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During the course of your practise as a Speech and Language Therapist with Norfolk Community Health and Care Trust, you:
1. Failed to manage your case load effectively, in that:
a. your caseload was 50% larger than the level recommended for Team;
b. the case load of one patch doubled in size since you took over the patch from your colleague;
c. You allowed 2 months to pass between a failed first appointment and the second appointment in the case of (MB), a child who had been identified as having potential safeguarding needs;
d. failed to apply discharge criteria correctly in that you retained cases beyond the point at which they should have been discharged;
e. You failed to implement follow up plans;
f. You failed to implement therapy plans;
g. You failed to see your patients in a timely manner;
h. You failed to write letters to services users in a timely manner;
i. You failed to write a report back to the referrer after (DP) initial assessment;
2. Failed to maintain complete and accurate case records in that:
a. following an audit conducted on 17 March 2010, over 30% of your patient notes were incomplete and/or unacceptable;
b. Many records lacked assessments;
c. You failed to follow Trust policy on structuring consultation notes;
d. Many case records were not up to date in that you failed to scan documents in a timely manner;
e. You failed to indicate the date of next contact in cases;
f. The status of cases were unclear;
g. One case (SM) had no entries recorded for 18 months;
h. One case (ML) had no entries recorded for 15 months;
i. One case (DS) had no entries recorded for 24 months;
j. Failed to specify the diagnosis or differential diagnosis;
k. Failed to specify the name of schools of some patients;
l. Failed to specify the names of teaching assistants in relation to some patients;
m. Failed to add the assessment from 22/09/2010 to the System One record in (BE) case.
3. You failed to indicate clear aims and treatment plans in your patient notes;
4. You failed to engage with families and other partners adequately;
5. You made poor clinical decisions, in that you;
a) Failed to see the patients who benefitted most from Speech and Language Therapy input;
b) Failed to recognise what is work for a Speech and Language Therapist and what is not;
c) Provided therapy to children at Carbrooke School with no Teaching Assistant backup
6. The matters set out in 1-5 constitute lack of competence;
7. By reason of that lack of competence, your fitness to practise is impaired.
Decision and Order:
1. This is a mandatory review of a Suspension Order originally imposed on 10 November 2011 and last extended on 03 November 2014.
2. The Panel is satisfied that a letter notifying the Registrant of the hearing was sent, on 01 April 2015, to her HCPC registered address and that this amounts to good service.
3. The Registrant has not attended the hearing today and is not represented.
4. The Panel first considered whether it ought to exercise its discretion to continue with this hearing in the absence of the Registrant and concluded that it was in the public interest to do so, having considered the HCPC Practice Note on Proceeding in the Registrant’s absence and having taken the Legal Assessor’s advice, for the following reasons:
(a) The Panel is satisfied that the Registrant had notice of the hearing.
(b) The Registrant did not attend the final hearing and has not attended any of the previous mandatory review hearings.
(c) The Panel has seen a letter dated 19 April 2015, from the Registrant in which she indicated that she would not be attending the hearing today.
(d) The Panel was of the view that even if these proceedings were adjourned there was very little likelihood that the Registrant would attend on a subsequent occasion.
(e) The Panel concluded that the Registrant has deliberately chosen not to take part in these proceedings.
(f) The Panel determined that it was reasonable and in the public interest to proceed today in the circumstances – the public interest outweighing the rights of the Registrant in these circumstances. The order has to be reviewed prior to its expiry on 03 June 2015.
5. The Registrant was employed as a Band 6 Paediatric Speech and Language Therapist (SLT) by Norfolk Community Health & Care Trust. Concerns were raised from June 2009 onwards about the Registrant’s practice, following the introduction of a new electronic database called SystemOne. A review and audit of Mrs Parker’s workload led to a decision to proceed to a disciplinary hearing on 16 July 2010. That hearing found allegations against the Registrant, primarily in relation to record keeping and the proper application of her employers discharge policy, were proved and a formal written warning was imposed.
6. The Registrant did not return to work and resigned from the Trust. The Conduct and Competence Committee found the majority of allegations proved and concluded that the Registrant’s fitness to practise was impaired by a lack of competence. A Suspension Order was imposed for a period of 12 months.
7. At the time of the last review hearing, the Registrant was working as a care assistant. She had been out of practice since 2010 and had taken no steps to address the issues which gave rise to the finding of a lack of competence against her. There was no evidence that the Registrant had engaged in any CPD training in the field of Speech and Language Therapy and they concluded that her fitness to practise remained impaired.
8. The previous review Panel raised the question of whether the voluntary removal procedure had been had been explained to the Registrant, in light of correspondence from the Registrant dated 19 October 2014, in which she appeared to consent to the voluntary removal of her name from the Register.
9. The previous Panel concluded that it would be disproportionate to impose a Striking Off Order and imposed a further short period of suspension to allow the HCPC to provide the Registrant with the necessary documentation to enable the Voluntary removal application, if made, to be decided by a future Panel.
10. Since the previous review hearing, the HCPC has sent voluntary removal documentation to the Registrant. However, this has not been returned by the Registrant to the HCPC.
11. The Panel has seen the letter from the Registrant dated 19 April 2015. She is employed as a domiciliary setting and continues to undertake mandatory training and NVQ qualifications applicable to her role. She confirms that she has not undertaken any further education in or training in speech and language therapy.
Decision and Order:
12. The Panel today has taken account of all the written evidence available in the hearing bundle, the representations of Mr Williams, and the Indicative Sanctions Policy of the HCPC. The Panel also took advice from the Legal Assessor.
13. In undertaking this review today, the Panel has reminded itself of the following matters:
(a) A proper exercise of the review process must involve a comprehensive re-consideration of the initial order, in the light of all circumstances, which are before the Panel today. However, it is not the Panel’s role to go behind the previous panel’s findings.
(b) The Panel in its deliberations applied the principle of proportionality and balanced the rights of the Registrant with the rights of the public.
(c) The Panel has, under Article 30(1) of the Health & Social Work Professions Order 2001, the power to extend or further extend the suspension order, or to replace the suspension order, with a conditions of practice order with effect from the expiry of the suspension order, or to make an order which it could have made at the time it made the order being reviewed.
(d) The Panel, has the power under Article 29(6) of the Health & Social Work Professions Order 2001, to make a striking off order as the Registrant has been continuously suspended for a period in excess of 2 years immediately preceding the date of the review hearing.
14. The Panel considered whether to take no action, or to impose a Caution Order but concluded that they were not appropriate in light of the lack of any evidence of insight of remediation and concluded they were not adequate to meet the degree of public protection which was required.
15. The Panel next considered a Conditions of Practice Order, but concluded that the same was impractical and unworkable, bearing in mind the length of time since the Registrant worked as a SLT and her lack of engagement in these proceedings.
16. The Panel next considered whether to impose a further Suspension Order and concluded that given the length of the time since the final hearing and the lack of progress towards remedying the shortcomings previously identified, that this would not be in the public interest. The Registrant has previously expressed interest in the voluntary removal process but has failed to engage with the HCPC regarding this procedure.
17. Therefore, having carefully considered all of the evidence before it and the powers available to it, the Panel determined that it is in the public interest, that an order striking the Registrant from the Register is the appropriate and proportionate order, to provide the required degree of public protection that is required and in the wider public interest which includes the deterrent effect on other registrants, the reputation of the profession concerned and public confidence in the regulatory process.
The Panel decided to strike the name of Angela M Parker from the HCPC Register.
History of Hearings for Angela Parker
|Date||Panel||Hearing type||Outcomes / Status|
|05/05/2015||Conduct and Competence Committee||Review Hearing||Struck off|