Nursing and Midwifery Council v Maynard

When deciding whether to extend an interim conditions of practice order, the court must assess the circumstances at the time of the application. The relevant considerations include the gravity of the allegations, the nature of the evidence, the risk of harm to patients, the reasons for delay, and prejudice to the practitioner. The absence of a concluded finding on fitness to practise does not determine whether interim protection remains appropriate. The court must balance the practitioner’s prejudice against public protection and the public interest. A pending full hearing and the withdrawal of consent to an intended consensual procedure may constitute a good reason for extending the order.

The Nursing and Midwifery Council applied under Nursing and Midwifery Order 2001, art 31(8), to extend an interim conditions of practice order imposed on a newly qualified nurse following concerns about her clinical practice. The order had previously been extended by the High Court and was due to expire on 18 October 2019.

The respondent opposed a further extension, relying on delay, the absence of any finding against her fitness to practise, and asserted improvements in her practice. A full panel hearing had been listed for December 2019 after the respondent withdrew consent to a proposed consensual panel determination. The issue was whether a further extension was justified and proportionate.

1. Application granted. The interim conditions of practice order was extended.
2. The court applied the five factors identified in General Medical Council v Hiew [2007] EWCA Civ 369: the gravity of the allegations, the nature of the evidence, the seriousness of the risk of harm to patients, the reasons why the case had not concluded, and prejudice to the practitioner.
3. The fact that no finding of unfitness to practise had yet been made was irrelevant to the interim application. The question was whether conditions remained appropriate before determination of the underlying allegations.
4. The withdrawal of consent to the proposed consensual panel determination, together with the listing of a full hearing in December 2019, provided a good reason for seeking a further extension. The court assessed the position as it stood at the hearing and could not remedy earlier delay retrospectively.
5. The allegations, although not at the most serious end of the spectrum, raised concerns about the practitioner’s capacity to care properly for patients. The evidence included material indicating that she accepted shortcomings requiring attention. Those concerns and the potential risk to patients outweighed, in the circumstances, the real prejudice caused by continuation of the conditions.

The judgment records that the High Court had previously extended the interim order on 19 June 2019 for four months. This application concerned a further extension under Nursing and Midwifery Order 2001, art 31(8). No appellate history is stated.