High Court warns against prolonged interim orders in fitness to practise cases

Overview

The High Court has delivered an important reminder to healthcare regulators that interim orders are protective measures, not a substitute for progressing a fitness to practise investigation.

In Nursing & Midwifery Council v Masih [2026] EWHC 2094 (Admin), handed down on 7 August 2026, the court refused the NMC’s application to extend an interim order and criticised aspects of the regulator’s handling of the case.

The judgment is particularly significant for nurses, doctors, dentists and other healthcare professionals who are subject to interim suspension or conditions of practice orders while their fitness to practise cases remain unresolved.

Regulators cannot assume an extension will be granted

An interim order can have serious consequences. Suspension can prevent a professional from working altogether, while conditions of practice can significantly restrict employment and clinical duties.

However, an interim order is imposed before the substantive fitness to practise allegations have been finally determined. The fact that an order was justified when originally imposed does not automatically mean that it remains justified months later.

Masih highlights the importance of the regulator being able to demonstrate why continued restriction is necessary and proportionate at the time an extension is sought, rather than simply relying on the circumstances which led to the original order.

This makes the progress of the underlying fitness to practise investigation highly relevant.

Where an extension is sought, professionals and their representatives should consider what has happened since the order was imposed. How much progress has the regulator made? Are there unexplained periods of delay? What remains outstanding? Has the regulator contributed to the delay? Has the evidence of risk changed?

An interim order cannot become a substitute for investigation

The wider message is that a regulator cannot impose restrictions on a professional and then allow the substantive fitness to practise investigation to drift indefinitely.

The longer an interim order remains in place, the greater its potential impact on the professional’s career, income and reputation. That makes continuing scrutiny of proportionality increasingly important.

Regulators should therefore be able to demonstrate that investigations are progressing and that the continued restriction remains necessary to protect the public.

For regulated professionals, Masih provides an important reminder that an interim order should not simply be extended because the regulator has not yet completed its investigation.

Evidence of regulatory delay, periods of inactivity, compliance with conditions, safe practice, remediation and developing insight may all become relevant when the continuation of an interim order is considered.

↓ Continued Below ↓

Implications for all UK healthcare regulators

Although Masih is an NMC case, its significance is not confined to nursing and midwifery.

The underlying principles concerning regulatory procedure, delay, proportionality and the continuing justification for interim restrictions are relevant across professional regulation. They may therefore have implications for professionals regulated by the General Medical Council, General Dental Council, Health and Care Professions Council, General Pharmaceutical Council and other UK healthcare regulators.

The precise statutory powers and procedures differ between regulators, so Masih does not establish an identical legal test for every regulator. However, the judgement provides an important indication of the level of scrutiny a regulator can face when seeking to maintain restrictions on a professional while a fitness to practise case remains unresolved.

For doctors, dentists, nurses, pharmacists and other regulated professionals, the practical message is the same: a regulator cannot assume that an interim order will simply be extended, particularly where there has been significant delay in progressing the underlying fitness to practise case.

Expert fitness to practise defence

Kings View Chambers – Expert GMC Defence Barristers is one of the UK’s leading specialist fitness to practise defence teams. Its barristers work exclusively in regulatory law and have extensive experience in GMC investigations, employer referrals, cross-border issues and appeals. Early legal advice can be critical in developing strategy, managing communications and ensuring remediation and insight are properly evidenced.

Insight Works Training provides targeted remediation, insight development, reflective practice support and behavioural change programmes for professionals facing complaints or regulatory scrutiny.

The key message from Masih is clear: an interim order should not become a substitute for progressing a fitness to practise case, and regulated professionals should not assume that a regulator’s application to extend an interim order will necessarily succeed.

Unique and practical courses focusing on impairment, reflection, insight, and remediation at highly competitive prices.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.