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(as proved at the Final Hearing)
During the course of your employment as a Biomedical Scientist at Western Sussex Hospitals NHS Foundation Trust, you:
1. In April 2010, whilst working on the faeces bench, you:
a) Did not display sufficient understanding of basic identification techniques;
2. Whilst working on the faeces bench, you
a) Did not communicate results of Clostridium Difficile Toxin testing to Consultant Microbiologists;
3. Between May to July 2011, whilst working on the wound bench, you:
a) Did not display sufficient understanding of the different types of media.
4. Following checks of your work during the formal capability process, it was identified that:
a) On 24 June 2011:
i. You recorded a Coagulase negative staphyloccus isolate instead of a yeast isolate;
ii. You reported +++Coliform and skin flora, instead of +++ Coliform and +++ Staph aureus;
5. The matters set out in paragraphs 1 to 4 constitute lack of competence.
6. By reason of that lack of competence, your fitness to practise is impaired.
1. The Panel found that there had been good service of the proceedings, by notice dated 21 April 2016 sent to the registered address of Mrs Atanasova (the Registrant) in accordance with Rule 3 (1) of the Health and Care Professions Council (Conduct & Competence Committee) Rules 2003.
Proceeding in absence
2. The Registrant was neither present nor represented. Conscious of its duty to deal with this matter expeditiously the Panel considered that it was appropriate and fair to proceed in her absence. The Panel was satisfied that she had voluntarily waived her rights to attend the Hearing. In coming to this conclusion the Panel had in mind the HCPC Practice Note on Proceeding in the Absence of the Registrant and the provisions of Rule 11 of the rules. The Panel noted, in particular, that the Notice of Hearing had been both posted and emailed; that she had not attended any of the previous hearings; her last communication with the HCPC was in 2014, but her last meaningful communication with this process was in 2012.
3. Mr Newman pointed out that there were typographical errors in previous determinations about what it was that the substantive panel had found proved within the allegation. In fact, particulars 4(a)(iii) and 4(b) had not been found proved and this determination reflects those findings.
4. On 17 March 2010, the Registrant began work as a Band 6 Specialist Biomedical Scientist (SBMS) in the Microbiology Department of Worthing Hospital (the Hospital), which was part of Western Sussex Hospitals NHS Foundation Trust (the Trust).
5. In April 2010, the Registrant was placed on the ‘Faeces Bench’ within the plate- reading section of the Microbiology Department. Concerns were raised by a colleague in relation to the Registrant’s understanding of the basic identification techniques used in the Microbiology Laboratory.
6. In May 2010, the Registrant was placed on the Blood Culture Bench. Concerns were raised regarding her communication abilities and lack of basic microbiology knowledge. A mentor was then assigned to the Registrant to provide her with support and training. In December 2010, other staff expressed further concerns about errors made by the Registrant during her time on the Blood Culture Bench.
7. Following a meeting in December 2010, the informal capability stage of the Trust’s Performance Management Procedure was invoked on 05 January 2011 and objectives were set for the Registrant to meet. Internal reviews of her work were undertaken in February, April and May 2011.
8. Concerns in relation to the Registrant’s performance continued and the Trust’s capability procedure was followed through to the formal stages, the outcome of which was a conclusion that the Registrant was not able to work autonomously as a Band 6 SBMS. She resigned from her post with the Trust on 26 July 2011 before the Trust’s performance management procedure was concluded. Her resignation took effect from 26 August 2011.
9. A referral was then made to the HCPC on 11 November 2011 about the Registrant’s lack of competence.
10. On 21 May 2013, a panel of the HCPC’s Conduct and Competence Committee found the Registrant’s fitness to practise to be impaired on the grounds of lack of competence. That panel imposed a Conditions of Practice Order on her registration for a period of two years on the grounds of public protection and in the public interest.
11. The Conditions of Practice Order was reviewed by a panel of the Conduct and Competence Committee (the reviewing panel) on 07 May 2014. The reviewing panel was concerned that there had been no engagement by the Registrant with the HCPC since the substantive order was imposed in May 2013. The reviewing panel was conscious of the communication received by the Council from the Registrant, dated 23 July 2012, in which she indicated that she intended to return to Bulgaria and in which she appeared to express no desire to return to work in the United Kingdom as a Biomedical Scientist.
12. The reviewing panel further took the view that the Conditions of Practice imposed on the Registrant’s registration was “no longer workable or appropriate”. That panel also noted an absence of evidence of insight on the part of the Registrant. It went on to replace the Conditions of Practice Order with a Suspension Order with immediate effect for 12 months.
13. At the second review hearing on 13 April 2015, in extending the Suspension Order for a further 12 months, the panel noted that the Registrant “had not taken advantage of the period of her suspension to reflect on her clinical shortcomings and to address the deficiencies in her competence”.
14. That same panel further emphasised that its order would provide the Registrant with further opportunity to engage with the proceedings and collate evidence to put before the next panel in confirmation that she had remediated the deficiencies in her clinical knowledge and skill.
15. Stress was also placed upon the fact that the period of such a sanction meant that all sanctions would be available to the future reviewing panel.
16. Today, Mr Newman submitted that the Registrant’s fitness to practise was still impaired. There had still been no engagement from her over the last 12 months and the HCPC had no notion as to where she was and what job, if any, she was doing. In brief, circumstances had not changed since the last review, except that a further year had expired without any communication from the Registrant.
17. On the subject of sanction Mr Newman highlighted that a Striking Off Order was now available to the Panel and stressed that there had been no indication of the Registrant’s intention to seek to remediate the issues that had compromised patient safety.
18. The Panel accepted the advice of the Legal Assessor and applied its own independent judgement as to whether or not the Registrant’s fitness to practise was still impaired.
19. In taking proper account of the contents of the relevant Practice Note, the Panel noted that no evidence at all had been produced by the Registrant for this review.
20. It reminded itself of the remarks of the last reviewing panel referred to above and concluded that, yet again, there was no evidence of remediation, a continuing risk to patient safety, and that the Registrant’s fitness to practise therefore remained impaired.
21. In considering the appropriate sanction, if any, to impose, the Panel took note of the contents of the Indicative Sanctions Policy and took the view that the deficiencies identified by the substantive panel of the Registrant’s practice were serious. Her failings were across a range of clinical skills and techniques; were repeated over an extended period of time; continued despite support and mentoring; and had had the potential of putting patient safety at risk.
22. Some form of sanction, in the Panel’s view, is necessary in the public interest and on the grounds of public safety. In considering the sanctions in ascending order, the Panel concluded, in the circumstances of this case, there has, in effect, been no significant or meaningful engagement from the Registrant for a period of almost 4 years and that there is no evidence of any attempts at remediation. The Panel also took the view that there is a public interest in these fitness to practise proceedings being brought to a conclusion. The only appropriate and proportionate sanction now to impose is that of a Striking Off Order.
The Registrar is directed to strike the name of Mrs Zhelana Atanasova from the register with immediate effect.
History of Hearings for Zhelana Atanasova
|Date||Panel||Hearing type||Outcomes / Status|
|19/05/2016||Conduct and Competence Committee||Review Hearing||Struck off|