The past few months have seen the publication of judgments in three Professional Standards Authority cases. In this article, we summarise the issues arising.

GMC & Anor v Gilbert [2026] EWCA Civ 53

The Court of Appeal dismissed an appeal brought by the GMC and the PSA against the decision of Calver J in relation to their earlier appeal against the decision of the Medical Practitioners Tribunal (“MPT”) to order the suspension of Dr Gilbert for a period of eight months. Calver J had allowed the appeals in part, found that two further allegations proved and substituted a twelve month suspension with review. The GMC and the PSA argued that erasure was the only appropriate sanction.

Mr Gilbert was a Consultant Transplant and Vascular Access Surgeon at Oxford University Hospitals NHS Foundation Trust. He was alleged to have engaged in inappropriate conduct on various occasions between 2009 and 2022 towards six colleagues. His actions were found by the MPT in August 2024 to have been sexually motivated, an abuse of his position and to have constituted sexual harassment (in addition to a finding of racist conduct).

The appeal was concerned with the issue of whether Calver J should have remitted the matter rather than substituted his own sanction decision and whether, having decided to make the sanction decision himself, he had properly applied the GMC Sanctions Guidance. The GMC argued that 7 out of the 10 factors that indicated erasure were present in this case.

The Court of Appeal was not persuaded. Lord Justice Bean held (at paragraph 62):

“In a case where several allegations have been found proved and the Tribunal is deciding whether the ultimate sanction of erasure is necessary the judgment should be based on an evaluation of the overall gravity of the matter. This is a question of substance rather than of counting how many factors out of ten were present and on how many occasions, as though paragraph 109 was a form of score sheet against which the Tribunal should place ticks or crosses and then count up the number of ticks… The GMC’s somewhat repetitive style of pleading allegations runs the risk of encouraging a score sheet approach”.

Lady Justice Andrews supported the dismissal of the appeal and held (at paragraph 71):

“… Erasure was not the default position from which any departure had to be justified…What matters far more than any labels is the substance of what the registrant actually did, which might well be characterised in more than one of the ways identified in the Guidance”.

The Court rejected the PSA’s arguments. Lady Justice Andrews held described the submissions made by the PSA as variants of the GMC’s primary ground of appeal – that erasure was the only rational outcome, for which permission to appeal had been refused and that had been rejected by Calver J for what Lady Justice Andrews described as “unimpeachable reasons”.

The judgment provides a reminder of the status of sanctions guidance as an “authoritative steer” rather than a straitjacket or checklist mandating a particular outcome, and of the need for sanction decisions to involve a rounded, evaluative judgment of the conduct, the seriousness of it and what the public interest requires.

In an earlier judgment dated 9 December 2025, the High Court had refused an application made by the PSA for an interim injunction requiring Dr Gilbert’s suspension to be continued pending the outcome of the appeal proceedings. The suspension had been reviewed at a hearing on 2 September 2025 and Dr Gilbert’s fitness to practise was found not to be impaired. The PSA has lodged an appeal against that decision on three grounds.

Applying the American Cynamid principles, Mrs Justice Lang found that one of the PSA’s three grounds had a real prospect of success but that the balance of convenience did not favour the granting of the application given that the Court of Appeal’s determination of the matter had been expedited.

PSA v (1) NMC & (2) Tchampet [2026] EWHC 141 (Admin)  

In PSA v (1) NMC & (2) Tchampet [2026] EWHC 141 (Admin) the High Court allowed the PSA’s appeal against a decision of a panel of the NMC Fitness to Practice Committee to impose a nine month suspension and substituted the sanction of erasure. Ms Tchampet had been found to have fallen asleep on duty when in sole charge of a highly vulnerable child in a home setting.

This was the second time Ms Tchampet had faced allegations of falling asleep on duty and falsifying records and had previously received a 12 month warning for doing so. In the case  for which she was ultimately erased, the allegations found proved included that she had covered a CCTV camera so as to avoid discovery, had fallen asleep on duty, had made dishonest records stating that she had carried out observations when she had not and dishonestly concealed the fact that she had slept when responding to her employer’s investigation.

Mr Justice Griffiths allowed the PSA’s appeal on all grounds.  He found that the panel had failed to properly apply the relevant Sanctions and Fitness to Practise Guidance and that the balance of factors identified in that guidance pointed clearly to striking off rather than suspension. He held that the reasoning of the Panel was incomplete and unsound and did not support its conclusion that suspension was an appropriate and sufficient sanction. The Panel’s own findings of primary fact supported the “inevitable and correct” decision to strike Ms Tchampet off the register.

PSA v (1) NMC and (2) Graham [2025] EWHC 3132 (Admin)  

The case of PSA v (1) NMC and (2) Graham [2025] EWHC 3132 (Admin) related to NMC guidance that permitted registrants to “lapse with impairment”. That outcome had been made in relation to Mr Graham who had been subject to a lengthy suspension in relation to allegations that involved his interactions with a teenage girl while working as an acute mental health nurse. Mr Graham had denied the allegations and while he did not wish to return to nursing, he did not wish to be struck off. In light of that wish and the NMC’s guidance, a panel of the NMC’s Fitness to Practise Committee decided that his registration should be allowed to lapse with a finding of impairment.

HHJ Karen Walden-Smith allowed the PSA’s appeal against that decision and substituted the sanction of striking off. The panel had not properly applied the relevant guidance and its reasoning for doing so was inadequate. The panel had failed to justify why a decision to allow Mr Graham to lapse with impairment satisfied the need to maintain public confidence and proper standards in the profession and was not a decision that was reasonably open to the panel following the NMC guidance.

Capsticks’ view

These cases provide a useful reminder of the importance of the proper application of sanctions guidance, undertaken in the context of an evaluative assessment of the seriousness of the conduct and all the circumstances of the case and used as an authoritative steer rather than a checklist. The need for proper reasoning is also reinforced and as is the need for panels to ensure a ‘golden thread’ of consistency as between their findings of fact and their findings in relation to impairment.

How Capsticks can help

Capsticks’ market leading professional disciplinary practice acts for a wide range of statutory and non-statutory regulatory bodies. Our team of specialists is experienced at navigating both complex public law issues such as those discussed in this article as well as allegations concerning breaches of professional boundaries. To find out more, please contact Ros Foster, Partner, Regulatory Division.