High Court upholds Striking-Off Order in – Ajana v NMC

Ms Ajana, a registered midwife with over 12 years’ experience, faced multiple allegations of misconduct while working at Barnet Hospital between June 2020 and April 2021. Complaints from seven mothers described aggressive behaviour, refusal to provide pain relief, neglect of basic care, and inappropriate handling of babies.

Among the most serious findings, the NMC panel concluded that Ajana had shouted at vulnerable patients, ignored requests for help, and in one incident shook a baby for several seconds and squeezed a mother’s nipple without consent. The panel determined that her behaviour was attitudinal, posed risks to patient safety, and breached fundamental tenets of the profession.

Following a 20-day hearing, the NMC’s Fitness to Practise Committee imposed a striking-off order, finding that lesser sanctions would not protect the public or maintain confidence in the profession.

Grounds of appeal

Ajana appealed solely against the sanction, not the findings of misconduct. Her counsel argued that:

• The panel gave insufficient weight to mitigating features, including her completion of an action plan and subsequent practice without incident.
• The panel failed to properly consider a suspension order, dismissing it on the basis of attitudinal concerns.
• The panel wrongly equated her denial of allegations with lack of insight.
• The proportionality of striking-off was not adequately assessed, particularly regarding risk of repetition.
• The panel’s treatment of mitigation evidence was flawed, omitting references and training records from its list of mitigating features.

Court judgment

Mrs Justice Brunner, sitting in the Administrative Court, rejected all grounds of appeal. She held that:

• While the panel erred in not listing all mitigating features, it had considered them elsewhere in its reasoning, so the omission was not material.
• The panel’s conclusion that Ajana’s behaviour reflected deep-seated attitudinal issues was justified, given the repeated pattern of misconduct over ten months.
• The panel did not equate denial with lack of insight; rather, it assessed her evidence and found her insight “not sufficiently developed.”
• The panel properly considered risk, concluding that despite recent incident-free practice, there remained a risk of repetition due to entrenched attitudinal concerns.
• The striking-off order was proportionate and necessary to protect patients, uphold public confidence, and maintain professional standards.

Justice Brunner emphasised that the misconduct involved serious failings towards vulnerable women and babies, including physical harm, and that the panel’s expertise carried particular weight in assessing ongoing risks. The appeal was dismissed, and Ajana was ordered to pay the NMC’s costs of £7,247.

The ruling in Ajana v Nursing and Midwifery Council [2025] EWHC 3179 (Admin) reinforces the principle that striking-off is appropriate where misconduct raises fundamental questions about professionalism and patient safety. The case underscores the courts’ deference to regulatory panels in sanction decisions, particularly where vulnerable patients are at risk.

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