Nurses - Fitness to Practice

 Employment Law – Employment Lawyers - Nursing – Striking Off Order – Proportionality


In the recent case of Yeboah v Nursing and Midwifery Council [2010] the court had to make a determination relating to the proportionality of the sanction imposed on a nurse by the Nursing and Midwifery Council (“NMC”). The appellant in this case, Y, held a position as a registered nurse. She was employed at a hospital in Cambridge and had spent approximately two years working in a specialised haematology unit. The specialised haematology unit was called ”Ward C10”.


For approximately one year from July 2008, she was the subject of proceedings before the NMC's Conduct and Competence Committee (“the Committee”). In the course of the proceeding allegations against Y were raised in relation to a particular patient (“Patient A”). Patient A had been in Y’s care during April 2006.


The following allegations were made against Y:


  • That she had failed to check Patient A's identity prior to administering her with medication;
  • That she had administered a quantity of an antibiotic to which patient A was allergic;
  • That she had extracted a quantity of blood from patient A after the event and without obtaining the patient's consent;
  • That she had failed to report the drug error in a consistent manner so as to avoid delay and confusion amongst other staff; and
  • That she had challenged Patient A subsequent to a complaint being made to the ward manager.


The Committee held that all five of the above allegations were proved. It should be noted that some of the above had been admitted Y. Accordingly, it was subsequently concluded that Y's fitness to practise as a registered nurse was impaired.


The Committee went on to consider the sanctions that should be imposed on Y, and the various forms as set out in the Indicative Sanctions Guidance were considered.


It was held that the incident that took place in April 2006 was not isolated and that Y had not been able to demonstrate that she had sufficient insight into her failings in respect of her actions. Therefore, the Committee was of the opinion that only a striking-off order was appropriate in the circumstances (Y’s name would be removed from the register of registered nurses).


A striking-off order was duly imposed and the following remarks were made in the Committee’s conclusion:


“In [the committee's] view protection of the public and public confidence in the profession of nursing as well as the upholding and safeguarding of standards of the profession in this case, outweighs the registrant's own interests in continuing in her chosen profession”.


Y subsequently appealed against the Committee's decision under Article 38 of the Nursing and Midwifery Order 2001, SI 2002/253. In her appeal, Y argued that the striking-off order was either:


  • Excessive;
  • Disproportionate; or
  • Outside the range of what could be regarded as reasonable.


Y’s appeal was dismissed.

The court held that the Committee's decision was not erroneous in terms of its approach and that the reasoning of the Committee when deciding on the sanction to impose had taken into consideration the range of matters which had been raised by Y.


The court concluded that the Committee's approach was very careful and considered and that it was entitled to reach the decision that there had been a series of errors carried out by Y on the day in question during April 2006. These errors represented a serious departure from the standards expected of a registered nurse in Y’s position.


Furthermore, it was held that the committee was entitled to regard the incident that occurred in April as not being isolated. The incident demonstrated numerous inadequacies, both in practice and also in response to training. Accordingly, Y could not be said to have sufficiently demonstrated that the imposition of the striking-off order by the Committee was excessive or disproportionate or outside the range of what could be regarded as reasonable.


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© RT COOPERS, 2010. This Briefing Note does not provide a comprehensive or complete statement of the law relating to the issues discussed nor does it constitute legal advice. It is intended only to highlight general issues. Specialist legal advice should always be sought in relation to particular circumstances.


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