Rebecca J D Overton-Applebee

Profession: Operating department practitioner

Registration Number: ODP25397

Hearing Type: Review Hearing

Date and Time of hearing: 12:30 24/06/2015 End: 16:00 24/06/2015

Location: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

 

During the course of your employment as an Operating Department Practitioner from January to March 2012 with Gloucestershire Hospital NHS Foundation Trust, you:

1. On 7 March 2012, you received a caution for theft by employee of 4 x 30mg

Codeine Phosphate from Gloucestershire Constabulary

2. On 7 March 2012 you:

a. self-administered 4 x 30mg of Codeine Phosphate stolen

from the controlled drug cupboard whilst on duty

b. falsified records in the controlled drugs book to show that patients A

and B had received Codeine Phosphate when they had not

3. You falsified records in the controlled drugs book to show that patients had received Codeine Phosphate when they had not

a. on at least seven occasions and in particular on:

i. 3 February 2012 - 60mg, Patient C

ii. 24 February 2012 - 60mg, Patient D iii. 27 February 2012 - 60mg, Patient E iv. 5 March 2012 - 60mg, Patient F

v. 21 February 2012 - 60mg, Patient G

vi. 24 February 2012 - 60mg, Patient H

vii. 2 March 2012 - 60mg, Patient I

b. and in so doing, you

i. stole the Codeine Phosphate

ii. self-administered the Codeine Phosphate

4. not proved

5. Your actions in 2 to 3 were dishonest

6. Your fitness to practise is impaired by reason of your Caution as set out in paragraph 1.

7. The matters set out in paragraphs 2 to 5 constitute misconduct

8. By reason of your misconduct, your fitness to practise is impaired.

Finding

Preliminary Matters

1. Where matters related to the Registrant’s health and private family life, evidence was heard in private.

Background

2. The Registrant was employed by the Gloucestershire Hospital NHS Foundation Trust (the Trust) from 22 July 2002, initially as a Nursing Auxiliary, subsequently as an Operating Department Practitioner (ODP) in or about November 2006 after she had qualified as an ODP. She worked in the private sector between December 2006 and August 2008, after which she re- joined the Trust as a Band 5 Orthopaedic Scrub Practitioner. She moved into the Recovery Unit due to her recurrent back problems.

3. On the dates identified in the allegations, whilst on duty, the Registrant took Codeine Phosphate from Trust supplies and falsified the controlled drugs record book to make it appear that patients had been given the Codeine Phosphate.  In relation to allegation 2, the Registrant was arrested and given a Police Caution.

4. The Panel heard in June 2013 that Codeine Phosphate is a mild pain killer that should not be used over long periods as it has an addictive property.  It is a prescription drug that cannot be bought over the counter. The Panel took account of the number of occasions when the Registrant had falsely signed the drug out of the controlled medications store in the names of patients when she had in fact self-administered the drugs. The facts were admitted and found proved in relation to heads of allegation 1, 2, and 3. The Registrant admitted dishonesty, impairment and misconduct as alleged.

5. The Registrant acknowledged in June 2013 that the allegations constituted serious matters. It was noted that self-administering medication whilst on duty was a matter of serious concern. Although there was no evidence of actual patient harm, the Registrant’s actions had exposed patients to a risk of harm in that, having been falsely recorded as receiving pain control, they may have been denied pain management when it was genuinely required.

6. There was a breach of paragraphs 1, 3, 10 and 13 of the HCPC Standards of Conduct, Performance and Ethics which state:

1.  You must act in the best interests of service users.
3.  You must keep high standards of personal conduct.
10. You must keep accurate records.
13. You must behave with honesty and integrity and make sure that your behaviour does not damage the public's confidence in you or your profession.

Decision

7. The Panel took into account the submissions of Miss Fulcher and those of Mr Oestreicher. The Panel also took into account the letter dated 18 June 2015 from the Registrant. Miss Fulcher submitted that the Registrant’s fitness to practise remains impaired and she invited the Panel to impose a further suspension order for a period of 12 months. Mr Oestreicher did not seek to argue that the Registrant’s fitness to practise is no longer impaired and he also invited the Panel to impose a Suspension Order. He explained that as a result of the Registrant’s personal circumstances she was not in a position to remedy her failings. However he reiterated her clear desire to address the failings identified in her case and she was committed to remediating her misconduct and returning to safe practice. He reassured the Panel that she was aware of the need to undertake a return to practice course.

8. The Panel considered whether the Registrant’s fitness to practise remains impaired. It considered whether the Registrant’s conduct which led to the charge is easily remediable, whether it has been remedied; and third, whether it is highly unlikely to be repeated. The Panel has applied its own independent judgment throughout its deliberations. It has taken into account the public interest which includes protection of patients, maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.

9. The Panel noted that since the last hearing the Registrant has had a new baby and as a result of her personal circumstances she has been unable rather than unwilling to remedy the failings in her practice or to address the recommendations identified by the previous Panel. The Panel noted in her letter dated 18 June 2015 the difficulties that she has had to deal with and it took account of her commitment to remaining on the Register as an Operating Department Practitioner. She expressed in that letter her remorse for what she has done in the past and expresses a wish to eventually return to her profession.

10. The Panel considered that the misconduct identified in this case was serious and given that the Registrant has not been in a position to remedy the failings identified in her practice the Panel considers that her fitness to practise remains impaired for the same reasons as the previous Panel. The previous Panel reviewing this matter on 12 June 2014 determined that:

“…the Registrant demonstrated some insight and expressed remorse but has not taken any sufficient steps to demonstrate that she has remediated her behaviour to the extent that there is no risk of future repetition. The Panel noted that the insight shown was focussed toward the drug issue rather than the acts of dishonesty.

She has not provided any medical evidence which could have helped the Panel in determining whether there is any current risk of misusing codeine phosphate and has taken few steps towards maintaining her continuing professional development. She has not used any resources other than reading magazine articles in order to maintain professional knowledge. The Panel noted that the Registrant remained of the opinion that she had only taken Codeine Phosphate and that was not a major drug. She expressed little insight in to the effect of her actions on service users.

Whilst the Registrant did not concede that she was currently impaired, the Panel had concerns about lack of insight. The Registrant has not provided sufficient evidence of any remedial action but is undergoing counselling.  There is no evidence to persuade the Panel that the Registrant has taken any verifiable steps to remediate her behaviour.
The position remains as it was at the hearing last year:[2013] in the absence of any evidence of remediation it is the view of the Panel that there remains a risk of repetition.  For these reasons the Panel is of the view that the Registrant’s fitness to practise remains currently impaired.

The Panel notes the Registrant’s assertion made at the last hearing that she stopped taking Codeine Phosphate after the incident on 7 March 2012. It has taken account of the Registrant’s letter of 24 May 2014 and her evidence detailing how she feels about her past conduct and her desire to resume work as an ODP. It has taken account of the references provided on behalf of the Registrant.

The Panel remains concerned that the Registrant’s behaviour has had a serious impact  on  the  Registrant’s  reputation  and  on  that  of  the  profession and that there is insufficient evidence at present to assure the Panel that there is no continuing risk of repetition of her conduct.
This Panel considers that the Registrant has yet to develop full insight so as to preclude any further risk.”

11. Today’s Panel next went on to consider the appropriate sanction in the circumstances in this case. The Panel considered the various options open to it in ascending order of seriousness and it noted that Mr Oestreicher invited the Panel to impose a Suspension Order for a further period of 12 months.

12. The Panel concluded that on this occasion it would be appropriate and proportionate to suspend the Registrant for a further period of 12 months. In coming to this decision it took into account the reasons of the previous reviewing Panel and in particular the following paragraphs;

“To take no action or to impose a Caution Order would clearly not be appropriate as neither would adequately mark the unacceptable nature of the Registrant’s conduct or provide adequate safeguards to the public or maintain confidence in the regulatory process.

The Panel next considered a Conditions of Practice Order but this sanction would not mark the seriousness of the conduct in this case and in any event as the Registrant is not currently working the Panel could not identify conditions of practice which would be workable, verifiable or practicable. At this stage the Panel concludes that there is insufficient evidence of remediation to enable a Conditions of Practice Order to be adequate and fully effective.
The Panel next considered a Suspension Order and noted that a Suspension Order may be appropriate where the Panel considers that a Caution or a Conditions of Practice are insufficient or inappropriate to protect the public, or where the allegation is of a serious nature but there is a realistic prospect that repetition will not occur. A Suspension Order will prevent the Registrant from working until it is considered that she is safe to do so and will thus provide adequate protection for the public. It is a sanction also sufficient to mark the seriousness with which the Registrant’s shortcomings are viewed, to uphold professional standards, and to maintain confidence in the regulatory process.

Accordingly it is the Panel’s view that a Suspension Order for one year is the necessary, proportionate and adequate sanction to meet the circumstances of this case.

For the sake of completeness the Panel next considered whether a Striking off Order could have been more appropriate but it was of the view that such an order was not necessary; would have failed to acknowledge the potential for remediation and would have precluded a potentially valuable member of the profession from being able to return to safe practice.”

13. This Panel noted that a Striking Off order was an available option to it today but it concluded that such an order would be disproportionate at this stage. It is of course an available option for sanction at any future review of this order.

14. In conclusion the Panel concluded that a Suspension Order for 12 months was an appropriate and proportionate order. This Suspension Order will be reviewed before it expires. A reviewing Panel would be assisted by: independent medical evidence to show that the Registrant has been free from the use of Codeine Phosphate for a substantial period; evidence of achievement of insight into dishonesty; and evidence that the Registrant has taken actual steps taken to maintain continuing professional development. The Registrant remains able to provide further evidence of remediation and to seek an earlier review if circumstances change.

Order

Order: The Registrar is directed annotate the Register to show that the period of suspension on the registration of Rebecca Overton-Applebee is extended for a further period of 12 months from the date on which this Order takes effect.

Notes

No notes available

Hearing History

History of Hearings for Rebecca J D Overton-Applebee

Date Panel Hearing type Outcomes / Status
21/04/2020 Conduct and Competence Committee Review Hearing Voluntary Removal agreed
16/10/2019 Conduct and Competence Committee Review Hearing Suspended
26/10/2018 Conduct and Competence Committee Review Hearing Suspended
12/03/2018 Conduct and Competence Committee Review Hearing Suspended
27/06/2017 Conduct and Competence Committee Review Hearing Suspended
17/06/2016 Conduct and Competence Committee Review Hearing Suspended
24/06/2015 Conduct and Competence Committee Review Hearing Suspended