Since 2009 we know of more than 50 cases where a High Court Judge has ruled that the decision by an NMC Fitness to Practice panel or application for interim order extension is wrong. Seven of these cases were in 2025 and among an increasing number being supported by the Royal College of Nursing Union, support which had previously been extremely difficult to secure. The most recent was challenged by the Professional Standards Authority who can appeal on behalf of the public if they feel a sanction is too lenient. The NMC can also refer a case to the PSA if they feel the panel have made an error or a case outcome is unclear.
Registrants will look to their union to assist with an appeal but often find it lacking due to the financial commitment required. Without union support it is extremely difficult for a registrant to navigate the process, particularly when they are likely to be out of work and utterly demoralised from the Fitness to Practice process. Only having 28 days to bring an appeal is another major factor in registrants choosing to walk away from appealing, but this doesn’t mean all those outcomes are right.
An appeal story
On the 18th November 2025 one registrant decided to proceed to appeal by funding legal representation.
Kara Hannigan had been a registered nurse since 1991 and apart from the allegations which were considered by the Panel she has had an unblemished career. The allegations relate to the period from November 2014 to July 2019, a decade prior to the hearing that was conducted by the NMC. She was accused of bullying and / or harassment of nurses in a clinic and that she took improper steps to cover up her conduct. She has always denied these allegations but stated there was conflict around her management style and her use of capability to manage staff conduct.
She was referred to the NMC on 20th March 2020 – nearly a year after this alleged period ended.
The first stage of the hearing occurred in a number of installments, from 22nd July – 9th August 2024, and 23rd – 27th September 2024. The Panel found that a number of the allegations were proved as a matter of fact. The Panel found that a number of other allegations had been proved as matters of fact but subsequently concluded that they did not amount to misconduct.
The Panel then found that the remaining factual allegations had not been proved. The hearing to address the issues of misconduct; of whether the Appellant’s fitness to practise was impaired; and of the appropriate sanction lasted from 10th – 14th March 2025.
The Panel concluded that not all of the proven factual allegations amounted to misconduct, but did find misconduct in some.
The Panel was satisfied that the Appellant’s fitness to practise was not impaired by reason of a risk of harm to patients. It did, however, conclude that her fitness to practise was impaired because her conduct had been such as to bring the nursing profession into disrepute and because she had breached fundamental tenets of the profession. In coming to that conclusion the Panel was particularly influenced by its findings, first, that the Appellant had used a capability policy in order to deflect potential criticism and, second, that the Appellant had diarized daily meetings with the member of staff, in order to provoke an adverse reaction from her.The registrants submitted this was a group of disgruntled members of staff who had gathered together to cause trouble. This case was not dissimilar to that of Laura Hindle the previous year who the RCN had supported successfully at appeal.
The sanction of suspension for 12 months was imposed.
Read case notes for the 50+ cases
A written notification of the Panel’s decision arising out of the March 2025 hearing was sent on 18th March 2025. That notification contained a different version of the Panel’s decision and reasons on the facts from that which had been provided by the NMC after the September 2024 hearing. The NMC had provided an earlier and incomplete draft version which had been superseded by the latest document. Its important to note that a nurse facing allegations around poor documentation would not have been given such leniency.
The representation for Kara argued that the evidence relied on by the NMC was so flawed that it could not be a proper basis for findings that the allegations were made out in fact. She submitted, there would be no basis to send the matter for a further hearing, the inevitable outcome of which would be dismissal of the allegations. She alleged that:
- inconsistencies in her NMC witness evidence were such that the accounts could not be relied upon
- that supporting evidence of an additional witness was “so flawed it could not be believed” as her evidence was inconsistent with other NMC witnesses
- Further context around the capability process that had been supported by the clinical director. The judge agreed this aspect but referred to the key issue about the complication of such historic cases, “account must be taken of the period of time which had elapsed since the events in question”.
Prior to appeal the NMC conceded and attempted to get the registrant to agree to go to a new panel for the case to be reheard. She refused as she had lost faith in the NMC process and felt it required judicial review even if the outcome was the same. She was made aware that the NMC would pursue costs, a matter which they argued to her in great detail; she continued with her appeal despite this.
The judge went on to discuss the merits and disadvantages of remitting the case to a new panel to decide on the misconduct and in doing so stated:
This is a case where the agreed removal route would appear on the current material to be a sensible way forward but the decision on that is for the Registrar.
However he noted the need for caution also and went on to say:
“I am satisfied that the Appellant is genuine in saying that she does not intend to return to nursing and that she will seek to be removed from the Register, if the decision were simply quashed the Appellant would be free to change her mind and to seek to work as a nurse.”
He then went on to highlight the length of time since events, the length of time the original hearing took to conclude (25 days) and the issues the NMC may have to relist in a timely fashion. The NMC stated that they may be able to relist by August 2026 but we are aware of a more realistic date being early 2027. In trying to determine the best course of action the judge stated:
“It follows that there is a real prospect that the outcome of the remitted hearing will be the rejection of some or all of the outstanding allegations.
Therefore it is important to consider the public interest in pursuing to a hearing with such a likely outcome despite the allegations being so serious.”
The issue of funding representation was considered. It was unclear if the RCN would support a new hearing, but the judge stated that this wasn’t an aspect that should influence his decision. The important factor is public interest and public safety which overrides any financial restrictions the nurse may have, whether they are represented or not, or can afford to fund representation or not. The sad fact of such proceedings is that there is no real access to equal justice for registrants under FtP.
He finally concluded that:
“… the public interest in the proper regulation of the nursing profession and the interests of fairness and justice in this particular case are best served by the matter being remitted for a further hearing. That hearing will not be necessary if an application for agreed removal is made and the Registrar concludes that course is appropriate…”
The appeal was allowed and was sent to be heard by a new panel but the judge noted again about application for voluntary removal by saying:
“The order remitting the matter will provide that such a hearing will not be necessary if the Appellant’s removal from the Register is agreed in accordance with rule 14. .. It is not for this court to direct the Registrar as to the exercise of his discretion under rule 14 and this judgment should not be read as purporting to do so. However, if an application for agreed removal is made then a copy of this judgment is to be provided to the Registrar so that he can derive such assistance as he finds fit from my analysis of the relevant factors noting that the factors which operate against remittal would seem also (and arguably even more so) to be factors in favour of acceding to an agreed removal.”
Who really wins?
Whilst this is in effect a “win” for the registrant, the harsh reality is that she has an uncertain future. She no longer works in the profession due to process and restrictions imposed and has made peace with herself that her nursing career is over. However, she wanted to show in court that the NMC process was flawed and for this she has most definitely won. The NMC have fought against awarding the usual basis of costs which has meant that in effect she is put into further financial hardship as the costs awarded do not cover her legal representation. This is always the unfair balance of such appeals, if the NMC had won they could have sought considerable costs but the same does not apply to the registrant. Agreed removal would certainly be the most sensible option but as we know the NMC will often want to pursue to hearing for a panel to decide outcome and they know the likelihood of a registrant continuing to engage is then slim.
It is important that registrants appeal through the High Court but if the fitness to practice process does not change and improve as a result of these appeals then these judges’ words are futile. There needs to be independent oversight for the numerous appeals that have now gone through the High Court. We also need someone with authority and power to ask some difficult questions, otherwise the public will continue to be failed by flawed process, and registrants will continue to be failed by lengthy and punitive procedures.
