High Court ruling highlights risks of facing fitness to practise hearings alone

A recent High Court judgment in Nurrish v Nursing and Midwifery Council [2026] EWHC 2 (Admin) offers a clear warning to UK healthcare professionals: attending a fitness to practise (FtP) hearing without specialist legal representation can significantly undermine fairness and lead to avoidable adverse outcomes.

Mr Justice Eyre overturned an NMC striking‑off decision after finding that the January 2025 review hearing was procedurally unfair, particularly given that the nurse was unrepresented and visibly struggling with the pressures of the process.

Key difficulties highlighted by the court

Virtual hearings reduce nuance

The hearing was conducted remotely. The judge noted that in virtual settings “the scope for assessing body language and nuance is reduced”. For an anxious registrant, this increases the risk that hesitation or distress is misinterpreted as evasiveness or dishonesty—something legal representatives are trained to contextualise and challenge.

Delays heightened stress and affected communication

The hearing began late, and the delay “increased her nervousness”, with the court observing that “her nervousness increased in the course of the hearing”. Stress of this kind can impair clarity and expression, yet without representation, registrants are left to manage these pressures alone.

Intense questioning created confusion

During a 22‑minute period, the panel asked 44 direct questions, plus additional comments and follow‑ups. The High Court recognised that this level of intensity contributed to the registrant’s confusion and made it harder for her to present her case effectively.

Confusion in a stressful environment was misinterpreted

The court noted that “the Appellant appeared confused at times”. Confusion in a high‑stakes regulatory setting is unsurprising, but without an advocate to intervene, clarify, or slow the pace, it can be wrongly interpreted as inconsistency or lack of insight.

Lack of legal insight left key issues unaddressed

Crucially, the registrant did not understand that the panel was questioning her honesty. Although she was invited to make closing submissions, “it was not suggested to her that she might care to address the question of the truthfulness of her evidence and its relevance to the finding of impairment”. A representative would have immediately recognised the significance of this issue and guided her accordingly.

What this means for healthcare professionals

This judgment demonstrates how easily stress, procedural complexity, and misunderstanding can escalate into findings of impairment when a registrant is unrepresented. Specialist legal support is not simply helpful—it is protective.

How legal representation changes the process

• Clear guidance on the right approach: Counsel understand how panels assess insight, remediation, and credibility.
• Reduced stress and anxiety: Registrants are supported before and during the hearing, helping them communicate clearly.
• Active challenge to unfair questioning or assumptions: Representatives can intervene when panels or legal assessors stray into improper territory.
• Strategic advocacy for better outcomes: Fitness to practise specialists know how to frame evidence and address concerns in a way that panels understand.

Fitness to practise hearings are legal proceedings with serious consequences. This case shows how even well‑intentioned registrants can be disadvantaged without expert support. Early legal advice and representation can ensure fairness, protect wellbeing, and significantly improve the chances of a just outcome.