Lesley A Bakos-Hodge

Profession: Dietitian

Registration Number: DT03798

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 12/12/2016 End: 17:00 12/12/2016

Location: Glasgow Marriott Hotel, 500 Argyle Street, Glasgow, Lanarkshire, G3 8RR

Panel: Conduct and Competence Committee
Outcome: Voluntary Removal agreed

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Allegation

Between January 2004 and November 2014 and during your employment as a Dietitian, with NHS Highland, you;

1. Did not respond to referrals appropriately. In that they were not prioritised and/or actioned, including for Patients 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,
11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and/or 22.

2. Did not maintain patient records appropriately, including for Patients 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and/or 22.

3. Did not produce appropriate care plans, including for Patients 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and/or22.

4. Did not follow up patients appropriately, including for Patients 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and/or22.

5. Did not maintain patient confidentiality, in that patient records were stored in nonsecure places.

6. Did not communicate appropriately with dietetic colleagues, in that you;
a) did not raise concerns about managing your caseload; and/or,
b) did not inform colleagues of patients needing urgent attention whilst you were on annual leave.

7. Did not communicate appropriately with medical staff, in that you did not send and/or document requested interventions.

8. Following an audit of your dietetic cards between 4 February 2014 and 12 June 2015, which received a 'red rating', did not:
a) Informally audit your record cards:
b) Record the results of your audits described in paragraph 8a) above.

9. The matters described in paragraphs 1 - 8 constitute misconduct and/or lack of competence.

10. By reason of your misconduct and/or lack of competence, your fitness to practise is impaired.

Finding

Preliminary Matters

Service of Notice and Proceeding in the Registrant’s Absence

1. The HCPC produced evidence that Notice of today’s hearing had been sent by way of letter which contained the full and correct details of today’s hearing. This letter had been sent using the appropriate postal service and posted in sufficient time on 4 October 2016 to the address shown on the HCPC’s register.  The Panel accepted that the rules relating to service of Notice had been complied with.

2. Mr Chan for the HCPC made an application to proceed with the hearing in the Registrant’s absence. He advised that the Registrant had previously absented herself from the HCPC hearings. He submitted service had been effected, all reasonable steps had been taken to serve notice and there was nothing to suggest an adjournment would secure the Registrant’s attendance.  He reminded the Panel that the Registrant had written to the HCPC confirming she would not attend the hearing today and said she did not wish to be on the Register. He submitted that there was a public interest in the matter proceeding today.

3. The Panel accepted the Legal Assessor’s advice on the matters to be considered. The Panel is aware that its discretion to proceed in absence is one which should be exercised with care.  The Legal Assessor gave advice to the Panel and referred it to the HCPC Practice Note on Proceeding in Absence and to the case of GMC v Adeogba [2016] EWCA Civ 162. This makes clear that the first question the Panel should ask is whether all reasonable efforts have been taken to serve the practitioner with notice. Thereafter, if the Panel is satisfied in respect of notice, the discretion whether or not to proceed must be exercised having regard to all the circumstances of which the Panel is aware.  The Panel is required to balance the interests of the Registrant against those of the HCPC and the wider public interest, with fairness to the practitioner being a prime consideration, but with fairness to the HCPC and the public interest also considered.  

4. The Panel having considered matters decided that it was fair and appropriate to proceed in the absence of the Registrant. The Panel noted the Registrant has voluntarily absented herself and has told the HCPC that she will not attend the hearing.  She is aware of the hearing today and has indicated her full acceptance of the Voluntary Removal Agreement (“VRA”). Nothing would suggest that an adjournment would secure her attendance and, further, there was a public interest in proceeding today.

Background and Submissions for the HCPC

5. Mr Chan told the Panel that the Registrant was a Dietitian employed by the NHS Highland, Argyll & Bute (“NHS Highland”).  In November 2014 a large number of patient referral and patient records were found in unattended bags and folders.  These papers were reviewed and investigated by NHS Highland.  The Registrant was alleged to have failed to adequately provide a professional service to a large number of Service Users in a number of areas.  The Registrant had failed in a wide range of areas including failures to respond to referrals; failures to maintain patient records; produce appropriate care plans and failures to maintain confidentiality and to communicate concerns appropriately.  The Registrant referred herself in May 2015 and a case to answer was subsequently found by the HCPC.

6. Mr Chan referred the Panel to the HCPC Practice Note on Disposal of Cases by Consent.  He advised the Panel it must be satisfied on two issues – does the VRA provide the appropriate level of pubic protection, and secondly, is the VRA such that it is not detrimental to the wider public interest?  He advised that the HCPC is satisfied that in this case both issues are met.  Mr Chan reminded the Panel that it may consent to the VRA if it is satisfied that the facts and nature of the allegation would produce a similar result at a final hearing. Mr Chan referred the Panel to the bundle and to the investigation of the Registrant’s practice by NHS Highland. He reminded the Panel that the Registrant had fully admitted the allegation in the VRA and had agreed to leave the Register.

7. Mr Chan told the Panel that the Registrant had made it clear to the HCPC that she is not currently practising and has no interest in ever practising again. Mr Chan submitted that a final hearing would be likely to produce the same outcome as that now sought by the Registrant.  The allegations were serious and he submitted that voluntary removal would satisfy the public interest and would also provide the required degree of public protection. He submitted that it was accordingly proportionate and appropriate to proceed by way of a VRA.

8. The Legal Assessor referred the Panel to the HCPC Practice Note on Disposal of Cases by Consent. He reminded it of the requirement for full admissions by a Registrant of the allegation, and the over-arching public interest, including the wider public interest. 

Decision

9. The Panel has reminded itself that it has to be satisfied that by adopting this process there is the appropriate level of public protection and that it would not be detrimental to the wider public interest.  It considered the submissions of the HCPC, the legal advice, the terms of the HCPC Practice Note and the VRA documentation.  The Panel carefully considered the bundle, including the NHS Highland investigation of the Registrant’s practice. The Panel is aware that if it is not satisfied that the criteria have been met it may reject the VRA and allow the matter to proceed to a final hearing.

10. After careful consideration of all the information before it, the Panel has concluded that in the circumstances of this case the approval of the proposed VRA is appropriate.  The Panel is satisfied that the public will be protected by the removal of the Registrant from the Register and that the wider public interest is also satisfied by the Registrant’s removal from the Register. The Panel notes that the Registrant has fully admitted the allegation and notes the statement in schedule C of the proposed VRA which will appear in the Register.  The Panel also notes that the Registrant has made it clear that she has no interest in continuing her profession or holding the title of dietitian and seeks removal from the Register.

11. In all these circumstances, the Panel is satisfied that there would be no detriment to the wider public interest in this allegation not proceeding to a final hearing and that it is appropriate and expedient to consent to the proposed VRA.

12. Accordingly, the Chair of the Panel has, on behalf of the Panel, signed and dated the Notice of Discontinuance and Voluntary Removal which consents to the HCPC discontinuing these proceedings with immediate effect and giving effect to the VRA agreed with the Registrant effective as of the date of this hearing.

Order

The Panel consents to the HCPC application to withdraw the allegation and to discontinue proceedings on the basis of the signed Voluntary Removal Agreement.

Notes

If the Registrant seeks to return to the HCPC Register at any time the application would be treated as if the registrant had been struck off as a result of that allegation.

Hearing History

History of Hearings for Lesley A Bakos-Hodge

Date Panel Hearing type Outcomes / Status
12/12/2016 Conduct and Competence Committee Final Hearing Voluntary Removal agreed