Nursing and Midwifery Council determination — substantive hearing
NMC panel strikes off nurse Gemma Palfreman over unqualified prescribing and dishonesty
The Nursing and Midwifery Council has struck nurse Gemma Louise Palfreman off the register after a panel found she prescribed medication without holding a prescribing qualification, examined a 13-year-old patient outside her competence, and acted dishonestly on two occasions.
MedicWatch editorial · Published 21 July 2026 · Updated 23 July 2026
Erasure (struck off the register)
Added to MedicWatch: 23 July 2026Report a correction
What does “struck off the register” mean?
Being struck off (the regulator calls this "erasure") removes the practitioner from the register. They are no longer permitted to practise this profession in the UK. Erasure can be reviewed after a minimum of five years, but is otherwise indefinite.
Concerning Gemma Louise Palfreman, nurse (Nursing and Midwifery Council 07E2135E).
Decision date: 21 July 2026 · Hearing started 9 July 2026 and ended 21 July 2026
In plain English
The NMC's Fitness to Practise Committee found that Gemma Louise Palfreman, a registered adult nurse, prescribed medication to patients without a prescribing qualification and without consulting a GP, carried out two vaginal examinations on a 13-year-old patient outside her competence, and treated someone she knew personally. The panel also found she acted dishonestly on two occasions. It decided her fitness to practise was impaired and made a striking-off order, with an 18-month interim suspension order for the appeal period.
Charges
The NMC alleged that Mrs Palfreman, a registered nurse: on 6 July 2023 prescribed Fluconazole to a patient without consulting a General Practitioner and without holding a qualification to prescribe; on 14 August 2023 re-commenced Metformin for a patient without consulting a General Practitioner; between 17 January 2023 and 25 January 2024 prescribed medications/items to Patients A-O without consulting a General Practitioner and without a prescribing qualification; conducted vaginal examinations on Patient P on 20 July 2023 and 15 January 2024, outside the scope of her competence and without consulting a General Practitioner beforehand; on 28 June 2022 and/or 5 July 2022 conducted consultations with Patient Q, with whom she had a personal relationship, after registering them as a temporary patient, thereby breaching professional boundaries; on 28 June 2022 conducted and reviewed Patient Q's ECG without consulting a General Practitioner and outside her competence, and recorded that they had been seen by Doctor 'A' when they had not, which was dishonest; and on 31 January 2024 answered 'no' when asked if she had been through a disciplinary process before, which was dishonest.
Findings
The panel found all charges proved. It found Mrs Palfreman held no non-medical prescriber qualification yet prescribed medication to numerous patients over a prolonged period, continuing after being told not to. It found the two vaginal examinations on Patient P, who was 13 and then 14 years old, were far beyond her scope of competence and were carried out without consulting a General Practitioner. It found she breached professional boundaries by treating Patient Q, a friend, and that recording Patient Q as having been seen by Doctor 'A' was dishonest, as was her answer of 'no' when asked on 31 January 2024 whether she had been through a disciplinary process. The panel found these actions breached the Code and amounted to misconduct, and that her fitness to practise is currently impaired on both public protection and public interest grounds, citing a real risk of repetition, limited insight and no meaningful remediation. It directed the registrar to strike Mrs Palfreman off the register, and imposed an interim suspension order for 18 months to cover the 28-day appeal period.
Mitigating and aggravating factors
Mitigating factors
The panel took into account one mitigating feature, the detail of which is redacted as [PRIVATE] in the published determination.
Aggravating factors
Prescribing medication without the appropriate training and qualification and continuing this despite being told not to; dishonesty; charges spanned two years and two separate employers; Patient P was vulnerable; failure to attend the hearing without good reason; and absence of sufficient insight.
Source
All facts on this page are drawn from the publicly published Nursing and Midwifery Council determination linked below. MedicWatch does not editorialise the regulator’s findings.
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