Joanne Budzichowska v The Nursing and Midwifery Council

On an application concerning an interim professional restriction, the court exercises an original jurisdiction. It does not conduct judicial review, but may vary or terminate the order if it considers the order wrong.

An interim suspension may be imposed where necessary for public protection or otherwise in the public interest. The decision-maker must assess the evidence and risk without deciding disputed facts, weigh the practitioner’s interests, and consider whether workable conditions would sufficiently protect the public. Serious, repeated allegations of harmful or attitudinal misconduct may justify suspension despite positive employment evidence and a period of safe practice. Public-interest suspension has a high threshold, but no additional requirement of exceptional circumstances applies.

The applicant, a registered nurse, applied under Article 31(12)(a) of the Nursing and Midwifery Order 2001 to terminate an interim suspension order imposed by a Fitness to Practise Committee panel on 5 June 2024, or to replace it with conditions of practice.

The allegations concerned repeated neglectful, abusive, dishonest and unsafe conduct towards vulnerable residents at two care homes. The applicant relied on earlier decisions imposing conditions, later revoking an interim order, and on positive testimonials and a period of unrestricted practice. The central issues were whether the panel had properly assessed risk, proportionality, the conditions alternative, public interest, reasons and the effect on the applicant’s family life, and whether the duration of the order was proportionate.

1. Original jurisdiction. Under Article 31(12) of the Nursing and Midwifery Order 2001, the court’s jurisdiction was original, not appellate or judicial review-based. The court could consider whether the order was wrong, while remaining mindful that it was reviewing the decision of a specialist tribunal.
2. Risk assessment. Applying Perry, Hiew, Sandler, MXM and Sheikh, the panel had to assess whether an interim order was necessary for public protection, otherwise in the public interest, or in the practitioner’s interests. It could assess the nature and strength of the evidence, but could not determine disputed credibility or the merits of the substantive allegations. The allegations were supported by credible and cogent material and involved repeated conduct at different care homes towards vulnerable residents.
3. Positive evidence and proportionality. The panel had considered the applicant’s training, testimonials, reflective statement and 13 months of unrestricted practice. It was entitled to conclude that those matters did not eliminate a real risk of repetition, particularly given the alleged attitudinal nature, frequency, unpredictability and duration of the conduct, night-shift working and difficulties in providing effective supervision.
4. Least restrictive measure. The panel had properly considered conditions of practice and gave legitimate reasons for rejecting them. The level of supervision needed to protect residents and address the wider public interest was not workable. Suspension was therefore necessary and proportionate. The public-protection and public-interest considerations outweighed the applicant’s financial, professional, reputational and family-life interests.
5. Reasons and duration. The panel’s reasons adequately explained its conclusions on the principal issues. However, the agreed period of 18 months was disproportionate because the substantive hearing was listed within about four months, although adjournment remained possible. The application to terminate or replace the suspension was refused, but its duration was varied to 12 months from 5 June 2024, or until the fitness-to-practise proceedings were determined.