Health and Care Overseas Worker Visa Restrictions

In May the Government announced that the Health and Care Worker visa route will be closed to new overseas applicants for adult social care roles.

The adult social care sector currently faces more than 130,000 vacancies, but the Government has cited future reforms, including the Fair Pay Agreement and the Employment Rights Bill, as long-term solutions.

Professor Martin Green OBE, Chief Executive of Care England, commented:

“Cutting off international recruitment before a domestic solution is in place puts the cart well before the horse. The Fair Pay Agreement and the Employment Rights Bill, as outlined by Government, are years away from implementation and remain underfunded and undefined. They cannot replace what is being taken away now.”

Care England concluded that “Preventing overseas recruitment places even greater strain on a fragile system and jeopardises care for thousands.”

Read more: https://www.careengland.org.uk/from-crisis-to-collapse-care-england-express-concern-over-sudden-end-to-overseas-recruitment/

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Patient Safety Watch Survey Closing Soon

Campaign group, Patient Safety Watch, aims to reduce avoidable harm in healthcare and advocates for change to build safer healthcare systems.  Patient Safety Watch is currently running a survey until 2nd July, inviting healthcare professionals to:

“Tell us about your interventions to improve patient safety. We’re gathering NHS insights on what really works.”  

Read more and take part: https://www.thiscovery.org/project/interventions-to-improve-patient-safety

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Personal Injury Costs Challenge Judgement - Richardson & Ors v Slater & Gordon UK Limited

Law firm Slater and Gordon won a group-action case in May brought by hundreds of former clients, 10 of whom were selected as test claimants, and who argued that they did not give informed consent to deductions from personal injury damages.

In Richardson & Ors v Slater & Gordon UK Limited each claimant approached the firm to pursue a personal injury claim on a conditional fee agreement. The agreements required the claimant to pay the firm’s basic charges, disbursements and success fee which was capped at 25% of damages plus payment of the after the event insurance premium.

A spokesperson for the firm said: ‘We have repeatedly stated in response to these challenges that we reject any suggestion that former clients had been pressured to sign up to retainers or that the retainers were defective in some way. We are pleased that the costs judge found, expressly, that there was no pressure to complete the process and that the retainers were found to be fully enforceable.

Judge Rowley said the law firm had used a “perfectly appropriate method” for explaining what the clients had signed up for.

Read more: https://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWHC/Costs/2025/1220.html&query=(Richardson)+AND+(Ors)

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MedCo Examination Guidelines for Medical Experts

MedCo, medical report providers in low-value claims, has issued new guidelines for personal injury lawyers and expert witnesses on how client examinations must be administered.

The rules remove any reference to the use of remote examinations put in place during Covid and add the instruction that clients must always be assessed in an appropriate setting.

“Examinations must take place in locations that are confidential, private, safe, secure and regarded as a professional environment,” advised MedCo. “The examination location must be neutral and examinations should never take place at the offices of the instructing party or any other premises belonging to the instructing party.”

Hotel bedrooms, commercial premises and homes without medical facilities are considered not suitable by MedCo. Best practice for consultations is regarded as a clinic, GP practice or medical centre.

The updated guidelines also state that medical experts cannot carry out any more than 35 examinations in a day, with a minimum of 15 minutes spent face-to-face with a claimant.

Since 2021 The Civil Liability Act requires that all claims must be accompanied by a medical assessment.

Read more: https://medco.org.uk/examination-guidelines-update-and-reminder-cloned/

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Seshni Moodliar v GMC Judgement

The judgment in Moodliar v General Medical Council [2025] EWHC 913 (Admin) is a reminder to medical experts that giving expert evidence is a significant undertaking.  In this case, failures in the process led to eventual erasure from the medical register, after a failed attempt to appeal from the defendant, who was representing herself.

Dr Moodliar graduated in medicine from the University of the Orange Free State in South Africa in 2000 and gained full registration with the GMC in 2002. She then worked in various mental health roles in the fields of general and forensic psychiatry, until she qualified as a member of the Royal College of Psychiatry and, from 2015, she worked as a Consultant Psychiatrist in Learning Disability. She started undertaking medicolegal work in 2005.

Below is the background to the case and selected extracts from the High Court Decision:

“In 2020, a colleague reported concerns to the GMC in respect of Dr Moodliar's work as an expert witness in two criminal cases. The matter was referred to the MPTS and a hearing was held by a tribunal in May 2022. The tribunal found that Dr Moodliar had dishonestly copied sections of another expert's report when acting as an expert witness for the prosecution in the case of Patient A at a hearing in 2017. Further, the tribunal found that, when acting as a defence expert in respect of Patient B between September and December 2019, she had failed to assess the patient adequately in that she failed to obtain a detailed history, perform a detailed mental state examination or take steps to check the veracity of the patient's account; she had failed to explore the possibility of insanity, schizophrenia or psychosis; she had failed to prepare a report that was factually accurate; she had acted beyond her training and expertise in that she acted as an expert witness in a murder case without sufficient knowledge of the law of diminished responsibility; and she had failed to make or keep accurate records. The tribunal concluded that Dr Moodliar's fitness to practise was impaired by her misconduct and imposed conditions upon her registration for a period of 18 months.

“Subsequently further allegations of misconduct in respect of Dr Moodliar's medicolegal practice came to light. The new allegations concerned her work as a defence expert witness in the criminal trial of Patient D in March 2019. The allegations therefore arose from her conduct in another case between that of Patients A and B, and before the 2022 tribunal proceedings.

“Erasure is the most serious sanction available to a tribunal. A doctor who is erased from the medical register cannot apply to be restored to the register for five years and will only be restored if a tribunal is satisfied that they are then fit to practise: s.41(2)(a) of the Act.

“The Sanctions Guidance issued by the General Medical Council provides that the tribunal may erase a doctor from the medical register where this is the only means of protecting the public, and that erasure may be appropriate even where the doctor does not present a risk to patient safety but where such sanction is necessary to maintain public confidence in the profession. At paragraph 109 of the guidance, the list of non-exhaustive factors that may indicate that erasure is appropriate include "dishonesty, especially where persistent and/or covered up" and "persistent lack of insight into the seriousness of their actions or the consequences".

“The tribunal heard submissions as to the appropriate sanction and on 15 December 2023 it handed down its written decision directing the erasure of Dr Moodliar's name from the medical register.”

Read more: https://www.bailii.org/ew/cases/EWHC/Admin/2025/913.html

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New Legislation to Protect ‘Nurse’ as a Title

In May new measures were announced through the government’s NHS Plan for Change to protect the title ‘nurse’ in law. Anyone misleading the public and describing themselves as a nurse without the relevant qualifications and registration will face a fine. 

Those struck off by the Nursing and Midwifery Council (NMC) for serious misconduct or criminal convictions can still currently call themselves a nurse.

There will be exemptions for relevant professions like veterinary nurse, dental nurse and nursery nurse, where the title ‘nurse’ is legitimately used.

Health and Social Care Secretary Wes Streeting said:

“Nurses carry out lifesaving work every day, and I am determined we do everything we can to support them and safeguard trust in the profession.

“I’ve been appalled to read reports of so-called nurses spreading dangerous misinformation and harming the public.

“This new legislation will help crack down on bogus beauticians and conspiracy theorists masquerading as nurses, and those attempting to mislead patients.”

Only the title ‘registered nurse’ is currently protected in law, so the new legislation will ensure that only those individuals registered with the NMC can legally use the title. Anyone violating this will be committing a criminal offence.

Rachel Power, Chief Executive of The Patients Association, said:

“We welcome this commitment to ensuring patients know who is treating them and offering healthcare advice, and that those professionals are properly qualified. With health misinformation increasingly common, it’s more important than ever that patients can trust the expertise of those caring for them.”

These changes, which require legislative change, will be implemented within this Parliament as part of the government’s commitment to reform the regulation of health and care professionals in the UK.

Read more: https://www.gov.uk/government/news/fake-nurse-crackdown-to-boost-public-safety

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Pre-action Protocols and ADR after Churchill

Churchill v Merthyr Tydfil [2023] EWCA Civ 1416 was the landmark case concerning Judges having the power to compel parties to engage in alternative dispute resolution (ADR) during court proceedings, but more recent caselaw has indicated that parties should consider ADR even if they already
have had a failed attempt during the pre-action stage of disputes.

In Francis v Pearson [2024] EWHC 605 (KB) HHJ Matthews, sitting as a judge of the High Court, advised that the parties engage with a second mediation. HHJ Matthews explained: “Experience shows that it is often in entrenched cases such as this that ADR can make a real difference, often requiring honest conversations with parties as to the merits of their respective cases, and the potential downsides, as well as looking at pragmatic ways forward.

“I would strongly recommend that the parties reconsider some form of alternative dispute resolution process – which might include further mediation, or some other way of facilitating agreement – before matters in this case move forward and further costs are incurred.”

Read more: https://www.casemine.com/judgement/uk/65f9da68f2fa06429dd5d663

If you are interested in training to be a civil mediator, then please see the training courses run by the Society of Mediators here: https://www.specialistinfo.com/mediation-course

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BMA Back Fight to Challenge GMC over regulation of PAs and AAs

The BMA has announced it is appealing its case against the GMC over the regulator's use of the term “medical professionals” to describe Physician and Anaesthesia Associates (PAs and AAs), British Medical Association, R (on the application of) v General Medical Council [2025] EWHC 960 (Admin).

Meanwhile another legal case supported by the BMA and brought by Anaesthetists United (AU) and the parents of Emily Chesterton over the GMC’s failure to properly regulate PAs and AAs was heard at the Royal Courts of Justice in May.

Emily died aged 30 after two appointments with a PA whom she believed was a GP. A judicial review against the GMC alleges it has failed in its statutory duty to set standards by ensuring a clear scope of practice that would prevent such dangerous blurring of lines between the roles of PAs and doctors in the future.

BMA chair of council Professor Philip Banfield said:

“What Brendan and Marion Chesterton went through, losing their daughter Emily in such tragically avoidable circumstances, is something no parent should ever have to experience. It is a testament to their courage and determination to see that the chances of this happening again are drastically minimised that they have joined this case against the GMC. As we begin this court case today, we are saying simply that there must be no more stories like Emily’s. When our patients need to see a doctor, they must know that they are seeing a doctor.  

“At its heart the case is simple: the GMC is our medical regulator. It should have a duty to protect patients. Yet it persistently declines to set out what PAs can and can’t do. There is no scope of practice, no clear guidance, and thus no way the GMC can claim it has ‘set standards’ in any manner that patients or other staff would regard as necessary to ensure patient safety. The GMC has washed its hands of these duties and, along with the NHS, has perpetuated a postcode lottery with frightening inconsistencies.  

“We know from bitter experience that without a clear scope of practice in place, PAs will be permitted to do medical work and procedures that far exceed their capabilities, often with terrible consequences.

“We are grateful for the work of grassroots campaigners like AU who have raised so much money from public donations, including from doctors who are rightly concerned about this issue. Along with AU we hope to bring the GMC back to its most crucial purpose: protecting patients. This should not have taken legal action - but it’s not too late to correct.”  

Read more: https://caselaw.nationalarchives.gov.uk/ewhc/admin/2025/960

https://www.bma.org.uk/bma-media-centre/bma-backed-high-court-case-brought-by-parents-of-emily-chesterton-and-anaesthetists-united-against-gmc-over-regulation-of-pas-begins
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