Isaghehi v Nursing and Midwifery Council

On an appeal from a professional disciplinary sanction, the court must respect the specialist tribunal’s expertise and evaluative judgment. It may intervene where the decision was wrong, or unjust because of serious procedural irregularity. On sanction, the appellant must show that the order was excessive and disproportionate or outside the range of reasonable outcomes.

Striking off is not justified merely because a registered professional has committed serious criminal misconduct. The tribunal must assess whether the conduct is fundamentally incompatible with continued registration, whether suspension can protect the public interest, and whether public confidence can be maintained without permanent removal. A single incident, absence of entrenched attitudinal problems or repetition, genuine insight and low risk of recurrence may make suspension sufficient.

The appellant, a psychiatric nurse, appealed under article 38 of the Nursing and Midwifery Order (2001) against a Conduct and Competence Committee decision finding his fitness to practise impaired and imposing a striking-off order. The sanction followed his conviction and imprisonment for dangerous driving after an intimidating road incident.

The Committee accepted that suspension would address public protection concerns but considered striking off necessary for the wider public interest, because the conviction was fundamentally incompatible with continued registration and removal was required to maintain confidence in the profession and regulatory process. The central issue was whether striking off was the only sufficient sanction.

1. The appeal was allowed under article 38 of the Nursing and Midwifery Order (2001). The court substituted a 12-month suspension for the striking-off order.

2. The appeal was governed by the review approach in CPR 52.11. The court could dismiss the appeal, quash or substitute the decision, or remit the case. Respect was due to the specialist Committee, including its understanding of professional standards and its assessment of matters analogous to jury questions. That deference did not prevent intervention where the decision was wrong.

3. On sanction, the appellant had to establish more than that the order was wrong. The sanction had to be excessive and disproportionate or outside the range of what could reasonably be imposed.

4. The court applied the indicative sanctions guidance. The misconduct was a single incident and was not fundamentally incompatible with continued registration. There was no evidence of deep-seated personality or attitudinal problems, repetition or a significant risk of recurrence. The appellant had gained insight, shown genuine contrition and completed victim-awareness work. Those matters were relevant to how the public interest should be assessed, rather than merely mitigating the offence.

5. Striking off was not the only sanction sufficient to protect the public interest. Public confidence in the profession and the Council could be maintained without removal from the register. The striking-off order was therefore disproportionately high, and a 12-month suspension was substituted. On review, particular emphasis should be placed on whether there had been any recurrence of the serious loss of control underlying the conviction.

6. Other disciplinary decisions concerning criminally bad driving were too fact-sensitive and insufficiently comparable to assist.

The judgment describes an appeal from the Nursing and Midwifery Council Conduct and Competence Committee. The High Court allowed the appeal and substituted a 12-month suspension for the striking-off order.