Fitness to practise – interim suspensions

In Nursing and Midwifery Council v Pestano  [2026] EWHC 1412 (Admin), Simon Tinker, sitting as a Deputy Judge of the High Court, ruled on important issues in cases where healthcare regulators make interim suspension orders pending a final fitness to practise hearing.

Issues

In particular, the judge dealt with:

• Whether proceedings should be in private and/or any party anonymised
• When a suspension is necessary for the protection of the public
• When a suspension may be necessary in the public interest

It is noteworthy that when the case came before the judge, an interim suspension had been imposed on Nurse Pestano and that the nurse did not attend the High Court hearing. Despite not hearing from the nurse, the judge overturned the interim suspension.

The allegations

The allegations against the nurse are not spelled out in the judgment, but it is clear that the allegations related to something in the nurse’s private life, not professional life.

Private hearing and anonymity

Although the court’s starting point is that hearings will be in public, the judge considered there were grounds for conducting the hearing in private but making his judgment public. The judge made an order that if any third party wished to have access to the court records, a third party wishes to access court records, prior notice should be given to the parties so that they could make representations as to whether or not access should be granted. The judge considered that this gave sufficient protection to the parties without the need to make an order for anonymity.

No issue in professional life: it is necessary to impose a suspension to protect the public?

The judge said:

“If a nurse has been practising without issue in their professional life, especially if it is during the period of alleged risk, then that is likely to be evidence that there is limited, or no, risk to the public. The longer the period in which no issue has been identified, the stronger the evidence will be. Evidence from an employer of either the existence of issues or an absence of issue will clearly be of significant evidential value. Employers, however, generally have a duty to inform the regulator of issues. If there is no evidence from any employer of an issue then it is likely to be reasonable to infer that there has been no material issue in the clinical practice of the registrant.”

The evidence whether a registrant has or has not been working in their professional life without issue is likely to be a significant factor when determining whether suspension is “necessary” for the “protection of the public”.

In this case, there was no evidence of any issue in the professional life of the registrant. Indeed, the evidence was that the employer “had no concerns about [the registrant’s] clinical practice” and that the registrant had a “faultless work history”.

The judge considered that the NMC panel seemed to have disregarded evidence of the nurse’s work history. It instead formed the conclusion that because the nurse had done something in their private life then it followed that there was a risk to the public in their professional life. The judge concluded that the panel could not properly have reached this view. Instead, the panel should have considered whether conditions could be imposed to address the concerns raised.

The judge was “just about satisfied that the very limited conditions of practice that [he] imposed were necessary to protect the public.”

Is suspension necessary in the public interest?

Cases where interim suspension will be necessary in the public interest are likely to be very rare. The judge said:

“When a panel is considering the public interest it should assume that the public have knowledge of the full facts of the case and will form balanced and carefully considered opinions, taking into account the arguments and evidence put forward by both parties.”

In this case, there was no basis for an interim suspension on this ground. The judge criticised the NMC panel’s written reasons which, he said, tended “unfortunately, … to adopt slightly emotive descriptions of certain (disputed) facts rather than a more objective description.”