Following its full investigation, the NMC has now confirmed in its decision dated 1 July 2026 that the case examiners had found there was “no case” for Ms Melle to answer, that no further action would be taken, and that the case was closed.
The NMC recorded that the Trust accepted Ms Melle believed she was making a protected disclosure in the public interest and felt there was no effective internal route through which to escalate her concerns.
The regulator concluded there was “no evidence to support the allegation that a breach of confidentiality took place”, finding that the limited information disclosed did not result in the patient being identified, either in the media or online.
It also accepted that the pronoun incident was isolated, not malicious, and arose from Ms Melle’s protected Christian beliefs rather than any intention to harass or bully. The NMC further recognised that she had identified a practical way forward by using patients’ preferred names rather than pronouns where conscience or belief prevents her from using language she regards as untrue.
The NMC concluded that Ms Melle did not present a current risk to the health, safety or wellbeing of the public, that no restrictions on her practice were required, and that there was no realistic possibility her fitness to practise would be found impaired.
In its decision, the NMC stated:
“You have engaged with the NMC throughout and say, ‘My belief, which is in conformity with biology and my Christian faith, is that there are only two sexes, male and female. As I made clear in my legal case involving the Epsom & St Helier NHS Trust, I consider the denial of biological reality (a reality the Supreme Court has upheld) a denial of reality and my Christian faith.
When caring for patients face to face, I have never known the issue of pronouns to arise. As I explained in my previous response, even on this occasion the conversation involving pronouns was with the doctor and not the patient. When talking with patients I use a patient’s name and that is what I did here. I would never, deliberately or provocatively, seek to upset a person identifying in the opposite sex. I have throughout confirmed that I will use a patient’s (or colleague’s) preferred name, which seems a pragmatic work around for nurses like me, who for religious or philosophical reasons consider sex immutable’.”
The NMC added that the incident was “isolated” and:
“driven by your own protected characteristic of religious belief rather than a desire to harass or bully Patient A… In summary, we do not consider that this is one of those rare cases where the way you conducted yourself suggests a deep-seated attitudinal problem or that what you are alleged to have done is so serious that a finding of impairment may be necessary to protect the public or maintain the public’s confidence and trust in the professions and to uphold professional standards.
We therefore conclude that there is no realistic possibility that your fitness to practise would be found currently impaired.
Following our conclusions on facts and current impairment, we have determined there is no case for you to answer.”
The NMC also noted that Ms Melle remains employed by the Trust, which confirmed there had been no further concerns about her practice or the way she treats patients.
