Hemantkumar Harold Contractor

Profession: Operating department practitioner

Registration Number: ODP32380

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 15/04/2016 End: 11:30 15/04/2016

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

Allegation (as found proved at Final Hearing)

During your employment as a band 5 Operating Department Practitioner with University Hospitals of Leicester NHS Trust (”the Trust”), between January 2010 and 2012, you:

 

1. Did not prioritise effectively;

 

2. Did not communicate effectively with colleagues;

 

3. Did not adapt to accommodate emergency cases or last minute changes to the theatre lists;

 

4. Did not demonstrate appropriate organisational skills;

 

5. Did not prepare and provide appropriate equipment required for theatre lists;

 

6. Did not anticipate the needs of the anaesthetists;

 

7. On or around 28 June 2010:

 

a. Gave the reversal agent (glycol and neo) to the anaesthetist rather than the glycopyrolate as requested;
b. Did not correctly check the anaesthetic machine;
c. …;

 

8. In or around February or March 2010, attempted to extubate a patient when you should not have;

 

9. On or around 20 July 2011, did not properly perform a modified rapid sequence induction in that you:

 

a. …………………;
b. Removed the cricoid pressure after the patient had been intubated without ensuring that the endotracheal tube was inflated;

 

10. On 14 October 2011:

 

a. Did not change the soda lime when requested to do so by an anaesthetically qualified nurse;
b. Did not put TED stockings on the patient when you should have;
c. Removed the patient’s blanket before putting up the screen thereby exposing the patient.

 

11. On October 16 2011, did not act promptly or appropriately in an emergency situation and had to be prompted as to what you should do;

 

12. That the matters found proved constituted a lack of competence.

 

13. By reason of that lack of competence, your fitness to practise was impaired.

Finding

Preliminary Matters

1. The notice of hearing dated 2 March 2016 was sent to Mr Contractor at his registered address by first class post on that date and therefore was properly served as required by Rule 13, HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”). 

2. By rule 11 of the Rules, the Panel may proceed in the absence of the Registrant if satisfied that all reasonable steps have been taken to serve the notice of hearing on him. The notice of hearing was also served by email on 2 March 2016 to an email address of the registrant held by the HCPC. Mr Contractor sent an email to the HCPC on 8 April 2016 in which he stated, 
 "I have been informed that there will be an assessment hearing regarding fitness to practice related to the above case on 15th April 2016 at 10.00 at the above address [405 Kennington Road, SE11 4PT]. I have attended one such hearing previously, and came to a conclusion that as there was no guidance or assistance provided by HCPC to work towards a remedial course of action towards returning to the ODP Register, I would therefore take no further active actions to provide evidence to be considered by the Review Panel... I would request you to inform the Case Officer that I will not be attending as requested. I assume the HCPC would take action according to its guidelines to bring the process to an end as I am unlikely to benefit in any way regarding this matter. Thank you"

3. Having received advice from the Legal Assessor, the Panel decided to proceed in the absence of Mr Contractor. All reasonable steps have been taken to serve the notice of hearing on him because the notice was served on him by post and by email and it is clear from his email of 8 April 2016 that the notice did come to his attention.

4. In view of his email and the contents of the notice of hearing, it is clear that Mr Contractor has deliberately chosen not to exercise his right to be present or represented. The reasons he has given did not make it unfair to proceed in his absence. They have been rejected by the Panel, because the onus is on Mr Contractor to demonstrate that his fitness to practise is no longer impaired. 

5. The indications are that Mr Contractor would not attend a further hearing if this hearing were adjourned and a statutory review of the existing order must be conducted by Article 30(1) of the Health and Social Work Professions Order 2001 (“the Order”).

6. Therefore, the Panel decided that it was fair and appropriate to proceed in the absence of Mr Contractor.

Background

7. Mr Contractor qualified as an Operating Department Practitioner (“ODP”) in July 2009, but his first employment as an ODP commenced on 4 January 2010. This was as a Band 5 Theatre Practitioner with the University Hospital of Leicester NHS Trust (“the Trust”), based at Leicester General Hospital.

8. Concerns were raised about Mr Contractor’s performance from an early stage of his employment, and those concerns continued throughout the period of his employment by the Trust. On 20 January 2012, he was informed that he was required to attend a Stage 4 Improving Performance (Capability) Hearing on 31 January 2012. That hearing did not take place, because Mr Contractor resigned from his employment on 26 January 2012.

9. A panel of the Conduct and Competence Committee sat on 15-18 April 2013 to consider an allegation that Mr Contractor’s fitness to practise was impaired by lack of competence in view of what were wide-ranging and fundamental concerns. He had sought to shift responsibility on to others on a number of occasions. Mr Contractor had been aware of the hearing, but did not attend. No good reason for his non-attendance had been given and that panel decided to proceed in his absence. 

10. The allegations were in large part proved and the panel found that Mr Contractor’s fitness to practise was impaired by reason of lack of competence and imposed a suspension order for a period of 12 months.

11. Mr Contractor did attend the review hearing on 17 April 2014. The reviewing panel found that his fitness to practise was still impaired, finding that he had demonstrated limited insight into his shortcomings, and had adduced no evidence to show that his professional competence had improved. That panel found that the Registrant had made no attempts to develop his expertise, maintain professional standards or acquire insight. His position was that some of the proven allegations were no more than “flimsy”. He informed that panel that a restriction was necessary on his practice, but as he might want to do voluntary work in the future, a conditions of practice order would be appropriate.  The reviewing panel decided to extend the suspension order for a period of 12 months, having found that no other sanction could afford a sufficient degree of protection to the public. 

12. The order was further reviewed on 24 April 2015. Mr Contractor was neither present nor represented at the hearing. That reviewing panel found that the Registrant had been aware of the hearing and it decided to proceed in his absence, no good reason for his absence having been given. That panel referred to an email from the Registrant sent to the HCPC on 23 April 2015, which did not address his failings. In view of the contents of that email, the panel stated that it ‘wishes to reiterate that the matter is not pre-judged’ (Notice of Decision and Order, paragraph 19). It was concluded that in the absence of any evidence of remediation, the panel had no option but to extend the suspension order, which it did for a further period of 12 months.

13. The panel went on to state in its Notice of Decision and Order, -

  A period of 12 months would be sufficient for the Registrant to assemble appropriate evidence to put before a future reviewing Panel. The Registrant may request an early review should he consider that he has adequate evidence to satisfy a reviewing Panel.
 
 At that next Review, the Registrant should be aware that, as he will have been subject to suspension for a period in excess of 24 months, a reviewing Panel will have the further option of striking his name off the Register. If it is the Registrant’s wish to return to practice as an ODP, that reviewing Panel will be assisted by the following evidence: 
  i) Demonstration of insight into the matters which brought him before the Panel;
  ii) Action he is taking to demonstrate how he could safely return to practice as an ODP’.

Decision on Impairment

14. The first issue is whether Mr Contractor’s fitness to practise is currently impaired. In Abrahaem v GMC [2008] EWHC 183 (Admin) Blake J stated, at [23] - In practical terms there is a persuasive burden on the practitioner at a review to demonstrate that he or she has fully acknowledged why past professional performance was deficient and through insight, application, education, supervision or other achievement sufficiently addressed the past impairments

15. The Legal Assessor advised that this approach was appropriate in the present context and the Panel has applied those principles to this review.

16. The lack of competence found by the original panel was wide-ranging and covered basic issues of practice as an ODP. Mr Contractor has once again put forward no evidence of remediation, even though the previous reviewing panel had made suggestions as to the type of evidence he could provide today. Therefore, this Panel finds that his fitness to be practise continues to be impaired.

Decision on Sanction

17. The Panel accepted the advice of the Legal Assessor. It has available to it the full range of sanctions that would have been available to the original Panel. However, now that the Registrant has been continuously suspended for a period in excess of two years, the limitation in Article 29(6) of the Order no longer applies and a striking off order may be made.

18. In the circumstances, it would be inappropriate either to take no further action, to direct mediation or to issue a caution. The necessary degree of public protection would not be secured by any such measure.

19. The Panel next considered whether a conditions of practice order would be appropriate. However, there was no evidence that Mr Contractor would comply with such an order. There were numerous patient safety incidents throughout Mr Contractor’s employment with the Trust, and the Trust did try many of the measures that might be relevant to a conditions of practice order, such as supervision, mentoring, a development plan and periods of supernumerary status. These were not effective. For these reasons, conditions would not secure the necessary degree of public protection.

20. Mr Contractor has been suspended for nearly 3 years. It has apparently been 4 years since he last worked as an ODP, and at that time he was unable to demonstrate safe and effective practice. He has not used this time to make any attempt to remediate his lack of competence and he has shown no insight into his failings, which are fundamental. The Panel has concluded that an order of suspension no longer meets the demands of the public interest, in those circumstances.

21. The Panel has borne in mind the principles set out in the Indicative Sanctions Policy, September 2015. In particular, paragraph 41 states, -

 Striking off should be used where there is no other way to protect the public, for example, where there is a lack of insight, continuing problems or denial. A registrant’s inability or unwillingness to resolve matters will suggest that a lower sanction may not be appropriate.

22. This reviewing Panel has concluded that all these factors apply to the present case and that in all the circumstances, a striking off order is necessary.

Order

Order: That the Registrar is directed to strike the name of Mr Hemantkumar Harold Contractor from the Register on expiry of the current Order.

 

 

Notes

The current Order will expire on 16 May 2016

Hearing History

History of Hearings for Hemantkumar Harold Contractor

Date Panel Hearing type Outcomes / Status
15/04/2016 Conduct and Competence Committee Review Hearing Struck off