Angela Vanessa Brown v Nursing and Midwifery Council

An appeal from a professional disciplinary decision is a rehearing and succeeds only if the decision was wrong or unjust because of a serious procedural or other irregularity. The appellate court must respect primary factual findings, especially findings based on witness credibility, but may draw its own inferences from established facts.

In regulatory proceedings, the court approaches findings on misconduct, impairment and sanction with appropriate diffidence, while recognising that it may be well placed to assess dishonesty and the protection of the public. A sanction decision is an evaluative, multi-factorial decision and should be disturbed only for an error of principle or where it falls outside the range of decisions reasonably open to the tribunal.

The appellant, a registered nurse, appealed under arts 29(9) and 38(1) of the Nursing and Midwifery Order 2001 against a Fitness to Practise Panel decision dated 5 August 2025.

The Panel found proved failures in patient care, repeated removal of medication in excess of patient requirements, dishonesty and theft. It found misconduct, current impairment of fitness to practise and imposed a striking-off order.

The appeal challenged procedural fairness, disclosure, the factual findings, the burden of proof, the findings of dishonesty and theft, current impairment, and the proportionality of striking off. The central issues were whether the Panel’s decision was wrong or unjust because of a serious procedural or other irregularity, and whether its evaluative conclusions were outside the range of decisions reasonably open to it.

1. Appeal dismissed. The appeal was a rehearing under CPR PD 52D para 19.1(1)(h) and (2). It could succeed only if the Panel’s decision was wrong or unjust because of a serious procedural or other irregularity under CPR rule 52.21(3).
2. The Panel was entitled to conclude that no relevant documentary evidence had been withheld. The Omnicell evidence concerned medication recorded as removed compared with the patient medication records. Because the system was not linked to patient prescriptions and records, the relevant conduct would not have generated the discrepancy reports relied on by the appellant. The Panel was also entitled to refuse an adjournment to obtain a transcript and further reports.
3. The findings that the appellant deliberately removed excess medication, retained it, acted dishonestly and stole it were supported by the systematic review of primary records, the evidence about the robustness and operation of the Omnicell system, the number and duration of the incidents, and the appellant’s own evidence. The findings were not irrational in the Wednesbury sense.
4. The Panel properly distinguished between the patient-care errors in charges 1 to 3 and the repeated dishonesty and theft in charges 4 to 6. It was entitled to find residual risk in relation to the former and deep-seated attitudinal concerns, lack of specific remediation, and a high risk of repetition in relation to the latter.
5. The Panel considered the appellant’s clean record, training, references, hardship and lack of proven patient harm. Nevertheless, repeated dishonest removal of medication over several years constituted a serious abuse of trust. The Panel was entitled to conclude that conditions and suspension were insufficient, and that striking off was necessary and proportionate to protect the public and maintain confidence in the profession and the regulator.

Directions were given for written submissions or agreement concerning costs.

• Fitness to Practise Panel: On 5 August 2025, the Panel found misconduct, current impairment of fitness to practise and imposed a striking-off order.
• High Court (Administrative Court): The appeal was dismissed. The Panel’s decision was upheld.