Nursing and Midwifery Council v Ackland

An interim suspension order may be extended where the applicant proves, on the balance of probabilities, that continuation remains justified for public protection, the public interest or the practitioner’s own interests. The court assesses the gravity of the allegations, the evidence, the risk of harm, the reasons for delay and prejudice caused by continuation. It does not decide whether the allegations are true. Continued suspension may remain necessary where addiction creates a risk of impaired judgment or access to controlled medication, and where serious dishonesty or medication-management allegations make unrestricted practice contrary to the public interest. Delay caused by a proper referral and the practitioner’s failure to attend medical appointments may justify an extension, provided the regulator has proceeded with reasonable expedition.

The Nursing and Midwifery Council applied under article 31(8) of the Nursing and Midwifery Order 2001 for a three-month extension of an interim suspension order imposed on a registered nurse. The order followed allegations that she had taken morphine from nursing-home stocks for personal use and had accepted a police caution for theft.

The matter had been referred between the Conduct and Competence Committee and the Health Committee. A final hearing was listed for 29 May 2015. The defendant neither attended nor was represented. The central issue was whether the interim order remained necessary and whether the duration of the extension sought was justified.

1. Application granted. The interim suspension order was extended for three months under article 31(9) of the Nursing and Midwifery Order 2001.
2. The governing criteria were those identified in Hiew [2007] EWHC Civ. 369. They were the protection of the public, the public interest and the practitioner’s own interests. The applicant bore the onus of satisfying the court on the balance of probabilities.
3. Relevant considerations included the gravity of the allegations, the nature of the evidence, the seriousness of the risk of harm to patients, the reasons why the proceedings had not been completed and the prejudice caused to the practitioner by continuation. The court’s function was to decide whether prolongation was justified, rather than determine the truth of the allegations.
4. The order remained necessary. The medical evidence recorded continuing addiction to opiates. That created a continuing risk that the defendant might obtain medication from workplace stocks or work while affected by opiates, impairing her judgment and exposing patients to harm. The allegations also involved dishonesty and mismanagement of medication, making unrestricted practice contrary to the public interest while fitness to practise remained unresolved.
5. The regulator had proceeded with reasonable expedition. The referral to the Health Committee was proper, and later delay resulted from the defendant’s failure to attend two medical appointments. A two-month extension would not safely accommodate the required notice period if the listed hearing had to be relisted.

The judgment records that the High Court had previously extended the interim suspension order by consent for six months on 15 September 2014. The present application for a further extension was granted.