Jack Keizon Green v Nursing and Midwifery Council

An appeal from a professional regulatory panel is by way of rehearing, but appropriate deference must be given to the panel, particularly on factual findings and matters of professional practice. Reasons need not address every submission or provide reasons for reasons. They must, however, enable the parties and the appellate court to understand the material findings and why they were made. A panel may rely on hearsay evidence, but must assess its reliability, the circumstances in which it was made and any genuine corroboration. Evidence of heavy drinking while off duty does not corroborate an allegation of being intoxicated while providing care. Where a serious allegation depends principally on hearsay connected with a rejected allegation, failure to analyse those matters carefully may make the finding unsafe.

The appellant, a registered nurse, appealed findings of misconduct and impairment made by the Nursing and Midwifery Council’s Fitness to Practise Committee following allegations concerning his work at hospitals and a nursing home, and his care of Patient C. The panel imposed a six-month suspension subject to review.

The appeal challenged findings on sending healthcare assistants home without authority, failing to inform colleagues of an unauthorised assessment, undertaking an incompetent vaginal examination, caring for Patient C while under the influence of alcohol, and the resulting sanction. The respondent conceded that the finding concerning the vaginal examination could not stand. The central issues were whether the panel’s factual findings were wrong or unjust because of serious procedural or other irregularity, and what consequence followed for the sanction.

1. Approach to the appeal. The appeal under articles 29 and 38 of the Nursing and Midwifery Order 2001 was by way of rehearing and governed by CPR Part 52. The court had to decide whether the panel’s decision was wrong or unjust because of a serious procedural or other irregularity. Appropriate deference was required, but the court could not abdicate its responsibility to exercise its own judgment (paras [11]–[13]).
2. Reasons. A tribunal’s reasons must identify and determine the material issues sufficiently to enable the parties and an appellate court to understand the decision. Reasons may be short or implicit when the decision, read with the evidence and submissions, makes the finding and its basis apparent. The court must not construct findings or reasons which the tribunal did not make (paras [14]–[16]).
3. Charge 2. The panel was entitled to accept the ward sister’s evidence that the appellant had sent healthcare assistants home. Its reasoning, though brief, identified the central issue, namely whether the evidence had been fabricated, and explained why that issue was resolved against the appellant. The appeal on charge 2 was dismissed (paras [24]–[29]).
4. Charge 4(b). Having found that the appellant exceeded his remit by writing the assessment, the panel was entitled to find that he had a duty to inform his line manager and others. Placing the assessment in electronic records was not equivalent to expressly drawing attention to the fact that he had written it. The appeal on charge 4(b) failed (paras [36]–[40]).
5. Charge 5(c). The respondent accepted that the panel could not properly find that the appellant had carried out a vaginal examination when he was not competent to do so. The appeal on that charge succeeded (para [41]).
6. Charge 7. The panel failed to analyse the hearsay evidence with the necessary care. It did not properly consider the rejection of the alleged incision, the connection between most allegations of intoxication and that rejected allegation, the inherent plausibility of the asserted alcohol consumption, or whether the supporting material genuinely corroborated intoxication while providing care. The finding was unsafe and the appeal on charge 7 was allowed (paras [48]–[60]).
7. Sanction. Although other findings could support misconduct and impairment, the findings on charges 5(c) and 7 had materially influenced those conclusions and the sanction. The sanction therefore could not stand. Further submissions on the consequential order were reserved (paras [61]–[62]).

• Fitness to Practise Committee: Following hearings between January 2024 and June 2025, the panel upheld some allegations, found misconduct and impairment, and imposed a six-month suspension subject to review. Its decision was dated 17 June 2025.
• High Court (Administrative Court): The appeal was dismissed on charges 2 and 4(b), allowed on charges 5(c) and 7, and allowed in respect of the sanction. Further submissions on the consequential order were to be heard.