
This was an appeal against an NMC panel decision to impose a 12- month suspension order with a review. This case involved a School Nurse who on multiple occasions accessed the medical records of a deceased child and their mother without clinical justification. The nurse had previously faced disciplinary and regulatory proceedings for accessing patient records without clinical justification. We had concerns that the panel was wrong not to find harmful deep-seated attitudinal or personality problems, failed to give consideration to the nurse’s previous suspension for near identical behaviour, failed to give adequate reasons why a suspension order was appropriate, and the sanction was insufficient to protect the public and/or to uphold and maintain the public interest.
A consent order was agreed. This means the appeal has been upheld and the panel’s original sanction decision is substituted with a striking off order.
Appeal against an NMC decision involving a nurse who made racist and derogatory comments over a two-year period
This was an appeal against an NMC panel decision. The panel imposed a 12-month suspension order with a review in respect of a nurse. Over a two-year period, the nurse sent multiple messages to a colleague making racist and derogatory comments about patients and other colleagues, as well as appearing in a video which impersonated staff from a rival business in a racially offensive and/or discriminatory way. We had concerns that the panel failed to properly identify relevant aggravating factors, mischaracterised the seriousness of the repeated misconduct, wrongly concluded that the nurse’s behaviour was ‘out of character’, failed to conclude that there was evidence of harmful deep-seated attitudinal or personality problems, placed excessive weight on some mitigating factors, failed to correctly apply the sanctions guidance, and failed to give adequate reasons why a suspension order was appropriate.
A consent order was agreed. The appeal has been upheld and the panel’s original sanction decision is substituted with a striking off order.
Appeal against an NMC decision in the case of a mental health nurse who failed to provide adequate and 121 care to a highly vulnerable patient, fell asleep, and locked the door, exposing the patient to a significant risk of harm
This was an appeal of an NMC panel decision to impose suspension for six months with review in respect of a nurse working as a bank Registered Learning Disabilities Nurse; she was one of two mental health nurses allocated to provide two-to-one care to Patient A for the entirety of her shift. Patient A had Parkinson’s and had additional needs due to hospital-acquired pneumonia. Patient A was producing thick secretions and was at risk of aspiration. When Patient A was not in bed, he risked falling due to his comorbidities and was considered a vulnerable patient for these reasons. The registrant failed to provide appropriate care to the patient (she did not maintain constant observation and fell asleep during her shift, thereby exposing the patient to risk of aspiration); she locked or permitted a colleague to lock patient A’s door and when the patient’s grandson arrived, she delayed opening the door. We are concerned that the panel did not treat the conduct seriously enough based on its own findings, did not apply the sanctions guidance and did not provide adequate reasons.
A consent order was agreed. The appeal has been upheld and the panel’s original sanction decision is substituted with a striking off order.
Recent Court Hearings
General Dental Council (GDC)
An appeal involving a dentist who behaved inappropriately towards three colleagues
This was an appeal against a GDC panel decision to impose a suspension for five months with review in respect of a dentist whose behaviour towards three colleagues was sexually motivated. We were concerned that the panel found some of the registrant’s behaviour was not sexually motivated when there was no other available explanation. We were also concerned that the panel did not treat the registrant’s misconduct seriously enough, identified irrelevant mitigating factors or gave them disproportionate weight, wrongly concluded that there were no attitudinal failings and did not consider removing the dentist from the GDC’s register (erasure) and explain why, in terms of the GDC’s sanctions guidance, this would be disproportionate. The registrant also appealed against the panel’s decision.
Both appeals were jointly heard on 31 October, 1 November 2023, 23-24 January and 12-13 March 2024. The decision was handed down on 16 October 2024. The judge agreed with our view that the dentist’s behaviour was sexually motivated, and this should have been found proved by the panel. However, the judge considered the sanction to be sufficient and the panel decision remains in place.
General Medical Council (GMC)
An appeal involving a doctor who sexually harassed colleagues over a lengthy and sustained period of time
This was a GMC Section 40A appeal which we joined. It related to a doctor who behaved inappropriately and sexually harassed seven colleagues between May 2017 and September 2020. This included stroking and rubbing various colleagues body parts, hugging and holding them, pressing his genitals against them, kissing their necks, as well as blocking colleagues from leaving rooms when they tried to leave. This was despite colleagues objecting to such behaviour and telling the registrant to stop, which he failed to do. The Medical Practitioners Tribunal Service (MPTS) found no current impairment but imposed a warning. We joined the GMC’s appeal to raise additional concerns about the panel’s failure to adequately address the registrant’s motivation for his behaviour and the failure to give adequate reasons for the not impaired decision.
The appeal was heard on 24 April 2024 and the GMC and PSA grounds of appeal were upheld, but decision was reserved. The judgment was handed down on 25 October 2024. The judge agreed that the doctor’s fitness to practise was impaired by his serious professional misconduct. The case has been remitted to a differently constituted MPTS panel for it to consider the question of sanction.
Our appeals against fitness to practise decisions are a legal process – this means that we use a lot of specialist phrases and terminology. If you are not sure what any of them mean – you can find some of our frequently used terms explained in this glossary.