NMC Dishonesty & Competence: No Case to Answer

In 2024, our client, a midwife sonographer, was referred to the NMC after a significant cardiac abnormality was not identified at a 20‑week anomaly scan and one of the twins sadly died shortly after birth. The NMC alleged failure in assessment, failure to safeguard, poor record‑keeping, dishonesty, and lack of competence in sonography.

We were instructed early and worked closely with the registrant to produce detailed, structured written submissions. These accepted, in clear terms, that the cardiac anomaly had been missed, expressed genuine remorse, and carefully explained the clinical context: high scan volumes, equipment issues, systemic management gaps, and the fact that this was a discrete area of specialist practice. We then analysed the evidence against the NMC’s own guidance, showing that while a missed abnormality could amount to a competence concern, there was no evidential basis for any suggestion that our client knew the scan was abnormal, or that she had deliberately failed to escalate, refer or document concerns.

As a result, the case examiners accepted that there was no realistic prospect of proving the safeguarding, record‑keeping or dishonesty allegations and that, although some aspects of lack of competence might be capable of proof, there was no realistic prospect of a finding of current impairment. They placed particular weight on points we had advanced: our client’s consistent insight and ownership of the error, her otherwise positive midwifery record, supportive employer evidence, successful supervised practice, and her commitment not to return to sonography without formal retraining. Applying the “case to answer” test, the NMC closed the case with no further action and our client continues in employment without restriction.

This case illustrates how early, specialist advice can reshape an apparently very serious NMC case: narrowing the issues, neutralising unsustainable dishonesty and safeguarding allegations, and focusing decision‑makers on insight, remediation and realistic current risk. If you are facing similar concerns about missed diagnoses, competence or alleged dishonesty, tailored representation of this kind can be the difference between a full hearing and a closed file.

What this means if you’re facing similar allegations

A missed clinical finding does not automatically mean dishonesty, and serious-sounding allegations can often be narrowed before a full hearing. Early, specialist advice that separates a genuine competence issue from any suggestion of deliberate concealment — and that evidences insight and remediation — can be decisive. If you are facing similar concerns, how the case is framed at the investigation stage may change its outcome entirely.

Facing a NMC case? Learn more about our Nursing and Midwifery Council (NMC) defence services, or contact us for a free case evaluation.