The Nursing and Midwifery Council v Ishaq Ibrahim

In a professional regulatory appeal, quashing a fitness-to-practise committee’s findings does not make remittal automatic. Under the Nursing and Midwifery Council Order 2001, the appellate judge has a discretion to quash, substitute or remit. Remittal may be refused where a rehearing would serve no useful public-interest purpose or would be disproportionate, considering the likely sanction, later practice, insight, the need for a full rehearing, delay and wider resource effects. Deference to an expert panel is important but not overriding. Its weight depends on the clinical nature of the issues and the panel’s relevant expertise. An interim order cannot be treated as time served towards a later sanction.

The Nursing and Midwifery Council appealed against the High Court’s decision in [2024] EWHC 2991 (Admin). The Deputy Judge had allowed the registrant’s appeal against findings of misconduct and impairment made by the Fitness to Practise Committee, quashed the related orders, dismissed the charges and declined to remit the matter.

Permission to appeal was limited to whether the judge made inadequately reasoned implicit findings and erred in failing to remit the case. The challenge to the quashing of the factual findings was not permitted. The central issue was whether remittal was the only proper disposal after the Committee’s findings had been set aside.

Appeal dismissed. Lord Justice Dove gave the judgment, with Lord Justices Snowden and Males agreeing.

1. Article 38(3) of the Nursing and Midwifery Council Order 2001 gives the court a discretion among the available disposals of an appeal from an FPC decision. Where the appeal must be allowed because the Committee’s findings cannot stand, the court may quash, substitute or remit. Remittal is not mandatory, and appellate interference with the judge’s exercise of that discretion is limited.
2. The High Court judge was not required to make alternative factual findings after quashing the FPC’s findings. Substitution was a possible course under article 38(3)(c), but it had not been advocated as the appropriate disposal. The judge was entitled to consider whether remittal would serve any useful purpose.
3. In assessing purpose and proportionality in the public interest, the judge could consider the likely outcome even at the highest against the registrant, the absence of later regulatory concerns, the insight shown, the need for a complete rehearing and the consequences of delay. Those matters supported the conclusion that remittal would be purposeless or disproportionate.
4. Deference to a professional panel is not absolute. As explained by reference to the dictum of Thorpe LJ in Meadow v GMC [2006] EWCA Civ 1390; [2007] Q.B. 462 at [280], its extent depends on the clinical nature of the issues and the panel’s relevant expertise. The present charges raised no complex clinical issues, and the judge had properly taken deference into account.
5. An interim order could not be treated as time served towards a later sanction. However, the absence of adverse findings concerning the registrant’s practice since the events was a legitimate consideration. Delay was also fact-sensitive and could properly include the timescale for a rehearing and its effect on other cases.

The High Court’s order quashing the findings, sanctions and orders, dismissing the charges and refusing remittal therefore stood.

• Court of Appeal (Civil Division) — In [2025] EWCA Civ 1631, dismissed the NMC’s appeal and upheld the refusal to remit.
• High Court of Justice, King’s Bench Division, Administrative Court — In [2024] EWHC 2991 (Admin), allowed the registrant’s appeal, quashed the factual, misconduct and impairment findings and related orders, dismissed the charges and declined to remit.
• Fitness to Practise Committee — On 31 October 2023, found the charges proved, determined that the registrant’s fitness to practise was impaired and imposed a 12-month Conditions of Practice Order together with an 18-month interim order.