Ms Amy Jackson

Profession: Operating department practitioner

Registration Number: Operating Department Practitioner

Hearing Type: Review Hearing

Date and Time of hearing: 13:00 17/03/2016 End: 15:30 17/03/2016

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

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Allegations:

As amended

During the course of your employment as an Operating Department Practitioner at BMI the Lincoln Hospital, you:

1. Not proved.

2. Not proved.

3. On 20 August 2013, did not wear a lead apron when walking into a theatre case which required one.

4. On or around 29 August 2013, did not:

a. Follow the theatre checklist for a patient;

b. Not proved.

c. Wear gloves when shaving a patient and did not wash your hands before and after the procedure.

5. On 29 August 2013 during a clinical process:

a. Were unable to locate a Magills forcep and handed a Consultant a straight artery clip.

b. Not proved.

c. Did not apply cricoid pressure to a patient when requested to by Colleague A.

6. On 29 August 2013, did not:

a. Ascertain the allergy status of a patient; and

b. Ask the patient whether they had drunk any liquid or time food was last eaten.

7. On or around 9 September 2013, did not:

a. Notice that a patient's saturations were dropping and the patient was not breathing;

b. Notice that there was a leak in a patient's ventilator.

8. The matters described at paragraphs 1- 7 constitute misconduct and/or lack of competence.

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

Finding

Preliminary Matters

Service of Notice
1. The Notice of today’s Hearing was sent to the Registrant at her address as it appeared in the register on 12 February 2016 by first class post. The Notice contained the date, time and venue of today’s Hearing.

2. The Panel accepted the advice of the Legal Assessor. The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) require that a Notice of Hearing must contain the above information and be sent to the Registrant at her address not less than 28 days before the date of the hearing.

3. Accordingly, the Panel is satisfied that Notice of today’s Hearing has been served in accordance with the Rules.

Proceeding in the absence of the Registrant
4. The Panel then went on to consider whether to proceed in the absence of the Registrant. In doing so, it considered the submissions of the Presenting Officer for the HCPC. The Registrant has made no response to the Notice of today’s Hearing.

5. The Presenting Officer submitted that the HCPC has taken all reasonable steps to serve the Notice on the Registrant. She further submitted that the Registrant has not sought an adjournment. She submitted that the Panel can be satisfied that the Registrant’s absence today is voluntary and she has waived her right to attend and/or to be represented. An adjournment would serve no useful purpose and there was a public interest in this matter being dealt with expeditiously.

6. The Panel heard and accepted the advice of the Legal Assessor. He advised that if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the Hearing then the Panel has the discretion to proceed in the absence of the Registrant. He reminded the Panel that it should exercise that discretion with the utmost care and caution. He drew the Panel’s attention to the principles to be
considered when exercising the discretion to proceed in the absence of the Registrant as outlined in the case of R v Jones [2002] UKHL 5. He further advised that the Panel should consider the nature and circumstances of the Registrant absenting herself, in particular whether the decision was voluntary and, if so, whether the Registrant has waived her right to be present and/or represented. He reminded the Panel that it should also remember the general public interest that the Substantive Order is reviewed today.

7. The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of today’s Hearing. In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPC Practice Note ‘Proceeding in the Absence of a Registrant’. The Panel weighed its responsibilities for public protection and the expeditious disposal of the case with the Registrant’s right to a fair hearing.

8. In reaching its decision, the Panel took into account that the Registrant has made no application to adjourn today’s Hearing and that there is a public interest that this Substantive Order is reviewed before it expires. The Panel was satisfied that the Registrant had voluntarily absented herself from the Hearing and has waived her right to be represented. It determined that it was unlikely that an adjournment would result in her attendance at a later date. The Panel would not draw any adverse inference from her non-attendance. Having weighed the public interest in the expeditious disposal of this case with the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.

Background
9. The Registrant had been employed by the BMI, the Lincoln Hospital (the Hospital) as a registered Operating Department Practitioner (ODP) in theatres from 2011 until her dismissal in December 2013. She commenced healthcare work in 1992, first working as an enrolled nurse. In 1997 she went into agency work for 2 years and from 1997 until 1999 she had worked as an ODP, when she broke her career to raise a family. She then worked as a Healthcare Assistant in theatres from approximately 2010 until
approximately 2011. From the time of her re-registration in July 2011 as an ODP, the Registrant was working part time for Hospital for approximately 27 hours a week.

10. Following an incident, a Performance Improvement Plan (PIP) was begun for the Registrant which commenced on 2 July 2013 and included weekly meetings and reports, the requirement to keep a reflective diary and the maintenance of a patient log. The PIP was implemented and maintained by a theatre manager, from 27 May 2013, and it was supervised by a lead ODP and the Registrant’s supervisor.

11. In addition, at around this time, a National Theatre Clinical Skills and Education Trainer for BMI’s Education and Training group was also asked to conduct an ongoing assessment of the Registrant in practice. She met the Registrant and prepared a report on her. She then undertook two assessments of the Registrant and prepared reports after each assessment. In June 2013, the HR Department of the Hospital appointed another practitioner, a Quality and Risk Manager, who specialised in theatres, and who was also a registered nurse, to investigate concerns about the Registrant’s performance as a result of a morphine incident on 1 June 2013.

12. During the course of the PIP, a number of further failings were identified by the Hospital. These formed the basis of the allegations before the HCPC final hearing panel on the 16 - 20 March 2015. The Registrant’s performance was reviewed on 12 September 2013, after which the Registrant was suspended from her employment. As part of the Hospital investigation in November 2013 the Registrant was interviewed and an Investigation Report was prepared dated 28 November 2013.

13. The Hospital undertook a disciplinary hearing on 20 December 2013 in relation to non-clinical matters unrelated to this case. This resulted in the Registrant’s summary dismissal, which she appealed against. A compromise agreement was entered into.

14. The Registrant received a final written warning on 9 December 2013 in relation to the matters alleged in this case. However, by reason of the suspension and the dismissal the Registrant has not worked for the Hospital as an ODP since 17 September 2013.

15. At the HCPC final hearing on 16 - 20 March 2015 that panel, having heard the evidence, found allegations 3, 4a, 4c, 5a, 5c, 6a, 6b, 7a and 7b proved. It decided that the facts proved at 3 and 4c amounted to misconduct and the remainder of the facts proved amounted to lack of competence and that the Registrant’s practise was impaired. It concluded that a Suspension Order for 1 year was the appropriate and proportionate sanction.

Submissions:

16. The Presenting Officer drew to the Panel’s attention the decision at the final hearing on 20 March 2015. The Registrant did not attend and was not represented at that hearing. The Presenting Officer drew to the Panel’s attention paragraphs 87 and 93 of that decision and the concerns that panel expressed as to the Registrant’s lack of insight and remediation. That panel at paragraph 99 of their decision had suggested further information from the Registrant which would assist a reviewing panel. No information has been provided by the Registrant and since that hearing she has not engaged with these proceedings. The Presenting Officer referred the Panel to the HCPC‘s Indicative Sanctions Policy and to their powers on review.

17. The Presenting Officer confirmed that no information has been provided by the Registrant. She submitted that if the Panel were minded to extend the current Suspension Order it may be helpful if it were to suggest what information from the Registrant would assist a future reviewing panel.

Decision
18. The Panel accepted the advice of the Legal Assessor. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if she is fit to return to unrestricted practice. Its role is not to conduct a rehearing of the allegations nor is it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment. He advised the Panel that it should make its determination based on the evidence before it today.

19. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired all the options under Article 30 of the 2001 Order could be exercised by the Panel. He advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the HCPC’s Indicative Sanctions Policy. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.

20. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it and the submissions of the Presenting Officer.

21. Taking all of the above into consideration, the Panel determined that there is no evidence upon which the Panel can judge the level of insight the Registrant has into her failings or assess whether she has taken any steps to remediate them. The Panel determined that the Registrant’s fitness to practise remains impaired.

22. The Panel then went on to consider what action, if any, it should take in light of its finding of current impairment. In doing so, it had regard to the HCPC Indicative Sanctions Policy. The Panel first considered whether it would be appropriate to take no further action and to allow the current order to lapse at its expiry. The Panel is of the view, given the seriousness of the matters and the absence of any evidence of insight and remediation on the part of the Registrant, that it would not be appropriate to allow the order to lapse. The Panel next considered whether a Caution Order would be an appropriate order but concluded that a caution order would not be sufficient to address the lack of competence and misconduct.

23. The Panel next considered whether a Conditions of Practice Order would be an appropriate order in this case. However, it determined that in the absence of any information whatsoever about the Registrant’s current circumstances, and her lack of engagement in this process, a Conditions of Practice Order would be not be appropriate or workable.

24. The Panel then considered a Suspension Order. It considered that an extension of the existing Suspension Order would, in all the circumstances, serve to allow the Registrant an opportunity to engage with her regulator and provide evidence of her competence, insight and remediation. It noted that the failings found proved were a mixture of a lack of competence and misconduct, which should be possible to remediate.

25. The Panel would reiterate that the information suggested by the panel at the final hearing is information that a future reviewing panel would find of assistance, namely :

 Documentary and oral proof of the Registrant’s reflection and insight;

 What the Registrant has done about her identified failings;

 Anything else the Registrant considers as relevant, such as relevant professional development and any references and testimonials, so as to demonstrate if the Registrant might be ready to commence a staged return to practice as an ODP.

26. The Panel considered Striking Off the Registrant. However, it concluded that this would not be an appropriate or proportionate sanction at this stage. It considered that the Registrant should be given one further opportunity to demonstrate to a future review panel that she has developed full insight and taken steps to remediate. The Panel were concerned that, over the period of 12 months since the Suspension Order of 20 March 2015, the Registrant has made no attempt to engage and has failed to provide any of the evidence suggested by the panel at the final hearing at paragraph 99 of that decision. The Panel noted that there is no evidence that the Registrant has worked as an ODP since her suspension from work some 30 months ago. If there is no new information available to a future reviewing panel, this Panel considers it possible that such a panel might conclude that her failings are no longer capable of being remediated.

27. In the light of the above, the Panel are satisfied that the appropriate and proportionate response to protect the public and being otherwise in the public interest in these circumstances, is to extend the existing Suspension Order for a further 12 months.

Order

ORDER: The Registrar is directed to suspend the registration of Amy Jackson for a further period of 12 months on the expiry of the existing order. The order imposed today will apply from 17 April 2016. This Order will be reviewed again before its expiry 17 April 2017.

Notes

This Order will be reviewed on or before its expiry.

Hearing History

History of Hearings for Ms Amy Jackson

Date Panel Hearing type Outcomes / Status
17/03/2016 Conduct and Competence Committee Review Hearing Suspended