Nursing and Midwifery Council, R (on the application of) v Akinleye

When deciding whether to extend an interim suspension order imposed by a professional regulator, the court must assess the gravity of the allegations, the seriousness of the risk of harm to patients or the public, and the reasons why the substantive proceedings remain unresolved.

Serious misconduct and an ongoing risk to public protection may justify continuation despite substantial delay and personal hardship. Delay caused by another investigating authority may explain part of the period, but the regulator must proceed with urgency once that investigation has ended. A further extension may be refused where the regulator has not progressed a relatively straightforward case expeditiously.

The Nursing and Midwifery Council applied under section 31(8) of the Nursing and Midwifery Order 2001 to extend for a further 12 months an interim suspension order imposed on the defendant’s registration.

The order had been imposed after allegations that the defendant falsified antenatal records and purported to provide official NHS treatment, placing a patient’s health at risk. The Council’s investigation had been delayed while the NHS Counter Fraud Service considered criminal proceedings, which were ultimately not pursued. The central issues were whether continuation remained necessary for public protection and how the delay should affect the application.

1. Application granted. The interim suspension order was extended for the further 12 months sought.
2. In determining an application for extension, the court must have regard to the gravity of the allegations, the seriousness of the risk of harm to patients, and the reason why the case has not been concluded. Those principles were stated in General Medical Council v Dr Stephen Chee Cheung Hiew [2007] EWHC Civ 369.
3. The alleged misconduct was exceptionally serious. The defendant had admitted falsifying documents and had purported to treat a patient as though the treatment were officially supported by the NHS when it was not. The conduct placed the patient’s health at risk. Continued suspension was therefore necessary for the protection of the public.
4. The court took account of the defendant’s difficult family and financial circumstances and the considerable duration of the proceedings. The initial delay was substantially explained by the NHS Counter Fraud Service investigation and could not be attributed to the Council. Once that investigation ended, however, the Council had delayed significantly in reactivating its proceedings.
5. The Council was required to proceed urgently and set a hearing date as soon as reasonably practicable. The judge indicated that he was unlikely to be sympathetic to any further extension application absent overwhelming reasons.

First instance application in the Administrative Court. No appellate history is stated in the judgment.