the FtP process – Step 3 of 8

Navigating FtP: Interim Orders and extensions

Interim Order Hearings (IOH)

The NMC may have an Interim Orders Panel (IOP) hearing, to determine whether a nurse should be suspended or restricted with a Conditions of Practice (CoP), or can carry on unrestricted while the NMC investigation takes place. Whilst these usually happen within 8 weeks of a referral to the NMC they can occur at any point following referral and can also be placed if new information comes to light during the investigation phase. Not receiving an interim order does not give an indication of what the outcome of the overall investigation may be. Some registrants have had no IO but then received a substantial impairment following full investigation and visa versa.

The IOH is a risk assessment performed by the NMC based on the balance of probabilities of risk associated with the allegations. It is tricky to understand as it is not based on any examination of evidence. It is purely a risk assessment to determine if, whilst they do investigate, the public would be at any risk by you continuing to work unrestricted.

This can be either an Interim Conditions of Practice:

  • the panel imposes conditions on the nurse, midwife or nursing associate for up to 18 months
0r an Interim Suspension Order:
  • the panel suspends the nurse, midwife or nursing associate’s registration for up to 18 months.

 

The RCN has produced some great leaflets that explain this further:

NMC Guide to Interim Order Hearings

The NMC has produced some useful guides – this one helps to explain an Interim Order Hearing with some good questions and answers. The NMC must satisfy the test for interim orders in order to place them – here is further explanation.

Download the guide

NMC Interim Orders hearings – Guidance for RCN members

1.   Orders available to the panel

The interim orders panel may decide to make no order or may impose one of the following restrictions:

Interim suspension order (ISO): or

  • Interim conditions of practice order (ICOPO).

2.   Criteria considered by the panel

The interim orders panel must be satisfied that an interim order is necessary:

  • for the protection of members of the public; or otherwise in the public interest; or
  • in the interests of the registrant.

3.   Venue

This hearing is to be held virtually, so you will need access to a phone or computer that has a camera.

4.   What should you bring?

Some items which may be relevant are:

  • a pen and notepad:
  • training portfolio:
  • original testimonials and other relevant original documents;
  • a book or newspaper (as there may be large periods of waiting around):
  • a friend or relative for support.

4. What should you wear?

Hearings are held in a formal, professional environment. Although this is a virtual hearing. there is an expectation that your clothing will be smart. We would suggest that you dress as if attending an interview.

5.   The procedure

Pre hearing

5.1   You should be ready by 8:30 am (unless we notify you of a different time):

The hearing

5.2  The people present in the virtual hearing room will introduce themselves as follows:

        • The panel – this is made up of the chair of the committee plus two other members. At least one member of the panel is a nurse or midwife. There is always at least one lay member on the panel.
    • Legal assessor – advises the panel on matters of law and helps the panel draft its reasons for its decision. The legal assessor does not play any part in the decision-making process.
    • Panel secretary – a member of the NMC staff not involved in the investigation or presentation of the allegations. Assists the panel with procedures and retires with the panel to take a note of its discussions and help it draft its decision and reasons.
    • Case presenter – presents the case on behalf of the MC and is, in effect, the prosecutor.
    • Shorthand writer – takes a full transcript of the hearing.
    • The member’s advocate – sits with member throughout the hearing.
    • Observers – the hearing is generally open to the public so there may be observers in the room, eg members of the press or student nurses.

5.3   Any preliminary matters/applications will be considered, e.g.

  • A rule 19 application to hold the hearing in private. Relevant if there are health concerns or any other matters of a confidential or sensitive nature.
    The panel may briefly go into private to reach a decision.
  • numbering exhibit bundles.

    5.4   The case presenter will make submissions on behalf of the NMC.

    5.5   The panel may ask the case presenter any questions.

    5.6.  The advocate will make submissions on your behalf. You will generally not be asked to give evidence yourself.

    5.7   The panel will ask the advocate any questions. Generally the advocate will answer these questions on your behalf, if the advocate is unsure of the answer, they can turn to you and privately take further instructions.

    5.8.  The legal advisor will give their advice on the law.

    5.9   The panel chair will then ask both advocates if they have any comments on the legal assessor’s advice. Any comments will be given.

    5.10.  The hearing will adjourn and all parties will leave the room while the panel makes its decision.

    NMC Guide to Interim Order Hearings

    The NMC has produced some useful guides – this one helps to explain an Interim Order Hearing with some good questions and answers. The NMC must satisfy the test for interim orders in order to place them – here is further explanation.

    Download the guide

    Unlike a full hearing, you will not get an opportunity to say anything about your case other than confirm your name and PIN number – your representative will give an outline to indicate why no Interim order is required and you can give the panel evidence to back this up such as testimonials from work colleagues and initial reflections. At NMCWatch we sometimes get the registrant we are advocating for, to speak briefly at the end before the panel go off to make their decision. This is decided on a case-by-case basis but is sometimes helpful.

     

    Read more about NMC IOP hearings. This flowchart outlines what happens during an IOH quite clearly.

    Some investigations can take many months or years, so an IOP hearing is held to safeguard the public interest, protect patients, and otherwise uphold confidence in the nursing profession and the NMC. An IOP Order has to be reviewed every 6 months and can only run for a total period of 18 months.

    If the investigation has not concluded by this time the NMC will have to apply to the High Court for an extension to the Interim Order. Although not widely publicised by the NMC you can attend this hearing and you can provide a submission to the judge – many people don’t bother but this is your opportunity to explain to the court why you feel the excessive amount of time to investigate to date should not continue.

    Here is an example of a submission against extension, the registrant this was used for is happy for you to replicate it for your own case as a template:

    Please look at the separate section that explains Conditions of Practice.

    IN THE HIGH COURT OF JUSTICECASE NO CO/2184/2019

    QUEEN’S BENCH DIVISION ADMINISTRATIVE COURT

    IN THE MATTER OF AN APPLICATION UNDER ARTICLE 31(8) OF THE NURSING AND MIDWIFERY ORDER 2001 TO EXTEND AN INTERIM ORDER

    BETWEEN:

    THE NURSING & MIDWIFERY COUNCIL

    Applicant and

    xxxx|

    Respondent

    RESPONDENTS SKELETON ARGUMENT

    1.   This submission is made in order to support the Registrants/Defendants view that’s the NMC application to extend a set of conditions of practice imposed on 20/12/2017. The Defendant apologises for the lateness of the submissions but the proceedings were served by letter dated 6 June 2019 and so it was not possible to comply with any time limits relating to time for service of relevant documents.

    2.  The Respondent adds the following documents to the response

      1. The investigative report dated September 2018

    3.   The Respondent has read the Applicants submission and it appears to miss a few vital factual issues.

      1. The NMC were late in applying for this extension and gave no for warning of this to the Respondent despite the fact that there were active negations and contact taking place
      2. The Respondent is concerned that the whole basis of the present allegations are based upon one witnesses evidence and the Respondent is of the view that there is a degree of personal animosity from that witness
      3. The NMC has produced an intermediate report dated September 2018 (attached) in which some 60 % of the allegations have been rejected and yet the allegations have been presented to this court as being live.

    4.   The Defendant does wish to oppose the continued imposition of Conditions of Practice on
    the following basis;

      1. The Defendant has not at this time been found to be unfit to practice
      2. The present COP was introduced when some 5 or 56 separate areas of concern were raised and it would seem that the NMC’s own Investigative committee report has caste doubt upon them and therefore the present unworkable Condition of Practice provisions are not necessary for the protection of the public or otherwise
      3. The Claimants have had insufficient time to produce more detalled response in view
        of the late service and apparent lack of candour on the part of the NMC

    5.   Background

      1. The Defendant is a qualified staff nurse and the Claimant is her regulator the NMC.
        In December 2017 as a result of a referral relating to alleged fitness to practice allegations the Registrant was made the subject of conditions of practice. In the intervening period the NMC has not presented or heard the allegations or come to a decision on the issues of her fitness to practice.
      2. The Defendant has seen the Claimants statement of case and would take issue with a number of points and would submit that there is no need for the ongoing conditions of practice and would also submit that the facts behind the allegations made are by no means accepted or dear.

    6.   Application to extend the conditions of practice

      1. These proceedings are governed by the civi Proceedings cegulations it is the Defendants submission that the proceedings were served late and it is this lateness which is the hallmark of the manner in which the proceedings appear to have been handled. The letters serving the proceedings are dated 6/6/2019 and were received on 7/6/2019
      2. In the 18 months that the proceedings have been ongoing the Begistrat, as a conscientious professional, has cooperated throughout, shown appropriate insight and accepted shartcomings and adjusted her practice. Hower she has been unable to return to work as a staff nurse and has instead been forced to seek alternative but related employment.
      3. The actions of the Caimants organisation in imposing length and prohibitive conditions of practice has effectively prevented the Defendant from working within the profession. As a qualified staff nurse regulated by the NMC the Defendant is subject to the regulatory framework imposed by them. Hasew er the exercise of this has been carried out in an unfair and unreasonable manner which has caused the Defendant undue and unfair prejudice
      4. My time line and my reflection made at the time and on a contemporaneous basis indicates, supports and confirms that as a professional I understand that my practice, as a newly qualified nurse, needed to be adjusted which I had achieved by refection and learning.
      5. I am of the wiew that I am now a safe practitioner and that the intervening 18 manth period subject to onerous and unworkable conditions of practice is unfair, disproportionate and unreasonable. The conditions of practice should not therefore be maintained and the NMC evidence is flawed and somewhat weak.

    Dated

    The Respondent

      02. Screening process

      04. Will they Investigate?