Mohammed Islam Ahmad Khan v The Nursing and Midwifery Council [2026] EWHC 1975 (Admin)

[2026] EWHC 1975 (Admin)Case No AC-2025-LON-002012
IN THE HIGH COURT OF JUSTICE
KING’S BENCH DIVISION
ADMINISTRATIVE COURT
Venue Royal Courts of Justice, Strand, London, WC2A 2LLDate 30/07/2026
Before
THE HONOURABLE MR JUSTICE MORRIS
Between
MOHAMMED ISLAM AHMAD KHANAppellantTHE NURSING AND MIDWIFERY COUNCILRespondent
Ian Skeate (instructed through Direct Access) for AppellantBenjamin D'Alton (instructed by the Nursing and Midwifery Council) for RespondentHearing Hearing dates: 3 December 2025
Approved JudgmentThis judgment was handed down remotely at 10.30am on Thursday 30 July 2026 by circulation to the parties or their representatives by e-mail and by release to the National Archives..............................Mr Justice Morris :

Introduction

[1]This is an appeal brought by Mohammed Islam Ahmad Khan (“the Appellant”) from decisions of the Fitness to Practise Committee (“the Panel”) of the Nursing and Midwifery Council (“the NMC”) made on 8 May and 13 May 2025. On 8 May 2025 the Panel refused the Appellant’s application to postpone and decided to proceed to hear charges in the Appellant’s absence (“the Postponement Decision”). On 13 May 2025 the Panel went on to determine that the Appellant should be struck off from the register of nurses for impairment of his fitness to practise arising out of misconduct (“the Sanction Decision”). The Panel found that the Appellant had cheated in certain exams. The respondent to the appeal is the NMC.

Some factual background

[2]The Appellant was an employed nurse on the NMC’s register of nurses, midwives and nursing associates. In 2021 he was a student on the Master of Sciences Advanced Neonatal Nurse Practitioner programme at the University of Southampton.[3]On 15 April 2021 during an exam as part of that programme, an invigilator found a model answer tucked amongst the Appellant’s permitted materials. He was awarded zero remarks. He was allowed to re-sit the exam, which he subsequently failed. At a further and final re-sit on 9 December 2021, the Appellant was discovered by an invigilator to have swapped his clean copy of the British National Formulary with a copy in which the model answers had been glued on to the pages.[4]The matter was then referred to the NMC who brought proceedings before the Panel. After a hearing in May 2025, the Panel found a number of allegations of fact proved and that those findings of fact amounted to misconduct and impairment of fitness to practise. On 13 May 2025 the Panel imposed the sanction of striking off. The Panel’s two decisions are contained within a single written determination (“the Determination”) sent to the Appellant under cover of a letter dated 15 May 2025.[5]In this judgment I address the legislative framework and relevant legal principles, the facts in more detail, the proceedings before the Panel, the Determination and the two Decisions, and the two Grounds of Appeal, addressing each ground in turn.

The Legislative Framework and relevant legal principles

[6]The statutory framework for the NMC and the Panel is to be found in The Nursing and Midwifery Order 2001 S I 2002 No 253 (“the 2001 Order”) and the NMC (Fitness to Practise) Rules 2004, made under the 2001 Order (“the Rules”). Other relevant material is to be found in the NMC’s guidance in its online fitness to practise guidance library and in certain case law.

The NMC and the Fitness to Practise Committee

[7]Under the 2001 Order, the NMC regulates standards for nurses, midwives and nursing associates. Article 3(4) of the 2001 Order provides that “the over-arching objective of the Council in exercising their functions is the protection of the public”. Article 3(4A) expands on this, providing that:
“the pursuit bythe Council of the over-arching objective involves the pursuit of the following objectives - (a) to protect promote and maintain the health safety and well-being of the public; (b) to promote and maintain public confidence in the professions regulated by this Order, and (c) to promote and maintain proper professional standards and conduct for members of those professions”
.

Fitness to practise proceedings

[8]Article 22 of the 2001 Order addresses allegations of impairment of fitness to practise by reason, inter alia, of misconduct and their reference to the Fitness to Practise Committee. The determination of impairment of fitness to practise involves a two-stage process (see rule 24 of the Rules and as set out in the present case at page 31 of the Determination). First the issue of whether there has been misconduct (or other grounds) and, second, whether as a result of such misconduct (or other ground), fitness to practise is impaired.

NMC Guidance on Sanction

[9]The NMC Guidance in relation to sanctions provides, inter alia, as follows:
“Sanctions for particularly serious cases … Cases involving dishonesty Honesty is of central importance to a nurse, midwife or nursing associate’s practice. Therefore allegations of dishonesty will always be serious and a nurse, midwife or nursing associate who has acted dishonestly will always be at some risk of being removed from the register. However, in every case, the Fitness to Practice Committee must carefully consider the kind of dishonest conduct that has taken place. Not all dishonesty is equally serious. Generally, the forms of dishonesty which are most likely to call into question whether a nurse, midwife or nursing associates should be allowed to remain on the register will involve: - deliberately breaching the professional duty of candour by covering up when things have gone wrong, especially if it could cause harm to people receiving care - misuse of power - vulnerable victims - personal financial gain from a breach of trust - direct risk to people receiving care - premeditated, systematic or long standing deception Dishonest conduct will generally be less serious in cases of: - one off incidents - opportunistic or spontaneous conduct - no direct personal gain - incidents outside professional practice Nurses, midwives and nursing associates who have behaved dishonestly can engage with the Fitness to Practice Committee to show that they feel remorse, that they realise they acted in a dishonest way, and tell the panel that it will not happen again. Where the professional denies dishonesty, it is important that they make every effort to attend the hearing so that the Committee can hear at first hand their response to the allegations”
(emphasis added) Other relevant parts of the NMC Guidance on Sanctions are referred to in the Sanction Decision: see paragraphs 61 and 62 below. Cases involving dishonesty - deliberately breaching the professional duty of candour by covering up when things have gone wrong, especially if it could cause harm to people receiving care - misuse of power - vulnerable victims - personal financial gain from a breach of trust - direct risk to people receiving care - premeditated, systematic or long standing deception - one off incidents - opportunistic or spontaneous conduct - no direct personal gain - incidents outside professional practice (emphasis added)

Appeals

[10]Articles 29((9) and 38 of the 2001 Order make provision for appeals from Panel decisions to, inter alia, this Court. By Article 29(9), appealable decisions include a Panel decision under Article 29(5) giving a direction for a striking off order, a suspension order, a conditions of practice order, or a caution order. Under Article 38(3), this Court's powers on appeal include the power to dismiss the appeal, to allow the appeal and quash the decision appealed against, to substitute its own decision, or to remit the case to the Fitness to Practise Committee to dispose of the case in accordance with the Court's directions.[11]On appeal, the question for the Court is whether the decision was wrong, or unjust because of a serious procedural or other irregularity: see CPR 52.21(3). Further, an appeal under Article 38 is a full appeal by way of re-hearing (and is thus, in principle, broader than the usual jurisdiction of “review” applicable to most appeals): see CPR 52.21(1)(a) and Practice Direction 52D, §19. The approach to sanctions on appeal Approach of court in relation to appeal against sanction

The approach to sanctions on appeal

[12]In the relation to questions of sanction, I have considered, in particular, Bolton v Law Society [1994] 1 WLR 512 at 518E-519E, Khan v General Pharmaceutical Council [2016] UKSC 64 [2017] 1 WLR 169 at §36; General Medical Council v Theodoropoulos [2017] EWHC 1984 (Admin) at §§36 to 40; General Medical Council v Jagjivan [2017] EWHC 1247 (Admin) [2017] 1 WLR 4438 at §40(v) to (vii) and Bawa-Garba v GMC [2018] EWCA Civ 1879 at §67. From these authorities, I derive the following propositions:(1) The principal purpose of sanctions in disciplinary proceedings is not punishment of the practitioner, but rather maintaining the standards and reputation of the profession as a whole and maintaining public confidence in the integrity of the profession. The second main purpose is to be sure that the offender does not have the opportunity to repeat the offence: see Bolton at 518F-H.(2) It follows from the principal purpose above that particular force is to be given to the need to accord special and appropriate respect to the judgment of the disciplinary body: Jagjivan §40(v).(3) However there may be matters, such as dishonesty, where the court is likely to feel that it can assess what is needed to protect the public or maintain the reputation of the profession more easily for itself and thus attach less weight to the expertise of the tribunal. The Court will not defer to that body’s judgment “more than is warranted by the circumstances”: Jagjivan §40(vi)(4) The court should not interfere with the evaluative judgment of a specialist adjudicator unless: (i) there was an error of principle in carrying out the evaluation; or (ii) it fell outside the bounds of what an adjudicative body could properly and reasonably decide: Bawa-Garba at §67.(5) Matters of mitigation are likely to be of considerably less significance in regulatory proceedings than to a court imposing retributive justice, because the overarching concern of the professional regulator is the protection of the public: Jagjivan §40(vii).

Sanctions and dishonesty

[13]In the context of doctors, dishonesty is particularly serious where it occurs in the performance of a doctor’s duties or involves a breach of trust placed in a doctor by the community. Honesty and integrity are also fundamental in relation to qualifications and the system of applying for medical positions. Further where a doctor engages deliberately in dishonesty and lacks insight erasure may in practical terms be inevitable: GMC v Theodoropolous supra, at §§36 to 38. In my judgment, these principles apply to a similar extent to nurses.

Adjournment and proceeding in the absence

[14]Rule 32 of the Rules is headed “Postponements and adjournments” and provides, inter alia, as follows:
“(1) The Chair of the Practice Committee may, of her own motion, or upon the application of a party, postpone any hearing of which notice has been given under these Rules before the hearing begins. (2) A Practice Committee considering an allegation may, of its own motion or upon the application of a party, adjourn the proceedings at any stage, provided that— (a) no injustice is caused to the parties; and (b) the decision is made after hearing representations from the parties (where present) and taking advice from the legal assessor. (3) Where the proceedings have been adjourned, the Practice Committee shall, as soon as practicable, notify the parties of the date, time and venue of the resumed hearing. (4) In considering whether or not to grant a request for postponement or adjournment, the Chair or Practice Committee shall, amongst other matters, have regard to— (a) the public interest in the expeditious disposal of the case; (b) the potential inconvenience caused to a party or any witnesses to be called by that party; and (c) fairness to the registrant.” (a) no injustice is caused to the parties; and (b) the decision is made after hearing representations from the parties (where present) and taking advice from the legal assessor. (a) the public interest in the expeditious disposal of the case; (b) the potential inconvenience caused to a party or any witnesses to be called by that party; and (c) fairness to the registrant.”
[15]As regards the approach to applications to adjourn disciplinary tribunal hearings, I have been referred to General Medical Council v Adeogba [2016] EWCA Civ 162, [2016] 1 WLR 3867 at §§13 to 23 and 62. In that case the tribunal decided to proceed in the absence of the practitioner in question. (Unlike the present case, there was no positive application to adjourn). Adapting the principles identified in that case to the position of the NMC and the Panel, I derive the following propositions from Adeogba.(1) The starting point is the approach, in criminal law, to trial in the absence of the defendant, namely the discretion to proceed must be exercised with great care, fairness to both sides must be taken into account, and fairness to the defence is of prime importance.(2) Amongst the factors relevant to whether to proceed in absence are whether an adjournment might result in the defendant attending, the likely length of any adjournment, the extent of the disadvantage to the defendant, and the general public interest.(3) However there is a difference between a criminal trial and disciplinary proceedings - in the latter the decision must also be guidedby the over-arching objective in Article 3(4) of the 2001 Order The fair, economical, expeditious and efficient disposal of allegations against the practitioner is of very real importance.(4) Fairness to the practitioner is of prime importance and a prime consideration; fairness to the regulator and the interests of the public must also be taken into account.(5) There is a burden on practitioners to engage with the regulator, in relation to the investigation and resolution of allegations made against them.(6) It would run counter to the NMC’s over-arching objective if a practitioner could effectively frustrate the process and challenge a refusal to adjourn when that practitioner has deliberately failed to engage in the process.(7) However, where there is good reason not to proceed, the case should be adjourned. Where there is no such good reason, the case should proceed.(8) Ultimately, the discretion whether or not to proceed must be exercised having regard to all the circumstances of which the tribunal is aware, taking account of the above features.(9) If the tribunal proceeds in the practitioner's absence, it will not have his or her input in relation to the facts, the question of impairment, or the ultimate decision of sanction (which always carried the risk of striking-off). However that difficulty cannot override all other considerations for, if it did, it would provide a premium on non co-operation.

Medical evidence to support an application to adjourn

[16]In General Medical Council v Hayat [2018] EWCA Civ 2796 at §§37 to 43, the Court of Appeal considered, in the context of a regulatory case, the authorities dealing with the nature and standard of the evidence necessary to found an application for an adjournment on the grounds of ill health. The Court identified the following principles.(1) There must be evidence that the individual is unfit to participate in the hearing. That evidence must identify with proper particularity the individual's condition and explain why that condition prevents their participation in the hearing.(2) Such evidence should identify the medical attendant and give details of his familiarity with the party's medical condition, and should identify with particularity what the patient's medical condition is and the features of that condition which prevent participation in the trial process; and what arrangements might be made (short of an adjournment) to accommodate a party's difficulties.(3) Whether to adjourn a hearing is a matter of discretion for the first instance judge.(4) Generally, the court should adopt a rigorous approach to scrutinising the evidence adduced in support of an application for an adjournment on the grounds that a party is unfit on medical grounds to attend the trial.(5) A pro-forma sick note may well be insufficient to justify non-attendance at a hearing, particularly if it refers only to an unfitness to attend work.(6) The tribunal has a discretion to conduct further enquiries if the medical evidence does not meet the requirements. This is a discretion, not a duty. The courts have generally supported tribunals who have refused to adjourn hearings when presented with medical evidence that was inadequate or insufficient. The onus remains on the individual to engage with the Tribunal and the process, and "a culture of adjournment is to be deprecated".(7) If no medical report is available, the applicant must demonstrate that a medical report could not with reasonable diligence have been obtained before the hearing.

Fresh evidence on appeal

[17]In Adeogba at §§26 to 35 and §64 the Court of Appeal also considered the approach of the Court on appeal from a tribunal to the question of the admissibility of fresh evidence, both specifically as to the reason for non-appearance before the tribunal and as to the general merits of the underlying case.[18]First, the Court of Appeal confirmed that the established principles in Ladd v Marshall [1954] 1 WLR 1489 apply in such circumstances. Those principles are as follows:(1) It must be shown that the evidence could not have been obtained with reasonable diligence for use at the trial.(2) The evidence must be such that, if given, it would probably have an important influence on the result of the case, though it need not be decisive.(3) The evidence must be such as is presumably to be believed, or in other words, it must be apparently credible, though it need not be incontrovertible.” (emphasis added)[19]Evidence as to the reasons why, in any case, a practitioner does not appear or engage in a disciplinary hearing is likely to constitute fresh evidence (in so far as it could not have been obtained with reasonable diligence at the trial – by definition the explanation was not available.) The Court of Appeal considered that such evidence as to the reasons would require consideration, at least de bene esse. On the other hand, even if there is good reason for non-attendance, that would not necessarily extend to fresh evidence going to the merits of the disciplinary complaint which would have been available to be deployed at the time of the hearing.

The Facts

[20]The Appellant qualified as a nurse in Pakistan in 2001. In September 2004 he commenced employment in the UK at the Whittington Health Trust. In due course he became a Band 7 charge nurse, reflecting 23 years of experience. In around 2016-2017 the Appellant was formally diagnosed with multiple sclerosis. The Trust had been aware of that since 2022. In September 2019 he commenced a part-time Advanced Neonatal Nurse Practitioner MSc at the University of Southampton. Participation in the course was voluntary and not mandatory for his employment as a charge nurse at the Trust. He was undertaking that course in connection with his employment as an already practising nurse on the NMC’s register.[21]On 15 April 2021 during examination as part of the programme an invigilator found a model answer tucked amongst the Appellant’s permitted materials. He was awarded zero marks but allowed to re-sit the exam. When he re-sat the exam he failed. On 9 December 2021 the Appellant re-sat the exam one more time. At that exam he was discovered by an invigilator to have swapped his clean copy of a British National Formulary with a copy in which model answers had been glued onto the pages.[22]In relation to the first incident, the Appellant was present at the subsequent academic integrity meeting and gave an explanation to the investigators. He explained that English was not his first language, and he had written the model answers as part of his revision to practise writing in the same way for the actual examination. He said he had brought this with him, and looked at it several times on the way to the exam. He said that he memorised it. He was late to the exam, and took the model answer with him to the exam table, but had not used it. He said that when he handed his exam paper to the invigilator, a plastic envelope fell containing all the model answers he had written, but not used, and which he had not noticed, given he was in a rush, fell out of the plastic wallet. This was his innocent explanation for its presence.[23]In relation to the second incident, on 3 March 2022 the Appellant attended a second academic integrity meeting. During the meeting, the Appellant vehemently denied placing the model answer in the book himself and claimed that his 10-year-old daughter had stuck the material into the book without his knowledge.[24]However the position now is that the Appellant admits this conduct and admits that it was dishonest.[25]On 4 July 2022 the University of Southampton referred the matter to the NMC regarding the Appellant’s dishonesty. In January and February 2023 Appellant provided references from his employers which were positive. The matter was investigated by the NMC and referred for consideration by a Fitness to Practise Committee. The Fitness to Practise Proceedings The Charges

The Fitness to Practise Proceedings

[26]In summary the Appellant was charged, first, in respect of his conduct in the pharmacology examination of 15 April 2021 (charges 1 to 4), and secondly in respect of his conduct in the pharmacology examination on 9 December 2021 (charges 5 to 8). In respect of each incident, he was charged with having in his possession illicit material during an examination, and that that conduct was dishonest in that he knew he was not permitted to have any model answers in his possession and/or use during such examination and that he intended to use the model answers to assist him as necessary during the examination. He was further charged with having used the illicit material to complete the examination and that that use was dishonest because he knew it was wrong to use illicit material during examination and that he intended to pass the examination by cheating. Finally it was alleged by the NMC that in the light of that conduct, the Appellant's fitness to practice was impaired by reason of his misconduct.

The lead up to the Hearing

[27]The hearing was initially fixed for January 2025. The NMC maintains that in October 2024 it made clear that medical evidence was needed to support an application to adjourn the hearing of the charges. Following a request from the Appellant to adjourn which attached sick notes, the NMC agreed to postpone the hearing and asked for dates to avoid. There was then a further request for an adjournment from the Appellant and a subsequent date in May 2025 was agreed.[28]On 27 March 2025 formal notice of a hearing date of 8 May 2025 was sent by the NMC to the Appellant. That letter pointed out that if the Appellant did not engage with the hearing process the Panel could proceed with the hearing in his absence. It also pointed out that the Appellant had a right to ask to postpone the hearing. He would need to provide evidence to show why he couldn’t go ahead on the specified date and to provide a medical certificate if the reason for non-attendance was because he was ill.[29]By letter dated 31 March 2025 Professor Chataway, the Appellant’s consultant neurologist, wrote verifying that the Appellant was still disabled from his MS relapse. The letter explained that he would be moving to more advanced treatment and asked if any investigation could take place after that transition had occurred to avoid any deterioration in his condition. However, in his letter the Professor went on to say that the Appellant “remains in work, despite the above”. 14 and 15 April 2025[30]On 14 April 2025 the NMC’s Case Coordinator, Ms Opoku, wrote to the Appellant asking if he would be attending and whether he would be represented.[31]By email dated 15 April 2025 at 1224pm, the Appellant explained that he was not well and had been sick for about a few months. His neurologist had advised a delay of the hearing as he was going to change his medicine. He stated that he would send his consultant’s feedback and asked Ms Opoku to wait for his response as he was just recovering from his illness.[32]On the same date Ms Opoku responded by email at 103pm that if the Appellant wanted a postponement he would need to provide the NMC with medical evidence which confirmed that he was currently not fit to take part in a hearing and to provide a timeframe of when it would be likely that he would be well enough to attend and participate. The email concluded:
“This information is needed and will need to be considered should you make a postponement request of the current listed dates.”
(emphasis added) (emphasis added) 7 May 2025[33]At 1036am on 7 May 2025, the day before the hearing, the NMC’s Hearings Coordinator sent an email to the Appellant informing him of the substantive hearing due to take place the next day at 930am, and pointing out that she would be facilitating a virtual hearing via a Teams link.[34]By email at 104pm, Ms Opoku wrote to the Appellant, further to her email of 14 April, pointing out that the hearing was due to commence on the next day. She asked the Appellant to confirm if he would be attending and/or be represented. The email continued: “Please further note that the NMC will make an application to the panel for the case to proceed in your absence”. (At some point on that day Ms Opoku also sent a text message to the Appellant asking him to confirm whether he was attending.)[35]The Appellant responded by email at 302pm, stating that he had asked his neurologist to send him the medical certificate for the new drugs he was going to start on, but he was on annual leave and should come next week. He asked for the NMC to wait for this to happen as the neurologist was going to start new drugs and see the effect of those drugs. The email continued:
“He did send me one but there was no date mentioned until what time he wants the hearing to postponed so let me ask him again if he can do it next week. Meanwhile I can send you his medical certificate”
[36]Within 15 minutes Ms Opoku responded by email at 317 pm, stating:
“You will need to attend tomorrow and make you application to postpone the hearing. Please note the NMC will oppose this application. As previously explained to you will need to provide medical evidence from your treating team that confirms when the medication will be started, why you are not fit to participate in the hearing and when you are likely to be able to participate in the hearing. Can you please confirm if you are currently still working or if you have been signed off from work due to your medical conditions”
[37]The Appellant responded by email at 348pm, stating that he had sent her the medical certificate… “attached to this email. I can send again now so pls considered this as proof and will not attend as I am currently on this medication so it needs careful consideration and stress free environment as it can cause suedo-symptoms.” It appears that the medical certificate said to be attached to that email is the letter from Professor Chataway dated 31 March 2025 referred to in paragraph 29 above. This is when the Appellant first provided this letter to the NMC.[38]By email at 414 pm, Ms Opoku responded asking the Appellant to confirm if he would be attending virtually or in person tomorrow. She also asked him to confirm if he would be formally making an application to adjourn tomorrow’s hearing. In that email, she then pointed out that the document provided was over one month old and “states that you are currently still in work, further Professor Chataway has not requested any kind of postponement/adjournment of the current proceedings”.[39]At 430pm the Appellant responded, stating that he had emailed the neurologist to send to her or to him a letter to confirm that he was going to start the new medication. He pointed out again that he was on annual leave and he would make changes to the current letter and request an extension of time. The email continued:
“Until then can you wait for him to send me an updated letter so I can send it to you.”
The Appellant’s email added, that as he would be on new medicine and the advice of the neurologist was to stay away from stress and that he would definitely attend the hearing once this phase was finished. But for the time being he was very sorry to say that he would not be able to attend the hearing. The email continued with a request to Ms Opoku to wait for a week so the consultant neurologist could come back from annual leave.

The Hearing

[40]The hearing before the Panel took place between 8 and 13 May 2025. The substantive hearing commenced at 2pm on 8 May and continued on 9 May, 12 May and concluded on day 4 on 13 May 2025, when the final determination was made. 8 May 2025: The application to postpone and the decision to proceed[41]8 May 2025 was the first day of the hearing. The hearing opened some time before 1030am. The Appellant was not present. It was initially adjourned until 1030am to allow time for the NMC and the Panel’s Legal Assessor to speak to the Appellant.[42]Thus, at 1011am the NMC’s Hearings Coordinator, Hamizah Sukiman, sent an email to the Appellant stating that she understood that the Appellant wanted to postpone the hearing and invited him to a Teams meeting “very briefly so we can further understand your position… just a private chat between myself, the NMC lawyer and the legal assessor”.[43]Then at some time between 1011am and 1115am, there was a telephone call between the Hearings Coordinator and the Appellant. It is not disputed that this phone call took place. It is in this call that the NMC says that the Appellant mentioned going to the hospital.[44]Then at 1115am the Hearings Coordinator sent an email to the Appellant stating as follows:
“Further to our phone call, I would just like to say if you do have documentation in relation to your consultant’s leave, your current health or any other information helpful to the panel in deciding this postponement please send them over to me”
(emphasis added) The Appellant now says that he did not see this email at the time; nor at any time before June 2025 at the earliest.[45]From that 1115am email, it is implicit that in the telephone call, it was discussed that the Panel would be deciding whether to postpone or not. Further the reference to the word “do” implies that documentation was discussed in that telephone call.

The decision to adjourn until 2pm

[46]The hearing then resumed (some time shortly after 1115am). The transcript of the hearing records as follows. Based on information provided to him by the Hearings Coordinator, the NMC’s Case Presenter informed the Panel that they had been able to get in contact with the Appellant on a telephone number. He reported that the Appellant was currently at a consultant appointment for his wife and was unable to join the link as he had been invited to. The Case Presenter went on to state that the Appellant had informed the NMC that he was willing to engage and willing to attend today to explain his application to postpone but could not do so at that stage. He did not know how long the appointment would take. The Case Presenter suggested that in fairness the Panel might adjourn until 2pm. After taking advice from the Legal Assessor, the Panel agreed to postpone until 2pm that day.[47]At page 4 of the Determination, the Panel set outs its “Decision and reasons for adjourning the hearing until 14:00 on Day 1”. “… the NMC has been able to contact Mr Khan via the Hearings Coordinator and that this morning Mr Khan indicated he may be able to join the hearing remotely via MS teams or provide further information in relation to his application to postpone the hearing by reason of his health. However he told the Hearings Coordinator that he was unable to do so immediately as he was supporting his wife at a hospital appointment and that he did not know when this appointment would conclude.” The Determination recorded that, in so deciding, the Panel took into account the correspondence in April and May 2025 as well as the letter of Professor Chataway dated 31 March 2025. It continued: “The Panel also took into account that Mr Khan informed the Hearings Coordinator that he may be able to attend later in the afternoon to make his application via Teams to postpone these proceedings or provide the panel with additional documentation in support of his application, but that he was presently elsewhere”. (emphasis added)[48]The Panel took into account documents which indicated that Mr Khan had a health condition and wished to postpone these proceedings but that there was no further independent documentation supporting his postponement application. The Panel concluded as follows:
“Consequently in interest of the fairness to all parties, the panel determined to adjourn the proceedings until 14:00 on Day 1, to allow Mr Khan the time to either make his application to postpone before this panel and [or] to provide any further documentation to assist the panel in its decision-making on such an application”
[49]In his further witness statement dated 27 November 2025 for this appeal hearing, (“the November Witness Statement”), the Appellant now disputes this account of events on the morning of 8 May 2025, and in particular he expressly denies that he was aware of the hearing being adjourned until 2pm later that day. He did not tell the Hearings Coordinator that he might be able to join the hearing remotely by Teams and that it was not suggested that he should do anything further or provide any more information on that day. This evidence is set out in paragraphs 69 to 77 below.

The application to postpone: 2pm on 8 May

[50]The Panel reconvened at 2pm. The NMC’s Hearings Coordinator, Ms Sukiman, provided an update to the Panel (at the invitation of the Chair). She explained that they had called the Appellant again but he didn’t answer the phone on that occasion. At 130pm she had given him another call that went to voicemail to explain that they were recommencing at 2pm and that he had the opportunity to attend or send submissions or documentation. But she had not received a call back. She also explained that she had also sent emails that afternoon. The NMC’s Case Presenter then then made submissions, inviting the Panel to proceed in the Appellant’s absence.

The Postponement Decision: the decision to proceed

[51]At 2pm the Panel considered the Appellant’s postponement application. The Panel’s Legal Assessor gave advice. The Panel concluded that it was fair to proceed in the absence of the Appellant and dismissed his application for a postponement of the proceedings i.e. the Postponement Decision.[52]In its 6-page written ruling (at pages 6 to 12 of the Determination), the Panel set out parts of the email exchanges on 7 May, and in particular the emails from the Appellant at 302pm and 348 pm. The written reasons also referred to, and quoted, the Appellant’s email of 15 April 2025 and also the letter from Professor Chataway dated 31 March 2025. The NMC’s Case Presenter had informed the Panel that the Appellant wished to adjourn the matter for a week to allow Professor Chataway to return from annual leave in order to provide the NMC with sufficient medical information to support his position (thereby effectively passing on the content of the Appellant’s email of 7 May at 430pm (paragraph 39 above)).[53]The Case Presenter had submitted that there was no independent medical evidence before the Panel which indicated that he was unfit to attend the hearing and that there was no evidence to suggest that in fact Professor Chataway was away on leave in the first place. He had submitted that the Appellant had not provided sufficient evidence for the postponement of the proceedings and invited the Panel to dismiss the application.[54]The Panel accepted the advice of the Legal Assessor, who had drawn to the Panel’s attention relevant NMC Guidance and the principles derived from the cases of Adeogba and Hayat. The Panel had had regard to the Appellant’s written representations. The Panel “could not be certain that Mr Khan would attend even if these proceedings were postponed today”. The Postponement Decision continued:
“… The panel was of the view that there is insufficient medical evidence before it to support the assertion that Mr Khan is unable to participate in these proceedings. The panel considered that the letter from [Professor Chataway] makes no reference to the nature of Mr Khan’s medical condition, whether reasonable adjustments could be made to support him in attending these proceedings or the impact of any potential medication on his ability to participate. It also indicated that (at that date) Mr Khan remained at work. In any event the panel took into account that the letter was dated in March 2025 and there had been no update since then as to Mr Khan’s health, his treatment or its effect on him or any possible ill-effect on him which might result from participating in the hearing which prevents him from fully engaging with these proceedings. … The panel was of the view that there is insufficient medical evidence before it to suggest Mr Khan is too unwell to participate in these proceedings. … The panel gave careful consideration to the fairness to Mr Khan. The panel considered that on Day 1 of these proceedings, Mr Khan has made some attempt to discuss with the NMC and the panel has awarded him until 1400 to either provide further information, make submissions (oral or written), or provide an alternative time which would allow him to fully engage with the proceedings. The panel heard from the Hearings Coordinator that both emails and telephone messages subsequent to the first telephone call (albeit via voicemail) were made to Mr Khan explaining the situation, and his opportunity to engage. Mr Khan had not answered those calls, and had not replied to the messages or emails. … … The panel noted that Mr Khan appears to be well enough to accompany his partner to appointments and, as of March 2025, the medical evidence was that he was well enough to still be working. Accordingly, the panel was of the view that it would be fair to dismiss this application. The panel also considered that, if at any point in these proceedings Mr Khan does engage and provide further evidence it would be open for the panel to consider the situation at that stage. The panel acknowledged that there is some disadvantage to Mr Khan in proceeding in his absence. Although the evidence upon which the NMC relies will have been sent to him, Mr Khan will not be up to challenge the evidence relied upon by the NMC in person and will not be able to give evidence on his own behalf. However, in the panel’s judgement, this can be mitigated. The panel can make allowance for the fact that the NMC’s evidence will not be tested by cross-examination and, of its own volition, can explore any inconsistencies in the evidence which it identifies. In these circumstances, the panel has decided that it is fair to proceed in the absence of Mr Khan and dismiss his application for a postponement of these proceedings. The panel will draw no adverse inference from Mr Khan’s absence in its findings of fact.”
(emphasis added)

The substantive proceedings: 8 to 13 May 2025

[55]The Panel then proceed to hear live evidence from three witnesses from Southampton University and took account of all oral and documentary evidence and submissions from the Case Presenter. It drew no adverse inference from the Appellant’s absence.[56]At pages 12 to 31 of the Determination, the Panel set out the details of charges, the factual background, and its decision and reasons on the facts. All charges were found to be proved. Then at pages 31 to 39 it dealt with “Fitness to Practise, submissions on misconduct and on impairment and then set out its “Decision and reasons on misconduct” and “Decision and reasons on impairment”, making findings of misconduct and impairment of fitness to practise.

The Sanction Decision

[57]At page 40 of the Determination, the Panel turned to address sanction. After recording the NMC’s submissions on sanction, the Determination set out “Decision and reasons on sanction”. The Panel reminded itself that any sanction had to be appropriate and proportionate and, although not intended to be punitive, it might have such consequences. The Panel had had careful regard to the Sanctions Guidance.[58]The Panel took into account the following aggravating features: deep seated attitudinal issues; lack of insight into failings; a pattern of misconduct over a period of time, dishonesty was not an isolated event and the Appellant had cheated twice; and conduct which could have put patients at risk of suffering harm if the Appellant had not been caught.[59]As regards mitigating features the Panel took into account the Appellant’s unblemished 21 years nursing record with good references and challenging personal circumstances at the time of the incident. It then went on to conclude that the aggravating factors outweighed the mitigating factors in the case. The employment references provided by the Appellant fell short of sufficient mitigation due to “Mr Khan not addressing the seriousness of the charges as they relate to dishonesty.”[60]The Panel then took into account the NMC guidance “Considering sanctions for serious cases”, in particular cases involving dishonesty (see paragraph 9 above). The Sanction Decision then continued (at page 41):
“The panel reminded itself that Mr Khan’s dishonesty did not arise from a single incident but was a pattern of dishonest conduct which was premeditated. It also noted that Mr Khan had been dishonest for personal and financial gain, and had he not been caught, he would have gone on to practice as an advanced neonatal nurse practitioner who could have put patients at a direct risk of harm. Furthermore Mr Khan has not provided any evidence or information to the NMC to demonstrate that he has developed any further insight into the concerns identified in this matter. The panel concluded that Mr Khan’s actions were a deliberate breach of the professional duty of candour and in all the circumstances amounted to serious dishonesty”
. The Panel then went on to consider various possible sanctions open to them, considering in[61]The Panel then went on to consider whether a suspension order would be an appropriate sanction. The Panel set out the factors in the Sanctions Guidance, the presence of some of which indicate that such an order may be appropriate:
“- a single instance of misconduct but where a lesser sanction is not sufficient; - No evidence of harmful deep-seated personality or attitudinal problems; - No evidence of repetition of behaviour since the incident; - The Committee is satisfied that the nurse or midwife has insight and does not pose a significant risk of repeating behaviour”
The Sanction Decision continued:
“The conduct, as highlighted by the facts found proved, was a significant departure from the standards expected of a registered nurse. Indeed serious dishonesty is fundamentally incompatible with the fundamental tenets of the profession. None of the factors which would indicate a suspension order is appropriate are present in this case. Moreover, the Panel noted its earlier findings and further determined that Mr Khan has not indicated a want to demonstrate that he would work to remediate the concerns or that he is willing to do so. Without this want to remediate; or temporal removal from the register will do is delay the risk of the repetition to a later date. In this particular case, the panel determined that a suspension order would not be a sufficient, appropriate or proportionate sanction.”
[62]The Sanction Decision then finally turned to consider a striking off order and cited the following paragraphs of the Sanctions Guidance: “- Do the regulatory concerns about the nurse or midwife raise fundamental questions about their professionalism? - Can public confidence in nurses and midwives be maintained if the nurse or midwife is not removed from the register? - Is striking-off the only sanction which will be sufficient to protect patients, members of the public, or maintain professional standards?”

fundamental questions about their professionalism?

[63]The Panel’s analysis was as follows:
“Mr Khan’s actions were significant departures from the standards expected of a registered nurse, and are fundamentally incompatible with him remaining on the register. The panel was of the view that the findings in this particular case demonstrate that Mr Khan’s actions were serious and to allow him to continue practising would undermine public confidence in the profession and in the NMC as a regulatory body. Balancing all of these factors and after taking into account all the evidence before it during this case, the panel determined that the appropriate and proportionate sanction is that of a striking-off order. Having regard to the effect of Mr Khan’s actions in bringing the profession into disrepute by adversely affecting the public’s view of how a registered nurse should conduct himself, the panel has concluded that nothing short of this would be sufficient in this case. The Panel observes that this will have a significant negative effect on Mr Khan’s ability to practice in his desired profession and make an income. However, this is necessary to uphold public confidence and professional standards. In light of our previous findings no lesser sanction is capable of fulfilling these objectives considering the serious unremedied dishonesty Mr Khan has engaged in. The panel considered that this order was necessary to mark the importance of maintaining public confidence in the profession, and to send to the public and the profession a clear message about the standard of behaviour required of a registered nurse.”
The Determination therefore imposed the sanction of a striking-off order.

Events following the Hearing

[64]On 15 May 2025 the NMC sent an email to the Appellant informing him of the Sanction Decision. The Appellant claims that it was password protected. On 21 May 2025 Professor Chataway sent a further letter, in which he confirmed that the Appellant was still disabled from his MS relapse and requested that the investigation be postponed for at least a year to avoid any deterioration in his condition.[65]The Appellant claims that he became aware of the Decision for the first time on the 4 June 2025. By email dated 4 June 2025 to the NMC the Appellant stated that he did not receive any emails or letters. “I writing to let you know that I was scheduled for a hearing on the 8th of May 2025 0930. But my wife was not well and I could not attend the hearing. After this I did not receive any emails or letters in the post about my NMC PIN being cancelled. I came to know from my matron that I have been struck off from NMC. Now I need to appeal against this decision but I need documentation so I can go to a solicitor. I know the hearing was on 8 May but I did not receive any email or letter in the post so that I can appeal against this decision…” The Appeal The Grounds of Appeal

The Appeal

[66]By Appellant’s notice dated 11 June 2025 and filed on 20 June 2025 the Appellant appealed against the Sanction Decision. Grounds of Appeal dated 11 June 2025 were attached.[67]There are two grounds of appeal:(1) The Panel erred in refusing the Appellant’s application to postpone the hearing and in proceeding in his absence (“Ground 1”).(2) The Panel’s decision to impose a striking-off order was unduly harsh (“Ground 2”).[68]At paragraph 16 of the Grounds of Appeal, the Appellant stated:
“On the first day of the hearing (8 May 2025) the Appellant unexpectedly had to accompany his wife to A & E due to concerning pain she was experiencing in her stomach. As a Senior Nurse, the Appellant was concerned of potential cardiac issues and rushed her to hospital. The Appellant’s wife does not speak English, so she could not have attended by herself, nor does the Appellant have any family or friends in the UK that could have attended on his behalf”
. The Grounds of Appeal were supported by a statement of truth signed personally by the Appellant.

The Appellant’s witness statement

[69]For the purposes of this appeal, the Appellant has provided a witness statement dated 27 November 2025 and seeks its admission into evidence: the November Witness Statement. The purpose of the Statement is said to be in relation to the hearing on 8 May 2025. The Appellant does not accept that the account of events on 8 May set out in paragraphs 41 to 48 above provides the complete picture. I have considered this witness statement de bene esse. I consider its admissibility in the course of my discussion on Ground 1.[70]The witness statement starts off by setting out, in terms, paragraph 16 of the Grounds of Appeal, but stating that his account of taking his wife to the hospital on 8 May was wrong. He asserts that what the Panel had been told on that date was an inaccurate picture. He states that he was not told that he had until 2pm on that date to provide further information or an alternative time which would allow him to engage with the proceedings.[71]In the witness statement he then gives a different account of events on 8 May as follows. At 730am his wife had developed back pain and she was in immense pain. He gave her some painkillers at around 9am. He wanted to take her to hospital, but she did not what want to go to hospital. At 11am he gave her some dihydrocodeine. Then when the Hearings Coordinator called him about the hearing [i.e. the call between 1011am and 1115am], he told her that he was too busy calming down his wife with her pain and he could not go anywhere. He goes on to state that as he was under pressure due to his wife’s condition he told the Coordinator it was an emergency and “I would attend the hearing when my wife gets better”. The Statement continues:
“I did not tell the HC that I might be able to join the hearing remotely by MS Teams and there was no suggestion by either me or the HC that I should do anything further or provide any more information that day”
[72]In early June he had looked back at his emails and had seen that the Hearings Coordinator had emailed him, after their telephone conversation, and asked him to send her any further information and invited him to a short Teams meeting. (This is the email at 1115am: paragraph 44 above). He states in his witness statement that he did not see this on the day of the hearing because he was solely concerned with looking after his wife. During the telephone conversation the Hearings Coordinator did not ask him for any further information or invite him to join a Teams meeting. The statement to the Panel that he could potentially join the hearing by Teams was a confusion.[73]As regards the report that he had taken his wife at a hospital appointment, that was not the case. The Panel was making a decision about whether to proceed in his absence on inaccurate information.[74]He notes that the Panel thought it would be fair to allow him to provide further information. As he was unaware that he had to do that by 2pm that day, he was not in a position to provide the further information or make submissions to the Panel about his application to postpone. The reference to him being able to accompany his wife to a hospital appointment was a distortion of what was actually happening. He was never aware that he could attend at 2pm by Teams on that day.[75]Having checked his voicemails for 8 May, he accepts that the Hearings Coordinator had left him a voicemail saying that the Panel would start the hearing at 2pm that day. He asserts that he “did not see that voicemail” and was unaware of it until making the statement in November 2025. (This is a reference to the 130pm voicemail: see paragraph 50 above).[76]In the circumstances on 8 May 2025 of him being unaware of the email and voicemail sent to him by the Hearings Coordinator, he assumed that the hearing was not going ahead. He goes on to say that he would have expected the Hearings Coordinator to let him know the next day. He did not hear back from the Hearings Coordinator further to say that the Panel had concluded the case. Having heard nothing back, he assumed, that the Panel/Hearings Coordinator would call him or email him with a new hearing date and he was waiting for that communication.[77]He adds that he had not been able to open the striking off decision because it was password protected. He had telephoned the NMC (on 15 May) and they said they would provide him with a password but they did not do that. He did not know the content of email until 4 June 2025.

Fresh evidence on remorse/remediation

[78]For the purposes of this appeal, the Appellant seeks to rely on fresh material in relation to remorse and remediation.[79]On 17 June 2025 the Appellant wrote an apology letter to the NMC, stating that he understood the seriousness of the matter and accepted full responsibility for his actions which he deeply regretted. He explained that his absence from the Panel hearing was due to significant family difficulties and personal health issues. He took full responsibility for not addressing the Council in time. He then went on to explain that in the period leading up to the exam he experienced a relapse of his MS which significantly affected his memory and mental clarity. He stated that he made the grave mistake of bringing notes into the exam room which he recognised as a clear breach of conduct for which he was entirely at fault. He stated that although he did not use the notes during the exam “I now understand the gravity of bringing unauthorised material into the examination room.” He then went on to explain that, since the incident he had been in a state of extreme distress and mental anguish. He had faced overwhelming guilt and he had thoughts of self-harm. He asked the NMC to reconsider his case. He concluded: as follows “I know words cannot undo my actions, but I hope my honesty and willingness to be held accountable will demonstrate my commitment to making things right. I am ready to appear before the Panel at your earliest convenience and would be truly grateful for the chance to speak”[80]He attached references and feedback from his line manager, consultants and the practice development nurse. Those five references, some dated June 2025 and others undated, speak to the Appellant’s positive attitude as a dependable, responsible and well liked colleague.[81]The Appellant has written a further document, dated some time in August 2025, entitled “Reflection on my mistakes”. In that document he stated that he has reflected upon “the mistakes and unprofessional conduct” that he made and how he could avoid this in the future. He explained why he had not owned up in the academic integrity meeting to what had happened, explaining that that was a very serious error of judgment. He had now undertaken training in ethics and further professional development and had sought guidance from a senior and respected member of the nursing profession who had agreed to act as a mentor. He hopes that he would not “hide any mistake” again. He believed that working with a mentor will support him in rebuilding trust and reduce the likelihood of any repeat misconduct. Ground 1: Proceeding in absence/Refusal to postpone. The Parties’ submissions The Appellant’s case[82]The Appellant submitted that the Panel was wrong to reject the Appellant’s application to postpone the hearing due to his health issues.[83]The Panel should have considered the impact of his medical condition on his ability to take part and given the Appellant the chance to produce better evidence. Moreover, the Panel was wrong to proceed in his absence when dishonesty was in issue. The Appellant should have been able to provide his own account of his state of mind. The Panel deprived itself of hearing the Appellant’s own oral evidence of his remorse and of the steps he intended to take to mitigate against repetition.[84]The Court should admit the evidence provided by the November Witness Statement. In any event, whatever had happened before 8 May was not relevant. The Panel made a new direction to adjourn until 2pm and the Appellant was not aware on 8 May of the resumption of the hearing at 2pm on that day. Further the decision taken at 2pm to proceed in his absence was not communicated to the Appellant. At the very least the Panel should have waited a further week until Professor Chataway return from leave. The Appellant relied on Professor Chataway’s later letter of 21 May.[85]For these reasons the hearing was procedurally unfair and the Determination should be quashed and remitted to a differently constituted panel.

The NMC’s case

[86]The NMC submitted that, having applied the relevant principles in Adeogba and Hayat, the Panel took appropriate steps to ensure fairness to the Appellant and was entitled to conclude that the Appellant had not provided sufficient information to justify an adjournment.[87]On 8 May the Panel adjourned the hearing until 2pm to allow the Appellant to attend a hospital appointment for his wife. The NMC attempted to contact the Appellant, but he failed to comply with his duty to engage with the proceedings. It was appropriate for the Panel to consider the application to postpone at 2pm and in the Appellant’s absence.[88]Applying the principles in Hayat, the medical evidence before the Panel, namely Professor Chataway’s letter of 31 March 2025, was not sufficient to justify postponement on grounds of health. The further letter from Professor Chataway dated 21 May 2025, even if admissible now, does not establish that the Appellant’s health condition prevented him from engaging with the hearing process.[89]Whilst accepting that in cases of alleged dishonesty, the registrant’s own evidence is likely to be highly relevant, registrants have a duty to engage with the proceedings and not to frustrate them. The Appellant had been given proper notice and time to provide his evidence and in support of any adjournment application. The Panel had noted the disadvantage to the Appellant by not attending, but addressed this issue appropriately in its decision.[90]As regards the November Witness Statement, its contents are not credible; it puts forward an account which is inconsistent with what the Appellant had said previously. Given the admitted exchanges in the lead up to 8 May, it is not credible that the Appellant assumed that the hearing was not going ahead. Nor is it credible that he was unaware of the resumed hearing at 2pm. For that reason, applying Ladd v Marshall,the November Witness Statement should not be admitted. Further there was no obligation upon the Panel immediately to notify the Appellant of the Postponement Decision made at 2pm.[91]Finally because there was no additional remediation evidence available at the time or even if the Panel had adjourned for one week, then even if the Postponement Decision did amount to a serious procedural irregularity, it was not unjust because even if the Appellant had been in attendance, the only reasonable outcome would have been to make a striking off order in any event.

Discussion

[92]Ground 1 is at the heart of this appeal.[93]The Appellant had been on notice of this specific hearing date of 8 May since 27 March. There had been earlier postponements. Since that time the Appellant had been informed of the possibility of proceeding in his absence. By 15 April he had indicated that it was possible that he would be asking for postponement. The NMC replied on that day indicating the need for medical evidence that would be required. On the morning of 7 May, the Appellant was provided with the link to the hearing on the next day. The next correspondence from the Appellant was on the afternoon of 7 May, and at 104pm on that day he was told by NMC that they would apply to proceed in his absence.[94]Thereafter the sequence of events on 8 May was as follows:(1) The hearing before the Panel commenced some time before 1030am.(2) The Panel adjourned the hearing until 1030am to allow contact with the Appellant.(3) At 1011am, the NMC sent an email to the Appellant.(4) Between 1011am and 1115am there was a telephone call between the Hearings Coordinator, Ms Sukimanand the Appellant.(5) At 1115am the NMC sent a further email to the Appellant.(6) Some time thereafter, probably in the morning, the hearing resumed, the outcome of the call was reported by the NMC to the Panel and the Panel decided to adjourn until 2pm.(7) At 130pm the NMC called the Appellant and left a voicemail.(8) At 2pm the hearing resumed, and after being updated, and hearing from the NMC and the Legal Assessor, the Panel took the Postponement Decision.[95]On 8 May the Panel had before them all the correspondence from the day before. Whilst the Appellant’s “please wait a week” email is not referred to in the Postponement Decision, it is clear that the Panel were told that the Appellant wanted it to be adjourned for a week.[96]The account of the telephone conversation (between 1011am and 1115am) on 8 May (as recorded both in the transcript of the hearing and in the Postponement Decision itself) was that the Appellant would be able to join the hearing following a hospital appointment with his wife. The Appellant adopted the same position in relation to the hospital appointment in the verified Grounds of Appeal dated 11 June 2025 and that remained his consistent position up to the November Witness Statement, provided 8 months after the Determination.[97]The Panel’s decision to proceed in the Appellant’s absence was a discretionary decision. The Panel directed themselves properly as to the relevant legal principles: see paragraphs 54 (and 15 and 16) above. It applied those principles to the facts before them. It undertook a detailed consideration of the relevant factors and gave a clear and cogent explanation for its decision (as summarised in paragraph 55 above). In particular, the medical evidence submitted did not satisfy the requirements of Hayat. There was no medical evidence that the Appellant was unable to participate in the proceedings. Nor do I consider that adjournment for one week would have made any difference, given the content of Professor Chataway’s further letter of 21 May 2025. In my judgment, the Panel’s decision did not contain any relevant error of law, nor was it a decision which no reasonable tribunal could have reached, based on the information before it at the time.[98]The question then is whether that conclusion is open to challenge in the light of the new evidence. I therefore turn to consider the November Witness Statement and its admissibility.[99]The account in the November Witness Statement represents a significant change in the Appellant’s account of relevant events. First, he accepted that the telephone call between 1011am and 1115am on 8 May took place. The evidence before the Panel was that in that call the Appellant told the NMC(1) that he would attend later that day and(2) that he could or would provide additional documentation. In his November Witness Statement the Appellant denied that he had said any of these things. However the terms of the follow up email from the Hearings Co-ordinator at 1115am strongly supports the conclusion that in the course of that call there was discussion of postponement and of the provisions of documentation by the Appellant: see paragraph 45 above. In this regard I do not find the November Witness Statement credible. Secondly, as regards the hospital appointment for his wife, in the November Witness Statement he denied that there was any such appointment; this is a direct contradiction to the statement he personally verified in the Grounds of Appeal; and directly contradicts what he is reported to have told Hearings Coordinator in the telephone conversation between 1011am and 1115am, which was then passed on to the Panel by the Case Presenter. That information was very specific. I do not find it credible that the suggestion of such a hospital appointment could have come solely from the NMC’s representatives, nor that it was a misunderstanding on their part due to “Chinese whispers”. The Hearings Co-ordinator who was on the telephone call with the Appellant was also present before the Panel when the Case Presenter passed on that information to the Panel. The Appellant has now given two different accounts in relation to his wife and her being unwell. Both cannot be true. This substantially undermines his credibility. Thirdly, his email at 428pm on 4 June 2025 does not support his account now given in the November Witness Statement. That email says nothing about whether he did or did not receive the two emails on the morning of 8 May or the voicemail at 130pm on 8 May. Fourthly, his evidence in the November Witness Statement that he did not notice the voicemail at 130pm until November 2025 is hard to believe, given that it was a voicemail left on the same phone that he was using and which he had used to speak to the Hearings Coordinator earlier that day. Moreover that voicemail is referred to in the Postponement Decision, which the Appellant had had since June, at the latest. Fifthly, the Appellant did not raise any of the matters in the November Witness Statement until at least 5 months later.[100]In summary, I do not find the account to be credible and it was not reasonable for the Appellant to assume (after the call between 1011am and 1115am) that the hearing had been adjourned (without more), particularly given the history and the clear indication from the NMC (and given to the Appellant) that it would be applying to proceed in his absence on 8 May. He had received no indication to the contrary nor that the NMC’s application would not be considered on that day. As is clear from the email at 1115am any such assumption was not shared by the NMC/Hearings Coordinator. I do not accept that the Appellant did not know about the resumed hearing at 2pm nor, at the very least, that he reasonably assumed that the matter had been adjourned as at the time of the phone call in the morning when, on his account, he says that he had the last contact that day.[101]Having considered the November Witness Statement de bene esse, I conclude that the account there provided is not “apparently credible”. It therefore fails to satisfy the third condition in Ladd v Marshall. I therefore decline to admit the Statement as fresh evidence.[102]Moreover I do not accept that what happened prior to 8 May was not relevant. The Appellant had had ample notice about the hearing and about what was going to happen and of the NMC’s intention to proceed in his absence if need be. He did not discharge the burden upon him to engage in the process; but rather the potential effect of his conduct was to frustrate it.[103]Accordingly the Postponement Decision was neither wrong nor involved any serious procedural or other irregularity. For these reasons, Ground 1 fails. Ground 2: Sanction/striking off The Parties’ submissions The Appellant’s case

Ground 2: Sanction/striking off

[104]The Appellant submitted that the sanction of striking off was unduly harsh. It was disproportionate and failed to consider the Appellant’s professional history and mitigating circumstances. The Sanction Decision should be quashed and remitted to a different panel or the Court should impose a lesser sanction.[105]The Court will not defer to the Panel more than is warranted and must determine whether the sanction was appropriate and necessary in the public interest[106]The Panel was required to consider remediation, insight and all mitigation. The Panel failed to take account of the evidence of mitigation before it at the time. The Sanction Decision does not demonstrate that the mitigating circumstances were properly factored in.[107]As regards dishonesty, not all findings of dishonesty justify striking off. Here the cheating in the exams was unrelated to clinical practice. It did not relate to performance of the Appellant’s duties as a nurse nor amounted to a breach of trust. There was no risk to patient safety. This case was at the less serious end of dishonesty. The lesser sanction of suspension was appropriate.[108]The Appellant relied on fresh evidence now provided to demonstrate his remorse and insight. Remediation steps in this case can be taken during a period of suspension. Mr Skeate accepted in oral argument that, if Ground 1 failed and the Panel had been entitled to proceed on the basis of the evidence which was before them at the time, then the Panel’s decision to strike off was not wrong. For that reason, he placed substantial reliance upon the fresh evidence of remediation.

The NMC’s case

[109]The NMC submitted that, given the seriousness of the misconduct proved, it was entirely appropriate and in line with case law and guidance for the Panel to impose a striking off order. Secondly, the dishonesty here was not at the lower end of the spectrum. Thirdly, as to the new insight evidence, the NMC submitted, first, that it is not admissible as it does not meet the Ladd v Marshall criteria. It could have been obtained for the Panel hearing and it would not have affected the outcome. Secondly, and in any event it is relatively weak evidence of insight.

Discussion

[110]I consider this Ground on the basis that Ground 1 does not succeed, and that the Panel was therefore entitled to proceed in the Appellant’s absence and on the basis of the material before it. I apply the legal principles set out in paragraphs 12 and 13 above.[111]First, in my judgment, the dishonesty in this case was serious. I accept the NMC’s submission that the Appellant’s conduct represented a premediated pattern over a long period of dishonest conduct for personal and financial gain. I do not accept that there was no risk to patient safety. The Appellant’s dishonesty meant that he could have gone on to practice as an advanced neonatal practitioner, without being properly qualified and that could have put patients at direct risk of harm. I note that when the Appellant re-sat for the first time the examination without model answers, he did not pass.[112]Secondly, the Panel considered the Appellant’s mitigation and professional history on the basis of the information before it at the time. The Panel was entitled to conclude that this was outweighed by the seriousness of the conduct and by the lack of insight and remediation shown at that time; and that the Appellant had not addressed the seriousness of the dishonesty.[113]Whilst I recognise that, in cases of dishonesty, this Court will not defer to the assessment of the Panel more than is necessary, nevertheless there was no error of principle in that assessment nor was the decision to impose a striking off outside the bounds of what the Panel could properly and reasonably have decided. The Panel’s reasoning and analysis is fair and appropriate on the basis of the material placed before it.[114]Thirdly, as Mr Skeate accepted, the substantial question on Ground 2 is whether the new material provided by the Appellant since the Sanction Decision is such as to render that Decision wrong or one which the Panel could not reasonably have reached, if it had had that evidence before it. That new material comprises an apology letter and a “reflection” of the Appellant himself together with further references. First, there is some doubt that this material is admissible under Ladd v Marshall. On one view, the material could have been obtained with reasonable diligence for use at the trial, and so the first condition would not be satisfied. On the other hand, it is difficult to apply this condition in circumstances where the Panel proceeded, justifiably, in the absence of the Appellant. Secondly, and in any event, and assuming the new evidence is admitted, in my judgment it is not sufficient to warrant the lesser sanction of suspension. I am not satisfied that this material evidences true insight or remediation nor that it is sufficient when set against the whole history. The Appellant had many months in which to address these issues and these materials were provided only once he was faced with the sanction of striking off. In his apology letter and “reflection”, the Appellant does not admit dishonesty; rather he explains his conduct as a mistake. Nor does he exhibit an understanding of how his conduct might have put patient safety at risk. It has been provided only now some 4 years later, and only as a direct result of having been struck of. This shows a lack of insight and understanding of the seriousness of the conduct at the time. Moreover the new references take the matter no further than the references which were before the Panel.[115]I accept the Appellant’s sincere regret and apologies for his conduct and that these are heartfelt. He explains his personal circumstances in which the misconduct came to happen. However, first, he continues to characterise that misconduct as a “mistake”, rather than dishonest. He explains why he did not subsequently own up to conduct, but not why he did it in the first place. Secondly, in my judgment, although he states that he “understands the seriousness of the matter” he does not appear to understand the real implications of the dishonesty, both in the context of public confidence in the integrity of the profession and in relation to patient harm. In his further materials, he makes no reference to the risk of patient harm, in the event that he had passed the exam with the benefit of the model answers.[116]For these reasons, Ground 2 fails.

Conclusions

[117]In the light of my conclusions at paragraphs 103 and 116 above, the appeal is dismissed.[118]I will hear the parties in relation on consequential matters. I am grateful to counsel for the helpful manner in which this case has been prepared and conducted.

order

taking no action; the imposition of a caution order; and the placing of conditions of practice on the Appellant’s registration. It rejected each of those options pointing out in relation to the last of those that “the misconduct identified… was not something that can be addressed through retraining as it was not a clinical concern and Mr Khan had not demonstrated any remorse or insight into his actions” (emphasis added)