Nursing and Mid-Wifery Council, R (on the application of) v Apara

An interim suspension order may be extended where regulatory proceedings have been delayed because the registrant has repeatedly failed to cooperate with directions necessary to obtain essential medical evidence. The court must be satisfied that the proposed extension is appropriate and reasonable in the circumstances. An order may include liberty to apply to vary or discharge it on written notice.

The Nursing and Midwifery Council applied to extend an interim order suspending the defendant from the Register of Nurses. The order, previously extended by Sullivan J on 27 October 2008, was due to expire on 26 October 2009. The underlying referral concerned alleged impairment of competence to practise on medical grounds. Progress had been delayed by the defendant’s repeated failure to cooperate with directions for psychiatric examination. The issue was whether a further 12-month extension should be granted pending an anticipated referral to the appropriate disciplinary panel.

1. Extension granted. The interim suspension order was extended for 12 months, from 26 October 2009 until 25 October 2010.
2. The referral arose from concerns that the defendant’s competence to practise was impaired on medical grounds. The investigating committee had directed her to undergo psychiatric examination. Although described as an invitation, the panel had power to direct the examination.
3. The necessary psychiatric evidence remained unavailable because the defendant had repeatedly failed to provide the required cooperation and consent. That evidence was an essential prerequisite to referral to the panel responsible for considering competence to practise and physical and mental capacity.
4. The Council had decided to refer the defendant for consideration of a disciplinary complaint based on her repeated failure to comply with the directions. A panel meeting was listed for 9 December 2009, with a hearing anticipated in early 2010 if referral occurred.
5. In those circumstances, the court was satisfied that the requested period was appropriate and reasonable. The defendant was granted liberty to apply to vary or discharge the order on three days’ written notice to the Council.
6. The court also observed that the Council might have proceeded by application notice in the original proceedings rather than by a Part VIII claim form, potentially saving court fees. That procedural observation was not investigated or made part of the operative decision.

The judgment records that Sullivan J had extended the interim suspension order on 27 October 2008. The present application for a further extension was granted by the Administrative Court.