The data

This HCW has ongoing process which has continued for many years. They have an interim conditions of practice and as is often the case, due to the case not concluding within the time of the order, the NMC had to apply for an extension.

We made some freedom of information requests and found that this is not rare.

FOI ref: NMC-07704-S6H3M6 – HCIO applications made 2021

FOI ref: NMC-15462-C2X0X1 – HCIO applications 2022

FOI ref: NMC-30882-Z5V8M4 – HCIO applications made 2023-24

Number of High Court Extensions 2020-21:

From  2020 – 2021 there were 595 applications, nearly half having gone through a prior extension.

Number of HCIO applications made for RCJ England – 529

Number of HCIOs extended – 229

Number of IO applications made to Scottish Court of Session – 66

Number of IO applications made to Scottish CoS extended – 21

Number of High Court Extensions 2023-24:

In 2023 – 2024 applications increased, and although we did not request the number of extensions, we would expect similar ratios.

HCIO applications made in 2023 (Jan-Dec):

England/Wales – 636

Scottish Court of Session – 71

SDM, N. Ireland – 22

HCIO applications made in 2024 (Jan-Dec):

England/Wales – 638

Scottish Court of Session – 67

SDM, N. Ireland – 44

Overall, between 2020 and 2024, HCIO applications increased considerably:

England/Wales – 278% increase

Scottish CoS – 319% increase

This does beg the question, “who is safeguarding the registrants?”.

Good use of fees?

We are reliably informed by a barrister previously working on regulation prosecution that applying to the High Court has a cost of £528 for the case to be heard, and if a barrister is in court for that hearing there is an additional cost of £750 for each hearing with legal representation by the NMC.

So, with an average number of High Court extension applications of around 600 a year since 2020, approximately 3,000 cases have cost £1,584,000 if no barrister is in attendance. We are also told that often High Court attendances are used for NMC pupillage barristers to “get more experience in the courtroom” – more experience with spending registrant’s fees!

We are not suggesting that a High Court extension should not be applied for in order to maintain public safety while a case is investigated. But, even though the NMC have a huge backlog of cases and those cases take many years to complete, what concerns us is that no one is monitoring the cost. The funding for this originates from annual registrant fees and the spend is huge. With careful case management and a regular audit of progress, many of these cases could be and will be closed with no case to answer and yet the spend on getting them to that point does not appear to be well-managed.

Reflection on attending court

On attending the high court extension hearing this week, our group member observed:

1. First, it was important to have supporters speaking occasionally on the registrant’s behalf.
2. You may not come across as your real self as you are nervous and probably exhausted.
3. Afterwards, write everything down including everyone’s thoughts and observances (I asked others to take notes too).
4. The real registrant was thoughtful and their experiences powerful. Registrant, in the session which lasted almost 1.5 hours (when 10 minutes is the usual and 45 minutes was allotted) was given time and space, consideration and commendation by the judge.
5. However, they were not able to counter the barrister/NMC’s language and their statements were repeated and kept ‘front of mind’ for a random observer.
6. The registrant’s written submissions seemed to clearly counter their narrative and the judge mentioned how important they were.
7. The boundaries are clearly stated by the judge but as the person up there, it’s really difficult to not interject.
8. Non-attendance at previous hearings was weaponised, showing the importance of turning up at EVERY hearing even when you really don’t want to or feel too unwell to do so.
9. It was eye-opening to attend even though I had to dampen down my own feelings of terror due to my own process