When we receive an allegation, we will consider whether the facts alleged can amount to an allegation of an incorrect or fraudulent entry relating to a named nurse, midwife or nursing associate on our register.
If we receive an allegation that could be described as either about a nurse, midwife or nursing associate’s fitness to practise or about whether their entry on the register is fraudulent or incorrect, we prioritise whichever case involves evidence of a more significant risk.
We won’t refer an allegation to the Investigating Committee if, after an investigation, the evidence doesn’t support a finding of fraudulent or incorrect entry.
We may decide that we don't need to refer an allegation to the Investigating Committee if:
- there’s no suggestion that an entry was gained through fraud
- the error or inaccuracy was trivial or unimportant
- the error or inaccuracy has since been corrected
- we have subsequently entered the nurse, midwife or nursing associate on the register based on correct information
- it’s unlikely that the Investigating Committee would take any action if it were considering the allegation.
If we conclude that an allegation can amount to an allegation of fraudulent or incorrect entry, we’ll refer the case to the Investigating Committee which makes a final decision on whether or not the entry on the register is incorrect or fraudulently procured.
Deciding on incorrect or fraudulent entry
The NMC has the burden of proving that the alleged facts amount to incorrect or fraudulent entry. When it considers an allegation of incorrect or fraudulent entry1, the Investigating Committee’s focus is on deciding whether it is more likely than not that our registration, renewal or readmission decision was based on information that was incorrect or fraudulent.
Depending on the nature of the allegation, the Investigating Committee may assess:
- whether it appears that the entry on the register was made in error by the NMC
- the validity of the original registration, renewal or readmission decision
- how the nurse, midwife or nursing associate was accepted onto, or remained on our register, in the first place
- whether any of the information submitted, or information that the Registrar (or one of our Assistant Registrars who also make decisions on behalf of the Registrar) took account of during the application process was correct at the time it was submitted
- whether any of this information was obtained or created fraudulently
- whether any wrong information was provided with the deliberate intention to mislead the NMC.
When deciding whether or not the register entry was incorrectly or fraudulently obtained the Committee is unlikely to assess:
- evidence about the person’s current practice or ability to provide care
- new information about whether the nurse, midwife or nursing associate would have been capable of safe and effective practice when they entered the register.
Interim orders
In cases of concerns about the legitimacy of the nurse, midwife or nursing associate’s entry in the register, the Investigating Committee can make an interim order while the concerns are being resolved.
One of the specific considerations for a panel deciding on whether to make an interim order for an IEFE allegation is the public interest in maintaining the integrity of the register. If they consider that there would be serious damage to the public interest in maintaining the integrity of the register by allowing the person to continue to practise without restriction, the panel will need to identify the specific risk in that particular case. Court decisions2 have emphasised the need for Investigating Committee panels to consider if the integrity of the register could be properly maintained through sanctions imposed at the end of proceedings.
If they decide an interim order is required, the Investigating Committee can impose either:
- an interim suspension order or
- an interim conditions of practice order.
The decision on which order is proportionate will be dependent on the circumstances of the particular case.
If an individual has more than one entry on the register (e.g. they are registered as both a nurse and a midwife) and concerns about fraudulent or incorrect entry relate to only one of their entries in the register, an interim conditions of practice order, to restrict the person from working in relation to the entry of concern, may be appropriate. The order could be tailored so that it only applies to the entry of concern, for example that an individual must not practise as a midwife. Interim suspension orders apply across all register entries so are appropriate if all entries are a concern, or where the concern in relation to one entry is so egregious that an FtP referral is being considered on the other entry.
There is further guidance on interim orders, including the test for applying them, in our fitness to practise guidance library.
Agreed Removal
Where a nurse, midwife or nursing associate is being investigated for an alleged fraudulent or incorrect entry, it won’t be appropriate for them to be granted Agreed Removal from the Register.
Allegations relating to applicants
The IEFE process only applies to people who are on our register. This section provides information about situations where we become aware that those applying to join our register might plan to provide fraudulent information or evidence as part of their application.
Where we suspect that an individual in the process of applying for registration with the NMC has fraudulent registrations evidence or information, once we have received a complete application and have investigated the potential fraud as part of our registration assessment we will write to them explaining our concerns, the regulatory approach we plan to take and the implications for them. Applicants should share this letter with their employer or sponsor.
Where we have concerns that somebody does not meet our requirements, an Assistant Registrar will consider their complete application and whether, in light of the evidence of fraud, they are capable of safe and effective practice, having regard to any character issues. We can refuse them entry to the register as part of our role in protecting the public. If an Assistant Registrar refuses an application to the NMC register, based on the evidence available, this will not be made public. The individual can appeal the decision and at a later date seek to reapply to the register.
Next: Drafting charges in incorrect or fraudulent entry cases
1 Rule 5 of The Nursing and Midwifery Council (Fitness to Practise) Rules 2004 (‘the Rules’) sets out the procedure to be followed
2 See Christou v Nursing and Midwifery Council [2016] EWHC 1947 (Admin)
