Applying the voluntary removal criteria to particular cases

Reference: CMT-5d

Last Updated 28/07/2017

How do we apply the decision-making criteria in practice? 

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The decision to grant a VR application will depend on the particular circumstances of each case. There are different considerations that will apply to different types of cases; the type of allegation of impairment will be a relevant factor in this regard.


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VR is likely to be an appropriate method of disposing of a case in certain matters relating to nurse or midwife's health.

  • When allegations and evidence relate exclusively to a nurse or midwife’s long-term physical or mental health and if there are no outstanding conduct issues.
  • If the nurse or midwife accepts that their fitness to practise is impaired as a result of their health condition. The public interest may be best served by granting a VR application (even if the nurse or midwife expresses a desire to seek readmission in the future should their health improve to an appropriate level). If VR is granted, this is recorded and may be disclosed to relevant enquirers, including potential employers and overseas medical authorities. The details of any medical condition will not be disclosed.
  • When the nurse or midwife is seriously ill. In these circumstances VR may be appropriate before a hearing starts. However, this will only be an appropriate course of action in exceptional circumstances, when the nurse or midwife is able to admit the details of the regulatory concern. If a nurse or midwife is seriously ill, they may be unable to make any formal admissions, or participate in the process. These cases are better dealt with under our cancellation of hearings process, when there is no requirement for the nurse or midwife to make admissions.

Lack of competence or not having the necessary knowledge of English

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VR may be appropriate when:

  • a nurse or midwife accepts that their fitness to practise is impaired through lack of competence or through not having the necessary knowledge of English, and
  • the nurse or midwife has already stopped practising and has no intention of returning to practice. VR may be appropriate in some circumstances where the nurse or midwife has an intention to return to practise where English language skills are not required.

If the nurse or midwife’s actions have resulted in harm to a patient, the Registrar will have to consider whether they are suitable for VR, taking into account the public interest considerations.


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Cases where the allegation primarily relates to misconduct, convictions or determinations from another regulatory body concerning the nurse or midwife’s conduct are less likely to be appropriate candidates for VR. The seriousness of such allegations is likely to require scrutiny at a public hearing in order to uphold the public interest.

Allegations of impairment on more than one ground

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If it is alleged that the nurse or midwife’s fitness to practise is impaired on more than one ground, decision makers and the Registrar will look at all the allegations and consider whether, in all the circumstances, VR is appropriate.

When there is a case to answer on allegations of impairment by lack of competence, not having the necessary knowledge of English or misconduct, but the case has allegations of impairment by reason of health, the Registrar will consider all outstanding allegations when deciding whether to grant an application for VR.

If the case includes misconduct allegations of a serious nature, suitable for a suspension or striking-off order, then the Registrar is unlikely to grant a VR application.

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