Standard reviews before expiry

Reference: REV-3a

Last Updated 28/07/2017



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Substantive order reviews usually take place when a conditions of practice or suspension order has been imposed, as our legal requirements state that these types of orders must be reviewed by a panel before they expire.1  We will usually schedule a review within eight weeks of the date of expiry of the order. This allows us time to reschedule the hearing if there’s any reason that the review cannot go ahead.

Making a decision

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At the review, the panel considers whether the nurse or midwife’s fitness to practise remains impaired. It is useful to remember that a previous panel will already have made findings about the effect of the proven allegation on patient safety and the public interest. We may ask the panel to consider new facts in relation to the issue of impairment. The nurse or midwife may do the same. The party presenting these facts (a lawyer taking the role of case presenter) must prove them on the balance of probabilities.

What has happened in the nurse or midwife’s practice since the last hearing or meeting is important, especially the following factors:

  • has the nurse or midwife complied with any conditions imposed? What evidence has the nurse or midwife provided to demonstrate this? What is the quality of that evidence and where does it come from?
  • does the nurse or midwife show insight into their failings or the seriousness of any past misconduct? Has their level of insight improved, or got worse, since the last hearing?
  • has the nurse or midwife taken effective steps to maintain their skills and knowledge?
  • does the nurse or midwife have a record of safe practice without further incident since the last hearing?
  • does compliance with conditions or the completion of required steps demonstrate that the nurse or midwife is now safe to practise unrestricted, or does any risk to patient safety still remain?

If the panel decides that some restriction on the nurse or midwife’s practice remains necessary because their fitness to practise is currently impaired, then they will decide what sanction, if any, to impose.

A panel’s powers

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A panel can extend the existing order, make a new order or allow the existing order to expire.

When extending the duration of the existing order, a panel cannot extend a conditions of practice order by more than three years at a time or a suspension order by more than one year at a time.2

When replacing one order with another in a case based on health, lack of competence, or not having the necessary knowledge of English, a panel cannot make a striking-off order unless the nurse or midwife has been on a substantive conditions of practice order, a substantive suspension order, or a combination of the two, for more than two years.

Any time spent on an interim order does not count towards the two year period. For example, if a nurse or midwife has been subject to two 12 month suspension orders (one following on immediately from the first), a panel cannot make a striking-off order at the second standard review. This is because the nurse or midwife will not have been on a substantive order for a total period of two years when the panel is carrying out the review hearing, as the review hearing takes place before expiry of the second 12 month suspension order.

Any change to the order, or extension of the order, does not take effect until the existing order expires.

Making an immediate change to the order, rather than waiting for the change to happen once the existing order has expired, is only necessary in exceptional cases.

1 Article 30(1) of the Order
2 Article 30(5) of the Order