Last reviewed by Jonathan Meadows (Solicitor, Regulation Resolution) on 21 July 2026.
Quick answer. In Professional Standards Authority v NMC and Tchampet [2026] EWHC 141 (Admin) (30 January 2026), the High Court allowed a section 29 appeal by the PSA and substituted a striking-off order for the nine-month suspension an NMC panel had imposed on a nurse found to have slept on duty while caring for highly vulnerable children, covered a CCTV camera, falsified observation records and initially lied in the investigation. The court held the panel’s reasoning was incomplete and unsound: the dishonesty formed a pattern across incidents, previous assurances had proved unreliable, and record falsification had been given too little weight. The case is a sharp reminder that sustained dishonesty — especially dishonesty within an investigation — points to erasure, and that insight accepted by a panel can be overturned on appeal.
Most registrants think of a fitness to practise hearing as the final word on sanction. It is not. Under section 29 of the NHS Reform and Health Care Professions Act 2002, the Professional Standards Authority (PSA) can refer a panel’s decision to the High Court where it considers the outcome insufficient to protect the public — and in recent years it has used that power repeatedly against NMC sanction decisions it regards as too lenient. Tchampet is the latest, and one of the starkest: a suspension replaced not with a longer suspension, but with erasure, by the court itself.
The facts
The nurse had twice slept on duty while responsible for critically dependent children. In 2015–16, she slept while caring for a child with severe epilepsy who required constant monitoring. In 2019, she slept for nearly four hours while caring for a ventilator-dependent ten-year-old — having covered the CCTV camera — and falsified observation records. When the 2019 incident was investigated, she initially lied before later admitting what had happened. The NMC panel found all the allegations proved, including dishonesty.
The panel’s decision — and where it went wrong
Despite those findings, the panel imposed a nine-month suspension, persuaded by the registrant’s insight and by five years of safe practice since the 2019 events. Mr Justice Griffiths held that reasoning incomplete and unsound. Three strands stand out:
- Assurances had failed before. The registrant had previously given assurances about her practice which “turned out not to be a reliable indicator” — a panel must confront that history before relying on similar assurances again.
- The dishonesty was a pattern, not a lapse. Covering a camera, falsifying records and lying to investigators across separate incidents could not be treated as isolated conduct.
- Falsification was underweighted. The falsified observations were serious misconduct in their own right, which the panel had effectively overlooked at sanction.
Rather than remitting for a fresh decision, the court substituted the sanction itself: striking off (PSA commentary).
What Tchampet means for registrants and panels
Three practical lessons follow. First, dishonesty within the regulatory or employer investigation is treated as gravely as the underlying misconduct — often more so, because it goes to whether the regulator can ever trust the registrant’s account. A registrant who has not been frank at the outset needs to address that head-on, with genuine and evidenced insight, not gloss over it. Second, insight must be demonstrated against the registrant’s own history: where past assurances have failed, a panel — and therefore the defence — must explain concretely why this time is different. Third, a favourable panel outcome is not safe until the PSA’s referral window has passed; sanction submissions should be built to survive a section 29 appeal, which means squarely engaging with the aggravating features rather than hoping the panel overlooks them. These pressures only intensify under the NMC’s new fitness to practise rule changes, which put legally qualified chairs and tighter case management at the centre of hearings.
Tchampet sits in a line of PSA appeals in which the High Court has intervened on NMC sanctions — we have analysed an earlier example in our note on PSA v NMC (EWHC 637 (Admin)). The direction of travel is consistent: panels that under-reason leniency invite reversal.
How we help. Regulation Resolution represents nurses and midwives at NMC misconduct hearings and in High Court appeals, including responding to PSA section 29 referrals. If your case involves dishonesty allegations, the framing of insight and sanction is where it will be won or lost — get advice before the hearing, not after.
Frequently asked questions
Can the PSA appeal an NMC decision?
Yes. Under section 29 of the NHS Reform and Health Care Professions Act 2002, the PSA can refer a final fitness to practise decision to the High Court where it considers the sanction insufficient for public protection. The court can quash, remit, or substitute its own decision.
What happened in PSA v NMC and Tchampet?
The High Court allowed the PSA’s appeal against a nine-month suspension imposed on a nurse who slept on duty while caring for vulnerable children, covered CCTV, falsified records and initially lied to investigators. The court substituted a striking-off order.
Why is dishonesty treated so seriously in fitness to practise cases?
Because regulation depends on trust in what registrants record and say. Dishonesty — particularly falsifying records or lying in an investigation — undermines that foundation, and the courts have repeatedly said sustained dishonesty will usually be incompatible with continued registration.
Can a sanction be increased on appeal?
Yes. On a PSA referral the High Court can substitute a more severe sanction, as it did in Tchampet — replacing suspension with erasure without sending the case back to a new panel.
Is a panel’s acceptance of my insight final?
No. If the panel’s reasoning is incomplete — for example, it fails to grapple with previous failed assurances or a pattern of dishonesty — the High Court can overturn it. Insight must be evidenced, specific and reconciled with the registrant’s history.