Professional Standards Authority for Health and Social Care v Nursing and Midwifery Council & Anor

On a statutory appeal from a professional disciplinary decision, the court conducts a review rather than a rehearing. It must show appropriate deference to evaluative findings and sanction decisions, but may intervene where the decision is materially wrong or procedurally unjust.

Dishonesty involving vulnerable patients, falsified clinical records, concealment, and repetition after an earlier warning may make a lesser sanction plainly inadequate. Remediation, insight, favourable references and an otherwise satisfactory work record must be assessed against the nature of the misconduct and the reliability of earlier assurances. Where the panel’s reasoning is incomplete and unsound, the court may quash the decision and substitute the sanction that the statutory scheme permits.

The Professional Standards Authority appealed against a decision of the Nursing and Midwifery Council’s Fitness to Practise Committee concerning Marina Tchampet, a registered nurse.

The Committee found proved that Ms Tchampet had slept while solely responsible for a vulnerable, ventilated child, failed to carry out required observations, falsified records, breached infection-control requirements and dishonestly maintained a false account during the employer’s investigation. It found current impairment on public-interest grounds but imposed a nine-month suspension rather than striking her off.

The appeal challenged the sanction, four alleged material errors and the adequacy of the Committee’s reasons. The central issue was whether suspension was a sufficient and proportionate response in light of the seriousness, dishonesty, vulnerability of the patient and Ms Tchampet’s earlier warning for similar misconduct.

1. Appeal allowed. The Committee’s decision was quashed. The court substituted a striking-off order.

2. Under section 29 of the National Health Service Reform and Health Care Professions Act 2002, read with CPR rule 52.21(3), the court may intervene where the disciplinary decision was wrong or unjust because of a serious procedural or other irregularity. The appeal is a review, not a rehearing or redetermination. Appropriate respect must be given to the professional tribunal’s expertise, particularly on evaluative questions and credibility.

3. The Committee’s sanction reasoning was incomplete and unsound. It gave insufficient weight to the fact that Ms Tchampet had deliberately enabled herself to sleep while solely responsible for a child exposed to potentially fatal risks, failed to monitor him, falsified records, breached infection control and maintained dishonest explanations for about six weeks.

4. The Committee wrongly treated the misconduct as a single instance and the dishonesty as a single episode below the higher end of seriousness. The misconduct involved multiple acts and continued over a substantial period. It followed an earlier warning for similar sleeping and record-keeping failures, despite an assurance that Ms Tchampet would not return to community work. That repetition and escalation undermined the Committee’s conclusion that there was only a minimal risk of repetition.

5. Under the NMC sanctions guidance, dishonesty involving deliberate concealment, falsified records, vulnerable patients and direct risk to patients is particularly serious. The guidance concerning neglect of children or vulnerable people and serious concerns that are difficult to remediate also pointed strongly towards striking off. Insight, training, testimonials and an unblemished period after the misconduct were relevant, but insufficient to justify suspension on these facts.

6. Given the Committee’s primary factual findings and the guidance, striking off was the only possible lawful sanction. The court therefore exercised its power to substitute that decision.

• High Court (Administrative Court): allowed the Authority’s appeal against the Fitness to Practise Committee decision dated 4 April 2025, quashed the decision and substituted a striking-off order.