Stage two: what happens during the review process?

Reference: REV-1b

Last Updated 28/07/2017


Main principles

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At stage two,1 the Registrar is considering if the material flaw of the decision or the presence of new information would have led to a different decision, and whether a fresh decision is required in the public interest.

This means that the Registrar at the second stage is required to come to a definitive conclusion on the merits of the request, as opposed to considering whether there is a possibility that one or both of the grounds were met.

Review grounds

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At stage two the test is more definitive, and there is a higher threshold.
The Registrar should address the following questions:

  • Was all or part of the decision materially flawed?
  • Would the new information have probably led to a different decision in whole or in part?
  • If the answer to either of the first two questions is yes, is a fresh decision needed in the public interest?

Factors that may have led to a review being in the public interest will not necessarily mean that there is a public interest in a case being reopened, even if one of the grounds has been met. It may be that the public interest has been adequately served through a matter being reviewed.

If the Registrar decides that there is no public interest in the case being re-opened, then the no case to answer decision stands, and the Registrar informs the nurse or midwife, referrer and other relevant people by sending a notification of the outcome (see below).

Public interest in the case being reopened 

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If the Registrar decides that that there is a public interest in the case being re-opened and a fresh decision is required, they will then have the choice of two options. The Registrar can:

  • refer the decision back to the case examiners for reconsideration2
  • substitute a new decision.3

In deciding which of the above two options is appropriate, the Registrar might take into account the following considerations:

  • Whether the reason for their review (the flaw or the new information) requires a total re-examination of the evidence, or relates to a narrower issue of interpretation on which the Registrar is able to take a decision.
  • The allegation itself, and in particular whether the specialist clinical knowledge of a registered case examiner is required to assess the case
  • Delay to the progress of the case, the interests of the nurse or midwife in that regard, and the wider public interest in concluding cases expeditiously.

Notification of outcome

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The Registrar must notify the following parties of any decision taken to review a decision.

  • The nurse or midwife.
  • The referrer (maker of the allegation).
  • Any other person who the Registrar thinks has an interest in being informed through a notification.

1 Rule 7A(6)
2 Rule 7A(7)(a)(i)
3 Rule 7A(7)(a)(ii)