Nursing And Midwifery Council v Coombs

On an application to extend an interim restriction on a nurse’s registration, the court applies the same criteria as the regulatory body applying for the original interim order. The court does not determine the truth of the underlying allegations or make primary findings of fact. It assesses whether the allegations justify continuation of the order. Relevant considerations include the gravity of the allegations, the risk of harm to patients, the reasons for delay, and prejudice to the practitioner. Public protection and confidence in the profession may outweigh prejudice where serious allegations create a continuing risk. A specialist regulatory review may be the appropriate forum for a more detailed assessment of the order’s necessity and form.

The Nursing and Midwifery Council applied under article 31(8) of the Nursing and Midwifery Order 2001 for a further nine-month extension of an interim conditions of practice order restricting Anthony John Coombs’s registration as a nurse.

The order arose from referrals concerning alleged medication and patient-care errors. The investigation had been delayed by difficulties obtaining evidence, staff changes, workload, and the public health crisis. The respondent had notice but did not attend or contest the application. The central issue was whether continuation of the interim order remained necessary for public protection and otherwise in the public interest.

1. Application granted. The interim conditions of practice order was extended for nine months under article 31(8) of the Nursing and Midwifery Order 2001.
2. Following GMC v Dr Stephen Chee Cheung Hiew [2007] EWCA Civ 369, the criteria for extending an interim order are the same as those applicable when the regulatory body makes the order. Relevant factors include the gravity of the allegations, the seriousness of the risk of harm to patients, the reasons why the case remains unresolved, and the prejudice to the practitioner.
3. The regulatory body bears the burden of satisfying the court that the criteria are met. The court must not determine the truth or falsity of the allegations, make primary findings of fact, or consider the merits of the substantive case. The question is whether the allegations justify prolonging the interim restriction.
4. The allegations were serious and directly concerned nursing practice. If repeated, they created a serious risk of harm to patients and a related risk to public confidence in the profession. Although the investigation had suffered unacceptable delay, particularly in relation to the second referral, the public interest in maintaining the order outweighed the respondent’s prejudice.
5. The requested early specialist-panel review provided the appropriate forum for a nuanced assessment of whether an order remained necessary and, if so, what form it should take. The Council’s assurances concerning progression of the investigations were material. The court warned that it should not assume any further extension would be granted and that those commitments must be honoured.

First-instance application in the High Court (Administrative Court). No appeal or earlier judicial decision is stated in the judgment.