Yaboah v The Nursing and Midwifery Council

On a statutory appeal against professional disciplinary sanction, the appellant must show that the sanction was excessive, disproportionate, or outside the range of reasonable responses. A striking-off order may be justified where a nurse’s conduct comprises a series of serious failures, including the handling and reporting of a medication error, and demonstrates deficiencies in practice, insight, or response to previous training. The disciplinary panel is entitled to assess the practical efficacy of training or conditions of practice and to protect patients, public confidence, and professional standards.

The appellant, a registered nurse, appealed under article 38 of the Nursing and Midwifery Order 2001 against a Conduct and Competence Committee decision ordering her name to be erased from the nursing register. The panel found proved a series of failures arising from the administration of an incorrect antibiotic, the subsequent withdrawal of blood, failure to report the medication error, and inappropriate contact with the patient. It also found impaired fitness to practise and imposed a striking-off order. The central issue was whether that sanction was excessive, disproportionate, or outside the range of reasonable responses.

1. The appeal was dismissed. The appellant had to demonstrate that the striking-off order was excessive, disproportionate, or outside the range of what could be regarded as reasonable.
2. The panel’s approach could not be faulted. Its reasoning showed that it had considered the relevant range of sanctions, the appellant’s limited experience, the training and supervision suggested, the circumstances of the incident, and the appellant’s conduct and evidence during the proceedings.
3. The panel was entitled to assess the appellant’s demeanour and apparent lack of acknowledgement of the seriousness of the events, notwithstanding the pressure inherent in the hearing. It was also entitled to conclude that further training would not address the deficiencies identified.
4. The conduct was not confined to the original medication mistake. The proved matters included failure to check the patient’s identity and medication, withdrawing blood without consent, failing to report the error appropriately, and subsequently speaking to the patient after the complaint. Taken together, these matters represented a serious departure from the standards expected of a registered nurse.
5. The earlier drug-related incident and subsequent training entitled the panel to regard the later events as demonstrating inadequacies in practice and in the appellant’s response to training, rather than as an isolated incident. The panel was therefore entitled to conclude that striking off was the proportionate and reasonable sanction.
6. The costs of £2,200 were allowed.

1. Conduct and Competence Committee of the Nursing and Midwifery Council: found the allegations proved, determined that the appellant’s fitness to practise was impaired, and ordered erasure from the register.
2. High Court (Administrative Court): dismissed the statutory appeal under article 38 of the Nursing and Midwifery Order 2001 and allowed costs of £2,200.