Fitness to Practise · Legal Commentary

Delay and Interim Orders: The Case for Change

Why an interim order imposed years after the event may be wrong in principle — and why registrants across every regulator should not simply accept it.

If you have been through fitness to practise proceedings, you may know the feeling. The investigation ran its course. You carried on working. Months passed, then a year, then two. And then, out of nowhere, comes an interim order — an interim suspension order, or interim conditions of practice — landing on your career long after the events that triggered it. Or perhaps you are living it right now: sitting in front of an interim order hearing, wondering why, after all this time, you are suddenly said to pose a risk that is urgent, current and immediate.

That experience is not unique to any one profession. It is felt by nurses and midwives facing an NMC interim order, doctors before the GMC, dentists before the GDC, pharmacists before the GPhC, optical professionals before the GOC, social workers facing a Social Work England interim order, and the many professions regulated by the HCPC. The regulator changes; the pattern does not. Our interim order solicitors defend registrants across all of them.

That question — why now? — is not naïve. It goes to the heart of what an interim order is for, and it exposes a tension in the way some regulators, and at least one recent authority, have approached delay. This article sets out why we believe the current position, as reflected in the Social Work England authority of Northover, is open to serious challenge, why the weight of principle across all the regulators points the other way, and why this is a subject that is ripe for appeal.

What an interim order actually is — and what it is not

An interim order is a holding measure. It is imposed before any final finding of impairment, while allegations are still being investigated or determined. Its statutory purpose is protective, not punitive. Whatever the regulator — NMC, GMC, GDC, GPhC, GOC, HCPC or Social Work England — an interim order, whether an interim suspension order or a set of interim conditions of practice, can only properly be made where it is necessary for the protection of the public, otherwise in the public interest, or in the registrant’s own interests.

The critical word is necessary. Not convenient. Not reassuring. Not desirable. Necessary. An interim order is one of the most serious things that can happen to a professional short of erasure, because it stops them earning a living and marks their name before anything has been proven. The law has long recognised that the bar for such a measure is high, and that it must be justified by evidence of present risk — not by the mere gravity of an allegation, and not by the passage of time alone.

That is precisely where delay becomes so important — and the principle is the same whichever regulator you appear before.

The problem with delay

Delay cuts against the logic of an interim order in two ways.

First, it undermines urgency. An interim order is, by its nature, an emergency brake. If a regulator has allowed two years to pass while the registrant continued to practise, it is difficult to see how the situation can suddenly be characterised as one of immediate and pressing risk. There is an obvious irony in asserting that a matter is too urgent to wait for a full fitness to practise hearing, when the regulator itself did not treat it as urgent for a very long time.

Second, and more importantly, delay generates evidence. Every month a registrant practises without incident is a data point. It is real-world evidence, tested in the workplace, that the feared risk has not materialised. A period of safe, unremarkable practice during the very window in which the registrant was said to be dangerous is not neutral. It is positive evidence that the risk is limited, or that it does not exist at all.

This is not a matter of sympathy. It is a matter of proper risk assessment. And the numbers — as well as the case law — bear it out.

The numbers: how often interim restriction ends in no finding

Interim orders are not rare. They are imposed in their hundreds every year, across every regulator, against professionals who have not been found to have done anything wrong.

Here is the crucial, and troubling, gap. None of the regulators routinely publishes the cross-tabulation that would tell the public precisely how many of the professionals placed under an interim order were later found to have no case to answer, no impairment, or facts not proved. The figures are reported side by side, but never joined up. Yet even taken separately they tell a clear story: large numbers of registrants are restricted pre-emptively, and a substantial minority of cases end with no adverse finding at all. That a professional can lose their livelihood on an interim basis — sometimes for years — and then walk away with no finding against them is not a hypothetical. On these numbers it happens routinely.

That absence of published linkage is itself an argument for change. If interim orders are truly reserved for cases of genuine, current risk, the outcome data should show it. The fact that regulators do not publish it, and that the headline outcome figures show so many cases collapsing to no finding, should give any panel pause before treating an interim order as a routine step.

The relevant case law

There is a body of authority of direct relevance to how delay and interim orders should interact. Importantly, although these cases arise before different regulators, the courts have treated the underlying principles as common to all of them. Taken together, the authorities point strongly against the imposition of the most restrictive interim measures years after the event, and against justifying such measures on public interest grounds save in genuinely rare cases.

Bradshaw: the irony of asserting urgency after delay

In Bradshaw v General Social Care Council [2012] UKFTT 3 (HESC), the tribunal criticised delay on the regulator’s part and recognised the “irony” of asserting urgency while having allowed a substantial period to pass. It held that where a registrant has practised without incident for a significant period since the alleged events, the justification for the most restrictive interim measures is weakened.

Bradshaw is persuasive support for a straightforward proposition: delay, and uneventful practice during that delay, undermine any assertion of current and immediate risk — and therefore point strongly against interim suspension or its equivalent, in front of any panel.

Persand and Sheikh: necessity, intense focus, and the rarity of public interest suspension

The now well-known case of Persand v NMC [2017] EWHC 3356 (Admin) is essential reading on this subject. On the question of public protection, the Court held at paragraph 41:

“It seems to me that, in every case, the NMC Committee and the Court, has to ask itself precisely why it is said to be necessary to impose an interim sanction on the nurse. If the case is that it is necessary to protect patients, then there needs to be an intense focus on precisely how and why the evidence demonstrates that patients may be at risk from the nurse and how serious that risk is………..”

That is the test in a sentence: an intense focus on precisely how and why the evidence demonstrates present risk. Not a generalised sense of unease. Not the seriousness of the allegation standing alone.

On the public interest limb, Persand drew on R (Sheikh) v General Dental Council [2007] EWHC 2972, quoting at paragraph 21 the observation of Davis J at paragraph 16 of Sheikh:

“It is a very serious thing indeed for a dentist or a doctor to be suspended. It is serious in many cases just because of the impact on that person’s right to earn a living. It is serious in all cases because of the detriment to him in reputational terms. Accordingly, it is, in my view, likely to be a relatively rare case where a suspension order will be made on an interim basis on the ground that it is in the public interest”

The Court in Persand then made clear, at paragraph 22, that this applies with equal force across the regulated professions:

“Those observations are equally applicable to the suspension of a nurse as they are to the suspension of a doctor or dentist. It appears clear from the approach taken by the Committee in this case that the initial suspension was imposed, in part, because the Committee was concerned that sanctions were justified because ‘an informed member of the public would be concerned if a registered nurse facing such allegations was allowed to practise without restriction whilst an investigation is carried out by the NMC’. It seems to me that such an approach is inconsistent with the above dictum because it would justify suspension on public interest grounds in almost every case where a nurse faces serious allegations. I agree with Davis J that an order on public interest grounds is only justifiable in a relatively rare case. There must be something in the evidence of the individual case which far more substantial than anything arising here to justify a public interest suspension. That must be far more than a concern that a hypothetical member of the public might have a concern if no interim sanction was imposed…..”

Note the reach of that reasoning. It expressly moves from dentists to nurses to doctors, and the logic applies just as readily to social workers, pharmacists, optical professionals and every profession regulated on the same statutory footing. Public interest suspension is meant to be rare. The instinct that “a member of the public would be worried” cannot, on its own, do the work — because if it could, it would justify suspension in almost every serious case, which is exactly what the law does not permit.

Pestano: safe practice is evidence of limited or no risk

The most recent and pointed authority on delay is NMC v Pestano [2026] EWHC 1426 (Admin). At paragraph 24, the Judge held:

“If a nurse has been practising without issue in their professional life, especially if it is during the period of alleged risk, then that is likely to be evidence that there is limited, or no, risk to the public. The longer the period in which no issue has been identified, the stronger the evidence will be. Evidence from an employer of either the existence of issues or an absence of issue will clearly be of significant evidential value. Employers, however, generally have a duty to inform the regulator of issues. If there is no evidence from any employer of an issue then it is likely to be reasonable to infer that there has been no material issue in the clinical practice of the registrant”.

This is the point made concrete. Continued safe practice — particularly during the period of alleged risk — is evidence. The longer it goes on, the stronger it gets. And where employers, who are under a duty to report concerns, have raised none, the reasonable inference is that there has been no material problem. Although Pestano concerns a nurse, the principle is not profession-specific: it turns the passage of time, in any registrant’s career, from a background fact into a central evidential consideration that weighs against an interim order. Read alongside the outcome statistics above, Pestano gives an evidential name to what the numbers already suggest — that many of those restricted were never a present risk at all.

Where we say the law has gone wrong: Northover

Against that backdrop sits Northover v Social Work England [2023] EWHC 3259 (Admin). In Northover, the High Court appeared to downplay the significance of delay and to accept a precautionary approach that tended to support interim restrictions despite the passage of time.

We say, with respect, that Northover is wrong in principle — and wrong not just for social workers, but for every registrant, because interim order panels across all the regulators draw on the same authorities.

It is wrong because it fails to grapple with the way delay informs present-day risk and proportionality. Delay is not a neutral backdrop to be noted and set aside; on the authorities above, it is evidence that bears directly on whether an interim order is necessary today. An approach that treats a long, incident-free period as broadly irrelevant is difficult to reconcile with Bradshaw, with the “intense focus” demanded by Persand, and with the evidential weight that Pestano expressly attaches to safe practice over time.

It is also wrong because it risks allowing precautionary measures to become punitive. An interim order justified not by current risk but by the seriousness of an allegation, or by a generalised desire to be seen to act, drifts away from necessity and towards desirability. That is the very slide the higher authorities warn against. Northover appears to stray into the possibility of an interim order being imposed on the basis of desirability rather than necessity — and necessity, properly understood, must be grounded in current risk, not purely in the gravity of what is alleged.

If an interim order can be justified simply because an allegation is serious and a hypothetical member of the public might be concerned, then the “relatively rare case” described in Sheikh and endorsed in Persand becomes the ordinary case — before every regulator, not just Social Work England. On the outcome data, that is a real risk, not a theoretical one. That cannot be right.

The case for change — and for an appeal

This is why we believe the subject is ripe for challenge. The tension between Northover on the one hand and Bradshaw, Persand, Sheikh and Pestano on the other is not academic. It decides real cases, across every profession. It determines whether a social worker, a nurse, a doctor, a pharmacist, an optical professional or any other registered professional keeps working while allegations are resolved, or is suspended for a period of delay that the regulator itself created — and, on the statistics, sometimes for allegations that are never proved.

The principled position, we submit, is this. Necessity must be grounded in current risk. Delay and uneventful practice during that delay are evidence that current risk is limited or absent, and the longer the safe period, the stronger that evidence. Public interest suspension is reserved for the rare case, supported by something substantial in the evidence, not by the reflex that the public might be uneasy. An interim order that cannot be tied to a present, evidenced, and serious risk is not a protective measure at all — it is a punitive one imposed before any finding has been made.

An authority that dilutes those safeguards deserves to be revisited. We consider that Northover should be appealed, or at least distinguished and confined, so that the law returns to the clear line drawn by the higher courts — a line that protects registrants of every regulator equally. Alongside that, regulators should publish the outcome data for those subject to interim orders, so that the true rate of pre-emptive restriction without a final finding is transparent.

What this means if you are facing an interim order

If you are facing an interim order, an interim suspension order, or an interim order hearing before any regulator — the NMC, GMC, GDC, GPhC, GOC, HCPC, Social Work England or another — the timeline matters. The questions to ask are simple but powerful. Why is this said to be necessary now? What has changed? If you have been practising safely throughout the delay, where is the evidence of present risk? Has any employer raised a concern — and if not, what does that silence tell the panel?

Delay is not merely a grievance to be aired. On the authorities, it is a live evidential argument that goes directly to necessity and proportionality. Handled properly, it can be the difference between remaining in practice and being suspended for something that was never urgent in the first place.

Interim orders: frequently asked questions

This article is a commentary on legal principle and reflects the arguments we advance on behalf of registrants across the regulated professions. It is not legal advice and should not be relied upon as such. Every case turns on its own facts. All case-law quotations are taken from the judgments cited, and all statistics are taken from the regulators’ own published fitness to practise reports (NMC Annual Fitness to Practise Report 2024–2025; GMC Fitness to Practise Statistics 2024). If you are affected by any of the issues raised, seek advice on your individual circumstances.