In Ajana v NMC [2025] EWHC 3179 (Admin), the High Court upheld the Nursing and Midwifery Council’s decision to strike off Ms Olubokola Bridget Ajana, a midwife found to have committed serious misconduct following allegations from seven mothers between June 2020 and April 2021. The concerns included failures in basic care, inappropriate handling of a baby, and aggressive behaviour. After a 20‑day hearing, the Panel imposed a striking‑off order, which Ms Ajana appealed, seeking to have the sanction quashed or replaced with something less severe.

Reluctance of the Court to interfere with sanction decisions

The High Court approached the appeal through the lens of GMC v Bawa‑Garba [2018] EWCA Civ 1879, reaffirming that sanction decisions involve “multi‑factorial judgments, mixing facts, guidance, and the law.” Brunner J reiterated that an appeal court should only intervene where there is an error of principle, key evidence has been overlooked, there has been procedural impropriety, or the decision falls outside the bounds of what a reasonable panel could properly decide. The judgment confirms again that the scope for successful appeals against sanction remains narrow.

Procedural shortcomings identified – but not material

The High Court accepted that the Panel had not fully set out its evaluation of the mitigating material advanced by Ms Ajana. Under the NMC’s Sanction Guidelines, evidence of good character — including testimonials — should be taken into account. Ms Ajana had submitted positive testimonials from patients and colleagues, yet the Panel listed only a single mitigating feature: her action plan. This contrasted sharply with an extensive list of aggravating factors.

Although the Panel had referred to Ms Ajana’s character references in the impairment decision, they were not referenced again at the sanction stage. The Appellant argued that, had the mitigating factors been properly considered, a striking‑off order would have appeared disproportionate.

The High Court agreed that the Panel had made an error by conflating two distinct steps:

1. identifying and listing mitigating features; and
2. assessing the weight to be attached to them.

Brunner J concluded that the Panel had decided some mitigating factors carried little weight and, for that reason, did not list them — but best practice requires Panels to separate identification from evaluation. However, the Court was clear that this was not a material error and did not render the striking‑off decision wrong or unjust.

Conclusion

The threshold for appeal intervention remains high

The High Court reaffirmed that it will only interfere where there is a clear error of principle. Panels remain the primary decision‑makers, and appeals will not succeed simply because the outcome is considered harsh or because the appellant disagrees.

Procedural irregularities do not automatically undermine the decision

While the Panel’s treatment of mitigating factors was flawed, the error was not material in this case. The seriousness of the misconduct meant that a striking‑off order remained a justified and proportionate sanction.

Capsticks’ view

The High Court’s clear and concise judgment is notable for its strong endorsement of specialist Panels in sanction decision‑making and its continued reluctance to interfere where public protection is paramount. For appellants, this case underscores the difficulty of challenging sanctions where the underlying findings are serious and the panel’s reasoning remains within acceptable bounds.

The judgment also reinforces the importance of best practice in drafting decisions. To avoid the type of “error” identified by Brunner J, regulators may wish to consider:

• ensuring case presenters refer expressly to relevant mitigating factors in sanction submissions; and
• providing training or guidance to Panel members on the need to reference mitigating factors in their decisions, even where those factors are ultimately given little weight.

How Capsticks can help

Capsticks has extensive experience providing training to regulators and can assist with guidance or workshops for case presenters, Panel members, or in‑house legal teams, with a focus on decision‑making, sanction reasoning and appeal resilience. 

This article was co-authored by Michael Collis, Partner and Lauren Atwell-Thomas, Trainee Solicitor in our Regulatory Team. If you have any queries around what is discussed in this article, and the impact on your organisation, please speak to Michael Collis or anyone in our regulatory team to find out more about how Capsticks can help.