About NMC fitness to practise hearings
An NMC fitness to practise hearing takes place before a panel of the Nursing and Midwifery Council. The NMC will be represented by a presenting officer, typically a solicitor or barrister. The registrant has the right to be legally represented. Hearings are adversarial: the presenting officer will cross-examine witnesses, challenge the registrant’s account, and make submissions on impairment and sanction. They are also usually held in public.
The panel makes three sequential decisions. First, whether the facts alleged are proved on the balance of probabilities. Second, whether any proved facts amount to impaired fitness to practise. Third, where impairment is found, what sanction is appropriate. The NMC’s sanctions range from a caution to conditions of practice, suspension, and striking off. The panel can also take no further action where impairment is not established.
Where the NMC pursues a wide-ranging case involving multiple allegations across different time periods and roles, the preparation required is substantial. Each allegation must be individually assessed, the evidence tested, and a coherent narrative developed that addresses both the factual disputes and the question of current impairment. In this case, the NMC sought removal from the register. The panel made limited findings of impairment and did not impose that outcome. That result was a product of focused, forensic preparation and advocacy throughout the hearing.
When the Nursing and Midwifery Council (NMC) brings a wide-ranging fitness to practise case, the consequences for a nurse can be profound. Such cases can place careers, livelihoods, and professional identities at risk overnight. In this case, the NMC pursued allegations of clinical incompetence and misconduct across multiple roles and time periods. It advanced its case on the basis that the nurse should be removed from the register.
That outcome did not happen.
After a lengthy and contested NMC Fitness to Practise hearing, the panel made very limited findings of impairment and rejected significant elements of the NMC’s case. The panel did not impose the most serious sanction the NMC sought. Focused, forensic advocacy throughout the hearing delivered this outcome. Jake Herman undertook all advocacy and now uses this experience to underpin a new advocacy-led service at Regulatory Defence for healthcare professionals facing regulatory proceedings.
From the outset, the NMC presented its case cumulatively. Although the nurse admitted some factual matters, the regulator alleged repeated failures of basic competence, unsafe practice, poor knowledge, and breaches of professional obligations. The NMC argued that these matters demonstrated a fundamental and ongoing impairment of fitness to practise. On that basis, it initially pursued removal from the register as the appropriate outcome.
However, a critical turning point in the case came from a detailed understanding of the relevant statutory framework, rules, and sanction guidance. Through close analysis of the Nursing and Midwifery Council (Fitness to Practise) Rules and the applicable sanction regime, it became apparent that removal from the register was not, in fact, a sanction that was legally available to the NMC in the circumstances of this case. This was not a matter of discretion or sympathy, but one of law and regulatory structure. That point fundamentally altered the landscape of the hearing and reframed the realistic range of outcomes open to the panel.
Alongside this, Jake Herman robustly challenged how the NMC attempted to prove its case. A central issue concerned the NMC’s reliance on hearsay evidence from colleagues who did not attend the hearing. Jake Herman relied on Article 6 fairness and the Fitness to Practise Rules to oppose its admission. He argued that admitting the evidence would be unfair and prejudicial.
The panel accepted those submissions in part and refused to admit an entire witness statement. It found that the NMC had not taken reasonable steps to secure the witness’s attendance. This decision removed evidence relied upon to support multiple allegations. It significantly narrowed the case the panel could properly consider.
The defence also successfully opposed the NMC’s attempt to amend and broaden charges mid-hearing. The NMC made this application after weaknesses emerged in the evidence. Jake Herman resisted the application to prevent retrospective repair of the NMC’s case. The panel agreed that fairness required the charges to remain as originally drafted.
Submissions on impairment focused on regulatory purpose, proportionality, and the difference between past failings and current risk. Even where some facts were admitted or proved, Jake Herman challenged whether they demonstrated ongoing impairment. The panel rejected the NMC’s broad position on impairment. It instead made restricted and tightly framed findings.
The outcome was decisive. The nurse was not removed from the register. The most severe outcome pursued by the NMC did not occur. The findings preserved a realistic route to remediation, review, and return to practice. For the nurse, this meant the difference between losing a profession and rebuilding a career.
This case highlights a critical lesson for healthcare professionals. Regulatory outcomes are not inevitable, even in serious cases. Detailed knowledge of the rules, procedures, and sanction framework can change what is possible. Strong advocacy can narrow issues, exclude unfair evidence, and prevent unjustified escalation.
Following this case, Regulatory Defence now offers a dedicated advocacy service for healthcare professionals. This includes full representation at NMC Fitness to Practise hearings.
If you are facing an NMC investigation or hearing and the regulator is seeking conditions, suspension, or removal from the register, the way your case is argued matters. Specialist advocacy grounded in a deep understanding of the rules and regulations can be the difference between losing your profession and preserving it.
If you are a nurse or midwife facing NMC fitness to practise proceedings, our NMC defence solicitors can advise and represent you at every stage of the process.