Mrs Karen S Collister
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During the course of your practise as a Biomedical Scientist with the Countess of Chester Hospital NHS Foundation Trust, you:
1. Repeatedly failed bench competency tests, including:
a) a blood culture bench test over the period 4-13 January 2011, in which you made major errors in 18.8 per cent of total specimens and minor errors in 25 per cent, including:
i) you wrongly recorded Gram films;
ii) you failed to preserve isolates with regard to sample number 150163A;
iii) you left slopes at the back of the bench and/or you failed to label them properly;
iv) on 5 January 2011 and/or 6 January 2011 you did not report amoxicillin sensitivity results for sample numbers 150052A, 150052N, 156130A, 150076A and 150076N;
v) you reported CNSI from anaerobic bottle and CNS2 with the same sensitivity pattern from the aerobic bottle, in reference to sample number 156091N;
vi) you incorrectly read the sensitivity plates for the aerobic bottle numbered 150183J;
vii) you did not repeat the Oxacillin test for sample number 150008A.
b) a respiratory bench test over the period 4-13 January 2011, in which you demonstrated poor understanding of respiratory bacteriology, including:
i) In respect of number of sample number 170079P, you reported a Moraxella catarrhalis (MCAT) as sensitive to AMO because zone size was 31mm and larger than the zone on the template although the Beta lactamose (BLAC) was positive;
ii) In respect of sample number 170079P, you reported counts from the selective plates rather than the non-selective plates.
c) a blood culture bench test over the period 21 February - 4 March 2011, in which you made major errors in 17.8 per cent of total specimens and minor errors in 16 percent, including:
i) occasions where organisms were recorded as saved on beads but were not, for example, Samples 150863XB and 15075XN;
ii) you did not use the sensitivity templates in respect of sample 150894XN.
d) a respiratory bench test over the period 21 February - 4 March 2011, in which you demonstrated that your knowledge and/or understanding were insufficient to avoid interpretive errors, in particular:
i) In respect of sample 17001, you carried out sensitivity testing on MCAT bacterium although it was not actually MCAT bacterium;
ii) In respect of sample numbers 171095 and 121203, you failed to realize that you had mixed up the BLAC results despite the sensitivity profiles indicating otherwise;
iii) In respect of sample number 171100, you failed to record the results at 48 hours;
iv) In respect of sample number 170981, you incorrectly reported the sample as Trimethoprim when it was Trimethoprim resistant.
2.In March 2011 you plagiarised a colleague's work in written evidence you submitted for your specialist portfolio.
3.The matters set out in paragraph 1 amount to lack of competence.
4.The matters set out in paragraph 2 amounts to misconduct.
5.By reason of your lack of competence and/or misconduct your fitness to practise is impaired.
1. The Panel was satisfied that the Registrant had been properly served with the Notice of the hearing by a letter dated 12 July 2016.
Proceeding in absence
2. Ms Owusu-Akyem made an application for the hearing to proceed in the absence of the Registrant. She referred the Panel to an e-mail from the Registrant dated 23 July 2016 which was forwarded to the HCPC on 11 August 2016. The Registrant states that she will not be able to attend the hearing and refers to her difficult financial circumstances.
3. The Panel took into account the HCPC Practice Note “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel was satisfied from the Registrant’s e-mail dated 23 July 2016 that she is aware of today’s hearing and has waived her right to attend the hearing. No useful purpose would be served by an adjournment, because there was no likelihood that the Registrant would attend at a later date. It was in the public interest that the hearing of this mandatory review should be dealt with expeditiously. In all the circumstances, the Panel decided that it was in the interests of justice to proceed with the hearing in the absence of the Registrant.
4. The Registrant was a Band 5 Trainee Biomedical Scientist employed by the Countess of Chester Hospital NHS Foundation Trust (the Trust), now known as the Wirral University Teaching Hospital NHS Foundation Trust. As a Trainee Biomedical Scientist, the Registrant had completed her HCPC registration by 2006 and would have been expected to commence her specialist portfolio in order to progress to a Band 6 Biomedical Scientist. She did not start her specialist portfolio until 2008.
5. By 2009 the Registrant’s mentor had concerns that she had not completed her specialist portfolio within the allocated timeframe. The Registrant was given a one-year extension of time, but still had not completed her specialist portfolio by December 2010. Performance management procedures were initiated on 13 December 2010 and further assistance was provided to the Registrant to assist her to complete the portfolio. The Trust was concerned that, without completing the portfolio and associated competencies, the Registrant was unable to undertake the full range of the duties required.
6. The Registrant failed blood culture and respiratory bench tests between 4 and 13 January 2011 and between 21 and 4 March 2011. In May 2011 the Registrant initiated a grievance against the Chief Biomedical Scientist, which was not upheld by the Trust. However, it became apparent to the Trust that the Registrant had been plagiarising another colleague’s work.
7. On 22 March 2012 the Trust terminated the Registrant’s employment and made a referral to the HCPC about her lack of competence.
8. At a final hearing in 2013, the Registrant admitted the act of plagiarism, although she invited the Panel to accept that she had good reason for so doing. She did not admit that this amounted to misconduct. She denied the other particulars of the allegation.
9. The Final Hearing Panel found all but part of one of the particulars proved and that that these findings amounted to the statutory ground of lack of competence. The Panel also determined that the admitted plagiarism was serious enough to constitute misconduct.
10. The Final Hearing Panel was concerned about the Registrant’s lack of insight into her failings and the potential for harm, if she had not been closely supervised. There was an absence of remediation through undertaking relevant training courses or otherwise. The Panel was unable to discount the possibility of repetition of the Registrant’s deficiencies. Impairment of her fitness to practise was, therefore, found on the ground of lack of competence. The Panel did not accept that there was justifiable reason for the Registrant’s misconduct, nor that she had expressed any particular remorse about her actions. On the basis of the wider public interest and in order to maintain public confidence in the Biomedical Science profession, the Panel determined that the Registrant’s fitness to practise was impaired as a result of her misconduct.
11. The Panel decided that the appropriate and proportionate sanction was a Conditions of Practice Order for a period of two years.
12. The Conditions of Practice Order was reviewed on 12 August 2015. The Registrant attended the hearing and represented herself. The reviewing Panel was not presented with any evidence that demonstrated her remediation of the failings identified. She had not worked within a Biomedical Scientist or related environment and her skills had not been tested. The Panel was also concerned that her evidence demonstrated a continued lack of insight into the failings identified in her practice. The Panel on 12 August 2015 found that the Registrant’s fitness to practise remained impaired in relation to the Registrant’s lack of competence.
13. The Panel decided that the suitable and proportionate disposal of the case was to extend the conditions of practice for 12 months. The Panel varied the conditions to widen the scope for the identification of a person to supervise the Registrant. The purpose of the amendment was to reduce the impact of the Conditions on the Registrant’s obtaining employment as a Biomedical Scientist. The amendment involved no appreciable decrease in the protection afforded to the public.
14. The Panel expressed its concern about the length of time the Registrant would have been out of practice if she were not to secure employment during the course of the next 12 months, or otherwise provide evidence of remediation of her proven failings. The extension of the Conditions of Practice Order should be seen by the Registrant as a final opportunity to remediate the concerns about her practice as a Biomedical Scientist.
15. Ms Owusu-Akyem submitted that the Registrant’s fitness to practise remained impaired. There was no evidence of remediation, no evidence of attempts by the Registrant to find employment as a Biomedical Scientist, even though she said she had applied for work, no evidence of compliance with the Conditions of Practice and no evidence that the Registrant has maintained her CPD. She submitted that the ultimate sanction of a Striking Off Order was appropriate in the circumstances because there was no evidence that the Registrant has a continuing desire to practise as a Biomedical Scientist, the Registrant has been subject to conditions for three years, and has not complied with the conditions.
16. The Registrant’s position is set out in her e-mail dated 23 July 2016:
“The unfortunate position I find myself in, is as a direct result of my losing my job as a biomedical scientist. I have been unable to find any similar employment, I think due to these conditions of practice, I fought so hard to prevent the whole dreadful experience from happening but to no avail. Also the fact that I have now been out of the laboratory for more than 4 years, does not recommend me to potential employers…”
17. The Panel noted that the Conditions of Practice applied to both paid and unpaid work as a Biomedical Scientist, but there is no evidence that the Registrant has worked as a Biomedical Scientist in any capacity. The Registrant was given a further 12 months to comply with conditions, but there is no evidence that she has taken any steps to seek paid or voluntary work. There is no evidence of any remedial action, training or CPD. In these circumstances the Panel found that the Registrant’s fitness to practise remains impaired.
18. The Panel gave careful consideration to the HCPC Indicative Sanctions Policy. Although the Registrant has not attended today’s hearing, the Panel’s assessment was she has an interest in maintaining her registration. Her position 12 months ago was that she had a desire to return to practise and there is no evidence that her position has changed.
19. In the absence of evidence of remediation, the Panel was satisfied that a restriction on the Registrant’s practice remains necessary. It took the view that taking no action or a Caution Order would be insufficient to protect the public and maintain public confidence in the Biomedical Scientist profession.
20. The Panel decided that Conditions of Practice would not be sufficient or appropriate in circumstances where the Registrant has not provided any evidence that she has worked towards compliance with conditions over the last 12 months.
21. The Panel next considered the sanctions of a Suspension Order or a Striking Off Order. Both sanctions provide protection to the public because the Registrant is unable to work as a Biomedical Scientist. The Panel had in mind the need to balance the Registrant’s interest and the public interest. The Panel recognised that if the Registrant is to return to unrestricted practise, this will require commitment and dedicated effort from her, and that she has not provided evidence that she remains committed. Nevertheless, the Panel recognise that the Registrant has faced difficulties in complying with the Conditions of Practice in that she has been unable to obtain work as a Biomedical Scientist. The Registrant has not therefore demonstrated compliance with the conditions. There has been no breach of the conditions. The Panel’s assessment was that there still remains some prospect that the Registrant can be rehabilitated and return to unrestricted practise.
22. The Panel considered the wider public interest considerations including the need to maintain confidence in the profession and the regulatory process. The Panel’s view was that there was no compelling public interest reason for a Striking Off Order which was the most severe sanction in all the circumstances set out above.
23. The ultimate sanction of a Striking Off Order would remove the Registrant’s ability to practise as a Biomedical Scientist for at least five years. The Panel gave serious consideration to imposing a Striking Off Order; however, it concluded that, at this stage, such an order would be punitive and disproportionate. The Panel decided that the appropriate and proportionate order was a Suspension Order for 12 months. The 12 month period will give the Registrant a further opportunity to demonstrate that she is taking steps towards remediation of the failings in her practice identified by the Final Hearing Panel.
24. The Suspension Order will be reviewed before it expires. A future panel may be assisted by the following:
• Evidence that the Registrant has maintained her CPD and kept her knowledge up to date;
• Evidence of work experience, either paid or unpaid, in a medical laboratory environment, and testimonials in relation to that work.
The Registrar is directed to suspend the registration of Karen S Collister from the Register for a period of 12 months from the date of expiry of the current Order.
The order imposed today will apply from 13 September 2016.
This order will be reviewed again before its expiry on 13 September 2017.
History of Hearings for Mrs Karen S Collister
|Date||Panel||Hearing type||Outcomes / Status|
|15/08/2017||Conduct and Competence Committee||Review Hearing||Voluntary Removal agreed|
|12/08/2016||Conduct and Competence Committee||Review Hearing||Suspended|
|12/08/2015||Conduct and Competence Committee||Review Hearing||Conditions of Practice|