Holder v Nursing And Midwifery Council

An adjournment may be granted where medical evidence, although inadequate when considered alone, is materially connected with a genuine and unresolved issue affecting the fairness of the hearing. General assertions of stress or anxiety are insufficient. Medical evidence relied upon for a further adjournment should identify the attendant, explain the medical condition and why it prevents participation, provide a reasoned prognosis, and demonstrate an independent opinion following proper examination. The court must also balance the party’s ability to participate against the need for finality and the public interest in concluding regulatory proceedings.

The appellant, a registered nurse, brought a statutory appeal against a decision of the Nursing and Midwifery Council’s Conduct and Competence Committee to strike her off the register. The appeal had already been adjourned three times. Shortly before the listed hearing, she sought a further adjournment based on alleged ill health, outstanding documents, and access to the original recording of the disciplinary hearings.

The central questions were whether the medical material justified another adjournment, whether the requested documents and recording were relevant to a fair determination of the appeal, and how the court should balance those matters against finality and the public interest in resolving professional disciplinary proceedings.

1. The application for a fourth adjournment was granted, but only because the court found an unexpected connection between the appellant’s anxiety and her longstanding inability to access the underlying recording of the disciplinary hearings. The medical evidence, considered in isolation, was extremely weak. The court nevertheless regarded the failure to provide access to the recording earlier as unfortunate and considered that the resulting stress had a sufficient connection with the fairness of proceeding.

2. General statements that litigation has caused stress or anxiety do not ordinarily justify an adjournment. The court applied the fact-specific approach discussed in Tariq Rehman v Bar Standards Board [2016] EWHC 1229 (Admin). A court may accommodate ordinary litigation anxiety, particularly where the party has competent representation, but must assess whether the medical condition genuinely prevents participation.

3. Any future application based on ill health had to be supported by expert and detailed medical evidence. Following Levy v Ellis-Carr, the evidence should identify the medical attendant, explain the attendant’s familiarity with the party’s condition and recent consultations, identify the condition and the features preventing participation, provide a reasoned prognosis, and give confidence that the opinion is independent and based on proper examination.

4. The court ordered the NMC to facilitate access to the original recording, with technical assistance and attendance by an NMC legal representative so that any discrepancies could be noted. It also ordered disclosure of certain unredacted emails and required the NMC to use best endeavours to obtain other documents. The proposed disclosure of the contract with the transcribers was refused as irrelevant.

5. No further adjournment would be granted except for unforeseen and grave ill health or a similar grave event. The court stressed the need to bring litigation to an end and the strong public interest in the proper and final conclusion of proceedings concerning regulation of the nursing profession.

• Conduct and Competence Committee of the Nursing and Midwifery Council: found allegations proved and ordered that the appellant be struck off the register.
• High Court (Administrative Court): considered the appellant’s statutory appeal and granted a further adjournment of the substantive hearing, subject to detailed directions and a final-warning condition.