Gemma Louise Palfreman

Introduction

Gemma Louise Palfreman is a former UK registered adult nurse who was struck off the register by the Nursing and Midwifery Council (NMC) in July 2026. At a substantive hearing, a Fitness to Practise Committee panel found that she had prescribed medication to numerous patients over a prolonged period without holding any prescribing qualification and without consulting a General Practitioner, had carried out two vaginal examinations on a 13-year-old patient far beyond her scope of competence, and had treated someone she knew personally in breach of professional boundaries. The panel also found she acted dishonestly on two separate occasions. It concluded that her fitness to practise was impaired and directed that she be struck off, with an 18-month interim suspension to cover the appeal period.

Background Information

Palfreman was registered with the NMC as an adult nurse under registration number 07E2135E. The allegations against her covered a period from June 2022 to January 2024 and, as the panel noted when weighing aggravating factors, the charges “spanned two years and two separate employers”. Patients were identified in the determination only as Patients A-O, P and Q.

The case was heard by the NMC’s Fitness to Practise Committee at a substantive hearing that ran from 9 July 2026 to 21 July 2026. Palfreman did not attend, and her “failure to attend the hearing without good reason” was among the factors the panel treated as aggravating. The decision date was 21 July 2026.

The Controversy or Incident That Led to Their Cancellation

Adjudicated vs. alleged. All findings described below were made by an NMC Fitness to Practise Committee panel applying the civil standard of proof. This was a regulatory process, not a criminal one, and no criminal proceedings are reported in the source. The panel found all charges proved, including the two charges it expressly found to be dishonest.

The charges fell into four broad groups. The first concerned prescribing. On 6 July 2023, Palfreman prescribed Fluconazole to a patient without consulting a General Practitioner and without holding a qualification to prescribe. On 14 August 2023, she re-commenced Metformin for a patient without consulting a General Practitioner. More broadly, between 17 January 2023 and 25 January 2024 she prescribed medications and items to Patients A-O without consulting a General Practitioner and without a prescribing qualification. The panel found that she “held no non-medical prescriber qualification yet prescribed medication to numerous patients over a prolonged period, continuing after being told not to”. That persistence was treated as an aggravating factor: she kept prescribing without the appropriate training and qualification even after being told to stop.

The second group concerned Patient P, a child. On 20 July 2023 and 15 January 2024, Palfreman conducted vaginal examinations on Patient P, who was 13 and then 14 years old at the time of the two examinations. The panel found these examinations were “far beyond her scope of competence” and were carried out without consulting a General Practitioner beforehand. In its assessment of aggravating factors, the panel recorded that Patient P was vulnerable.

The third group concerned Patient Q, with whom Palfreman had a personal relationship. On 28 June 2022 and/or 5 July 2022, she conducted consultations with Patient Q after registering them as a temporary patient, thereby breaching professional boundaries; the panel found she had treated a friend. On 28 June 2022 she also conducted and reviewed Patient Q’s ECG without consulting a General Practitioner and outside her competence. On that same occasion she recorded that Patient Q had been seen by Doctor ‘A’ when they had not been — a recording the panel found was dishonest. The panel found that both the recording and her later answer were dishonest, and that her conduct in treating Patient Q breached the professional boundary between practitioner and patient.

The fourth group concerned her account of her own history. On 31 January 2024, asked whether she had been through a disciplinary process before, Palfreman answered ’no’; the panel found that answer was dishonest as well. Taken together, the panel found these actions breached the Code and amounted to misconduct.

Public Reaction and Consequences

The source is a regulatory write-up of the NMC determination rather than news coverage, and it reports no public or media reaction to the case. The consequences it records are institutional. The panel found Palfreman’s fitness to practise 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 her off the register, and imposed an interim suspension order for 18 months to cover the 28-day appeal period. The case is documented publicly on MedicWatch, which lists her erasure under the heading “struck off the register”.

In mitigation, the panel took into account only one mitigating feature, the detail of which is redacted as [PRIVATE] in the published determination. Against that stood a substantial list of aggravating factors: prescribing without the appropriate training and qualification and continuing despite being told not to; dishonesty; charges spanning two years and two separate employers; the vulnerability of Patient P; failure to attend the hearing without good reason; and absence of sufficient insight.

Current Status

As of the determination dated 21 July 2026, Palfreman has been struck off the NMC register — the regulator calls this “erasure” — and is no longer permitted to practise as a nurse in the UK. An 18-month interim suspension order covers the 28-day appeal period. Erasure can be reviewed after a minimum of five years, but is otherwise indefinite.

Impact on Their Career/Life

The striking-off order ends Palfreman’s ability to work as a registered nurse in the UK, and the dishonesty findings — the false record that Patient Q had been seen by Doctor ‘A’, and her denial of any prior disciplinary process — are the kind of findings regulators treat with particular weight. The panel’s conclusions that she showed limited insight, undertook no meaningful remediation and posed a real risk of repetition meant no lesser sanction was imposed, and its view that her absence of insight was insufficient offered no basis to expect early rehabilitation. Unless a future review after at least five years goes in her favour, the erasure stands indefinitely, closing the profession to her following findings that included unqualified prescribing, examinations of a child far outside her competence, and dishonesty.