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

When deciding whether to extend an interim suspension order imposed on a registered health professional, the court applies the same criteria as the relevant practice committee. The order must be necessary for public protection, the public interest or the interests of the practitioner. Relevant considerations include the gravity of the allegations, the risk of harm to patients, the reasons for delay, and prejudice to the practitioner. The regulatory body bears the burden of satisfying the court. The court does not determine primary factual disputes on an extension application. Where serious, well-founded concerns remain and further investigation is required, an extension may be proportionate and justified.

The Nursing and Midwifery Council applied for an eight-month extension of an interim suspension order imposed on a nurse whose suspension was due to expire. The application arose from allegations that she attended vulnerable, end-of-life patients while apparently affected by alcohol, together with a drink-driving conviction and medical evidence of longstanding alcohol misuse. The matter had been referred to the Health Committee for investigation into current impairment of fitness to practise. The central issues were whether the court had jurisdiction to extend the order, whether the statutory criteria were satisfied, and whether the proposed period was reasonable.

1. The court had jurisdiction under Article 31 of the Nursing and Midwifery Order 2011. Under Article 31(9), an extension could last for up to 12 months, but only where the general criteria in Article 31 were satisfied.
2. The applicable criteria were those governing the making of an interim order by the relevant practice committee. The court had to be satisfied that suspension was necessary for the protection of the public, otherwise in the public interest, or in the interests of the practitioner. The regulatory body bore the burden of proof.
3. Relevant factors included the gravity of the allegations, the seriousness of the risk to patients, the reasons why the proceedings had not concluded, and prejudice to the practitioner. On an extension application, the court was not required to make primary findings of fact.
4. The concerns in this case were serious, well documented and well founded. There was no evidence that they had abated. Given the risk to vulnerable patients and the need for further enquiries into fitness to practise, continued suspension was necessary, proportionate and justified on all three statutory grounds.
5. An eight-month extension was reasonable. The suspension was extended to 21 October 2013. No costs order was sought.