In November 2023 NMCWatch was contacted by Mildred and her husband; she had navigated a Fitness to practice process since 2013 and was exhausted. Initially she funded her own legal representation and when funds ran out, her husband tried his best to navigate the process for them both.
Mildred Wylie qualified as a registered nurse in 1975 and had an unblemished career. She and her husband opened two residential homes in Ireland, in 1989 and 1991, and she was then registered manager for both homes with a total of 43 residents. Mildred never had any responsibility for finances – her husband dealt with this initially and then they employed a finance manager. Mildred focussed on employing all new staff, ensuring competencies and that the home provided high quality care. They had a contract with Southern Health Trust for over 30 years.
In February 2013 a referral was made to the NMC by the CEO of Southern Health Trust with allegations around charging residents for meals and outings that were either too expensive or that did not occur as the residents were in daycare. The Wylies vehemently denied the charges.
The Wylies were also referred to The Regulation and Quality Improvement Authority (RQIA) and the DBS – they were cleared by all of any wrongdoing. Even though the police referred the case to the public prosecution service, in February 2015 they decided not to prosecute.
In Jan 2013 it was reported that the RQIA were threatening to ban the Wylie’s from operating care homes due to financial mismanagement and gave a notice of proposal to cancel their registration. The abuse allegations focussed on “unjustified and significant overpayment” in relation to meals and the homes’ transport services. The Wylie’s denied these allegations vehemently.
Care home owners may face ban over ‘financial abuse’ – BBC News
As a result of this, in March 2013 The NMC undertook their first interim order hearing based on the referral received and the RQIA report in October 2012. However, the RQIA was found guilty of abuse of process in a court of law by Judge Patrick King because of how they dealt with the referral of the Wylies. After the RQIA panel investigated they stated:
“The Vulnerable Adult Report contained factual inaccuracies in relation to the estimated day care meal charges. The correspondence between Arthur Cox Solicitors and SHSCI demonstrated that the Provider had acted on legal advice relating to interpretation of the contract; furthermore the SHSCf has significantly reduced the figure to be paid”.
Mildred also requested that both the RQIA and Southern Health Trust undertake financial inspections of her business in order to demonstrate her innocence – they both refused and continued to refuse over the next 8 years.
The RQIA has also been under the spotlight with failings during the abuse at Muckamore Abbey and information is available in the public domain in regards to these failings.
Muckamore: Patients’ families were ‘undoubtedly failed’ – Department of Health – BBC News
Muckamore Abbey Hospital Inquiry Report (MAHI) – RQIA statement
The links between inter organisational failings can not be ignored.
For the Wylie’s however, the NMC process continued with Interim review hearings every six months. Mildred endeavoured to continue to attend and be represented at all times, attempting to ensure the full picture was outlined and all parties were aware of the history behind this referral.
In March 2017 the Wylie’s did an application for judicial review – in May 2017 Southern Health Care applied for an award for costs associated with the application for the judicial review; it was not granted. Blake Morgan, the NMC’s own legal team at the time stated:
“on the face of it there is no dishonesty no financial concerns and no clinical concerns so potentially the case may be returned as a No Case to Answer”
Yet despite this, on the 8 January 2018, the NMC began their Fitness to Practice hearing. What continued was a six year process concluding in November 2024 with Mildred being struck off the register. The hearing was held in 24 individual parts, each lasting between 1 and 25 days (an average 5 days for each session). There were sometimes gaps of many months before it resumed – one being from Sept 2019 to July 2021 and another being from March 2022 to May 2024. The hearing was conducted over a total of 148 days, excluding judicial review.
It’s interesting to note that the Quality Care Commission’s unannounced inspection of the nursing home that the Wylie’s ran showed no concerns, with the report stating:
“This inspection resulted in no areas for improvement being identified.”
Prior to the inspection the CQC reviewed a number of reports in order to ensure a thorough assessment, this included notifiable events since the previous care inspection, the registration status of the home, written and verbal communication received since the previous care inspection and the previous care inspection report. The inspectors talked to staff and residents and looked at staff duty rotas, staff competency and training, residents records of care, complaints records, compliments records, audits and monitoring reports including the RQIA registration.
“Evidence of good practice was found in relation to the friendly, supportive and caring interactions by staff towards residents and we were assured that there was compassionate care delivered in the home.”
In 2021 A FOI made to the NMC in 2022 showed hearing panel costs to be as follows:
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- Daily Cost of panel chair to CCC hearing: £340 per day
- Daily Cost of registrant panel member to CCC hearing: £310 per day
- Daily Cost of lay person panel member to CCC hearing: £310 per day
- Daily Cost of legal assessor to CCC hearing: £500 + VAT per day
- Daily cost of case presenter to CCC hearing (in house and externally sourced): We don’t hold data for our in house Case Presenters as they are paid an annual wage not a fee per hearing.
- Daily cost of panel secretary to CCC hearing: We don’t have daily rates for our internal Hearing Co-ordinators, they are salaried, but the majority of them will be within the lower end of the pay scale £26,805- £33,909.
This total cost for the panel to be in attendance for the hearing alone, was £216,080 – the equivalent of 1,800 registrants fees prior to the fee increase. This does not include the cost of the case presenter and ancillary staff associated with the hearing and the case. All for a case against an elderly lady that was never going to work in the profession again.
By the time Mildred had reached her strike off order she was frail, in ill-health, 71 years of age and retired from practice. Throughout this process Mildred attested to her ill-health and the impact the prolonged process was having on her health but she was determined to see it through, hoping that fairness and reasonableness would prevail. Although reasonable adjustments of shorter days and gaps between days of hearing were made, little acknowledgement was made in this respect.
By the time NMCWatch became involved it was obvious that this case had been extremely poorly managed, but we were limited as to what we could change. Facts had already been proven by the time Mr Holborn began representing – all we could do was help Mildred demonstrate good insight through reflection work and show she posed no ongoing risk. In the substantive hearing the panel asked Mr Holborn to give commentary on sanction:
“The panel asked how conditions of practice would work given that you have retired and do not intend to work as a registered nurse again.
Mr Holborn submitted that the public can be safeguarded by a requirement that you need to undertake a return to practice course in relation to finances. He also submitted that a condition could be that you work with a nurse who provides a report to the NMC at regular intervals.
The panel also bore in mind that Mr Holborn had made reference to the fact that you had retired [PRIVATE]. When it asked how conditions would be applicable in such circumstances, Mr Holborn submitted that you could be required to take a return to practice course and undertake courses in relation to finances.”
In November 2025 the Wylies went to the High Court to appeal the strike off order and on 12 June 2026 the appeal judge quashed the order in full. This time the wait was worth it.
An article in the Ulster Gazette (paywalled) on Thursday 25th June 2026 outlined the findings of Mr Justice John O’Hara RC, who said that the cumulative effect of issues raised in the appeal showed the original finding “cannot possibly stand”, and that there was “real cause for concern” on the “approach of the NMC generally”. All charges were quashed including the strike off order. Mrs Wylie is quoted in this article saying:
“This proves beyond doubt not only my innocence but that this has been a stitch up from the very start and I have been a scapegoat from the failings of the Southern Trust, RQIA and NMC.”
She went on to talk about the reputational damage that was caused by local and national headlines about her NMC case and resulting strike off order. Mrs Wylie went on to criticise the way the NMC carried out the investigation process and the length of time they took to complete the case:
“It should never have started and after it started it should have finished long ago with my innocence proven, but certain people were determined to destroy my life and they did not care who else’s life they destroyed in the process.”
She stated that the process caused harm to residents of the care home she managed and that they were the true victims, with organisations, including the NMC, in collusion with each other.
The case was heard by 10 different panels throughout, each panel having to recuse themselves and despite legal advisors stating on different occasions that no case to answer should be found, the NMC continued.
The appeal judge also commented on the issue of poor disclosure of evidence stating:
“was fundamentally flawed because it was based on erroneous legal advice from the case presenter and from the legal assessor”
“The legal assessor’s analysis of the concept of equality of arms is simply wrong. It is, of course, necessary to consider the extent of any alleged inequality but there is simply no authority to support the proposition that the only inequality which has to remedied is one of a catastrophic character.”
“The Committee was also misled by the suggestion that as an alternative to disclosure, the appellant could call witnesses from other care homes and ask them what their policies were in relation to transport or supervision charges at the relevant time. Ignoring for the moment the prospect of her being able to do that approximately 10 years after the relevant time period, that is not an answer to the question of whether the documents are relevant. In fact, it suggests that the documents were indeed relevant.”
“The Committee was further misled by being invited to consider whether any order made for disclosure, eg against the Southern Trust, RQIA or PSNI would be resisted or ignored or‘might meet the same fate as earlier demands by the appellant for production of the material.”
“There is no basis for such a submission especially in a case where the Trust and RQIA had already co-operated extensively with NMC. On what possible basis would they then refuse to assist further in the same case?”
“In short, the Committee was taken down the wrong path entirely by both the case presenter and the legal assessor. It got the test for disclosure wrong
in multiple respects. Not only does this represent a serious irregularity in the present case, but it is a real cause for concern if this attitude is one which is
representative of the approach of the NMC generally.”
NMCWatch has tracked 56 successful appeals since 2009 where the High Court has intervened and shown that the NMC panels and often the NMC themselves have not correctly carried out their duties. This is the 56th case we have analysed which repeats many of the mistakes of the previous 55. The common themes are:
- NMC refusing to start from a point of neutrality in their investigations
- NMC failing to adhere to appropriate disclosure around evidence
- NMC pursuing cases when their own findings suggest no case to answer
- Extraordinarily lengthy process causing harm to registrant
- Serious procedural irregularity during the hearing process
- Excessive and disproportionate use of registrants fees to pursue one case exonerated in appeal
The findings of this appeal are most welcomed and finally put an end to the 14 year battle that Mildred and her husband have had to restore their professional reputation and standing in their local community. For many others however, they would not have been able to demonstrate the resilience and determination that Mildred and her family have. They have not been able to carry on fighting to clear their name. The NMC should never have prolonged this case beyond its own recognition of no case to answer. This case epitomises everything that is wrong with the NMC Fitness to Practice process and shows what aspects need to be urgently addressed if any reassurance is to be given that similar events will not be repeated. Although the case spans over a historic period of time, the actions of the NMC panels do not. The final panel convened from Monday, 18 November 2024 to Tuesday, 19 November 2024. This was the 10th panel to be involved in this case, with multiple legal assessors and case presenters all of whom at any point could have stepped in and questioned the conduct that went before them. This case once again shows us that once the NMC enter a path of progression through FtP hearing they can not reassess, reevaluate and redetermine if this is the best course of action which ultimately for a healthcare regulator of nearly 900,000 registrants who are expected to do just that in their professional conduct does not give confidence that they are in fact fit to practice themselves.
We are told by many registrants we support that it feels as if collusion between organisations who avoid reputational damage to themselves is minimised by focussing on the registrant rather than any concerns they may raise. The pursuit of these registrants via the regulator is an easy way in which to discredit them. We hear from registrants who have tried to raise concerns with NHS England, The Care Quality Commission and others, that when informing the NMC of these concerns, little weight is given to them, and that the NMC continue to pursue in line with the allegations against the registrant. This pursuit of registrants, whilst ignoring the concerns they raise, is counter productive to good regulation and ultimately destabilises its overall purpose. Potentially the regulator is being used as a pawn to discredit registrants who have only fulfilled their professional duty by following Duty of Candour and escalation of concerns.
Paul Rees’s response to the recent PSA report was that it reflects “a dark period in the NMC’s history” but that it was “on the road to recovery”. But when such catastrophic failings are found via an appeal such as Mildred’s, how can we be assured that the the regulator has the appetite to improve and will do so with any real urgency.
Regulatory investigations are essential for public and professional safety, but when they focus only on the individual they can be counter productive and potentially cause harm. There is a huge responsibility on the regulator who not only ensures the professionalism of registrants’, but also is the gate keeper to what else is going wrong in the workplace that needs addressing. By focusing only on the prosecution of the registrant we will never move past the blame culture and ultimately will never be assured by our regulator that they are pursuing the right cases at the right time, in the right way.
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