Mohammed Islam Ahmad Khan v The Nursing and Midwifery Council

On an appeal from a professional disciplinary decision, the court must conduct the full appeal required by the Civil Procedure Rules 1998, r 52.21, but should respect the specialist tribunal’s evaluative judgment. In dishonesty cases, less deference may be appropriate where the court can assess public protection and professional reputation more readily. A panel may proceed in a registrant’s absence after considering fairness, engagement, the public interest and the likely value of an adjournment. Medical evidence supporting ill-health postponement must explain why the registrant cannot participate and address reasonable alternatives. Repeated, premeditated dishonesty in obtaining a professional qualification, coupled with insufficient insight or remediation, may justify striking off despite a good professional record. Fresh evidence must satisfy the Ladd v Marshall criteria.

This was an appeal under the Nursing and Midwifery Order 2001 from decisions of the Nursing and Midwifery Council Fitness to Practise Committee. The Committee refused to postpone a hearing, proceeded in the appellant’s absence, found that he had cheated in two examinations, and imposed a striking-off order for misconduct and impaired fitness to practise.

The appellant challenged the refusal to postpone and argued that striking off was disproportionate. He also relied on fresh evidence about his absence, remorse and remediation. The central issues were whether the Committee’s procedure was unfair and whether, on the evidence available on appeal, the sanction was wrong or unjust because of serious procedural or other irregularity.

The appeal was dismissed. Under the Nursing and Midwifery Order 2001, art 38(3), and the Civil Procedure Rules 1998, r 52.21, the appeal was by way of rehearing and required the court to consider whether the Panel’s decisions were wrong or unjust because of serious procedural or other irregularity.

1. Sanction. Disciplinary sanctions primarily protect the public by maintaining professional standards, reputation and public confidence, rather than punishing the practitioner. The court should give special respect to a specialist disciplinary tribunal, although less deference may be appropriate in dishonesty cases. Intervention is justified only for an error of principle or a decision outside the bounds of what the tribunal could properly and reasonably decide. Those principles were drawn from Bolton v Law Society [1994] 1 WLR 512, Jagjivan [2017] EWHC 1247 (Admin) and Bawa-Garba v GMC [2018] EWCA Civ 1879.
2. Proceeding in the appellant’s absence. Applying General Medical Council v Adeogba [2016] EWCA Civ 162 and General Medical Council v Hayat [2018] EWCA Civ 2796, the Panel had to balance fairness to the appellant with fairness to the regulator, the public interest in expeditious disposal, the appellant’s engagement and the likely value of an adjournment. The medical letter did not establish that he was unfit to participate, explain the relevant functional effects of his condition or address reasonable adjustments. The Panel gave him opportunities to engage and was entitled to proceed.
3. Fresh evidence. The principles in Ladd v Marshall [1954] 1 WLR 1489 applied. The November witness statement was not apparently credible because it contradicted the appellant’s verified account, the contemporaneous communications and the evidence about the resumed hearing. It was therefore inadmissible. A further week would not have altered the position in light of the later medical evidence.
4. Striking off. The dishonesty was repeated, premeditated and connected with personal and financial gain. It created a risk that the appellant could practise as an advanced neonatal practitioner without proper qualification. His good professional record and references were outweighed by the seriousness of the dishonesty and the lack of insight and remediation. Even if the later apology, reflection and references were admitted, they did not demonstrate true insight or address the implications for patient safety and public confidence. The striking-off order was within the range of decisions reasonably open to the Panel. Consequential matters were reserved for further hearing.

1. Nursing and Midwifery Council Fitness to Practise Committee: on 8 May 2025 refused the appellant’s postponement application and proceeded in his absence; on 13 May 2025 found misconduct and impairment of fitness to practise and imposed a striking-off order.
2. High Court (Administrative Court): dismissed the appeal and upheld the Panel’s decisions.