Kara Louise Hannigan v The Nursing and Midwifery Council

On 14^th March 2025 a panel of the Respondent’s Fitness to Practise Committee (“the Panel”) found that the Appellant’s fitness to practise was impaired by reason of misconduct. The Panel suspended the Appellant’s registration for 12 months and provided for a review at the end of that period. The finding of misconduct and impairment flowed from the Panel’s decision of 27^th September 2024 in which it had found proved a number of allegations that the Appellant had bullied or harassed nurses whom she was managing.

The Appellant challenges the Panel’s decisions and contends that the Panel’s factual findings are untenable in light of the evidence before it; that the finding of impairment of her fitness to practise was flawed; and that the sanction was unjustified.

The Respondent accepts that the Panel’s decision cannot stand and that the appeal is well-founded at least in part. It accepts that in respect of a number of the factual findings the Panel’s decision failed to engage with the arguments which had been advanced on behalf of the Appellant and/or did not contain adequate reasons for the findings made. It also accepts that the Panel’s exercise of its discretion on sanction was flawed by its failure to take into account as relevant to sanction the Appellant’s reflections.

It follows that there is agreement that the appeal should be allowed. The issue between the parties is as to the course to be taken on allowing the appeal. The Respondent submits that the matter should be remitted to a differently-constituted panel for rehearing of the allegations which the Panel had found to be proved and to amount to misconduct and for further decisions on misconduct, impairment and sanction if those allegations are found proved. The Respondent accepts that those of the allegations which the Panel did not find proved cannot be resurrected. In addition, the Respondent does not seek a further hearing in respect of those allegations which the Panel found proved but which it concluded did not amount to misconduct. The Appellant submits that the court should simply allow the appeal and quash the decision of the Panel. She contends that the evidence on which some of the allegations were based can be shown to be incapable of being accepted with the consequence that there will be no point in a remittal which is bound to lead to rejection of those allegations. The Appellant says that, in any event, she has no intention of returning to nursing and that this, combined with a number of other factors, means that there is no longer a public interest in a further hearing to determine the allegations.

The parties are agreed that I have a discretion as to whether to remit the matter to a new panel. They are substantially agreed on the factors which are relevant to that exercise of discretion. Their disagreement is as to the weight to be attached to particular factors and as to where the balance falls. The principal issues are, therefore, first, whether the Appellant is right to say that a number of the allegations are bound to be rejected as a matter of fact so that there is no point in remitting those for a further hearing, and second whether, if and to the extent that the allegations are not bound to fail, remittal is appropriate in the particular circumstances of this case.

The Appellant does not intend to return to nursing. If the matter is remitted for a further hearing she intends to apply for her voluntary removal from the Register. The Respondent accepted that such a voluntary removal might ultimately be appropriate. However, it said that if such an application were in due course to be made it would have to be determined by reference to the Nursing and Midwifery Council (Education, Registration and Registration Appeals) Rules 2004 (“the Registration and Appeal Rules”) and having regard to the considerations set out in those rules.

The Appellant was registered as a nurse in 1991. Apart from the allegations which were considered by the Panel she has had an unblemished career.

The allegations relate to the period from November 2014 to July 2019 and are in respect of the Appellant’s actions when employed as the Band 7 Clinic Manager of the Cardiff and Vale University Health Board’s Electro-Convulsive Therapy Clinic at Llandough Hospital. In summary, the allegations were that the Appellant’s conduct amounted to the bullying and/or harassment of nurses in that clinic and that she took improper steps to cover up her conduct.

The initial referral to the Respondent was made on 20^th March 2020.

The determination in respect of the factual allegations followed hearings on 22^nd July - 9^th August 2024, and 23^rd – 27^th September 2024. The Panel found that a number of the allegations were proved as a matter of fact. In summary, those allegations related to the Appellant’s conduct towards Samatha Sell and Danielle Saunders. The Panel found that aspects of the Appellant's conduct towards Samatha Sell amounted to bullying and/or harassment of Miss Sell; that her conduct had the purpose or effect of creating a work environment for Miss Sell which was degrading or humiliating; and that the Appellant placed Miss Sell on the informal stage of the capability policy as a way of justifying her conduct and/or deflecting criticism. In respect of the Appellant’s conduct towards Danielle Saunders the Panel found that one aspect of this conduct had the purpose or effect of creating an intimidating and/or hostile work environment for Miss Saunders. This conduct was putting a daily meeting between herself and Miss Saunders in the work diary without good reason and in order to discomfort Miss Saunders.

The Panel found that a number of other allegations had been proved as matters of fact but subsequently concluded that they did not amount to misconduct.

The Panel found that the remaining factual allegations had not been proved. Some of these related to the Appellant’s conduct towards Miss Sell and Miss Saunders and others were in respect of her conduct towards other nurses.

The hearing to address the issues of misconduct; of whether the Appellant’s fitness to practise was impaired; and of the appropriate sanction lasted from 10^th – 14^th March 2025.

The Panel concluded that not all of the proven factual allegations amounted to misconduct, but did find that those which I have summarized at [10] were misconduct.

The Panel was satisfied that the Appellant’s fitness to practise was not impaired by reason of a risk of harm to patients. It did, however, conclude that her fitness to practise was impaired because her conduct had been such as to bring the nursing profession into disrepute and because she had breached fundamental tenets of the profession. In coming to that conclusion the Panel was particularly influenced by its findings, first, that the Appellant had placed Miss Sell on the capability policy in order to deflect potential criticism and, second, that the Appellant had diarized daily meetings with Miss Saunders in order to provoke an adverse reaction from that nurse.

The sanction of suspension for 12 months was imposed against that background.

The written notification of the Panel’s decision arising out of the March 2025 hearing was sent on 18^th March 2025. That notification contained a different version of the Panel’s decision and reasons on the facts from that which had been provided to the Appellant after the September 2024 hearing. I accept the Respondent’s explanation for the differences between those documents which was that the version provided to the Appellant in March 2025 was provided in error and was an earlier and incomplete draft version which had been superseded by the document provided to the Appellant in September 2024. A comparison of the two documents shows that the Respondent’s explanation is correct. This is demonstrated in various ways but most clearly by the fact that the version sent to the Appellant in March 2025 did not address all the allegations whereas that sent in September 2024 did. I will proceed on the basis that it is the September 2024 document which properly reflects the factual findings made at the hearings in 2024 and that the March 2025 decisions as to misconduct, impairment, and sanction were made on the basis of those findings.

The Respondent advances a schedule of the allegations which it submits should be remitted for a fresh determination. The original list of allegations has been shorn of those which were not proved and of those proven allegations which the Panel found did not amount to misconduct.

The proposed charges are:

“That you, a registered Band 7 nurse:

1.

Between November 2014 to July 2019 on one or more occasions behaved inappropriately and/or undermined and/or interfered towards or with Samantha Sell, in that you:

a.

Endeavoured to have a meeting with Samantha Sell, as requested by them, without prior notice to Samantha Sell;

b.

Said to Samantha Sell “its something like prostitutes would wear” or words to that effect, when commenting on Samantha Sell’s appearance.

2.

Your actions at one or more of charges at 1(a) and 1(b) above amounted to bullying and/or harassment of Samantha Sell in that:

a.

Your conduct was unwanted;

b.

Your conduct had the purpose or effect of creating an intimidating, hostile, degrading, humiliating or offensive environment for Samantha Sell.

3.

On or after 17 September 2015 you inappropriately placed Samantha Sell on an informal stage of the capability policy.

4.

Your actions at charge 3 above amounted to bullying and/or harassment of Samantha Sell in that:

a.

Your conduct had the purpose or effect of:

i.

Violating Samantha Sell’s dignity, or

ii.

Creating an intimidating, hostile, degrading, humiliating or offensive environment for Colleague A.

5.

Between November 2014 to July 2019 on one or more occasions:

a.

Put a meeting in the daily diary between yourself and Danielle Saunders, for no reason;

b.

Said to Samantha Sell, that Daniel Champion Smith had a “drink issue” or words to that effect.

c.

Said to Danielle Saunders, “look at the way he’s done his notes, that’s disgusting, I need to have a word with him” or words to that effect, in regards to Daniel Champion Smith;

d.

Disclosed information about Daniel Champion Smith/Kelly’s redeployment;

6.

Your actions at charge 5(a) had the purpose or effect of creating an intimidating and/or hostile environment for Danielle Saunders.

And in light of the above, your fitness to practise is impaired by reason of your misconduct”.

The appeal is brought pursuant to articles 29(9) and 38 of the Nursing and Midwifery Order 2001 and is subject to CPR Part 52 and PD52D. By article 38(3) three courses are open to the court if an appeal is allowed. The decision might be quashed; the matter might be remitted to be disposed of in accordance with the court’s directions; or the court can substitute any decision which the panel below could have made.

It is common ground that I have a discretion and that the choice here lies between quashing the decision and remitting the matter for a fresh determination of the facts and, if the allegations are established, of the questions of misconduct, impairment, and sanction.

I identified factors which were potentially relevant to the question of whether there should be remittal in Hawkins v Health & Care Professions Council [2023] EWHC 3256 (Admin) at [42] – [48] thus:

“[42] Counsel’s researches have not found any authority setting out the approach to be taken by the court once a panel’s decision has been quashed and the court is deciding whether to substitute another decision for that of the Panel or to remit the matter for rehearing. They were, however, agreed on the applicable principles and I have substantially adopted their analysis.

[43] The court has a discretion. That discretion is necessarily a wide one because of the wide variety of differing circumstances in which it will have to be exercised. Those circumstances will differ both as to the form of the failing in the decision or procedure of the panel and as to the matters leading up the hearing before the panel. The discretion will have to be exercised having regard both to the purpose of the regulatory regime and to the interests of justice. The following considerations are potentially relevant in the current case.

[44] First, account must be taken of public interest in the proper regulation of health care professionals and in the maintenance of high standards in the healthcare professions. I have quoted above article 3(4) and (4A) with its identification of the protection of the public as the Respondent’s over-arching objective and with the subsidiary objectives of the promotion of public confidence and the promotion and maintenance of proper professional standards and conduct as being aspects of the pursuit of that overarching objective. The public interest in those matters is an important one and Mr Micklewright was correct to identify it as a consideration underlying the conclusion of the Court of Appeal in Ruscillo v Council for the Regulation of Health Care Professionals [2004] EWCA Civ 1356 that a regulatory body could appeal against an unduly lenient decision by a panel dealing with such matters.

[45] In order to maintain high professional standards and to uphold the public interest in the proper regulation of healthcare professionals allegations against such professionals must be properly investigated and properly determined once investigated. Those complaining of misconduct have an important interest in their allegations being determined before a panel properly considering the material advanced. Those accused of misconduct also have an interest in such proper determination which not only provides for the upholding of allegations against those properly accused but also for the definitive dismissal of allegations against those wrongly accused.

[46] However, a further factor is the public interest in finality of proceedings and in the prompt determination of allegations against healthcare professionals. Delay and multiple hearings in cases of allegations of professional misconduct are both to be avoided where possible. Not only are they wasteful of public resources but they increase the stress which such proceedings cause both for the accused professional and for the person whose allegation is under consideration.

[47] Next, regard must be had to the requirements of fairness and of justice. To some extent these requirements are elements of the public interest to which I have just referred. However, they are more focussed on the circumstances of the particular case and of the particular healthcare professional. The consideration will necessarily be fact-specific but it will be appropriate to have regard to the circumstances of the proceedings in question; the nature of the allegation being made; the reason why the decision of the original panel has been quashed; the time since the events in question; and whether it will be possible to have a fair hearing if the matter is remitted for rehearing by a new panel (and potentially when such a hearing will be possible). The question of whether there is unfairness or injustice to the professional concerned in having to face again the same allegations will depend on the particular circumstances. However, in light of the public interest in the proper regulation of healthcare professionals and in the proper determination of allegations of misconduct the mere fact that a professional will have to undergo a further hearing is unlikely of itself to be a potent factor against remittal.

[48] Finally, it is necessary to consider the utility or otherwise of remittal for a hearing before a further panel. There will be no point in remitting a matter for a further hearing if on a proper consideration of the evidence the only proper conclusion would be the dismissal of the allegation. Thus in Soni v General Medical Council [2015] EWHC 364 (Admin) Holroyde J, as he then was, declined to remit the matter for a further hearing having concluded that the evidence of the witnesses even when accepted could not properly lead to the necessary finding of dishonesty (see at [69] and [70]).”

Mrs Simpson and Mr D’Alton agreed that the factors listed there were relevant in this case. I agree but, as I noted in Hawkins at [43], regard must be had to the width of the court’s discretion and to the variety of circumstances in which it will have to be exercised. The list of factors set out in Hawkins was expressly a list of the factors potentially relevant in the particular circumstances of that case: not all of those will be relevant in other cases and there will be factors not listed there which will, on occasion, be relevant. In addition, although some assistance can be derived from seeing how the court’s discretion has been exercised in particular cases the ultimate decision is necessarily case and fact-specific.

In Hawkins the question of whether there should be remittal for a further hearing turned on whether a finding that the Appellant’s actions had been sexually motivated would be open to a further panel. The decision to remit the matter followed from my conclusion that such a finding would be possible.

In Soni v General Medical Council [2015] EWHC 364 (Admin) Holroyde J (as he then was) decided that there was no utility in remitting that matter. However, it is of note that this was because of his conclusion that even if the evidence of the respondent’s witnesses were to be accepted, a finding that the appellant had been dishonest could not be made as a matter of law.

The public interest in the determination of allegations; in the maintenance of high professional standards; and in the proper regulation of healthcare professionals is a very important consideration. The body primarily charged with determining what the public interest requires is the body to which Parliament has given the role of regulating the profession in question. Here that is the Respondent. In Southall v General Medical Council [2010] EWCA Civ 484 the allegations related to the contents of a medical report which had been written 12 years before the time when the Court of Appeal was considering the matter. The matter was nonetheless remitted to a further panel hearing and in explaining why that was being done Leveson LJ (as he then was) said, per curiam, at [8]:

“I am far from convinced that the public interest is truly served by a rehearing of the limited factual allegation that was made in this case, turning on the precise language used 12 years ago. Having said that, however, protection of the public interest is primarily for the GMC and I do not consider it appropriate to remove the responsibility for making this decision from them.”

Leveson LJ was not saying there that the view of the regulator was determinative of whether there should be remittal. Such an approach would be incompatible with the court’s exercise of its own discretion: a discretion entrusted to it by the relevant appeal provisions as Fordham J pointed out in Hendron v Bar Standards Board [2020] EWHC 1255 (Admin) at [48]. It would also be inconsistent with the approach articulated in Sastry v General Medical Council [2021] EWCA Civ 623, [2021] 1 WLR 5029 at [112], albeit in relation to sanction, namely that although “appropriate deference” is to be paid to the determination by the regulatory panel the court cannot escape its duty to reach its own decision as to whether the sanction was appropriate and necessary having regard to the public interest. I do not understand Leveson LJ to have been articulating a different approach. Nonetheless, the fact that there was remittal in Southall, notwithstanding the reservations which Leveson LJ expressed, does illustrate the importance to be attached to the role of the regulator as the primary judge of whether the public interest requires a further hearing.

In the context of the current case it is to be noted that it is not the Respondent’s position that a further hearing to determine whether the allegations are made out is necessarily required by the relevant public interest. Instead, its position is that if a further hearing is to be avoided through an agreed removal then there will need to be proper consideration of that course and a decision made in accord with the procedure laid down in the Registration and Appeal Rules.

Ultimately, the decision is one for the court taking due account of the views of the regulator. Thus, in Hendron Fordham J concluded that remittal was not appropriate. However, as the analysis at [47] – [50] makes clear that decision was taken because of the combination of a number of factors in the particular circumstances of that case.

It follows that determining whether there should be remittal here requires a staged consideration. First, it is necessary to consider whether the allegations against the Appellant are capable of being made out as a matter of fact. If they are not then there will be nothing to be gained by remitting the matter to another panel which will inevitably dismiss them. In addressing that question the court will be wary of concluding that an allegation is not capable of being established as a matter of fact. Particular caution is needed where, as here, it is being suggested that the evidence on which the regulator would seek to rely at a further hearing is not capable of belief. It is of note that in Soni Holroyde J's conclusion that there was no utility in remittal was because, even if accepted as factually correct, the evidence could not sustain the finding of dishonesty as a matter of law.

The next stage will be to consider the distinct but closely connected questions of whether, if the allegations are made out, they can properly be found to have amounted to misconduct and whether there can properly be a finding that the Appellant’s fitness to practise is impaired. Those are matters where particular deference is to be paid to the assessment of the regulatory body but if there would be no proper basis for a finding of misconduct or of impairment there will again be nothing to be gained by remitting the matter. Mrs Simpson contended that the questions of misconduct and of impairment are matters of judgement and not of discretion. They are matters, she submitted, where the court must make its own decision as to whether the Panel’s conclusion was wrong albeit taking account of the deference to be accorded to the Panel. That submission correctly states the approach to be taken when considering questions of misconduct and impairment on an appeal. The position here is different. It is common ground that the appeal is well-founded and the issue is whether the matter should be remitted to a differently-constituted panel. The relevant question for the purpose of determining that issue is not whether the Panel was right to find that there was misconduct and that the Appellant’s fitness to practise was impaired but whether such findings will be capable of being made if the allegations are found proved at a further hearing. If such findings could not be made even if the allegations were proved then there would be nothing to be gained by remitting the matter. However, if such findings could properly be made it would be necessary to have regard to the more general factors relevant to the exercise of the court’s discretion such as were summarized in Hawkins.

Before turning to those questions it is appropriate to note the procedure governing the agreed removal of a nurse from the Register.

Rule 14 of the Registration and Appeal Rules provides for an agreed removal. Where there are no outstanding fitness to practise proceedings removal is at the election of the nurse. However, where there are such proceedings which have not concluded the procedure laid down in rule 14(2B) must be followed. The decision is to be taken by the Registrar and the rule provides that:

“(2B)

Where matters have given rise to an allegation against the registrant under article 22 of the Order, and the Council’s proceedings in relation to that allegation have not concluded—

(a)

the Registrar shall before determining the application provide the maker of the allegation (if any) with a reasonable opportunity to comment on the application;

(b)

the Registrar, in considering whether to remove the registrant’s name from the register or, where paragraph (2A) applies, the Committee in considering its advice to the Registrar, shall amongst such other matters which the Registrar or, as the case may be, the Committee considers appropriate, have regard to—

(i)

any comments received pursuant to sub-paragraph (a): such comments may also be considered by the Registrar or Committee in discharging any of their other functions;

(ii)

the interests of the registrant; and

(iii)

the public interest.”

It will be noted that the rule requires the Registrar to take account of the views of the maker of the allegation in question together with the public interest and the interests of the nurse. The Respondent’s Guidance on Case Management says that “agreed removal can support our aim ‘to reach the outcome that best protects the public at the earliest opportunity’”. The Guidance also explains that when considering an application for agreed removal the Registrar will require information as to and will take account of the nurse’s plans for the future and, in particular, whether there is an intention to return to nursing within the next five years.

Mrs Simpson contended that the evidence relied on by the Respondent was so flawed that it could not be a proper basis for findings that the allegations were made out in fact. Therefore, she submitted, there would be no utility in remitting the matter for a further hearing, the inevitable outcome of which would be dismissal of the allegations. Mrs Simpson submitted, alternatively, that this was the position in relation to some of the allegations.

There were three limbs to this argument. The first was the contention that the answers which Samantha Sell gave in the course of cross-examination showed serious inconsistencies in her evidence such that her account could not be relied upon. Next, it was said that the supporting evidence of Lorraine Thompson was so flawed as to be incapable of being believed. It was said that Miss Thompson’s account was inconsistent with that of the Respondent’s other witnesses; that it changed in the course of her evidence; and that aspects of what she said were inherently incredible. Before the Panel Mrs Simpson had submitted that the deficiencies in the evidence of Miss Sell and Miss Thompson were such that the Panel should conclude that the evidence had been fabricated. Before me Mrs Simpson did not go that far but did submit that the evidence was so flawed that it could not be relied upon. The third line of argument related to the allegation that in placing Miss Sell on the capability policy the Appellant had acted inappropriately and with a view to deflecting concern from her conduct. Mrs Simpson pointed to the statement of Dr Maria Atkins. Dr Atkins had been the Clinical Director for Adult Mental Health Services at the Electro-Convulsive Therapy Clinic until 2016. In her statement Dr Atkins sets out a number of concerns which she had as to Miss Sell’s abilities. In addition, Mrs Simpson relied on an email which the Appellant sent on 16^th September 2015 referring to concerns about Miss Sell’s competency and saying that this had been a long-standing problem. On behalf of the Appellant this is said to show the true context and purpose of her actions in placing Miss Sell on the capability policy on 17^th September 2015.

The Appellant has a high hurdle to surmount to show that the evidence against her is so unsatisfactory that the allegations are bound to be rejected as a matter of fact. It is necessary to show not just that there are counter-arguments and that a finding in favour of the Respondent is not guaranteed but instead the Appellant needs to show that the evidence is so flawed as not to be capable of being accepted. The court is being asked to reach that conclusion by reference to the statements and the transcript of the hearing before the Panel. For the following reasons the Appellant has failed to show that.

It is clear that Mrs Simpson made considerable headway in her cross-examination of Samantha Sell. However, it is to be remembered that Miss Sell was giving evidence in the second half of 2024 about events in the period 2014 – 2019 with the most significant events being at the start of that period. The core factual aspects of the allegations in relation to Miss Sell which the Respondent wishes to pursue are that the Appellant tried to have a meeting with her without prior notice; that she made a comment on Miss Sell’s appearance to the effect that she looked like a prostitute; and that Miss Sell was placed on the capability policy inappropriately. The other aspects of the allegations in relation to Miss Sell are questions of whether that conduct amounted to harassment or bullying and the motive underlying it. The inconsistencies about matters of detail in Miss Sell’s evidence are not such that it would not be open to a panel to conclude that the core of her evidence was correct. It is of note that in relation to the allegation about the meeting the Appellant accepts that a meeting was arranged. She says that for good reason it had not been possible to give advance notice of this. It follows that there is little dispute about the underlying factual basis of the allegation. The issues are as to whether there was a good reason for the absence of notice and as to the Appellant’s motivation. The allegation in respect of the comment allegedly made by the Appellant turns not on the evidence of the precise wording used, as to which there were inconsistencies, but as to the gist of the comment being made and it would be open to a panel to conclude that a comment to that effect had been made. It follows that it would be open to the panel at a remitted hearing to conclude that Miss Sell’s account was substantially correct.

There is considerable force in Mrs Simpson’s critique of the evidence of Miss Thompson. It does appear that aspects of her account were unsatisfactory and were incompatible with the evidence of other witnesses. However, here again account must be taken of the period of time which had elapsed since the events in question. It is of note that Miss Thompson is not a central witness. Mrs Simpson submitted that allegations solely based on Miss Thompson’s evidence should not be remitted. However, none of the allegations which the Respondent now wishes to pursue are solely based on Miss Thompson’s evidence and I note that the Panel found not proved two allegations which were solely based on that evidence (the original allegations 1(d) and 1(g)).

The argument based on the evidence of Dr Atkins and on the Appellant’s email of 16^th September 2015 has considerable force. The allegation that Miss Sell was placed on the capability policy inappropriately and that this was done to deflect concern from the Appellant’s conduct is a serious allegation. Arguably it is the most serious of the allegations. The email and the statement of Dr Atkins provide potent support for the Appellant’s case that her concerns were genuine and that her action was appropriate and properly-motivated. However, they are not conclusive and the force of the email is weakened by Miss Sell’s evidence that the Appellant’s action on 17^th September 2015 was a response to the concerns which Miss Sell had raised on 16^th September 2015.

None of the matters advanced by the Appellant are such that the court is able to say that a panel exercising proper caution could not accept the Respondent’s evidence and conclude that the allegations were proved. Before doing so the panel would have to take account of the powerful counter-arguments and it may well be that at a remitted hearing some or all of the allegations will be dismissed. That, however, is a different question and it cannot be said that the allegations are so flawed that there would be no utility in remitting the matter.

The points which Mrs Simpson has made as to the evidence will, however, be relevant as a factor in the exercise of my discretion and my assessment of whether the purpose of the regulatory regime and the interests of justice require remittal. It will be relevant at that stage to take into account the fact that any remitted hearing will require the panel to assess oral evidence about events in the period 2014 – 2019 (with the earlier part of that period being of most relevance). The outcome will turn on the quality of the competing witnesses’ recollection and on the interpretation of oral exchanges. It is also relevant that the Appellant can put forward powerful counter-arguments to the Respondent’s case. It follows that this is not a case where the outcome of the further hearing can be predicted with any degree of confidence, rather it is one where there is a real prospect that the allegations will be rejected at a remitted hearing (as a number of others were by the Panel).

This question can be answered shortly. As noted above whether action does or does not amount to misconduct is a matter in respect of which particular deference is to be accorded to the view of the regulator. Even without such deference the matters alleged against the Appellant are capable of amounting to misconduct. Much will depend on the ultimate finding as to the Appellant’s intentions but if the allegations are established the panel would have to proceed on the basis that there had been bullying or harassment of nurses under the Appellant’s leadership. In the case of Samantha Sell the conduct alleged includes placing Miss Sell on the capability policy as a way of deflecting concern from the Appellant’s actions. In the case of Miss Saunders it is said that the Appellant deliberately sought to create an intimidating work environment for this nurse and I note that the Panel found that the Appellant took pleasure in doing so.

This question can also be answered shortly. There is no suggestion that the Appellant’s conduct caused harm to patients but the gravity of her alleged conduct is such that a panel finding that the allegations were made out would be entitled to conclude that there was impairment of the Appellant’s fitness to practise. That would be on the basis that the conduct was such as to bring the profession into disrepute and that the conduct was in breach of the fundamental tenets of professional behaviour. Whether the Appellant’s fitness to practise was in fact impaired would be a matter to be determined in light of the submissions to be made at the time. There is considerable force in the points which the Appellant makes by reference to her otherwise unblemished record and the evidence of a change in her approach as manager after these events. Those points are to be balanced against the gravity of the conduct and the fact that the allegations do not relate to a single isolated incident. It follows that a finding of impairment would be open to a further panel.

The position, therefore, is that it cannot be said that remittal would have no utility. Remittal could lead to a panel properly finding the allegations made out and concluding that they amounted to misconduct impairing the Appellant’s fitness to practise. I turn to consider the exercise of my discretion against that background.

The following points operate in favour of remittal for a further hearing.

The first is the public interest in the proper determination of allegations made against healthcare professionals. If the matter is not remitted the decision upholding the allegations will be quashed. That will, however, be on the basis of a failure by the Panel to address relevant arguments and to provide proper reasons. There will not have been a properly reasoned assessment of the merits of the allegations. The Appellant will not have received a clear vindication. There is, moreover, force in the point made by Mr D’Alton that those making the allegations will also have been deprived of a reasoned determination.

Next, I have to accord particular weight to the fact that the Respondent is the body primarily charged with assessing the needs of the public interest in these matters. Ultimately, the decision is for the court but weight is to be given to the view of the Respondent.

A closely-related point arises out of the agreed removal process. That provides a structure for an assessment to be made by the Registrar as to whether the public interest requires a matter to go to a hearing or whether matters can properly be resolved by the agreed removal of a nurse from the Register. That structure provides for those who made the allegations to have an input and for particular account to be taken of the likelihood of the nurse seeking to be removed from the Register subsequently wishing to return to nursing. This is a case where the agreed removal route would appear on the current material to be a sensible way forward but the decision on that is for the Registrar. It is not a foregone conclusion that it will be right for the Registrar to accede to an application from the Appellant for agreed removal and the court should be wary of forestalling the procedure laid down in the Registration and Appeal Rules. There would be such forestalling if the appeal were to be allowed and the decision simply quashed with the consequence that the Appellant could leave the Register voluntarily. Moreover, although I am satisfied that the Appellant is genuine in saying that she does not intend to return to nursing and that she will seek to be removed from the Register, if the decision were simply quashed the Appellant would be free to change her mind and to seek to work as a nurse.

Some of the matters alleged against the Appellant are less serious than others and there was no impact on patients. Nonetheless, taken as a whole the allegations are of serious matters. It is said that the Appellant bullied two separate colleagues over a period of some time; seeking to deflect concerns in respect of one; and taking pleasure in the bullying of the other. There is force in the contention that the public interest requires a determination of such allegations.

There are a number of potent considerations operating against remittal in the particular circumstances of this case.

First, it is relevant to note the time which has elapsed since the alleged conduct and also the time which will elapse before the matter is determined if there is remittal. The Respondent is now listing cases for August 2026. I accept the submission of Mrs Simpson that there is at the very least a real risk that the hearing would be later than that. This is because provision would have to be made of a hearing lasting several days and involving about ten witnesses. The original hearings lasted at total of 25 days. The number of allegations has now been reduced and it will not be necessary for the initial arguments about amendment and the admissibility of evidence to be refought. However, even at the most optimistic several days would be needed for the resumed hearing. It follows that if there is remittal it will be late 2026 (and potentially early 2027) when the witnesses will be giving evidence and the new panel making a decision about actions in 2014 – 2019 (and again with the most important findings being those about events in 2015).

Next, the Appellant had an unblemished career from 1991 to the time of the alleged behaviour. There is no suggestion that there has been any subsequent misconduct but rather the evidence is of a changed attitude on the part of the Appellant thereafter. This is not a case of an isolated incident but it is of alleged misconduct in a specific context some time ago.

The Appellant does not intend to return to nursing. She is currently engaged on a full-time university course which began in 2025 and which will last for 3 years. I accept that the Appellant intends to apply for agreed removal from the Register. If the matter is remitted then such removal will need the approval of the Registrar. The Appellant submits that agreed removal is a manifestly appropriate outcome in the circumstances of this case. She points out that the Respondent has not suggested that such a course is necessarily inappropriate (it has simply said that the process in the rules must be followed). In those circumstances the Appellant says that remittal will achieve nothing other than to require the time, expense, and strain of the agreed removal process to be incurred.

As I noted at [38] - [42] above there is considerable force in the arguments put forward on behalf of the Appellant and in the criticisms made on her behalf of the Respondent’s evidence. It follows that there is a real prospect that the outcome of the remitted hearing will be the rejection of some or all of the outstanding allegations.

Mrs Simpson submitted that I should take account of the fact that the Respondent’s witnesses would be forearmed against the questions which would be asked of them and the case they would have to answer by reason of having been questioned at the original hearing. In my judgement this cannot affect the position. The fact that the witnesses will have the benefit of having undergone the original hearing and will have to bear the burden of giving evidence for a second time is an almost inevitable consequence of any order for remittal. It cannot be a factor against remittal just as the fact that the relevant professional will have to undergo a further hearing cannot be a factor of any weight against remittal (see Hawkins at [47]). Moreover, the position is not as one-sided as Mrs Simpson suggested. The Appellant will also be forearmed in respect of the likely lines of questioning and of argument to be advanced against her. Her lawyers will know which lines of questioning and argument were effective against the Respondent’s witnesses and which were not. Further, the transcript of the earlier hearing will be available and so any witness who gives evidence which is radically different from that given at the earlier hearing will have to explain the discrepancy.

It was submitted to me that I should take account of the difficulties which there might be for the Appellant in funding her defence if the matter is remitted. Her legal expenses for the hearings before the Panel were met by the Royal College of Nursing. I was informed that there is uncertainty as to whether this funding would continue for any remitted hearing. The information about this was sketchy at best and the ultimate position was that I was informed that the Appellant’s lawyers had been told by the RCN that a decision would have to be made about funding and that the outcome of that decision was not guaranteed. Even if the position had been clearer this is a factor which cannot carry weight in the exercise of my discretion. If the public interest and the requirements of fairness and justice are otherwise such that it is appropriate for there to be remittal for a further hearing then the fact that the Appellant will have to fund her defence herself cannot be a countervailing factor.

I have reflected on those factors in the round. I have considerable reservations as to whether the public interest is served by a further hearing in respect of allegations as old as those here against a professional with an otherwise unblemished record and who does not intend to return to nursing. However, the public interest is not all one way and there is considerable force in the contention that there is a strong public interest in allegations as serious as those here being properly determined and in ensuring that any resolution by way of a removal of the Appellant from the Register takes place after the structured consideration for which the Registration and Appeal Rules provide. I also have particular regard to the weight to be given to the Respondent’s assessment of where the public interest lies. In light of those matters I have concluded that the public interest in the proper regulation of the nursing profession and the interests of fairness and justice in this particular case are best served by the matter being remitted for a further hearing. That hearing will not be necessary if an application for agreed removal is made and the Registrar concludes that course is appropriate.

The appeal is, therefore, allowed. The matter is remitted to be heard by a differently constituted panel. The order remitting the matter will provide that such a hearing will not be necessary if the Appellant’s removal from the Register is agreed in accordance with rule 14. If an application for agreed removal is made it will be for the Registrar to decide whether that course is appropriate having regard to the matters in rule 14 (2B). It is not for this court to direct the Registrar as to the exercise of his discretion under rule 14 and this judgment should not be read as purporting to do so. However, if an application for agreed removal is made then a copy of this judgment is to be provided to the Registrar so that he can derive such assistance as he finds fit from my analysis of the relevant factors noting that the factors which operate against remittal would seem also (and arguably even more so) to be factors in favour of acceding to an agreed removal.