Adekemi Adefidiya v Nursing and Midwifery Council

An appeal from a professional disciplinary decision is determined by whether the decision was wrong or unjust because of a serious procedural or other irregularity. The appellate court must remain cautious when reviewing factual findings and evaluative judgments, particularly those made by a specialist regulatory tribunal. It may intervene for material errors of law or fact, errors of principle, or an evaluation outside the permissible range, but must not simply substitute its own view. A tribunal may admit hearsay where its rules require relevance and fairness, provided it assesses the evidence and its weight fairly. Amendment of charges depends on whether the amendment can be made without injustice. Personal mitigation may carry limited weight where public protection and confidence are engaged. A striking-off sanction was proportionate where serious dishonesty, repeated unsafe practice, breach of regulatory restrictions and a high risk of repetition were established.

The appellant appealed under Articles 29(9) and 38(1) of the Nursing and Midwifery Order 2001 against a Fitness to Practise Committee decision dated 3 September 2025. The Committee had found multiple allegations of misconduct and lack of competence proved, found the appellant’s fitness to practise impaired, and directed that she be struck off the register.

The appeal raised six grounds, concerning procedural irregularity, factual findings, dishonesty, impairment, mitigation, proportionality of sanction and reasons. The central issues were whether the Committee’s decision was wrong, or unjust because of a serious procedural or other irregularity, and whether the striking-off order was disproportionate.

1. The appeal was dismissed. The applicable question under Articles 29(9) and 38 of the Nursing and Midwifery Order 2001 was whether the Committee’s decision was wrong or unjust because of a serious procedural or other irregularity. A material error of law or fact, an error of principle, or an evaluative judgment outside the permissible range could make a decision wrong.
2. The court should be cautious when reviewing factual findings because the original tribunal assessed the evidence as a whole, often including live evidence, and may be better placed to evaluate it. It should also avoid substituting its own evaluative judgment unless there was an error of principle or other error taking the decision outside the bounds of what the tribunal could properly and reasonably decide. That caution was particularly important for a specialist professional body.
3. The Committee had lawfully admitted hearsay statements under rule 31 of the NMC (Fitness to Practise Committee) Rules 2004. It considered relevance, fairness, the legal assessor’s advice, the parties’ submissions and the weight to be given to the evidence.
4. The amendment adding charges 18 and 19 was permissible under rule 28. The charges were closely linked to episodes already in issue, the Committee considered fairness and prejudice, and the appellant had time to respond without demonstrated injustice.
5. The challenges to the factual findings, dishonesty findings and impairment determination failed. The Committee had applied the dishonesty approach in Ivey v Genting Casinos [2017] UKSC 67, considered competence and misconduct separately, and was entitled to find impairment from their relationship and the resulting risks to patients and professional standards.
6. The striking-off order under Article 29(5) was a specialist evaluative judgment and was proportionate. Serious and repeated dishonesty, unsafe work beyond the appellant’s competence, breaches of practice restrictions, actual harm, public protection, public confidence and a high risk of repetition justified rejecting lesser sanctions.
7. The reasons were sufficient. A tribunal need not quantify the weight given to every item of evidence or address every argument. Its reasons must enable the reader to understand why the decision was reached, which the Committee’s decision did. The court observed, without affecting the outcome, that charge 13(d) appeared insufficiently supported as dishonesty, but that charge was immaterial to the overall result.
8. The Respondent was prima facie entitled to costs as the successful party. The court indicated a provisional view of £10,000, subject to further submissions or agreement.

The judgment records an appeal to the High Court under Articles 29(9) and 38(1) of the Nursing and Midwifery Order 2001 from the Fitness to Practise Committee’s decision dated 3 September 2025. The appeal was dismissed.