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During the course of your employment as a biomedical scientist with Worcestershire Acute Hospitals NHS Trust:
1. In March 2012 you approved an erroneous result in Haematology which resulted in a patient being admitted for a blood transfusion.
2. On 18 May 2013 you incorrectly labelled the red cell units for two cross matches for two patients which resulted in:
a) an uncross-matched red cell unit being available for one patient; and
b) an ABO incompatible uncross-matched red cell unit being available for a second patient.
3. On 2 October 2012 you changed patient A's cardinal blood group on the internal WINPATH computer system following a bone marrow transplant without:
a) following the standard operating procedure;
b) adequately discussing the proposed change with a senior colleague.
4. On 8 November 2012 you input two samples from different patients onto one patient's records on the internal WINPATH computer system.
5. The matters described in paragraphs 1 - 4 constitute misconduct and/or lack of competence.
6. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
1. As the Registrant had not attended today’s hearing the Panel considered whether the Notice of Hearing had been served in accordance with the Rules. The notice had been sent to the Registrant’s registered address by first class mail and email at least 28 days before today’s hearing. It contained all the relevant information and the Registrant had responded to it in two emails. The Panel was therefore satisfied that service had been effected in accordance with the Rules.
Proceeding in absence
2. The Panel has taken the advice of the Legal Assessor. Rule 11 of the Rules allows the Panel to proceed in the absence of the Registrant.
3. The Panel is satisfied that all reasonable steps have been taken to serve the Registrant with the notice and clearly it has been served as evidenced by the Registrant’s response. It acknowledges it has a discretion to proceed in absence and this must be exercised with all due care and caution. The Panel has read the emails sent by the Registrant from which it is clear the Registrant is aware of today’s hearing. She confirms that she does not intend to attend and she puts forward written submissions for consideration of the Panel today. The Panel is therefore satisfied she has voluntarily absented herself. She does not request an adjournment. If the case were to be adjourned there is a likelihood she would not attend on any future occasion. She has not attended in the past. The order expires in October and a hearing prior to that time would be difficult to arrange. The Panel is therefore satisfied it would not be unfair to proceed today in the absence of the Registrant.
4. The Registrant started employment at the Worcestershire Acute Hospital Trust (‘the Trust’) as a Band 6 Biomedical Scientist in the Haematology Blood Transfusion Department on 17 March 2008.
5. On 28 March 2011, AN, a Departmental Manager, noticed that an error had occurred involving the approval of an erroneous blood result some three days earlier. The allegation was that the Registrant was responsible for this, in that she had entered on the laboratory computer system her approval of an abnormal result which wrongly stated that the patient in question had extremely low haemoglobin.
6. As a result, the patient was unnecessarily admitted to the Acute Medical Unit for a blood transfusion.
7. Shortly after being questioned about this error, the Registrant left work on long term sick leave until 04 August 2011. To facilitate her return to work, competencies were put in place for training purposes.
8. On 18 May 2012, an incident occurred concerning two surgical patients who were due to be operated upon at the hospital. Their blood was cross-matched by the Registrant, but it was discovered that she had incorrectly labelled the red cell units. The numbers on the labels did not correspond with the numbers on the relevant units of blood. As a result, an uncross-matched red cell unit was available for one of the patients and an ABO incompatible uncross-matched red cell unit was available for the second patient.
9. The Registrant was placed on supervision for her transfusion work. On 02 October 2012, the Registrant, at work in the transfusion laboratory, was entering the details of a patient, who had had a bone marrow transplant, onto the internal WINPATH computer system. This involved her changing the patient’s cardinal blood group.
10. On 08 November 2012, the Registrant was responsible for inputting details of two blood samples from different patients onto the records of a single patient on the internal WINPATH computer system.
11. As a result of these additional mistakes coming to light, the Registrant was issued with a Final Written Warning on 12 June 2013
12. The Registrant resigned from her post on 21 June 2013.
13. Ms Horren submitted that it is the Panel’s first task to consider whether the Registrant remains impaired. Given the previous Panel’s findings and the developments since the substantive hearing if the Panel considers that Ms Hewitt is impaired as of today’s date, the Panel will go on to decide what if any sanction is appropriate to impose.
14. Ms Horren summarised the background to the case and submitted that the Panel would have to make two decisions:
i) Whether the Registrant’s fitness to practise remains impaired
ii) If so, what sanction to impose
15. As to the first question, she submitted that the Panel should consider whether there is evidence to suggest that the Registrant has remedied the failures identified by the previous Panel and that, as such, whether Registrant’s fitness to practise remains impaired.
16. She said that the Panel will want to consider whether the Registrant now poses a risk to the public and whether there are any public interest issues outstanding.
17. As to the second question, the matter of sanction, Ms Horren suggested no specific sanction, but asked the Panel to bear in mind:
- the previous Panel findings
- evidence of compliance with the recommendation made by the previous Panel in respect of providing information for a further review Panel
- previous and continued insight and remorse
- likely risk of repetition
- whether the seriousness of the Registrant’s actions warrants a further sanction in order to protect the public interest
18. Finally Ms Horren referred the Panel to the Registrant’s email of today’s date in which she states that she has complied with the conditions previously imposed.
19. The Legal Assessor gave his advice to the Panel. He advised that the Panel must consider whether all the concerns raised in the original findings of impairment had been sufficiently addressed to the Panel’s satisfaction. He reminded the Panel that there is a persuasive burden on a Registrant to demonstrate that she has addressed her past impairment.
20. In coming to this decision the Panel has accepted the advice of the Legal Assessor. It has first considered whether the Registrant is still impaired and if so what sanction it ought to impose.
21. It has also taken account of the extensive bundle of documentation provided by the HCPC and the emails sent to the HCPC by the Registrant. It has also taken account of Ms Horren’s submission on behalf of the HCPC.
22. The Panel has decided to extend the current order of conditions as varied for a further period of 6 months.
23. The Panel is satisfied that the Registrant’s fitness to practice is still impaired noting that the burden is on the Registrant to show that she has addressed all past concerns. The Panel has noted the last Panel’s concern that at the time of the first hearing there had been no independent verification of where the Registrant was working, details of how she was addressing her deficiencies or details regarding her health. The Panel is satisfied that a similar situation applies today. It has not received independent information about these matters and notes that the Registrant has indicated little expression of remorse.
24. The Panel notes that the Registrant has chosen not to attend today’s hearing although she has provided a written submission which the Panel has carefully considered. The Registrant’s submission is limited to her statements about her current employment, the lack of any further incidents and her confirmation that she is complying with the conditions imposed upon her registration. Despite the clear recommendations by the previous Panel that the Registrant should provide a report from her supervisor and her GP she has not submitted anything in writing from them. The Panel also notes that the Registrant has not submitted to the Panel any observations about the action that it should take today in respect of the current order.
25. The Panel is concerned as to the lack of attention the Registrant has given to these recommendations. Coupled with the lack of independent evidence the Panel cannot be satisfied that the Registrant is no longer a risk to the public. The Panel cannot be satisfied that there will be no repetition of those deficiencies identified at the original hearing or that public confidence would not be undermined if she were permitted to practice without restriction. Accordingly the Panel is satisfied that the Registrant’s fitness to practice remains impaired.
26. The Panel has considered what sanction if any to impose and in the light of the history and nature of the misconduct it is satisfied that a sanction ought to be imposed, that a caution order would be insufficient but a Conditions of Practice Order would address the concerns previously identified.
27. In considering the conditions currently in place the Panel has varied one of the conditions and has added 2 further conditions. The Panel notes that the Registrant erroneously assumed that the HCPC would obtain the reports recommended. Accordingly a condition has now been inserted making it clear that there is an obligation upon the Registrant to obtain those reports and submit them to the HCPC.
28. The Panel has determined that the current order should be extended for a further 6 months. This will give the Registrant sufficient time to collect all the necessary documentation and obtain independent evidence to present to the next review Panel. This should provide her with the opportunity to demonstrate that she has addressed her deficiencies.
The Registrar is directed to vary the Conditions of Practice Order against the registration of Mrs Nicola Hewitt for a further period of 6 months on the expiry of the existing order. The Conditions are:
1. You must place yourself and remain under the supervision of a work place supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to HCPC within 14 days of taking up any new position. You must attend upon that supervisor as required and follow their advice and recommendations.
2. You must submit a report from your workplace supervisor(s) at least 14 days prior to any review hearing regarding your conduct, work performance and insight into past deficiencies.
3. You must submit to the Committee at least 14 days prior to any review hearing evidence from your GP about your current health status.
4. You must cease practising immediately if you are advised to do so by your General Practitioner and/or Occupational Health Specialist.
5. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.
6. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
7. 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).
8. Any condition requiring you to provide any information to the HCPC is to be met by you sending the information to the offices of the HCPC, marked for the attention of the Director of Fitness to Practise or Head of Case Management.
No notes available
History of Hearings for Nicola Hewitt
|Date||Panel||Hearing type||Outcomes / Status|
|15/09/2016||Conduct and Competence Committee||Review Hearing||Struck off|
|11/03/2016||Conduct and Competence Committee||Review Hearing||Conditions of Practice|
|17/09/2015||Conduct and Competence Committee||Review Hearing||Conditions of Practice|