NMC Interim Orders Hearings
NMC Interim Orders Panel (IOP) Hearings
The Nursing and Midwifery Council (NMC) can impose interim orders on nurses whose fitness to practise may be impaired by way of misconduct, ill-health, or a lack of competence, while the NMC investigates allegations. A nurse can be suspended or have conditions imposed on their registration. Suspension would mean that the nurse cannot practise as a registered nurse. Conditions of Practice are restrictions that are imposed upon a nurse which affect their work, such as working only under supervision, or working for one particular employer. Some conditions of practice do, regrettably, create difficulties for nurses who are trying to find a job but the appeal courts have confirmed that that is not a good reason not to impose conditions of practice.
The IOP test : “An interim order may not be imposed unless the panel considering the case is satisfied that it is necessary for the protection of members of the public or is otherwise in the public interest, or is in the interests of the registrant, for the registration of that person to be suspended or to be made subject to conditions. In addition to protection of the public, the public interest includes maintaining public confidence in the profession, and maintaining proper standards of conduct and performance” (per NMC guidance and statutory regulations). The panel must also consider the NMC Conditions library document, when determining the wording and the scope of the conditions that they are considering.
A nurses fitness to practise may be impaired by reason of: misconduct, a lack of competence, a criminal offence or caution, physical or mental ill-health, not having a sufficient knowledge of English, a determination of another body. There must be evidence that the practitioner’s fitness to practise may be impaired on one of these grounds.
The NMC does not impose conditions or a suspension in every case that considered by an Interim Orders Panel (IOP). Many nurses are able to demonstrate to the NMC IOP panel that they have insight and are at very little risk of repeating events. In many cases, the NMC IOP panel will be satisfied that it is not necessary to impose an order, either to protect patients or uphold the reputation of the nursing profession (including the reputation of the NMC as a regulator of the nursing profession), or to otherwise impose an order in the public interest.
A nurse will need to attend the hearing to make oral submissions. Written submissions in the absence of the nurse can work, but oral submissions, backed up with answering questions that the NMC IOP panellists may have for the nurse, will increase the prospects of success.
A nurse is entitled to take lawyer with them to an interim orders hearing. A lawyer, acting on the nurse’s behalf, will generally present the nurse’s case on the nurse’s behalf. Written documents, or other exhibits may be of assistance to the panel, when it deliberates and comes to a determination. In many cases the lawyer will submit that no order is necessary. However, in some cases it is obvious that an order needs to be made, of at least conditions, and a lawyer may concede as much on the nurse’s behalf.
It is also important for the nurse to make submissions on workable conditions and to indicate their agreement to work to them. Should a nurse breach any condition imposed on them they are likely to be brought back before an IOP panel to be suspended. Nurses who do not work to the conditions that have been imposed can also be charged with professional misconduct, in further and additional NMC fitness to practise proceedings.
See our NMC IOP Procedural flowchart, for quick reference:-
You can also download the same NMC IOP procedural flowchart in pdf format: NMC IOP Procedural Flowchart (in PDF)
A nurse who is suspended from practice might at a later date be able to apply for the suspension to be lifted, where certain new evidence comes to light, or the nurse has taken steps to remediate any shortcomings, or they have a job offer that can provide the training and supervision that they objectively need to undergo, if they are to successfully return to practise. A nurse who wishes to apply for her conditions to be changed can also do just that. An early IOP review hearing can be convened on request, where there is a change of circumstances or new evidence. Otherwise, there will be statutory reviews every few months.
Interim orders are usually made for an initial 18 months. The NMC can appeal to the courts for an extension of an interim order. Read more information about extensions of interim orders.
Some cases are closed without the nurse being referred to a fitness to practise hearing. In such cases the interim order will be revoked. Where a nurse is referred to a fitness to practise hearing, the NMC FTP panel also has power to impose an interim order. Read more about NMC Fitness to Practise (FTP) hearings and NMC Investigations on our other pages.
Many employers are reluctant to take on nurses who have conditions or practice imposed on them and, so, if a nurse can avoid conditions (or suspension) being imposed, their future prospects will be that much brighter. Nurses who are suspended, or who cannot obtain a job, are often hampered when it comes to providing current and and recent evidence of competence and insight, because they have no clinical environment in which to be assessed or obtain references. Nurses must be pragmatic. There will be cases where it is obvious that conditions will be imposed. It will still be necessary to seek to persuade the IOP panel to impose conditions that are workable and which will give the nurse a fighting chance to obtain or keep a job.
Case Law on IOT Hearings
In Dr MXM v General Medical Council  EWHC 817 (Admin) an appeal court determined that an order of suspension as an interim measure was not appropriate in the circumstances. Within the statutory scheme, the appeal court lacked the authority to impose an order of conditions of practice, and it thereby advised the GMC to empanel a further interim orders tribunal hearing, for them to consider imposing an order of conditions instead. The appeal court also ordered that the name of the doctor be in anonymous form, as some of the allegations might be sensationally published by the press, so affecting the welfare of the doctor’s children. (April 2022)
Nurses Defence Service advises and represents nurses who attend Nursing and Midwifery Council (NMC) interim orders panel (IOP) hearings. To discuss your case with one of our specialist NMC IOP law lawyers, contact us without obligation and in strict confidence on: 0800 0122 506