NMC Fitness to Practise Hearing: How advocacy prevented removal from the register
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.