Mrs Joy Lytham

Profession: Operating department practitioner

Registration Number: ODP32487

Interim Order: Imposed on 01 May 2013

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 05/05/2015 End: 11:30 05/05/2015

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

Panel: Conduct and Competence Committee
Outcome: Suspended

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.

 

Allegation

During the course of your practice as an Operating Department Practitioner with Harrogate and District NHS Trust:

1.Between 5 and 6 April 2012 you were unable to demonstrate sufficient knowledge of basic procedures relevant to your role in that you:
 
a) did not have suitable laryngoscopes available
b) did not have a bougie available despite the Anaesthetists requests
c) were unable to set up a capnograph or arterial line
d) did not know how to zero an arterial line
e) did not apply cricoid pressure for a raid sequence induction
f) did not demonstrate independent judgement of what action was required.
 
2. On 12 July 2012 (during assessment of your skills as an Operating Department Practitioner) you were unable to practise at the required level of competence of a band 5 Operating Department Practitioner in that you were unable to:
 
a) check the set-up for the specialist needs of the patient in that you did not:
i. prepare fluids for administration to the patient by running them through the giving set;
ii. not proved;
b) correctly prepare airway management equipment for the situation in that you:
i. did not cut the ET tubes;
ii. did not attach a syringe for rapid sequence induction;
iii. did not prepare the difficult intubation trolley;
c) safely assist the clinician with intubation procedure in that you released cricoid pressure during intubation
d) not proved ;
e) not proved ;
f) not proved :
g) not proved;
h) provide a competent handover of care to the PACU team
i) not proved

j) not proved.
 
3. On 10 August 2012 (during assessment of your skills as an Operating Department Practitioner) you were unable to practise at the required level of competence of a band 5 Operating Department Practitioner in that you were unable to:
 
a) check the anaesthetic machine correctly as part of its set up;
b) check the set-up for specialist needs of the patient in that you did not
i. not proved;
ii. make correct adjustments for intubation where  a hard collar was in situation;
c) correctly prepare airway management equipment for the situation
d) safely assist the clinician with intubation procedure in that you:
i. released the syringe during the intubation procedure;
ii. not proved;
iii. rolled the patient onto their side whilst a hard collar was not in situ;
e) demonstrate awareness of or discuss alternative techniques for airway management
f) not proved
g) not proved;
h) adapt to a changing situation in that you did not notice the patient was in cardiac arrest for seven minutes;
i) assist with cardiac arrest management in that you used an ineffective CPR technique
j) undertake an effective A-E assessment and continue to monitor the patient
k) not proved

l) provide a competent handover of care to the ODP for transfer in that you did not:
i. explain that the patient had undergone cardiac arrest;
ii. not proved.
 
4. On 11 October 2012 (during assessment of your skills as an Operating Department Practitioner) you were unable to practise at the required level of competence of a band 5 Operating Department Practitioner in that you:
 
a) not proved
b) did not communicate adequately to the anaesthetist
c) were unable to use the pressure infuser device correctly
d) were unable to select the correct drugs for RSI in preparation for the anaesthetist arriving
e) were unable to deliver chest compressions at the correct ratio.
 
5. not proved
 
6. The matters described in paragraphs 1 - 5 above constitute a lack of competence.
 
7. By reason of that lack of competence your fitness to practise is impaired.

 

Finding

1.     The Panel has been convened to undertake a review of a Conditions of Practice Order imposed on Mrs Lytham's registration on 14 May 2014. Mrs Lytham has attended the hearing and addressed the Panel. The Presenting Officer has been Ms Nike Gustave.

2.     The final hearing of the allegations was held over seven days in May 2014, concluding on 14 May 2014. At that hearing the following particulars were proved in full: 1 a); 1 b); 1 c); 1 d); 1 e); 1 f); 2 a) i; 2 b) i; 2 b) ii; 2 b) iii; 2 c); 2 h); 3 a); 3 b) ii; 3 c); 3 d) i; 3 d) ii; 3 d) iii; 3 e); 3 h); 3 l) i; 4 b); 4 c); 4 d). Paragraphs 3(g) and (j) were proved in part. The allegations arose out of an incident in April 2012, the details of which are reflected in paragraph 1 of the particulars. Subsequently, three assessments were carried out in July, August and October of 2012. The detail included in the factual particulars means that no further elaboration is required in this summary.

3.     The Final Hearing Panel decided that the established facts were a fair and representative sample of Mrs Lytham’s work, and that as a consequence she did not possess the knowledge, skills and experience expected of an ODP. They determined that the facts demonstrated a lack of competence, then impairing Mrs Lytham’s fitness to practise.

4.     Notwithstanding the fact that the Final Hearing Panel was of the view that there was a lack of insight on the part of Mrs Lytham, the Panel decided that it might develop. They decided that there would be no risk to the public if Mrs Lytham was supervised in her practice at all times. Accordingly, they imposed  a Conditions of Practice Order for a period of 12 months. The conditions of the Order were as follows:

1.     Supervision requirements: You must place yourself and remain under the supervision of a registered, qualified Operating Department Practitioner approved by the HCPC, attend upon that Supervisor as required and follow their advice and recommendations. For the avoidance of doubt, throughout the duration of this Order, you must not practise autonomously as an ODP.

2.     You must work with your Supervisor to formulate a personal development plan designed to address the deficiencies in the following areas of your practice: prioritisation, planning ahead, preparation of machinery, making equipment and drugs available, recognising and assisting in rapidly changing clinical situations including emergencies, understanding the importance of effective communication with colleagues in the clinical area as well as constructive acceptance of criticism.

3.     Ensure that HCPC receive copies of supervision notes detailing how these Conditions are being met and detailing any on-going areas of concern. These notes to be provided to the HCPC every two months.

4.     Notification: You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

5.     You must inform the following parties that your registration is subject to these conditions: a) any organisation or person employing or contracting with you to undertake professional work; b) any agency you are registered with or apply to be registered with (at the time of application;) and c) any prospective employer (at the time of your application).A review of an Order under Article 30(1) of the Health and Social Work Professions Order 2001 requires a Panel to consider what, if any, sanction is required upon the expiry of the Order being reviewed. In undertaking this task the Panel is required to take the findings of the final hearing Panel on the allegations as settled. In deciding if those findings still require a sanction response the Panel is required to have regard to all that has, and has not, occurred in since the Order was made. Usual sanction considerations apply. A sanction is not to be imposed to punish. Rather, a sanction should only be imposed to the extent that it is required to protect the public and to maintain a proper degree of confidence in the registered profession.

5.     Mrs Lytham has complied with the terms of the Conditions of Practice Order, and has supplied for the consideration of the Panel reports of her supervised practice.

6.     On behalf of the HCPC, Ms Gustave has submitted that the reports provided by Mrs Lytham raise significant concerns as to Mrs Lytham’s ability to practise safely. Accordingly, she asked the Panel to consider making a Suspension Order. She further submitted that if the Panel considered that the Article 30(1) review required the imposition of a Suspension Order, then she would ask the Panel to consider an application under Article 30(2) for the immediate revocation of the Conditions of Practice Order with substitution of a Suspension Order for the remainder of the period of the present Order.

7.     The Panel fully accepts that in working under the Conditions of Practice Order, Mrs Lytham has striven to improve her practice. Mrs Lytham has referred to the fact that she was working in a busy department and also that she felt a degree of pressure as a result of being observed. The Panel accepts these factors would have been present, but it is relevant to add that to practise safely and effectively as an Operating Department Practitioner, it will be necessary to work under pressure and, in the view of the Panel, neither of these factors can explain the concerns that have been raised. Mrs Lytham has presented reports from the different placements she has undertaken. The Panel has considered all of the documents, and has also considered the written and oral submissions made by Mrs Lytham. In the judgement of the Panel, the reports that have been presented to it give a consistent picture of difficulties being experienced by Mrs Lytham with basic tasks and in remembering procedures. These problems are compounded by Mrs Lytham not appreciating the extent to which her shortcomings would make her an unsafe practitioner. The result of these findings is that the Panel has concluded that Mrs Lytham is unable to practise safely in significant areas of Operating Department Practitioner practice.

8.     In the view of the Panel, it is not appropriate for the Conditions of Practice Order to be maintained in circumstances where there is a complete inability to practise safely as an Operating Department Practitioner. The Panel has decided the matter in accordance with the process identified above, namely by considering the sanctions in an ascending order of seriousness. Having followed this approach, the Panel has concluded that a Suspension Order is required. No lesser sanction will sufficiently protect the public and maintain confidence in the profession. A Suspension Order should not only be applied following the expiry of the present Order, but should also be the sanction that should be substituted for the Conditions of Practice Order with immediate effect.

9.     It is customary for a Panel imposing a Suspension Order to make suggestions of steps a registrant can take for the purposes of the review that will take place before the Suspension Order expires. The Panel has considered whether there are any such suggestions that can be made in the present case, but in the light of the significant steps that have been taken hitherto to support Mrs Lytham, the Panel has concluded that it cannot make any helpful suggestions.

 

Order

Order
(1) The Panel revokes the existing Conditions of Practice Order and replaces it with a Suspension Order.

(2) Upon the expiry of the present Order, that is to say with effect from 11 June 2015, there be a Suspension Order for a period of 12 months.

 

Notes

This Order will come into effect on 11 June 2015. This Order will be reviewed before it expires.

Hearing History

History of Hearings for Mrs Joy Lytham

Date Panel Hearing type Outcomes / Status
26/06/2017 Conduct and Competence Committee Final Hearing Voluntary Removal agreed
12/07/2016 Conduct and Competence Committee Review Hearing Suspended
06/05/2016 Conduct and Competence Committee Review Hearing Suspended
05/05/2015 Conduct and Competence Committee Review Hearing Suspended