Early Admissions in NMC Investigations

If a concern is deemed serious & credible, the NMC will open an investigation, including consideration of early admissions. However, careful consideration should be given to early admissions.

NMC Investigations

If a concern is considered serious and within the NMC remit for fitness to practise investigations, it will formally open an investigation to gathering evidence including interviewing witnesses, and obtaining relevant documentation etc.

It is during the NMC’s investigation stage where a nurse or midwife will have the opportunity to make submissions to the NMC.

What are early admissions?

In brief, the NMC will correspond with nurses or midwives during the investigation stage, including, initially, outlining the allegations and, eventually, the evidence gathered.  Throughout the investigation, a nurse or midwife can make early submissions (including admissions) to the NMC.

When might early admission be appropriate?

It is important to say from the outset that specialist legal advice is important when considering early admission and other submission in response to an NMC investigation.  Early admission and other submissions will be taken into account by the NMC, and getting it wrong might very well lead to poor outcomes.

There may be certain circumstances where early admission and other submissions may be helpful (the list below is not exhaustive):

Vexatious Referrals – These types of referrals to the NMC could be made by dissatisfied patients, patient’s family members, members of the public or a nurse/midwife’s own family or friends. For everyone involved, it should become obvious at an early stage that these referrals are without merit and, often, outside the NMC scope and remit.

For these types of referrals, a nurse or midwife could consider making early submissions to the NMC to have the matter closed at a very early stage.

Isolated Incidents – In cases where allegations relate to an isolated incident, in an otherwise long and unblemished career, nurses and midwives may which to make an early admission to expedite the investigation process.

Whilst an early admission under these circumstances might seem appropriate, isolated incidents could be considered serious – notwithstanding an unblemished career – and it is highly recommended legal advice is sought.

Voluntary removal – The NMC has discretion to resolve investigations by agreeing to a voluntary removal. This would be the case where a nurse or midwife decides to leaving the profession for whatever reason.  Under these circumstances, a nurse or midwife could make an early admission to expedite the investigation and disposal.

It is worth noting that the NMC is not obligated to accept an offer of a voluntary removal because it may not be considered to be in the public interest.

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Will an early admission be considered evidence of insight?

Early admissions could be seen as a sign of insight.  Nurses and midwives have a duty to cooperate with the NMC during an investigation, and there is an overarching duty of Candour.  Under certain circumstances, and with the right legal advice and representation, a nurse or midwife may wish to make an early admission (or acknowledgement). 

When evaluating the strength of insight, the NMC will consider, for example, whether a nurse or midwife has:

• recognised what went wrong, why their actions, behaviour, or decisions are concerning;
• recognise and understood the potential public safety risks;
• fully engaged with the investigation process, including completing a reflective statement and action plans; and/or
• taken demonstrable steps and actions to remediate.

Things will go wrong, and we are here when you need us

Kings View has been advising and representing health care professionals for many years, and we know that despite their best efforts, some things do go wrong.  Through our experience, we know that the circumstances that lead to things going wrong are never straightforward.

It is a well-established fact that healthcare professionals who seek legal advice and representation at an early stage in any fitness to practise process, generally, receive better outcomes and lesser sanctions, if any.  We can advise on the right strategy to take and represent you before a fitness to practise hearing.

Kings View are public access barristers, meaning that you can instruct us directly without having the additional expense of hiring a solicitor first (so we are generally at least one third cheaper).

You can speak to us today for a free, no obligation assessment of your case.

In upholding the appeal, Alan Bates, sitting as a Deputy Judge of the High Court, said:

1. Failure to assess witness credibility and reliability The panel did not sufficiently evaluate the general credibility and reliability of key witnesses, whose evidence was essential to the charges. It failed to consider factors such as contradictions between witnesses' accounts and whether their testimonies should be approached with caution. This omission undermined the panel's ability to justify its conclusions.
2. Lack of explanation for preferred evidence The panel failed to provide adequate reasons for preferring the complainants' evidence over the appellant nurse's and the paramedic's. Simply stating a preference for certain witnesses' accounts without detailed justification left the appellant without a clear understanding of why her evidence was rejected.
3. Errors in evidence evaluation The panel assessed each charge in isolation without considering broader patterns or contextual evidence. It failed to recognize that inaccuracies in one allegation (contradicted by CCTV) could cast doubt on the reliability of witnesses' accounts in other allegations, leading to flawed conclusions.
4. Improper handling of contextual evidence The panel neglected to evaluate the behaviour of the complainant nurses during the investigation, which was relevant to determining their credibility. Additionally, it overlooked the appellant nurse's claims that the allegations were fabricated to remove her from her managerial position.
5. Insufficient reasoning for findings The panel provided inadequate reasoning for its findings of misconduct. It did not fully explain how the evidence supported its conclusions, including why the NMC had met the burden of proof for each disputed allegation. This failure left the appellant with unsubstantiated conclusions, undermining the credibility of the process.

Lessons

This case highlights several critical considerations for fitness to practise tribunals. One key lesson is the importance of thoroughly evaluating the credibility and reliability of witnesses, particularly when their testimony is central to the charges. Without such assessments, the accuracy and fairness of the tribunal’s findings can be compromised. Witness accounts must be examined not only in isolation but also in a broader context, taking into account patterns and inconsistencies to achieve a holistic evaluation.

Additionally, tribunals must provide clear and rational reasoning for their decisions. Merely preferring one witness’s account over another without detailed explanations can lead to procedural unfairness. Ensuring transparency in decision-making fosters trust in the process and supports robust outcomes. Tribunals must also maintain procedural fairness by upholding the burden of proof on the prosecuting body. Accused parties should never feel pressured to disprove allegations, as fairness is crucial to preserving the system’s integrity.

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.