AC-LON-2023-002572 - [2025] EWHC 2324 (Admin)

As to the striking-off order, the Panel meticulously identified and weighed the relevant factors in the published guidance (as included in the authorities bundle). Nothing irrelevant was considered. Nothing relevant was omitted. The published guidance on striking off was considered in appropriate detail and used as the framework for the Panel’s decision. The Panel rationally and reasonably concluded:

“The panel was satisfied that the misconduct in relation to medication administration is capable of remediation. However, the panel considered that it is extremely difficult to remediate dishonesty and attitudinal behaviours. Therefore, the panel carefully considered the evidence before it in determining whether or not Mrs Tsolo has strengthened her practice. The panel was of the view that Mrs Tsolo has not demonstrated her strengthened practice, nor has she undertaken any training at an appropriate level. The panel noted that the breaches of the interim orders which were deliberate showed a disregard to her regulator and represent a deep-seated attitudinal issue. Where the panel found dishonesty, it would expect Mrs Tsolo to demonstrate that she has gained clear insight and that there would be no repetition. The panel was of the view that Mrs Tsolo had not yet been able to demonstrate that she would know exactly where to turn to should she find herself in a similar situation, and she had not satisfied it that the risk of repetition was sufficiently reduced. It further noted that there has been a failure to follow simple instructions.”

The Panel considered the three questions set out in the guidance:

“Mrs Tsolo’s actions were significant departures from the standards expected of a registered nurse and are fundamentally incompatible with her remaining on the register. The panel was of the view that the findings in this particular case demonstrate that Mrs Tsolo’s actions were extremely serious and to allow her to continue practising would undermine public confidence in the profession and in the NMC as a regulatory body.

Balancing all of these factors and after taking into account all the evidence before it during this case, the panel determined that the appropriate and proportionate sanction is that of a striking-off order. Having regard to the effect of Mrs Tsolo’s actions in bringing the profession into disrepute by adversely affecting the public’s view of how a registered nurse should conduct herself, the panel has concluded that nothing short of this would be sufficient in this case.

The panel considered that this order was necessary to mark the importance of maintaining public confidence in the profession, and to send to the public and the profession a clear message about the standard of behaviour required of a registered nurse.”

The Panel found seriously dishonest conduct by the appellant. When charges of dishonesty are found proved, being struck off is a real risk for practitioners. In Parkinson v Nursing and Midwifery Council [2010] EWHC 1898 (Admin), Mitting J stated at para 18:

“A nurse found to have acted dishonestly is always going to be at severe risk of having his or her name erased from the register”

Further, Collins Rice J held in General Medical Council v Donadio [2021] EWHC 562 (Admin) (“Donadio”) at para 51:

“52.

There is no doubt whatever about the seriousness with which the decided appeal cases regard dishonesty. I was referred to Nicholas-Pillai v General Medical Council [2009] EWHC 1048 at paragraph 27 (untruthful record-keeping), Khan v GMC [2015] EWHC 301 (Admin) at paragraphs 6-9 (fake prescriptions for controlled drugs for financial gain), and GMC v Theodoropolous [2017] EWHC 1984 (Admin) at paragraphs 35-47 (false record of registration details used to obtain a locum placement). These are examples comfortably within what the Sanctions Guidance says about dishonesty, and the appellate courts are unhesitating in their view that dishonesty persisted in, coupled with a lack of insight, is a powerful indicator for erasure.”

Further, in Donadio, the court held that breaching a conditions of practice order deliberately is a very serious matter (para 71), and quashed a sanction short of erasure. There is nothing to indicate that the striking-off order was “excessive”, as the appellant submitted. It is a decision that cannot be characterised as “wrong”. It is a logical, reasonable and rational consequence of the appellant’s proved misconduct and impairment. Vulnerable patients were put a serious risk by the appellant’s deficient conduct and she has proved to be seriously dishonest with next to no insight, engaging in repeated and deliberate regulatory breach. It is, as commonly stated, difficult to remediate dishonesty.