La Vie Health Care Limited v NHS England (South East London Integrated Care Board) [2026] UKFTT 1232 (HESC)

First-Tier Tribunal Primary Health Lists

The Tribunal Procedure (First-tier Tribunal) (Health, Education and Social Care) Rules 2008

2026-01821.PHL

Neutral Citation Number: [2026] UKFTT 01232 (HESC)

Venue Hearing held at the Royal Courts of Justice

on 18-19 August 2026

Before

Tribunal Judge S. Trueman

Specialist Member Ms S Billington

Specialist Member Ms L Bromley

Between

La Vie Health Care LimitedAppellant

-v-

Between

NHS EnglandRespondent

(South East London Integrated Care Board)Respondent

DECISION

Date 2026-08-25

The Application

[1]This appeal is brought by La Vie Health Care Limited (a corporate entity) of whom the director is Mr Chinedu Ahamefula. Although in a technical sense the only Appellant is the company, given that the issues in this appeal really relate to the activities of Ms Eberechukwa Nwokocha-Ahaaiwe this decision also refers to Ms Nwokocha-Ahaaiwe as ‘the Appellant’ for convenience. The company is referred to as ‘La Vie’.

[2]This appeal concerns the decision of the South-East London Integrated Care Board (in this decision referred to as ‘the respondent’), dated 6 February 2026 to refuse to include the Appellant company in the pharmaceutical list for the London Borough of Bromley pursuant to rule 33(2)(d) of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 SI 2013 No 349, as amended. . These Regulations are referred to in this decision simply as ‘the Regulations’.

[3]The Appellant submitted an appeal to this tribunal on 6 March 2026, within the required time limit, and this matter now comes before us. Attendance

[4]The Appellant was represented by Mr Peter Wareing, advocate, appearing as lay representative. The Appellant’s witness was Ms Nwokocha-Ahaaiwe. Mr Chinedu Ahamefula, director of La Vie attended the hearing but did not give evidence.

[5]The respondent was represented by Mr Alexander Dos Santos KC, instructed by Mr Mark Jarvis and Mr Ryan Thomson of Capsticks LLP. The Respondent’s witnesses were Mr Tuskar Shah, Lead Pharmacy Adviser, NHS England, and Mr Jeremy Wallman, Head of Primary Care Commissioning, NE London ICB (who act as agents for SE London ICB). Preliminary issues Application to admit late evidence.

[6]On day 1 of the case, Mr Dos Santos applied to admit as late evidence a series of email exchanges between the NHS and the General Pharmaceutical Council (‘The GPhC’), concerning the investigation conducted by the GPhC into Ms Nwokocha-Ahaaiwe in 2017-2018. Mr Dos Santos accepted that the evidence had been submitted very late and could have been provided earlier but said it was submitted in response to changes in the Appellant's case, and it was not clear until the finalisation of the Scott Schedule that the Appellant was suggesting that she was unaware of the outcome of the investigation. He said that the new evidence showed the outcome of the investigation and that Ms Nwokocha-Ahaaiwe had been aware of it. He said that the issue had not been fully dealt with in the statements. Mr Wareing said that the Appellant was neutral as to the admission of this material.

[7]We considered that though late, the material was clearly relevant to the question of the investigation into Ms Nwokocha-Ahaaiwe in 2017-2018 and to her knowledge at the time at least, and that it was in the interests of justice to admit it, particularly as Mr Wareing took no point on this. We therefore admitted these 4 new emails (the email of 28 February 2026 was already in evidence). Witness evidence

[8]At the beginning of the hearing, we directed that all witnesses’ written statements should stand as their evidence in chief to avoid oral repetition. We therefore indicated that oral questions would mostly be confined to cross- examination by the other party and any essential re-examination arising. We heard all witness evidence on day 1 and we adjourned for submissions at the start of day 2. Bundle numbering

[9]The Respondent used a variety of numbering approached during this appeal which made it hard to cross-reference documents. References were made to parts of the bundle, A1, B1 for example in some places but only to consecutive numbering in others. The page numbers of the pdf did not match that of the bundle numbering either, which also meant all documents had at least two numbers and technically 3 in some cases. This is unfortunate. We would have expected more of Capsticks. For ease, this decision refers to numbers in the bundle as it is consecutively paginated, from page 1 to 574. We have not used the pdf numbering. Background

[10]The function of making and maintaining a list of pharmacy contractors entitled to provide NHS pharmaceutical services was one given to NHS England by the National Health Service Act 2006. It has since been delegated to the local ICB to determine for the area in which a person or entity wishes to be registered Although the Regulations impose these obligations on NHS England, since 1 April 2023 these functions have been transferred to and are now exercisable by the local Integrated Care Board (ICB) for the relevant area:see section 65Z5 National Health Service Act 2006, as amended and Regulations made under it. As a result of section 65Z5(6) any liability incurred in respect of the exercise of these functions are enforceable only against that ICB. . That area is overseen by a Health and Wellbeing Board (HWB), created in accordance with s.194 Health and Social Care Act 2012. Each local authority area has a HWB which aims to encourage integrated working in the supply of local health and social care services, which includes pharmacies.

[11]Under Regulation 10 of the 2013 Regulations, NHS England maintains two pharmaceutical lists for each HWB area: a list of those who provide pharmaceutical services in particular by way of the provision of drugs, and a list of those who provide pharmaceutical services only by way of the provision of appliances. Each list contains supplementary information about those included in the relevant list.

[12]From about 2013, La Vie provided a pharmacy service by way of the provision of drugs, trading as Grove Pharmacy from 17 The Village, Charlton, London SE7 8UG. The Superintendent Pharmacist was Ms Nwokocha-Ahaaiwe. La Vie were included on the pharmacy list for the London Borough of Greenwich. In July 2022, La Vie says that their landlord shut down the premises that they had been renting for some years and forcibly evicted them. The Appellant says that all of its documents and its supply of medicines were sealed in the building, and the Appellant was denied entry to recover them. Indeed, the Appellant says that they have never recovered these documents that were inside the repossessed premises. The business therefore needed to move premises and after what it said was an extensive search for suitable premises, determined that it would move from Charlton to an address in Mottingham, SE9 to be linked to a local medical practice there. La Vie therefore, made an application to the respondent to relocate their pharmacy business. It was common ground that such an application was an ‘excepted application’ under Regulation 24(2) of the Regulations.

[13]Initially, La Vie submitted a relocation application on 5 March 2024 on the assumption that the relocated pharmacy would remain in Greenwich- as it was still in SE9. On 1 May 2024, the respondent informed La Vie that the new location of the pharmacy, in Mottingham, would place them into the Bromley HWB area, and that consequently, they needed to re-apply to relocate to a new HWB. The respondent also said that ‘as LA Vie Healthcare Ltd is not included in the pharmaceutical list in Bromley HWB area, a full fitness to practise is required’. Some other minor issues were identified, but principally, the respondent enclosed a form for La Vie to complete.The second application was duly submitted on 19 July 2024. This application was also rejected, however, for reasons that are not material. The third application was made on 16 December 2024.

[14]The form of the application was that found in annex 2, Chapter 17 of the Pharmacy Manual. This form is entitled ‘Application in respect of a relocation to a neighbouring HWB area that does not result in significant change to pharmaceutical services provision’. The status of this application, and whether it could technically be called an ‘inclusion application’, as the Respondent asserted, however, was disputed at least until the hearing. It was accepted that it was an application under regulation 24(2) of the Regulations, however, and that it needed to be made, considered and determined in accordance with those Regulations. Annex 1 of Chapter 17 of the Pharmacy Manual contains the form to be completed for a business that wishes to move only within the HWB where it is already established.

[15]Paragraph 1.3 of the relevant form gives various options about providing fitness information as required by Part 1 of Schedule 2 to the Regulations. One option is for the applicant to indicate that they have provided relevant fitness information before, and to confirm that there is no ‘missing information’ (which is defined in the Regulations) and to confirm ‘that the previously provided information remains up-to-date and accurate’. The applicant ticked the box indicating that the information had been provided previously and confirmed that the information was up to date and accurate and that it had been provided to the Cluster Pharmacy Team at a given address on 20 February 2013. In section 10 of the form, the Appellant confirmed that they were content, if their application was granted to be removed from the pharmaceutical list for Greenwich and to be included in the pharmaceutical list for Bromley instead. The form was signed and dated by the Director of La Vie, Mr Ahamefula on 16 December 2024.

[16]On 23 January 2026, NHS England wrote to the Appellant indicating that there were missing documents and providing a list. This letter also said ‘you do not appear to be included in the pharmaceutical list in Bromley HWB area. Therefore, a full fitness to practise is required’. It said that the form should be amended at paragraph 1.3 to show that full information was being provided and it asked for revised information by a deadline or an explanation of why it couldn’t be provided in that time.

[17]Mr Ahamefula completed the fitness Information form (marked as Chapter 7, annex 2) on 27 January 2025. Part B of that form, however, was completed by Ms Nwokocha-Ahaaiwe and is signed by her and dated 10 February 2025. In that part of the form, Ms Nwokocha-Ahaaiwe submitted details of her pharmaceutical qualifications and her employment for the last few years and also completed a section marked ‘fitness information’ which consisted of a series of yes and no questions. This section was headed ‘please delete yes or no as appropriate to indicate whether you:-‘ And at D, it said ‘are, or have been to your knowledge, subject to any investigation into, or proceedings relating to, your fitness to practise by a licencing body’. Underneath ‘licencing body’ was defined as ‘any body anywhere in the world that licences or regulates any profession’. Ms Nwokocha-Ahaaiwe marked the answer to this question as ‘no’.

[18]On 28 February 2025, the Respondent acknowledged receipt of the information and said it would begin the process of assessment. Also on 28 February 2025, the Respondent received an email from the GPhC which said that Ms Nwokocha-Ahaaiwe was registered and in good standing with the GPhC but that she was given a warning by the Investigating Committee on 4 April 2018 with regard to a pharmacy operating without adequate indemnity insurance in place. No further details were supplied by the GPhC, and none were sought by the NHS.

[19]The respondent wrote to the Appellant company on 22 August 2025, seeking an explanation for the failure in their eyes to declare the investigation and warning given in 2018. The respondent later referred to this letter as a Dispute Resolution Letter (DRL), but it is right to record that it was not identified as such within the letter, and Ms Nwokocha-Ahaaiwe’s position at the hearing was that she had no knowledge that this was the status of the letter. In any event, on 4 September 2025 the Appellant replied to this letter. Thereafter, the Appellant sought on a number of occasions to chase a decision from the respondent on their application, and Ms Nwokocha-Ahaaiwe explicitly sought disclosure of the Board report to the ICB concerning the Appellant’s fitness to practise by email dated 27 January 2026. The respondent declined to provide this in an email dated 3 February.

[20]On 6 February 2026, the respondent provided to the Appellant two documents- a decision letter indicating that the South- East London ICB had decided to refuse the application under regulation 33(2) and the relevant extract of the minutes of the Pharmaceutical Services Regulations Committee (PSRC) of the Dentistry, Optometry and Pharmacy Commissioning Hub meeting at which the decision had been taken. The reasons given for the refusal were as follows: “Whilst the GPhC have considered the registrant Eberechukwu Nwokocha-Ahaaiwe to be registered and in good standing, they have also indicated that he [sic] was issued with a warning by the Investigating Committee on 4 April 2018 with regard to operating a pharmacy without adequate indemnity insurance. The registrant has not made this declaration in their submission. A dispute resolution letter has been sent to understand the reason for not making this declaration. The response does not give any good cause for not making this declaration. The response cites that the applicant is the corporate body and not the Superintendent Pharmacist. The applicant lacks insight around honesty and integrity into the fitness to practise declarations, to include Superintendent Pharmacists and Directors, that are required for being included in a pharmaceutical list for a Health & Wellbeing Board area where they are not already included. In the circumstances, there are good reasons to either refuse or put conditions for this application on fitness grounds”.

[21]La Vie appealed. Legal Framework

[22]As briefly noted above, under Part 7 of the National Health Service Act 2006, NHS England is responsible for making arrangements for commissioning pharmaceutical services as part of the NHS in England. Section 147A of the Act enables by Regulations the creation and maintenance of lists of persons approved by NHS England for the provision and performance of pharmaceutical services through a regulatory scheme. That Scheme is set out in the Regulations, and anyone wishing to provide such services must be included in the relevant list. Anyone included in the list is bound by the terms of service set out in the Regulations.

[23]For the reasons given above, references in the Regulations to NHS England are now to be read as references to the relevant ICB.

[24]The pharmaceutical lists are created by regulation 10 and subsequent regulations provide for applications to be made and determined for those wanting to join those lists. Regulation 10 provides, so far as relevant, as follows;- 10- Pharmaceutical lists(1) In respect of the area of each HWB, NHS England must prepare, maintain and publish 2 lists of persons (if there are any), other than medical practitioners or dental practitioners, who undertake to provide pharmaceutical services at or from premises situated in that area.

(2) Those lists (which are pharmaceutical lists) are— (a) a list of persons who undertake to provide pharmaceutical services in particular by way of the provision of drugs; and (b) a list of persons who undertake to provide pharmaceutical services only by way of the provision of appliances.

(3) Those lists must include— (a) the address of the premises in the area of the HWB at or from which the listed person has undertaken to provide pharmaceutical services (“the listed chemist premises”); (b) the days on which and times at which, at or from those premises, the listed person is to provide those services during the core opening hours and any supplementary opening hours of the premises. (6) NHS England must ensure that each HWB has access to the pharmaceutical lists ... that it holds which is sufficient to enable the HWB to carry out its functions under these Regulations and must notify it of changes to the lists that are relevant to the carrying out of its functions.

(c) other related matters

[25]Regulation 24(2) so far as relevant provides as follows: 24- Relocations that do not result in significant change to pharmaceutical services provision (2) Section 129(2A) of the 2006 Act does not apply to an application from a person already included in a pharmaceutical list for the area of a HWB (HWB2) for inclusion in the pharmaceutical list for the area of a neighbouring HWB (HWB3), or inclusion in the pharmaceutical list for the area of HWB3 also in respect of other premises than those already listed in relation to that person, if—(a) the purpose of the application is to relocate to different premises;

(b) for the patient groups that are accustomed to accessing pharmaceutical services at the existing premises (P1), the location of the new premises (P2) is not significantly less accessible;

(c) in the opinion of NHS England, granting the application would not result in a significant change to the arrangements that are in place for the provision of local pharmaceutical services or of pharmaceutical services other than those provided by a person on a dispensing doctor list— (i) in any part of HWB3's area; or (ii) in a controlled locality in the area of a neighbouring HWB (including HWB2), where that controlled locality is within 1.6 kilometres of P2;

(d) NHS Englandis not of the opinion that granting the application would causesignificant detriment to proper planning in respect of the provision of pharmaceutical services in the area of HWB3;

(e) the services the applicant undertakes to provide at P2 are the same as the services the applicant has been providing at P1 (whether or not, in the case of enhanced services, NHS Englandchooses to commission them);

(f) the provision of pharmaceutical services will not be interrupted (except for such period as NHS Englandmay for good cause allow);and

(g) the applicant consents to— (i) where the applicant has only one set of listed chemist premises in the pharmaceutical list for the area of HWB2, the removal of the applicant's name from that pharmaceutical list, or (ii) where the applicant has more than one set of listed chemist premises in the pharmaceutical list for the area of HWB2, the removal of P1 from being listed in relation to the applicant in that pharmaceutical list, with effect from the date on which the applicant undertakes to provide pharmaceutical services from P2.

[26]Regulation 33, so far as relevant, provides as follows: 33. — Refusal of applications for inclusion in a pharmaceutical list on fitness grounds (A1) In this regulation, “A” means, where an application for inclusion in a pharmaceutical list is made by a person who is—(a) an individual, the individual making the application;

(b) a partnership, any partner in the partnership making the application; or

(c) a body corporate— (i) except for the purposes of paragraphs (1)(a) and (b) and (3)(h)(i), the body corporate making the application, and (ii) except for the purposes of paragraph (2)(b) and (e), any director or superintendent of the body corporate making the application. (1) An application for inclusion in a pharmaceutical list by a person …who is not already included in it must be refused if NHS England is satisfied that— (a) …; (b) A— (i) has been convicted in the United Kingdom of a criminal offence, other than murder, which was committed after 1 April 2005, and (ii) has been sentenced to a term of imprisonment of over 6 months; … (2) An application for inclusion in a pharmaceutical list by a person who is not already included may be refused if NHS England— (a) … (b) considers that A is unsuitable to be included in the list; (c) having— (i) checked with the NHS BSA for any facts that it considers relevant relating to past or current fraud investigations involving or related to A, and (ii) considered these and any other facts in its possession relating to fraud involving or relating to A,considers the outcome of these enquiries justify refusal;

(d) Having- (i) Checked with the Secretary of State for any facts considered by the Secretary of State to be relevant relating to past or current investigations or proceedings involving or relating to A…, and (ii)considered these and any other facts in its possession involving or relating to A.. considers the outcome of these inquiries justify such refusal; … (3) Where NHS Englandis considering refusal of an application under paragraph (2), it must consider all facts which appear to it to be relevant and must in particular take into consideration in relation to paragraph (2)(b) to (e)— (a) the nature of any offence, investigation or incident; (b) the length of time since any offence, incident, conviction or investigation; (c) whether there are other offences, incidents or investigations to be considered; (d) any action taken or penalty imposed by any licensing or regulatory body, the police or the courts as a result of any such offence, incident or investigation;

(e) the relevance of any offence, investigation or incident to the provision by A of pharmaceutical services and any likely risk to users of pharmaceutical services or to public finances; … (4) When NHS England takes into consideration the matters set out in paragraph (3), it must consider the overall effect of all the matters being considered. (5) If an application for inclusion in a pharmaceutical list by a person who is not already included in it is refused under paragraph (1) or (2), NHS Englandmust notify the applicant of that decision and it must include with the notification an explanation of— (a) the reasons for the decision; (b) the applicant's right of appeal against the decision to the First-tier Tribunal, which must be exercised within 30 days of the date on which the applicant was notified of the decision.

[27]Schedule 2, so far as relevant, provides as follows: 3. — Fitness information about individuals: routine and excepted applications for inclusion in a pharmaceutical list(1) Subject to paragraph 5, the information mentioned below in this paragraph must be included in all routine and excepted applications for inclusion in a pharmaceutical list, as regards any person (P) who is— (a) the individual who is making the application; (b) a partner in the partnership that is making the application; or (c) a director or (if A is seeking entry in the list mentioned in regulation 10(2)(a)) superintendent of the body corporate that is making the application.

(2) Details of whether P— (a) has been convicted of any criminal offence in the United Kingdom; (b) has been bound over following a criminal conviction in the United Kingdom; (c) has accepted a police caution in the United Kingdom; … (5) If P is, to P's knowledge, or has been subject to any investigation into, or proceedings relating to, P's fitness to practise by a licensing body— (a) if the investigation or proceedings have not yet reached their final outcome, details of that investigation or proceedings; or (b) if the investigation or proceedings have reached a final outcome that was adverse, details of the final outcome of that investigation or proceedings. 5. — Fitness information that has already been provided under pharmaceutical or localpharmaceutical services (1) If information mentioned in paragraph 3 or 4 has already been provided to NHS England (or a home Primary Care Trust) on a previous occasion pursuant to regulations under Part 7 of the 2006 Act, an applicant need not provide that information again to NHS Englandin relation to the current application. (2) An applicant relying on paragraph (1) must, when making its application— (a) confirm to NHS Englandthat NHS England already has all the information required under paragraphs 3 and 4; or (b) if there is any missing information required under those paragraphs— (i) confirm to NHS England what information NHS England already has, and (ii) provide the missing information.

(3) Unless sub-paragraph (4) applies, information is only to be considered missing for the purposes of sub-paragraph (2)(b) if, having regard to the fact that the fitness of the applicant to be included in a pharmaceutical list has already been established (or if the applicant's fitness is under investigation, that investigation is being taken forward separately), it is nevertheless material to the consideration of the application.

(4) Information is to be considered missing for the purposes of sub-paragraph (2)(b) if it has previously been provided to NHS England or a Primary Care Trust by the applicant, but more than 7 years prior to the date of the application.

The legal appeal process

(b) The legal appeal process

[28]The Regulations provide in a number of places for appeals to lie against the decisions of NHS England, or the ICB in their stead, to the First- Tier Tribunal on some issues, and to the Secretary of State for Health for some other issues. There was no dispute for the purposes of this appeal that it lay to this Tribunal, because of the explicit provisions of regulation 33(5)(b). The powers of the Tribunal on appeal are less clear.

[29]Under the analogous regulations that apply to medical practitioners who are included in the Performers Lists for the purposes of undertaking NHS work, regulation 17(4) of the NHS (Performers’ Lists) Regulations 2013 SI 2013 No 335 as amended. provides explicitly for the powers of the Tribunal on any appeal (and these include the imposition of conditions). In this case, the Regulations with which we are concerned are silent as to the specific powers available to us.

[30]Nevertheless, it was common ground in this appeal that if we were to allow the appeal, the correct approach would be for us to quash the decision of the PSRC and remit the matter back to the Committee to reconsider in the light of our findings on fitness, and if appropriate, to proceed to consider the remainder of the issues arising in the remainder of regulation 24(2).

Issues in the appeal

[31]Issues in the appeal The parties had produced a Scott Schedule in this appeal, but it is fair to record that there was not a final agreed set of issues for the Tribunal to work to. The respondent’s skeleton argument contained a list of issues; and the Scott Schedule itself contained a list of what were termed ‘allegations’ but these were not agreed either. The Appellant for its part, had produced its own Schedule of Issues and Findings Sought (bundle, page 558) but Mr Wareing did not seek to rely on this complete list at the hearing

[32]Having considered all of the issues put forward, in our view a number of those of the Appellant were more detailed sub-sets of the questions put by the respondent. In the event, we considered that the relevant issues for us to determine were as follows:a. Was the application made by the Appellant properly to be considered an ‘inclusion’ application, or was it something else? And was Ms Nwokocha-Ahaaiwe obliged to provide fitness to practise material as part of that if required, or could she insist on the NHS using the previously provided evidence?

b. Was the Appellant aware of the 2017 investigation and the outcome and was she entitled to consider that this might not amount to a fitness to practise issue either for the GPhC or for the NHS?

c. Was the failure to disclose the information about the previous investigation ‘dishonest’ (and was Ms Nwokocha-Ahaaiwe given a fair chance to respond to the failure to provide it)?

d. Was the decision to refuse the application fair, proportionate and reasonable?

[33]At the conclusion of the appeal, Mr Wareing indicated that the issue at paragraph a. immediately above was no longer in issue, and that it was conceded that the application made in December 2024 was one for ‘inclusion’ in a list. Given the importance of this issue to the Appellant’s case, however, and her earlier responses to it we have considered it appropriate to deal with that issue in our decision in any event, recognising that the issue was not argued substantively before us. The Respondent’s Position

[34]The Respondent said the position on this appeal was simple: the Appellant’s Superintendent Pharmacist had given a materially inaccurate declaration on the fitness to practise form which she had been asked to complete and the answers given had not matched with the response from the Superintendent Pharmacist’s regulator, the GPhC. When questioned about this, Ms Nwokocha-Ahaaiwe had not explained why she had not disclosed this information, and she had in fact never provided any explanation as to why she had not provided this information, nor had she ever admitted that not providing it was a mistake on her part. The respondent said that Ms Nwokocha-Ahaaiwe knew about the 2017 investigation, she knew that there had been an outcome to this, and she failed to declare this in response to a direct, and unequivocal, question on the form. The respondent said that it was not the transgression in 2017-18 that was the problem for their application. Indeed, if the Appellant had admitted this breach then the respondent would probably have allowed the application anyway; it was rather the false declaration made in the form itself, and the failure to explain it thereafter, which was the source of concern. They said the declaration was dishonest or it became dishonest by not being corrected, and this in itself justified the refusal of registration on fitness grounds. There was no proportionality element to this decision, because the failure to be candid with the regulator was so serious. Public perception required the Appellant to be refused registration to maintain confidence in the pharmacy profession. The Appellant’s Position

[35]The Appellants’ argument was that the decision taken by the Respondent to refuse registration was disproportionate and had failed to have regard to the proper matters which the Regulations required it to take into account set out in regulation 33(3). In closing, Mr Wareing said this in itself would justify the setting aside of the decision on the basis of procedural irregularity. He noted that the factors in regulation 33(3) were relevant to the context of the alleged ‘offence’ of operating without indemnity insurance and he said that this infringement was one of inadvertent and wholly administrative error. The Appellant’s case was that there had been no suggestion at any point that the safety of the public had been compromised by the actions of the pharmacy.

[36]The Appellant denied that there had been any dishonesty involved in the making of the declaration in the fitness to practise form signed on 10 February 2025. It was said that the context in which it was signed was important, as the Appellant was in litigation with its former landlord at that point and was experiencing significant financial difficulties. It is said that Ms Nwokocha-Ahaaiwe was preoccupied with the other issues, and there was a ‘lack of focus’ on the fitness to practise question. The Appellant’s written case was also that Ms Nwokocha-Ahaaiwe believed that the requested information had been submitted and she had maybe not focused on the ‘minutiae’ of information required by the respondent (see skeleton argument, paragraphs 10 and 11). The failure to provide the information was said to result from ‘human failings’.

[37]In closing at the end of the hearing, the Appellant’s case was somewhat different. It was then said that Ms Nwokocha-Ahaaiwe had answered the question about previous fitness to practise issues honestly because she did not believe there had been any. She did not accept that the investigation in 2017-2018 concerning her lack of indemnity insurance had been a fitness to practise issue and that consequently she was not obliged to report it in response to the question posed in the FTP form which asked only about investigations and proceedings concerning fitness to practise. The request for an explanation of the position which arrived in August 2025 from NHS England also hadn’t suggested this was a fitness to practise issue and therefore had not triggered any requirement to explain further either. Evidence

[38]We had a bundle of documents of 594 pages. We also had a small volume of late evidence that was not included in the bundle. We include any relevant oral evidence in our findings. The Tribunal’s conclusions with reasons The application made on 16 December 2024; was this an inclusion appeal and could the respondent insist on the provision of fitness material?

[39]As we noted above, it was long a part of the Appellant’s case that it was not necessary for Ms Nwokocha-Ahaaiwe or the company to provide additional information on fitness to practise because this was either not relevant to the application being made, or it had been provided before. The appeal document (bundle, page 17) said that the relocation of the pharmacy did not justify retrospective reassessment of historic regulatory matters where there was no ongoing risk. In the email of 4 September 2025 (bundle, page 214) the Appellant said that they had ticked the box on the fitness form saying that they had provided the information before, and that it was still up to date and accurate. They also said later in the same document, ‘it is our position that the requirement to complete the Updated Chapter 7, Annex 1 [fitness to practise] form was unnecessary and duplicative, especially given that relocation is not a new market entry, nor should it trigger additional scrutiny of fitness unless valid grounds exist’.

[40]At the hearing, these arguments were not substantively pursued. We consider that the concession that this was, in fact, an application for inclusion was rightly made. It was accepted that the application was one made under regulation 24(2) as an excepted application. An excepted application is one where the market entry test is not applied because the applicant is already operating in the market. But the terms of regulation 24(2) make clear that the application to move from one HWB (Greenwich) to another (Bromley) is “an application from a person already included in a pharmaceutical list for the area of an HWB… for inclusion in the pharmaceutical list for the area of a neighbouring HWB.’; and under regulation 24(2)(g)(i), the applicant consents in making the application to their name coming off the register for the area they are leaving. The applicant, we note, is asked to confirm that consent to removal as well in the form they submit (see bundle pages 36-37).

[41]All applications, excepted or routine, are considered under regulation 10, and this requires compliance with schedule 2 (regulation 10(7)) which details information that must be supplied. Schedule 2, paragraph 3 contains information that must be provided under excepted applications for inclusion in a pharmaceutical list and at paragraph 3(5) this includes details of any ‘investigation into, or proceedings relating to’ a person’s fitness to practise by a licencing body. Paragraph 3(1)(c) of the same Schedule requires this information to be provided in respect of a Superintendent Pharmacist if the applicant is, as here, a corporate body. Pausing there, there is therefore no doubt that under the Regulations, the respondent was obliged to ask for fitness to practise information as part of the application process to join a neighbouring HWB.

[42]There is an administrative convenience provision at paragraph 5 of Schedule 2 however, which permits a person or body to rely on previously submitted material about fitness if the person or body confirms that the respondent already has all of the information required or, if there is ‘missing information’, provides the missing information. But if the information is out of date, the applicant needs to provide any updating information and an up-to-date declaration.

[43]A key complaint of the Appellant in its response to the 22 August 2025 letter was that it had already provided the fitness information in the past, in February 2013, and that it should not be necessary for it to resubmit that information again. It said that the respondent had given it no prior indication that it did not have access to that information, and it had not confirmed what attempts it had made to access or find that information.

[44]But the respondent had already indicated to the Appellant by this stage that as it was applying for first time entry into the pharmaceutical list for Bromley, and as it could not find the previous declaration, this information would need to be provided again. It asked La Vie to complete the fitness form again in its letter of 23 January 2025 (incorrectly dated 2024) (bundle, page 169). So it is not right to say that the respondent had not already said that they couldn’t find this information.

[45]But the overall complaint does not help the Appellant. Even if the respondent had held the earlier declaration, it was out of date. There had been developments since 2013 which meant that it was no longer accurate. So, for the Appellant to have relied on it again would have left them in the same situation as they now find themselves: of having made a declaration which the respondent says is false. And querying the respondent’s request for the information does not assist either. Paragraph 5(4) of Schedule 2 enables the respondent to treat information that is more than 7 years old as missing, and therefore in need of resubmission, in any event.

[46]It is therefore the case that it was legitimate, indeed necessary, for the respondent to request La Vie to submit its fitness information again, as it requested in January 2025, and to require fitness information on Ms Nwokocha-Ahaaiwe as part of that process. Was the Appellant aware of the 2017 investigation and the outcome and was she entitled to consider that this might not amount to a fitness to practise issue either for the GPhC or for the NHS?

[47]There appears to be no doubt that Ms Nwokocha-Ahaaiwe was aware of the 2017 investigation and accepted that it had happened and that she had taken corrective action in response. What was less clear was whether she was aware of the formal outcome of it, and whether she understood the status of such an investigation. As we noted above, the Appellant did not accept in her written evidence and appeal forms that she had been aware of any outcome to the investigation, and in the witness statement she said that it was so long ago, and as the material relied on had not been supplied to her ‘it is difficult to verify or interpret the matter accurately….As this information formed the primary basis for the decision, it was essential that the relevant documentation, including the exact date and supporting evidence, be provided to enable us to accept, refute or properly explain the circumstances…’ (bundle, page 233). She did not, at that stage, suggest that she had not thought this was a fitness to practise issue at all. Ms Nwokocha-Ahaaiwe confirmed at the hearing that this witness statement was true and that she did not wish to correct any part of it.

[48]Evidence received from the GPhC which was admitted as late evidence eventually confirmed that Ms Nwokocha-Ahaaiwe had been given a form to sign concerning the warning and this had been signed by her on 15 March 2026. A decision had been sent to her on 4 April 2018, but we did not see the content of that or how the warning that was contained in it was expressed. We accept therefore that whether or not Ms Nwokocha-Ahaaiwe remembered the outcome, the GPhC had reached a final decision to issue her with a formal warning about the absence of indemnity insurance in 2017.

[49]In her oral evidence to the Tribunal, Ms Nwokocha-Ahaaiwe said that at the time of completing the form she has been distracted by a protracted court case, and had not recollected the investigation; but she had subsequently provided the documents to the Tribunal that concerned the investigation. She accepted that her statement and appeal documents had not said in terms that she had forgotten about the investigation, but she said she had clearly accepted there was an investigation, through the submission of the documents at pages 91 to 98 of the bundle. Ms Nwokocha-Ahaaiwe was asked a number of times by Mr Dos Santos whether she had accepted that she had been investigated, and where it was she had said so in the appeal documents that this was the case but that it had slipped her mind. But Ms Nwokocha-Ahaaiwe did not give direct answers to any of these questions.

[50]She later said in oral evidence that she had not considered the absence of insurance or the resulting investigation to be any form of fitness to practise issue, so far as the GPhC was concerned, because it had not involved any hearing or being summoned to the GPhC and there had been no issues relating to patient safely, dispensing errors or drug misuse. She said that the investigation into her lack of indemnity insurance was an issue that she had resolved immediately, the inspector had confirmed it was resolved, and she considered that it was not a fitness to practise issue on that basis.

[51]In evaluating the evidence received, we find that at no time did Ms Nwokocha-Ahaaiwe ever actually answer the question as to whether she accepted that there had been any outcome to the investigation, or what that outcome had been other than that the inspector had confirmed in 2017 that the insurance issues had been resolved. She did not explain whether she had forgotten about the warning or how this had occurred given that, on her evidence, this was her only regulatory issue involving the GPhC in 30 years of professional practice. Her answers were consistently evasive, tangential or obfuscatory and at times very hard to follow.

[52]Having considered the written and oral evidence, we find that Ms Nwokocha-Ahaaiwe was aware of the investigation into her practice in 2017 and that she knew that she had been asked to make improvements in that practice. It was unclear whether she recalled that there had been an outcome, but we accept that she had signed a document relating to the conclusion of the investigation in March 2018. We find that it is more likely than not that following an inspection, Ms Nwokocha-Ahaaiwe had put right the issues identified in that inspection, but that this was followed by a formal consideration by the GPhC as to whether the issues that has arisen amounted to a fitness issue. We did not have sight of any of the documents from the GPhC which was unfortunate. But we accept that Ms Nwokocha-Ahaaiwe was given a written warning, and we consider that this was likely to have been a formal disciplinary sanction. Indeed, it is hard to conceive of what a warning would be if it were not some form of formal, professional admonishment.

[53]Ms Nwokocha-Ahaaiwe said that she did not consider this to be a fitness to practise issue. We can see that a number of registrants with the GPhC might take a similar approach in not conceiving that something of this nature might go to fitness to practise; but Ms Nwokocha-Ahaaiwe was a Superintendent Pharmacist and had been, on her own evidence, for 20 years. We find it harder to accept that Ms Nwokocha-Ahaaiwe did not know that a warning was a formal fitness to practise issue, and we consider that if she didn’t know this, she should have. We find that Ms Nwokocha-Ahaaiwe had a very narrow, limited understanding of what constituted a fitness issue, and it was confined to issues that could affect patient safety as a result of dispensing errors or advice given. In her oral evidence she minimised the issue, referring to it as a ‘business issue’.

[54]On balance though, and despite her failure to explain this earlier, we are prepared to accept that at the point that Ms Nwokocha-Ahaaiwe signed the fitness form in February 2025, she believed, wrongly, that the investigation from 2017-18 was not a fitness to practise issue, and that consequently, she believed that the answer ‘no’ to the question at paragraph D (bundle, page 196) was accurate. One of the considerations in reaching this view is that we can see no conceivable motive for Ms Nwokocha-Ahaaiwe to lie about this 2017-18 investigation or the outcome. Mr Shah and Mr Wallman’s evidence, which we accept, was to the effect that had this been declared it would not have prevented the relocation application from being granted; it was not an issue that gave them any real cause for concern. In that sense, Ms Nwokocha-Ahaaiwe had nothing to gain from concealment.

[55]Applying the Ivey Ivey v Genting Casinos Ltd

[2017] UKSC 67

at [74], per Lord Hughes. test, about which we say more shortly, we find that the Appellant believed that she did not have any fitness to practise issues to declare at that point, even though we also find that as a Superintendent Pharmacist she ought to have realised that fitness to practise issues go much wider than simply concerning patient safety and that the investigation conducted into her in 2017-18 ought to have been declared. However, given the state of her belief at that point, we also find that ordinary, decent people would not consider her to be dishonest at that point- simply mistaken, ill-informed and perhaps somewhat presumptuous of the fact that there were no problems in her practice to disclose.

[56]It is after this however, that we consider that the position changed significantly. Was the failure to disclose the information ‘dishonest’ (and was Ms Nwokocha-Ahaaiwe given a fair chance to respond to the failure)?

[57]Having concluded that Ms Nwokocha-Ahaaiwe was not dishonest in her initial completion of the fitness form, we turn to consider what happened thereafter. It was some months after the submission of that form that the respondent wrote to La Vie and in the letter, entitled ‘La Vie Healthcare Limited- application for inclusion in a pharmaceutical list- Fitness to Practice Consideration,’, said the following:

“The ICB notes that you were investigated by the General Pharmaceutical Council (GPhC) and were notified of the outcome on or around 4 April 2018. You have an application by a company for inclusion in the pharmaceutical list where there is an absence of declared information regarding a Superintendent Pharmacist of that applicant company pursuant to Schedule 2 (Fitness information about individuals), paragraphs [sic] 3 to which information relates that was not declared in the instant application but has come to light with our enquiries and under Regulation 33(2)(d) justify refusal to include the applicant in the relevant Health and Wellbeing Board (HWB) pharmaceutical list. Under Schedule 2 Part 1 Paragraph 3 of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 as amended; this declaration must be made as a Superintendent Pharmacist of a company whereby the individual has been subject to any investigations into, or proceedings relating to their fitness to practise by a licensing body. Please can you provide an explanation as to the reason for not making this declaration?”

Please can you provide an explanation as to the reason for not making this declaration?”

[58]There was debate in the hearing, and more in the evidence in the bundle, about this letter and its status. In particular, there were questions about whether the Appellant would have, and should have, realised the importance of this letter and whether, as a result, the failure to respond to the last question in the letter, quoted above, was problematic. Perhaps unhelpfully, the respondent referred to it as a Dispute Resolution Letter (DRL), which was clearly an internal administrative shorthand way of referring to such letters; it was not a concept that had any formal standing in the Regulations. A reference to it was made in the Board report of the PSRC and the Appellant picked up on this in her witness statement (bundle, page 232, paragraph 5). But in the end, nothing turned on the fact of whether or not it identified itself as a DRL, and as the Appellant said in her statement that she had worked out that this is what it was (paragraph 6) it was unclear why this was still taken as an issue in later documents.

[59]The Appellant also said it was not clear to whom the request for clarification was addressed because the letter referred to section C (directors) and not to Section B (Superintendent Pharmacist). She also said that no Superintendent Pharmacist was named in the letter. She complained also that no exact date for the investigation was given, nor copies of any documentation were provided, when it concerned matters from about 10 years before. The Appellant (paragraph 13 of the statement) asserted that information had to be provided to her to enable her, and the company, to accept refute or address the circumstances. That request for further details consistently formed the justification for the company, and Ms Nwokocha-Ahaaiwe in particular, not answering the question put them in the letter. The main thrust of the response, however, given on 4 September, was that the information on fitness to practise had already been submitted, and it was still accurate and it should not be necessary for it to be submitted again.

[60]But in our view, the letter was clear; and the requests for additional information, do not bear any significant scrutiny if relied on as justification for not responding substantively to the query in the 22 August letter.

[61]In his submissions, Mr Wareing said that the DRL letter was not clear on its face in terms of what it was asking or that its significance to the decision -making process was immediately apparent. He said that given her previous answers concerning fitness to practise, Ms Nwokocha-Ahaaiwe simply didn’t consider it relevant. We reject those submissions.

[62]In our view, the letter of 22 August is clear about 4 things:a. It concerns fitness to practise considerations- that is in its title;

b. It raises questions about an undeclared investigation conducted by the GPhC;

c. It says that the lack of declaration is grounds to refuse the relocation application; and

d. It asks why that information was not declared.

[63]Ms Nwokocha-Ahaaiwe told us in her evidence that the investigation of 2017 was the only time she had been investigated by the GPhC in 30 years. She said that she recalled the investigation, even if she didn’t recall whether there had been an outcome. That being so, it would have been immediately apparent to her exactly what incident the letter was referring to, and that this was considered to be a fitness to practise issue. Ms Nwokocha-Ahaaiwe is an intelligent, educated professional. She has been for many years a Superintendent Pharmacist. It is inconceivable in our view that she would not have appreciated the significance of what was stated in plain English. Given that the fitness forms submitted by La Vie did not raise any issues about the Directors either, and given that the letter refers in terms to the GPhC, it would also have been obvious that the reference to section C rather than B was a mistake. If that were not sufficient, the letter says in terms that the failure to declare concerns the Superintendent Pharmacist, not a Director.

[64]Mr Dos Santos put forcibly to us that there were a range of reasonable responses to this letter, depending on the Appellant’s state of mind at the time but that the Appellant Ms Nwokocha-Ahaaiwe gave none of them. We agree. It would have been open to her to say ‘I forgot about this’; or ‘I didn’t think this was a fitness to practise issue, but if you say it is, then…’ or to say ‘this isn’t a fitness to practise issue’. Given her evidence in the witness box, and the way the case was put ultimately, the last of these would have been the most expected, and consistent. But that is not what the 4 September 2025 response contains. As we noted, it simply takes issue with a range of facts, says none of it is clear and asks for documents. But the problem here is that the clarifications that the Appellant says were needed before they could response were quibbles. The exact date of the warning for example could not have mattered if there had only been one investigation; nor could whether the fitness form was correctly referenced. The form did only mention one Superintendent Pharmacist and not by name, but then the company only had one: who else did Ms Nwokocha-Ahaaiwe consider they might be referring to? The response document, tellingly, makes no reference to the investigation whatsoever. It does not even say, ‘we will look into this and come back to you’. It makes no request for extra time to respond. It simply says- you have all of this information already. It makes no attempt to explain or to justify the answer provided in February; nor does it apparently show any reflection on whether Ms Nwokocha-Ahaaiwe’s understanding of the position might be faulty.

[65]Having read the documentation and listened to Ms Nwokocha-Ahaaiwe’s evidence we were very concerned that during the course of this case a range of different explanations have been given for why the 4 September email did not engage directly with the investigation. In the appeal document itself (bundle page 13 and 17) it is said that the Appellant had no knowledge of the investigating committee outcome (ie presumably of the warning). This was why the declaration was honest. In the supporting skeleton argument this was reiterated, with a statement that the issues in 2017 had been satisfactorily resolved (bundle, page 21). The skeleton also said that the Appellant was unaware a warning had been issued, and ‘no regulatory matter was known to exist beyond the resolved indemnity insurance issue’. It said that the respondent presumed knowledge of an outcome that had not been communicated to the Appellant. The Appellant said that because the clarifications to her questions had not been given before the refusal was made, she had not been given chance to respond to the dishonesty allegation (bundle pages 22-23). She also said (ground 6) that the ‘regulatory matters’ had been fully resolved and that there were ‘no outstanding regulatory matters requiring disclosure’ (bundle, page 25).

[66]As we noted above, the witness statement of Ms Nwokocha-Ahaaiwe took a slightly different tack in terms of saying that as the dates given for the investigation and alleged infringement were ‘imprecise’ it was difficult for the company to respond or to verify or interpret the matter, especially given that the incident was 9 years before. But it must have been plain to La Vie and to Ms Nwokocha-Ahaaiwe which incident was being referred to, even if Ms Nwokocha-Ahaaiwe had forgotten some of the details and even if she did not think it amounted to a fitness to practise issue herself. So the point here being made appears to be that the Appellant did not know which or what regulatory issue was being referred to, when that plainly cannot have been the case. There was only one it could have been, even on Ms Nwokocha-Ahaaiwe’s own case.

[67]The late evidence, however, revealed that at least in 2018, Ms Nwokocha-Ahaaiwe had been aware of the outcome of the regulatory investigation because she had signed an acknowledgement form concerning a warning on 15 March 2018 and she had been sent a decision on 4 April 2018 (see the email from the GPhC dated 13 August 2026). At the hearing, Ms Nwokocha-Ahaaiwe argued that the investigation in 2018 was not a fitness to practise issue at all. She said that it did not concern patient safety and she had not had to appear before the GPhC and there had been no sanction. But again, we return to the point that she never explained any of this thinking in her response of 4 September. And as there had only been one investigation into Ms Nwokocha-Ahaaiwe, this must of necessity have been the incident that the NHS were referring to.

[68]The suggestion by Mr Wareing that the Appellant did not respond substantively to the 22 August 2025 letter in her reply of 4 September because she did not see the relevance, we do not accept. The letter contained a stark warning of a proposed refusal to allow the relocation application. Even if she did not consider the 2017 investigation to be a fitness to practise issue, it was plain by then that the NHS did, and we find that it was incumbent on her to engage with this substantively, even if to the extent of denying that there had ever been a fitness to practise issue. This was her substantive opportunity to revise her submission and answers and to correct the impression she had given. She did not take it.

[69]Ms Nwokocha-Ahaaiwe also said in her evidence that she had tried to contact various people, including the NHS and the GPhC in an attempt to confirm the regulatory position. But the Appellant’s own chronology (bundle page 121) shows that she contacted the PCSE only to chase an outcome and tried to chase the ICB for the same reason (but was told the ICB did not correspond directly). That chronology makes no mention of any attempt to contact the NHS or the GPhC to query the regulatory position about fitness to practise after 22 August 2025, nor does the bundle contain any documents from the Appellant to support this assertion either. The only contact with the GPhC (page 257) was essentially a complaint that the ICB were requiring multiple applications and requesting ‘incorrect’ forms and that was made in 2024.

[70]We return at this point to the question of honesty. In our view at this point, Ms Nwokocha-Ahaaiwe was plainly in possession of relevant facts that even if she had not considered the 2017 investigation and 2018 warning to be a fitness to practise issue, the NHS did, and so did the GPhC because they had informed the NHS of it. She knew that the NHS considered that she had not declared something that they considered to be material, as they had asked her in their letter of 22 August to explain it. And she knew that they considered the failure to declare it to be something that they could rely on to refuse La Vie’s relocation application.

[71]We find that at this point, the failure to respond substantively to the 22 August 2025 letter with any explanation as to the circumstances of the 2017 investigation, or as to why this had not been declared, and to simply say that the previous answer from 2013 remained accurate and up to date, was both disingenuous and dishonest within the meaning of Ivey. As Mr Dos Santos put to Ms Nwokocha-Ahaaiwe, it cannot logically be the case that information submitted in 2013 can still be up to date in 2025 if there had been an investigation into Ms Nwokocha-Ahaaiwe’s activities in 2017 which had now been raised with her. At the very least, there should have by then been doubt in Ms Nwokocha-Ahaaiwe’s mind as to the accuracy of her previous declaration. But rather than accept this, it is obvious that Ms Nwokocha-Ahaaiwe doubled down on her previous assertion. In our view at that point, Ms Nwokocha-Ahaaiwe plainly knew of the investigation and the assertion that she had received a warning but most importantly that the NHS regarded this as a fitness issue. She continued to refuse to acknowledge it or to explain it, and in effect insisted that the regulator rely on the previously submitted information.

[72]We also note that at no time after that response on 4 September did the Appellant provide any other response to the regulator; or to suggest that she wanted to; or to ask for more time to submit further information that she was seeking from others.

[73]The form completed by La Vie and by Ms Nwokocha-Ahaaiwe with individual declarations contains undertakings not only that the information provided was true and complete but also that any material changes to the information provided would be notified within 7 days (see bundle, pages 61 (company) and page 67 (Superintendent Pharmacist). We consider that at this point, Ms Nwokocha-Ahaaiwe must have known that the information she had provided in 2013 was no longer accurate and up to date. The NHS had effectively told her so, as had the GPhC (indirectly). In our view, maintaining at this point that there were no fitness to practise issues to declare was, by the standards of ordinary decent people, dishonest. We therefore find that Ms Nwokocha-Ahaaiwe’s response to the 22 August 2025 letter was itself dishonest. And we note that for these purposes, it does not matter whether Ms Nwokocha-Ahaaiwe herself considered that her answer was dishonest. It appeared she did not. But in our view to any objective ordinary person, it plainly was.

[74]We are at a loss to understand why it was Ms Nwokocha-Ahaaiwe took this position on La Vie’s application. There appears to be no particular reason to motivate such a response. Ms Nwokocha-Ahaaiwe had almost nothing to gain from such dishonesty, and the tragedy here is that as Mr Shah and Mr Wallman both said, had Ms Nwokocha-Ahaaiwe declared the position accurately at that point, the NHS would almost certainly have accepted her explanation and moved on to consider the rest of La Vie’s application. We can see from the documents, from the history and from how the 4 September 2025 response begins, that Ms Nwokocha-Ahaaiwe was evidently annoyed by the fact that La Vie had had to make 3 applications for relocation; that it had paid 2 lots of fees; that it was fighting a court case with its former landlord and was locked out of its own long-standing premises; that it had no income; and that there was a lot of bureaucracy involved in the NHS application. In this context, the continuing delays in having matters dealt with, the requests for additional documents and confirmations with very short turn-around deadlines, simply, in the eyes of La Vie, to be able to move from one postcode to another to continue operating a successful pharmacy must have been deeply distressing and frustrating. We understand that. But ultimately, it is incumbent on all professionals to be candid with a regulator undertaking regulatory checks at all times, however provoking that experience may appear to be. It is not appropriate to simply swipe concerns of this nature away.

[75]We turn now to consider the response of the respondent to these issues. Was the decision to refuse the application fair, proportionate and reasonable?

[76]We have included considerations of fairness in this topic because it was a key complaint of the Appellant that the decisions reached in La Vie’s case were procedurally unfair. We do not agree. La Vie completed the 3rd application on 16 December 2024. They were fairly asked to re-complete the fitness to practise questionnaire in January 2025, on the assumption that the NHS no longer had access to this material. For much of this case, Ms Nwokocha-Ahaaiwe said that this itself was unfair because the NHS never told her that they no longer had this information and that they should have still had it. She also at times said the nature of La Vie’s application made it unnecessary for this information to be required. We have already dealt with some of these issues. The application to move areas plainly required the submission of fitness information or confirmation of previously provided information. Given the terms of paragraph 5(4) of Schedule 2 to the Regulation, it was always open to the NHS to require resubmission of this information in any event. It is unclear why La Vie and Ms Nwokocha-Ahaaiwe spent so long fighting that requirement if they had nothing to declare and nothing to conceal.

[77]But they were also given fair opportunity in our view to respond to the issues that arose, when they arose. There was no requirement to give them multiple opportunities to explain the discrepancies in their application declarations. We are satisfied that by the time of the preparation of Mr Shah’s Board report in January 2026, La Vie had had every opportunity to put, and to correct, their application.

[78]Mr Wareing took issue with how the decision had been made by the NHS and in particular with what he said was the failure of the decision- making committee to have regard to the terms of regulation 33(3) in reaching its decision, when this is a mandatory requirement. He submitted that this procedural failure should, of itself, render the decision liable to be quashed on the basis that the decision was fundamentally flawed. It was common ground between the parties that if we did allow the appeal, the decision as made should be quashed and we should remit the matter to the decision-maker to make again based on our decision and the evidence before it.

[79]Mr Dos Santos said that although regulation 33(3) did apply, it was mostly irrelevant in the context of this case because the dishonesty relied upon was contained in the application itself, and was of such a nature that refusal could be the only appropriate response.

[80]In our view the error made by the Appellant in this case was to look in paragraphs 2 to 7 their skeleton argument, at the regulation 33(3) criteria through the lens of analysing the 2017-2018 investigation and whether that justified a refusal of inclusion in the list. In fact, it was common ground that it didn’t: the evidence was that if declared the NHS would not have considered this to be problematic. Rather, the regulation 33(3) criteria must be considered against the issue that was relied on to justify refusal and in this case it was the failure to declare the 2017-18 investigation in the form and then to fail to explain satisfactorily why it had not been declared. That much is clear from the Board report and the Minutes of the meeting of the PSRC, the latter of which accompanied the decision letter.

[81]That said, we were troubled by the evidence of Mr Shah and Mr Wallman that they had not considered regulation 33(3) or the criteria in it at all, and that they considered it irrelevant. No mention was made of any of the criteria in the board report or minutes, not even to the extent of saying that they had been considered but in the context did not appear to have much applicability. We can see how in some cases the criteria in regulation 33(3) might be said to have limited relevance, but in our view the terms of regulation 33(3) are such that the decision-maker must diligently consider them in any event even if it is to conclude that they do not assist with the final decision.

[82]Having reviewed regulation 33(3) and its criteria for ourselves, however, and having asked ourselves what impact those factors would have on the eventual decision, we have concluded that in the circumstances of this case, those factors would not have led the regulator to a different outcome.

[83]The regulator here had a discretion whether to refuse inclusion in the pharmaceutical list for Bromley on the basis of the failure to make an accurate declaration. In our view it was legitimate for the regulator to have regard to the fact that this involved a lack of honesty and integrity in the mandatory fitness to practise declarations, certainly by the time the decision came to be made. In particular, Mr Shah’s statement noted that in failing to acknowledge that the information provided was not accurate, the Appellant had shown a lack of insight into her mistake, how the mistake had occurred or why the regulator considered it a problem. The failure to correct the error was clearly the decisive issue, both in the decision as sent to La Vie and also in the oral evidence of the witnesses. It is also the point at which we have found that there was dishonesty.

[84]We have regard to the point made in Hussain Hussain v FCA

[2018] UKUT 186

at [224]. (AAC). that a lack of candour with a regulator is a very serious issue. The same principle must apply in all professional contexts to all regulators. The regulatory process relies, in large part, on a regulator having trust and confidence that those they regulate will keep them informed of relevant matters and will be honest and candid when this is required. A failure to do so strikes at the heart of the efficacy of a regulatory regime. And if the regulator does not consider that it can trust a regulated individual or company, it is hard to see how that could be remedied through conditions being imposed. It could be remedied over time by a demonstration of reliability; but the ‘offence’ here was immediate and bound up with the inclusion application itself.

[85]We also have regard to the fact that such omissions can have an impact on public confidence in a profession. In Bolton v Law Society

[1994] 1 WLR 512

, at p. 518H (per Lord Bingham MR). it was said in the context of the regulation of solicitors:

“The second purpose is the most fundamental of all: to maintain the reputation of the solicitors' profession as one in which every member, of whatever standing, may be trusted to the ends of the earth. To maintain this reputation and sustain public confidence in the integrity of the profession it is often necessary that those guilty of serious lapses are not only expelled but denied re-admission. If a member of the public sells his house, very often his largest asset, and entrusts the proceeds to his solicitor, pending re-investment in another house, he is ordinarily entitled to expect that the solicitor will be a person whose trustworthiness is not, and never has been, seriously in question. Otherwise, the whole profession, and the public as a whole, is injured. A profession's most valuable asset is its collective reputation and the confidence which that inspires.”

[86]We remind ourselves, of course, that the decision we are making is not one as regulator but one about the inclusion of a company to be on the pharmaceutical list for Bromley. We accept that the GPhC has accepted that Ms Nwokocha-Ahaaiwe is suitable to be a pharmacist and has good standing in the profession. But as part of a company seeking inclusion in a pharmaceutical list to provide medicines to the public on behalf of the NHS, similar considerations of the need to maintain public confidence in the NHS pharmacy system arise. In our view, we also need to give appropriate weight to the need to maintain public confidence in the system so that the NHS can be assured that those who provide services to it are honest with them. We consider that the public would be concerned to find that someone who had not been candid about their regulatory history was allowed to be registered to provide pharmaceutical services to the public notwithstanding their lack of candour and their refusal to acknowledge any errors.

[87]In conclusion and taking all relevant matters into account and for the reasons set out above, we do not accept that the company satisfied the ICB as to its fitness because of the lack of honesty about the regulatory history, and the failure to correct that history even when it was put to the company’s Superintendent Pharmacist. The dishonesty relied upon was immediate and directed at the regulator. Its relevance to the provision of pharmaceutical services was that it called into question whether the Appellant or its Superintendent Pharmacist understood what amounted to a fitness to practise issue, and whether they would be candid about them in and when these arose. We noted the evidence of Ms Nwokocha- Ahaaiwe to the Tribunal that now she would tick the box on the form to declare the incident ‘whether it was true or not’. That does not provide reassurance that the Superintendent Pharmacist understands her obligations to the regulator or takes them seriously.

[88]In all the circumstances, we consider that the refusal was a reasonable and proportionate step. That being so, we confirm the decision of the ICB. The appeal is dismissed. 91. First-tier Tribunal (Health, Education and Social Care) Date Issued: 25 August 2026 Decision:89. The Tribunal confirms the decision of the South-East London Integrated Care Board to refuse inclusion in the Pharmaceutical list for the London Borough of Bromley to La Vie on the grounds set out in Regulation 33(2)(d) of The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013.

90. The appeal is dismissed. Judge S.A. Trueman District Tribunal Judge