Nursing and Midwifery Council v Arkoh-Ankrah

When deciding whether to extend an interim regulatory suspension order, the court must assess the gravity of the allegations, the seriousness of the risk of harm to patients, the reasons for delay, and the prejudice to the practitioner. The court does not determine the truth or merits of the allegations. It asks whether the allegations, taken at face value, justify prolonging the order. The public interest in protecting patients and maintaining confidence in professional regulation must be balanced against the practitioner’s interests and the need for the disciplinary process to conclude promptly. Any extension should be limited to the period reasonably required.

The Nursing and Midwifery Council applied under article 31(8) of the NMC Order 2001 to extend an interim suspension order imposed on a registered nurse. The order had previously been extended by the High Court and was due to expire shortly after the application.

The respondent faced numerous allegations concerning basic competence in nursing practice. The disciplinary hearing had begun but was adjourned part heard, with the resumed hearing scheduled for February 2015. The respondent objected to further extension but did not identify specific prejudice. The central issue was whether the statutory and public-interest criteria for extending the interim order were satisfied, and for what period.

1. The application was granted. The interim suspension order was extended to Friday 20 March 2015, shortly beyond the scheduled resumed hearing. There was no order as to costs.
2. Under article 31(8) of the NMC Order 2001, the High Court’s role was to decide whether an extension of the interim order was justified. Article 31(9) permitted an extension or further extension for up to 12 months.
3. Applying the guidance in General Medical Council v Hiew [2007] EWCA Civ 369, the court considered the gravity of the allegations, the seriousness of the risk of harm to patients, the reasons why the disciplinary case had not concluded, and the prejudice to the practitioner.
4. The court was not required to make findings of fact or determine the merits of the allegations. It had to assess whether the allegations themselves justified prolonging the interim order. The allegations were numerous, wide-ranging and serious, and concerns about the respondent’s practice had persisted despite formal action plans and substantial support.
5. The substantial delay and the respondent’s interests were relevant countervailing considerations. It was in the interests of justice that the proceedings conclude as swiftly as reasonably practicable. Nevertheless, the hearing was part heard, all evidence had been given, and a resumed hearing had been fixed. The risk to patients and the public interest justified continuation, but only for a limited period. The NMC was expected to apply promptly for any further extension if the matter could not be concluded by the specified date.