A government health minister has told a Christian nurse cleared in an NHS pronouns row that the Nursing and Midwifery Council (NMC) must deliver “significant and sustained improvement” in its performance, particularly in its Fitness to Practise processes.
The intervention comes after Jennifer Melle, a registered nurse at Epsom and St Helier University Hospitals NHS Trust, was investigated, suspended, disciplined and referred to the Nursing and Midwifery Council after declining to use a convicted paedophile patient’s preferred pronouns during a clinical discussion about discharge planning.
The Trust later abandoned its disciplinary case against Jennifer, allowing her to return to clinical duties, and the NMC dropped both fitness-to-practise investigations, concluding there was “no case to answer.”
Now, in a letter to Jennifer this week, Karin Smyth MP, Minister of State for Health and Secondary Care, said the government takes the “performance of the Nursing and Midwifery Council very seriously.”
While stating that the NMC is independent of government and directly accountable to Parliament, Ms Smyth said the regulator “must continue to deliver a significant and sustained improvement in performance, particularly in relation to Fitness to Practise processes.”
She added that it is “essential that the public has confidence in the NMC register” and that the NMC must “deliver effectively on its primary purpose of protecting the public and maintaining confidence in the nursing and midwifery professions.”
The comments amount to a serious rebuke of the regulator after Jennifer endured years of investigation over allegations arising from her refusal to use language which conflicted with her Christian beliefs, her professional judgment and biological reality.
Ms Smyth also told Jennifer that she “absolutely” recognised that the process had been “incredibly distressing and challenging” and acknowledged the impact it had on her “both personally and professionally.”
Smyth added that the NMC is “under new leadership” and that, while the government welcomes the way the organisation is addressing “historic issues it has inherited”, it must continue to improve its performance.
Shadow Equalities Minister, Claire Coutinho, has also written to the NHS Trust at the centre of the controversy.
Jennifer had written to ministers after a meeting in Parliament earlier this year, where she says ministers made clear that no nurse should be compelled to use preferred pronouns or punished for holding and expressing lawful beliefs.
In her letter to ministers, Jennifer asked why, if that was the government’s position, she had ever been investigated, suspended, disciplined and referred to her regulator in the first place.
She has called for urgent national guidance to ensure NHS staff are not disciplined, suspended or referred to regulators merely for declining to use preferred pronouns; that freedom of religion and belief is respected in NHS workplaces; and that NHS Trust policies are brought into line with the government’s stated position.
Jennifer Melle, a registered nurse at Epsom and St Helier University Hospitals NHS Trust, was investigated after declining to use the preferred pronouns of a biologically male convicted paedophile patient who identified as female. The incident took place during a clinical discussion about discharge planning in May 2024.
The Trust investigated Jennifer and referred her to the NMC following allegations that she had failed to treat a patient with dignity by referring to the patient in a way inconsistent with their gender identity.
Jennifer later faced a second investigation after speaking publicly about her treatment, with allegations that she had breached patient confidentiality. The Trust abandoned its disciplinary case in January 2026, and the NMC has since closed both investigations with no further action.
‘The NMC must be held to account’
Jennifer Melle said:
“After everything I have been through, it is significant that a government minister has now acknowledged the distress and professional damage caused by this process, and has said clearly that the NMC must significantly improve its Fitness to Practise processes.
“I was referred to my regulator as if I posed some kind of risk to the public. In reality, I was doing my job in a pressured clinical situation, where biological sex was relevant to care, and I was seeking to communicate clearly and safely.
“The NMC pursued me for years before finally accepting there was no case to answer. That should never have happened.
“What happened to me was not just a misunderstanding. It exposed a system where nurses can be treated as dangerous professionals simply because they will not use language that conflicts with their conscience, faith and professional judgment.
“I welcome the minister’s recognition that the NMC must improve, but warm words are not enough. The government must now ensure that no nurse is ever again put through years of disciplinary and regulatory action merely for declining to use preferred pronouns.”
“Nurses need clear national guidance, and regulators must not be used as weapons against professionals who hold lawful Christian beliefs.”
Andrea Williams, chief executive of the Christian Legal Centre, said:
Find out more about Jennifer Melle“Karin Smyth’s letter is a serious admission that questions must be asked about the NMC’s conduct and its Fitness to Practise processes.
“Jennifer Melle was investigated, suspended, disciplined and dragged before her regulator because she would not bow to compelled speech. She has now been completely vindicated, but only after years of unnecessary suffering.
“The minister says the NMC must deliver ‘significant and sustained improvement’. The question is: why did it take Jennifer’s case to expose how badly the system is failing Christian nurses and other professionals who simply want to work with integrity?
“The NMC’s primary purpose is to protect the public. Jennifer was never a danger to the public. She was a conscientious nurse seeking to tell the truth in a clinical context.
“This case shows that regulators and NHS Trusts have been captured by ideological policies which punish staff for recognising biological reality and acting according to conscience.
“The government must now go further than criticising the NMC. It must issue binding national guidance making clear that nurses and healthcare workers cannot be compelled to use preferred pronouns, cannot be punished for their Christian beliefs, and cannot be referred to regulators for refusing to say something they believe is untrue.
“Jennifer’s courage has forced the government to confront the failings of the NMC. Now ministers must act decisively to make sure no other nurse faces the same ordeal.”