Emeka Umerah v The Nursing and Midwifery Council

An appellate court reviewing professional disciplinary sanction must respect the specialist tribunal’s evaluative judgment. It may interfere only for an error of principle or procedure, or where the decision falls outside the bounds of what the tribunal could properly and reasonably decide. The court is not entitled to substitute its own view merely because it would have imposed a less severe sanction or considers the outcome harsh. A tribunal may treat lack of insight, acceptance and effective remediation as material to current impairment and sanction. A strike-off order is not rendered impermissibly punitive merely because it causes financial or employment consequences where it is required for public protection.

The appellant, a registered nurse, appealed under article 38(1) of the Nursing and Midwifery Order 2001 against a Fitness to Practise Committee decision striking him from the register.

The appellant accepted the findings that he had failed to record and communicate an elderly resident’s fall, failed to provide adequate leadership and delayed calling an ambulance. He challenged the findings of current impairment, the assessment of insight and remediation, and the proportionality of the sanction. He sought reversal of the decision or a full rehearing.

1. The appeal was dismissed. The appellant accepted the factual findings and that the conduct amounted to misconduct. The issue was whether the finding of current impairment and the strike-off sanction were legally unsustainable.
2. Under rule 52.21(3) of the Civil Procedure Rules 1998, the court could intervene only if the decision was wrong or unjust because of a serious procedural or other irregularity. It was insufficient that the court disagreed with the committee or considered the sanction harsh.
3. The committee was best placed to assess the seriousness of professional misconduct and the sanction required to maintain standards and protect the public, following the guidance in Bolton v Law Society and Ghosh v GMC. The court lacked the committee’s specialist expertise and had to accord appropriate respect to its evaluative judgment.
4. The committee was entitled to find that the misconduct was capable of remediation in principle but that remediation had not been demonstrated. Training certificates and visits to care homes did not establish the necessary insight, acceptance of the findings or willingness to respond effectively to challenge and feedback.
5. The assessment of conduct, insight and willingness to improve was within the committee’s proper function. There was no obvious error of principle or procedure. The decision to strike the appellant from the register was therefore within the range of decisions the committee could properly and reasonably make. Its protective purpose was not displaced by the fact that the sanction had adverse financial and employment consequences.

• Fitness to Practise Committee: On 23 May 2024, determined that the appellant’s fitness to practise was impaired by misconduct and imposed a striking-off order.
• High Court (King’s Bench Division): Appeal dismissed under article 38(1) of the Nursing and Midwifery Order 2001.