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Appeals update

Recent results and outcomes of Section 29 appeals

Since our last newsletter, we have concluded 11 of our appeals of regulator final fitness to practise decisions. We decided to appeal these decisions based on our belief that they were insufficient to protect the public. The cases we have appealed cover a range of issues, including cases involving:

  • physical abuse of vulnerable patients
  • dishonesty
  • not treating a conviction for indecent assault seriously enough.

You can find out more details below.


Recent appeals

General Medical Council

Appeal against a GMC decision not to erase a doctor who continued to work while suspended and lied about it

This was an appeal against a GMC decision to suspend a doctor for 12-months with a review at the end of the suspension period. The misconduct in this case took place when the registrant was already suspended for a different matter (the first suspension order). The Registrant had attempted to appeal the first suspension order but had not complied with the procedural requirements of the Court of Session. She subsequently dishonestly told the GMC (in various communications) that she had lodged an appeal and continued to work despite knowing that the first order (suspension from the register) had come into effect and she should not have continued to work. We were concerned that the panel had made a mistake on the registrant’s insight into her misconduct and that, when assessing the misconduct, the panel did not take enough account of its seriousness. This appeal was heard in Scotland and was upheld. The registrant has been removed from the GMC’s register. 

Nursing and Midwifery Council

Appeal against an NMC decision not to charge dishonesty and the providing misleading references did not amount to misconduct 

This was an appeal where the underlying conduct suggested that the registrant had been dishonest in providing two references for a colleague. Our concern was that the NMC under prosecuted the case. As the charges of dishonesty had been proven, the panel was wrong to conclude that the registrant’s misleading behaviour in providing the references did not amount to misconduct. The parties settled the case by consent. The decision of the panel has been quashed and the case remitted to the same panel to re-determine misconduct. The concern we had about under prosecution was addressed via the NMC registrar review process (i.e. outside of the appeal process) whereby the Registrar reviewed the case examiner decision, determined that the case examiner decision was flawed, reconsidered the decision and referred a new allegation of dishonesty for a final hearing. The remitted panel hearing will consider a new factual allegation and then move to consider misconduct in light of its findings in relation to the new allegation and the factual findings made at the first hearing.

Appeal against an NMC decision not to strike off a nurse who seriously abused an elderly, vulnerable care home resident

This was an appeal against a decision of the NMC to impose a 12-month suspension with review in respect of a nurse in a care home who pushed, stamped on and restrained an elderly, vulnerable patient. Our concern was that the panel did not treat this misconduct seriously enough, particularly when the registrant had not engaged with the proceedings. The parties have settled this case by agreeing a Consent Order which substitutes striking-off for the original sanction of suspension. This means the nurse will be removed from the NMC’s register.

Appeal against an NMC decision imposing conditions where a registrant was convicted of indecent assault against a child

This was an appeal against a decision to impose conditions in relation to a conviction of indecent assault against a child. Our concern was that the sanction imposed is inappropriate and insufficient to reflect the seriousness of the registrant’s conviction and the sentence imposed which required completion of work to address re-offending as part of probation and registration as a sex offender. The parties have agreed a Consent Order quashing the original sanction decision and imposing suspension for 12 months with a review hearing.

Appeal against an NMC decision not to proceed with serious charges of physical abuse of a vulnerable care home resident

This was an appeal against a decision to allow the NMC to offer no evidence on charges relating to physical abuse of a vulnerable care home resident and the resulting decision to find no current impairment of the registrant. Our concern related to the failure by the NMC to contact and call relevant witnesses, including the resident who was the victim of the registrant’s behaviour and the failure by the panel to enquire into the circumstances before allowing the NMC to offer no evidence. The parties have agreed a Consent Order quashing the original outcome of not impaired and remitting the case to a fresh panel with additional allegations.

Appeal against an NMC decision to find no impairment after conviction for causing serious injury by dangerous driving

This was an appeal against a decision that the registrant is not currently impaired. The registrant was convicted of causing serious injury by dangerous driving. She was sentenced to 20 months’ immediate imprisonment. It was also alleged that she was dishonest in her interactions with her employer after the accident, specifically that she had lied when asked whether she had been on her phone at the time of the accident. We have identified errors in the panel’s approach, relevant material that was not taken into account and irrelevant factors that were taken into account. The appeal was settled by consent. The registrant has been suspended.

Appeal against an NMC decision to suspend a nurse who slapped and humiliated a vulnerable patient

This was an appeal against an NMC decision to impose a six-month suspension order with review. The case concerned an incident when the registrant slapped a vulnerable patient on the bottom approximately 20 times while at the same time repeating the words “you naughty girl”. The NMC raised concerns about the case directly with the Authority. The Authority was concerned that the NMC failed to reflect the full seriousness of the case in the charge and/or the way it prosecuted the case; the panel’s findings about the registrant’s actions were internally inconsistent; and the panel failed to appreciate and/or address the attitudinal issues underlying the registrant’s conduct amongst other things. The registrant was struck off the NMC register in September 2022 for a separate matter. The appeal was therefore withdrawn. The consent order recorded that the NMC conceded the appeal.

Social Work England

Appeal against an SWE decision where the charges did not fully reflect the registrant’s misconduct 

This was an appeal against a decision to impose a 12-month suspension order with review. The registrant engaged in a relationship with a service user. Our concern related to the adequacy of the charges and the final decision made by the panel. There was evidence to support allegations that the registrant participated in the relationship when she knew the service user was vulnerable, that she deliberately misled a local investigation, that she relied upon the vulnerability of the service user to persuade those investigating the allegations not to believe the claims made by the service user; and that she deliberately misled SWE. The panel did not appear to grapple with the seriousness of the misconduct and the impact that it has on the public interest. This was also case where the registrant showed limited insight into her wrongdoing. The parties have agreed a Consent Order quashing the original decision on sanction and remitting the case for sanction to be redetermined by a fresh panel. The Order also directs the panel to address the issues raised by the Authority in the appeal.

Appeal against an SWE decision not to proceed with serious charges of taking advantage of a service user

This is an appeal against a decision by SWE adjudicators to strike out serious allegations because they were not sufficiently particularised. Our concerns were that the panel did not follow the correct approach when deciding whether the charges were detailed enough to allow the registrant to meet the case and did not properly balance the public interest before striking out the charges, rather than consider an adjournment. The charges related to using a vulnerable service user’s home for sex work, financially exploiting them and using controlling, manipulative and threatening behaviour towards them. The Court agreed to make an Order where the panel’s decision to strike out allegation 1 (on the basis that it was insufficiently particularised) has been quashed, together with the decision to impose suspension. The case has been remitted to SWE for determination of allegation 1 and sanction on all matters. The facts, misconduct and impairment decision on the remaining allegations 2-4 are undisturbed. In the meantime, the registrant remains subject to interim suspension.

Recent Court Hearings

Appeal against a GMC decision to allow a doctor to retire from the register voluntarily without hearing serious allegations

This was an appeal against a decision of the GMC to allow the registrant’s application for voluntary erasure. Having taken legal advice the GMC stated that their Section 40A appeal powers did not extend to a voluntary erasure decision. At a hearing on 10 June 2022 the High Court of Northern Ireland considered the question of the Authority’s jurisdiction. We argued that the voluntary erasure decision was appealable, regardless of its statutory basis, because it is a final decision of the relevant committee and the effect of the voluntary erasure decision is that no disciplinary measures can or will be taken under the relevant provisions referred to in Section 29(1). The Court did not accept our arguments and reached the view that Section 29 powers cannot be extended to include voluntary erasure in this case. Two patients have ongoing judicial review proceedings against this voluntary erasure decision of the GMC.

Appeal against a GMC decision to suspend a doctor who did not comply with interim conditions

This was an appeal against a decision to impose a 12-month suspension with review. The registrant was found to have made many serious clinical failings and to have failed to notify his employer that he had been made subject to an interim order of conditions. We were concerned that the allegation did not capture the full seriousness of his misconduct in relation to failures to abide by the interim order, that the panel did not amend the charge to reflect the full seriousness of that conduct, that relevant evidence was not placed before the panel and the panel departed from the sanctions guidance. The appeal was heard on 15 June 2022 and upheld. The case has been remitted to the MPTS for consideration of new charges concerning compliance with the interim order and then redetermination of sanction on any new charges and the clinical failings previously determined.


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.