Fitness to Practise Appeals update - summer 2025

This is an update on our fitness to practise appeals (so no publication to download). In the past few months (from March to July 2025), we have concluded nine appeals. We have appealed these decisions based on our belief that they were insufficient to protect the public. These include cases settled by consent as well as outcomes from recent Court hearings.

The cases we have appealed cover a range of issues, including cases involving:

• a registrant who crossed professional boundaries with a patient and was then dishonest about it
• a registrant who was dishonest about medication documented as being given to patients but was not
• a registrant who supplied cocaine to a companion and also behaved violently towards her, as well as taking cocaine and attending work whilst under the influence
• a registrant who locked a vulnerable child in a room without clinical justification and then was subsequently dishonest about it
• a registrant working in a prison who failed to declare a familial relationship with a prisoner and a failure to act when they expressed suicidal thoughts and subsequently completed suicide
• a registrant who failed to disclose a number of criminal convictions
• three other cases involving registrants who either behaved inappropriately, or in a sexually motivated manner, towards patients or colleagues.

Appeals resolved by consent 

The following appeals have been resolved by consent with the regulator and registrant.

General Dental Council (GDC)

A registrant who failed to disclose a number of criminal convictions

This is an appeal against a GDC panel decision to impose a four-month suspension order without a review in respect of a dental nurse who was convicted of a number of offences between 2013 and 2022, however failed to report these to the regulator immediately, or at all. The registrant was alleged to have acted dishonestly and/or was misleading. We were concerned that the panel erred in finding that the registrant’s failure to report was not misleading, and the regulator failed to bring a charge in respect of the registrant’s misleading/dishonest statement to the GDC that she had informed the regulator of her previous criminal convictions when she had not. We were concerned that the Committee erred in failing to make a finding of fact on whether the registrant had disclosed her previous convictions which were relevant to the panel’s assessment of dishonesty. Further, we were concerned that the panel failed in its approach to considering dishonesty and failed to apply the correct legal test. Lastly, we were concerned as to the panel’s failure to have any proper regard to the registrant’s lack of insight. The Court of Session in Scotland has confirmed our Minute (consent order) in the appeal. This means that the original panel decision of a four-month suspension order without a review is quashed and remitted to a new panel to determine. 

General Medical Council (GMC)

A registrant who supplied cocaine to a colleague and also behaved violently towards her

This is an appeal against a Medical Practitioners Tribunal Service (MPTS) decision to impose a suspension for 12 months with a review in respect of a surgeon who supplied cocaine to a companion and behaved violently towards her. We were concerned that the panel did not determine one of the allegations about whether the registrant attended work whilst under the influence of cocaine and that the panel misinterpreted available evidence which suggested the registrant attended work on another occasion whilst under the influence. We were also concerned that evidence was not presented to explain the impact of the registrant’s cocaine use on his practice or what his clinical duties involved during the relevant period. The appeal was allowed, the original decision in relation to charge 1(a)(ii), impairment and sanction quashed, and the decision remitted back to a new panel to consider.

Nursing and Midwifery Council (NMC)

A registrant who crossed professional boundaries with a patient and was then dishonest about it

This is an appeal against a decision by a NMC panel to find no current impairment in respect of a nurse who failed to maintain professional boundaries with a patient and dishonestly failed to record interactions with the patient. We were concerned that the panel failed to adequately explain why a finding of impairment was not required on public interest grounds, did not address the registrant’s denied dishonesty and gave apparent weight to personal mitigating factors. The panel’s original decision is quashed and substituted with a finding that the registrant’s fitness to practise is currently impaired, and to impose a suspension order for 10 months.

A registrant who was dishonest about medication documented as being given to patients but was not

This is an appeal against an NMC decision to find no current impairment in relation to a nurse who was dishonest about medication he documented as being administered to patients but was not or was listed as being out of stock when it was not. We were concerned that the panel failed to properly consider the need to maintain public confidence and uphold professional standards. We considered that the panel did not treat the registrant’s misconduct seriously enough and inappropriately gave weight to the interest in not depriving the public of an otherwise competent nurse when this was not relevant at the impairment stage. The appeal was allowed, the decision quashed, substituted with a finding of impairment and remitted to a fresh panel to consider the sanction.

A registrant who locked a vulnerable child in a room without clinical justification and then was subsequently dishonest about it

This is an appeal of an NMC panel decision to impose a suspension for 12 months with review in relation to a nurse who locked a young vulnerable child patient in her room without clinical justification. We appealed because we were concerned the panel did not apply the sanctions guidance, failed to accurately identify aggravating and mitigating factors, and failed to give adequate reasons for the decision. We were also concerned that the NMC did not bring dishonesty charges relating to the registrant’s lack of candour during the Trust’s investigation. The appeal was allowed, the original decision quashed and substituted with a striking off order.

A registrant working in a prison who failed to declare a familial relationship with a prisoner and failed to act when the prisoner’s expressed suicidal thoughts and subsequently completed suicide 

This is an appeal of an NMC panel decision to impose a caution for five years in respect of a nurse working in a prison who dishonestly failed to disclose that there was some relation with a prisoner and did not adequately record reasons for her failure to escalate the prisoner’s condition when he expressed suicidal ideations. We appealed because we were concerned the panel did not treat the misconduct seriously enough, particularly the dishonesty, did not apply the sanctions guidance and did not give adequate reasons. A Consent Order has been agreed. This means that the original panel decision of a warning is quashed and substituted with an order to suspend the registrant’s name from the register for nine months without a review.

Recent Court hearings

General Medical Council

Appeal against a MPTS decision about a registrant who behaved in an inappropriate and sexually motivated way towards six colleagues

We decided to join the GMC’s appeal. This is an appeal against a MPTS decision to impose an eight-month suspension order without a review in respect of a Consultant Surgeon and Senior Registrar. The registrant behaved inappropriately and in a sexually motivated way in relation to six colleagues between August 2009 and April 2022. His alleged behaviour included inappropriate touching without consent, which constituted sexual harassment, as well as conduct which constituted harassment related to race, was intimidating, racist, and an abuse of his senior position. The GMC appealed the decision. We were also concerned that the panel failed to consider the significance of the registrant’s racist statements, they erred in finding that the registrant’s misconduct was ‘not difficult to remediate’, failed to give adequate reasons for its decision, and failed to consider the significance of its decision on public confidence in the regulation of doctors and that such misconduct will be adequately addressed. This appeal was heard on 11-12 March 2025 and handed down on 3 April 2025. The appeal was upheld on some grounds and the eight-month suspension order without a review was replaced with a 12-month suspension order with a review.  

A registrant who behaved in a sexually inappropriate way towards two patients

This is an appeal in relation to a MPTS decision to find allegations that a doctor who was alleged to have behaved in a sexually inappropriate way towards two patients was not proved. We were concerned that the panel did not correctly apply the test for or consider cross-admissibility of the evidence of the two patients when determining that the evidence was not sufficiently similar to outweigh the registrant’s denials. This appeal was heard on 28 January 2025 and the GMC and our appeal was upheld. The decision was quashed and the matter remitted to a differently constituted Tribunal. 

Nursing and Midwifery Council 

A registrant who engaged in sexually motivated harassment towards two colleagues

This is an appeal against a NMC panel decision to impose a 12-month suspension order with a review in respect of a nurse who engaged in sexually motivated harassment towards two female colleagues, which included physical touching and attempting to kiss a colleague on the lips. We were concerned that the panel erred in their assessment of the factors relevant to sanction, including failing to identify aggravating factors and wrongly identifying mitigating factors. We were also concerned that the panel failed to correctly apply the NMC’s sanction guidance and to give adequate reasons for why suspension was the appropriate sanction. The appeal was allowed on all grounds, and the panel decision on sanction quashed and the decision on sanction remitted back to a new panel to consider.