Osammor, R (on the application of) v Nursing & Midwifery Council

In a professional disciplinary appeal, the court should not interfere with a sanction unless it falls outside the reasonable range open to the tribunal. Persistent dishonesty, particularly involving more than one employer and accompanied by a continuing lack of insight, may justify striking a registered professional from the register. The tribunal must weigh mitigation, including clinical competence and personal hardship, but public protection, professional standards and public confidence may properly outweigh those matters. Each case turns on its own facts, and decisions in other dishonesty cases provide limited guidance.

Mrs Osammor appealed against the decision of the Nursing and Midwifery Council’s Conduct and Competence Committee following a hearing in September 2013. The committee found several allegations of misconduct proved, including a prolonged course of dishonesty concerning agency work, employment history and the nature of pending NMC proceedings. It found impairment and imposed a striking-off order.

The central issue was whether striking off was disproportionate in light of the appellant’s clinical competence, previous good history, partial disclosure, admission of some conduct, the non-clinical nature of the dishonesty and the hardship caused by removal from the register.

1. Appeal dismissed. The committee’s striking-off order was within the reasonable range legitimately open to it on the facts and reasoning.
2. The court should show restraint when reviewing a professional tribunal’s decision on sanction. The tribunal has heard the evidence and is principally concerned with protecting the public, maintaining professional standards and preserving confidence in the profession and its regulator. Intervention remains possible where the decision falls outside the reasonable range of lawful responses.
3. The committee was entitled to treat the misconduct as persistent dishonesty rather than an isolated incident. The dishonesty extended over a substantial period, involved more than one employer and included undertaking agency work contrary to supervised-practice restrictions and misleading those responsible for the appellant’s employment and supervision.
4. The committee was also entitled to find a continuing lack of insight. The appellant’s evidence, denial, attribution of responsibility to others and attempts to minimise the conduct were matters the committee was particularly well placed to assess.
5. Clinical skill, previous good conduct, limited disclosure, admissions and financial hardship were relevant mitigating matters, but they did not require a lesser sanction. The public interest could outweigh the appellant’s personal interests where the committee reasonably concluded that continued registration would undermine public confidence and that no lesser sanction would provide sufficient protection.
6. The court noted that dishonesty cases are fact-sensitive and that one decision rarely provides substantial guidance for another. Costs were awarded to the NMC in the reduced sum of £3,000 plus VAT.

• Conduct and Competence Committee of the Nursing and Midwifery Council: found misconduct and impairment proved and imposed a striking-off order, communicated on 12 September 2013.
• High Court (Administrative Court): dismissed the appeal and ordered costs of £3,000 plus VAT.