NMC v Masih: High Court Limits Long-Running Interim Orders

A long-running interim order can affect a nurse’s or midwife’s ability to work, earn a living and maintain their professional registration. In Nursing and Midwifery Council v Moras Masih [2026] EWHC 2094 (Admin), the High Court refused the NMC’s application to extend an interim conditions of practice order.

The judgment is a reminder that an extension is not automatic. The regulator must put forward current, clear and complete evidence showing why restrictions remain necessary. The court must decide for itself; it is not there simply to approve the regulator’s request.

The judgment was handed down in August 2026 and was reported by 2 Hare Court on 13 October. You can read the High Court judgment and the case note published by 2 Hare Court.

What is an NMC interim order?

An interim order is a temporary restriction imposed while a fitness to practise case is ongoing. Depending on the circumstances, it may place conditions on a nurse’s or midwife’s practice or suspend their registration.

It is not a final decision that the allegations are true. Its purpose is to address an identified need for public protection, the wider public interest or the professional’s own interests while proceedings continue.

Under Article 31 of the Nursing and Midwifery Order 2001, interim orders are subject to review. Where an order needs to continue beyond the period initially allowed, the NMC can apply to the court for an extension. The court’s role is substantive: it must decide whether an extension is justified on the evidence before it.

Why did the High Court refuse the extension in Masih?

The case had a lengthy and complicated history. The investigations began in 2018, and the concerns related to alleged events between 2019 and 2022. Restrictions had affected Mr Masih’s registration for several years, including a period of suspension. The substantive proceedings had not concluded.

By the time of the extension application, a number of allegations had been dismissed during the substantive hearing. Other allegations remained unresolved, but none had been proved. The case had also experienced delays and difficulties with the preparation and presentation of information at reviews and hearings.

The High Court identified major gaps in the NMC’s evidence. Among other things, the application did not provide a properly updated charge sheet, clearly identify the evidence supporting the remaining allegations or explain how those allegations established a current risk to the public. The judge also criticised the evidence for not fairly setting out relevant developments, including the latest review and the conditions the NMC was asking the court to extend.

This mattered because the court needed to understand the current case, not simply its earlier history. It could not be expected to reconstruct the remaining allegations or fill in gaps in the regulator’s evidence.

The judge concluded that the NMC had not shown that continuing the conditions of practice order, whether in its existing or a reduced form, was necessary for public protection. The application to extend it was therefore refused.

The regulator must provide candid and complete evidence

A central message of Masih is that the regulator bears the burden of justifying an extension. The judge said that its evidence must be candid and complete; it should not depend on the professional or their representative being present to correct a false impression or supply missing details.

In practice, an extension application should give the court a clear account of matters such as:

• The allegations that remain and those that have been dismissed.
• The evidence said to support the unresolved allegations.
• The current assessment of any risk to the public.
• The history of the case, including reviews and previous extensions.
• The reasons the proceedings have not concluded.
• The proposed restrictions and why each remains necessary.
• Any relevant changes, including remediation or the practical impact of the order.

The judge stressed that a large bundle of documents is not a substitute for a focused explanation. The court needs to be able to understand both the reasons for seeking an extension and the points that may weigh against one.

Delay can count against an extension

Delay does not automatically mean an interim order must end. But the reasons for delay can be relevant when the court considers whether restrictions remain justified.

In Masih, the judge considered the history of the proceedings, the lack of progress and the effects of restrictions on Mr Masih. The case illustrates why an extension application should explain what has happened, what steps remain and why the proposed timetable is realistic.

A regulator’s lack of urgency or difficulty progressing a case may also affect how the court assesses the application. The court must weigh the evidence of any current risk against the time already spent under restrictions, the impact on the registrant and any steps taken to reduce risk.

The judgment also gave general guidance that an interim order should not usually last more than about one or two years in total, counting from when it was first imposed through any period sought by extension. This is not a fixed statutory cut-off or an automatic expiry rule. The court will consider the circumstances of each case, but repeated extensions require proper explanation and justification.

What about missed six-monthly reviews?

The judgment considered the statutory requirement for reviews, including after a court has extended an order. The court found that the relevant mandatory review requirements had not been met in Mr Masih’s case.

However, it did not conclude that missing a review automatically makes an interim order expire. Instead, a missed review can be relevant to the circumstances and to the question of whether a further extension is justified.

If you believe a review has not taken place on time, keep copies of the relevant decisions and correspondence. The dates, the order in force and any new evidence or change in circumstances may all matter. The effect on your case will depend on the particular history and applicable rules.

How nurses and midwives can prepare to challenge an extension

If the NMC applies to extend an order affecting your registration, seek advice promptly. Preparation should focus on the current application and evidence, rather than treating the hearing as a repeat of an earlier review.

It may help to:

1. Check the timeline. List when the order was made, when reviews took place, when extensions were granted and what progress has been made in the substantive case.
2. Identify what has changed. This could include allegations being dismissed or narrowed, new evidence, a change in work arrangements or training and remediation undertaken.
3. Examine the proposed restrictions. Consider whether each condition addresses a specific, current risk and whether a less restrictive measure could manage it.
4. Explain the practical impact. Gather evidence about work opportunities, income, registration or revalidation requirements, and other effects of the order.
5. Respond to the evidence carefully. If information is incomplete, outdated or inaccurate, identify the issue clearly and refer to supporting documents where available.

These are practical considerations, not a guarantee of a particular outcome. An interim order hearing is fact-specific, and the court may grant, refuse or adjust an application depending on the evidence and applicable law.

What Masih means for your NMC case

Masih does not mean that every long-running order will be refused or that an unresolved allegation can never justify temporary restrictions. Nor did the High Court make a final decision on every allegation against Mr Masih. It decided that the NMC had not proved that the requested continuation was necessary on the evidence it presented.

The case does, however, underline that interim orders are temporary protective measures, not substitutes for completing proceedings. The regulator must make its case clearly, address relevant developments and justify why any restrictions remain necessary.

For more information about the wider process, read our guides to NMC hearings and the new rules in practice and what nurses and midwives should do when referred for an NMC investigation. If you are facing an extension application or review, our NMC defence service can advise on your circumstances.

This article provides general information, not legal advice on an individual case. The outcome of any NMC application depends on its facts, evidence and applicable law.

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