Mrs Jane M Little
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(as found proved at Substantive Hearing):
During the course of your employment as a Radiographer for Blackpool Teaching Hospitals NHS Foundation Trust:
1. On 8 October 2014, in respect of Patient 2
a. You did not ask a colleague to double-check the isotope vial and/or sign the administration sheet;
b. You injected Patient 2 with the wrong radiopharmaceutical
2. On 12 February 2015, you did not follow the correct procedure for a Glomerular Filtration Rate (GFR) test in relation to Patient 3 in that you:
a. Did not take blood from the patient prior to the administration of the radiopharmaceutical;
b. Did not complete an administration sheet in relation to the procedure
3. On 28 January 2015, in relation to Patent 4
a. You did not ensure that the adenosine infusion tubing had been correctly inserted into the infusion pump;
b. You administered an unmeasured volume of adenosine to Patient 4
4. On 2 July 2015, you did not check the calibration factor setting and/or calculate the radiopharmaceutical does accurately in the cases of:
a. Patient 6
b. Patient 7
c. Patient 8
d. Patient 9
5. Your actions as set out in paragraphs 1-4:
a. Exposed patients to unnecessary radiation, and/or
b. Demonstrated unsafe clinical practice,
6. The matters as described in paragraphs 1-5 constitute misconduct and/or lack of competence.
7. By reason of your misconduct and/or lack of competence you fitness to practise is impaired.
Proof of Service
1. The Panel found that there had been good service of the Notice of Hearing by a letter sent to the Registrant’s registered address informing her of the date, time and venue of the hearing.
Proceeding in the absence of the Registrant
2. Ms Senior made an application for the hearing to proceed in the absence of the Registrant. She referred the Panel to an e-mail sent to the Registrant dated 6 April 2018 and a follow up letter dated 9 April 2018. In this correspondence the Registrant was reminded of today’s hearing and asked whether she intended to attend the hearing or submit information. The Registrant has not responded to this correspondence.
3. The Panel carefully considered the circumstances of the Registrant’s absence. She has not requested an adjournment of the hearing and she has not engaged with the HCPC since 2017. The Panel considered that an adjournment would serve no useful purpose. This is a mandatory review of a Suspension Order which is due to expire and there was a strong public interest that the hearing should proceed. The Panel concluded that it was in the interests of justice to proceed with the hearing in the absence of the Registrant.
4. The Registrant was employed as a Band 7 Radiographer at Blackpool Teaching Hospitals NHS Foundation Trust (“the Trust”). At the time of the matters giving rise to the Allegation, the Registrant was the Deputy Nuclear Medicine Manager.
5. Between October 2014 and July 2015, a number of incidents occurred which gave rise to concerns about the Registrant’s ability to practise safely. Several patients treated by the Registrant, were either administered the wrong dosage of intravenous radiopharmaceutical and pharmaceutical drugs, or the correct clinical procedures were not followed.
6. At a hearing on 16-18 January 2017 the Registrant admitted some of the facts. A panel of the Conduct and Competence Committee found all the facts proved. The panel considered that there were serious breaches of the HCPC Standards of Conduct, Performance and Ethics and the Standards of Proficiency for Radiographers which amounted to misconduct.
7. The substantive hearing panel found that the Registrant had put her patients at risk of harm, had brought the profession into disrepute and had breached fundamental tenets by failing to act in the best interests of her patients. Although the Registrant had belatedly demonstrated some insight, there was not appropriate evidence of remediation, such as further courses or supervision. The Registrant had also failed to demonstrate sufficient insight into the substantial risks to service users, the public, and the Service as a whole as a result of her disregard for the Trust’s policies and procedures, in the context of nuclear medicine.
8. The substantive hearing panel found that the Registrant’s fitness to practise was impaired by reason of her misconduct and that the appropriate and proportionate sanction was a Suspension Order for a period of six months. A Suspension Order would afford an opportunity to the Registrant to demonstrate to a review Panel that she has gained insight into the damage caused to the profession by her misconduct, and to produce a reflective piece as to the role and procedures used in nuclear medicine to safeguard the interests of patients and the wider public.
9. The Suspension Order was reviewed by a panel of the Conduct and Competence Committee on 17 July 2017. On the day of the hearing the Registrant made a late application for an adjournment of the hearing. The Panel decided to reject that application and to proceed in the Registrant’s absence. The review panel decided to extend the Suspension Order for a further period of nine months. This would give the Registrant ample time to demonstrate remediation and insight into her failings. The review panel stated that a future reviewing panel would be assisted by: the Registrant’s attendance, a CPD portfolio; and a reflective piece detailing the role and importance of policies and procedures used in Radiography to safeguard the interest of patients and the wider public, as well as the impact the Registrant’s misconduct had or could have had on patients and others.
10. Ms Senior submitted that the Registrant’s fitness to practise remained impaired and that the appropriate sanction was a Striking-Off Order.
11. The Panel accepted the advice of the Legal Assessor.
12. The task of the panel today is not to go behind the decision of the previous Panel but to determine whether or not the Registrant’s fitness to practise remains impaired. The Registrant has not engaged with the HCPC since the review hearing in July 2017. There is no evidence that any changes have taken place since the substantive hearing. In particular there is no evidence of remediation, or that the Registrant has developed further insight. The Registrant was given advice by the substantive hearing panel and the review panel on the evidence she might provide to demonstrate that she is taking the appropriate steps, but she has not done so. She has been given fourteen months, which is ample time for her to take the necessary remedial action.
13. In these circumstances the Panel concluded that there remained a high risk of repetition of the Registrant’s misconduct if she were to be allowed to practise unrestricted. There was therefore a continuing risk to members of the public. The Panel also found that public confidence in the profession and the declaring of proper standards of conduct and performance demanded a finding of current impairment, given the lack of remediation and insight into the proved allegations.
14. The Panel noted the seriousness of the Allegation. The risks involved are substantial, involving the potential for patients to be exposed to unnecessary radiation. The Registrant’s misconduct adversely affected seven different patients over a ten month period of time.
15. The Panel concluded that the Registrant’s fitness to practise remains impaired.
16. The Panel considered that to impose no further action, or to impose a Caution Order would not be sufficient to protect the public or to address the wider public interest considerations, given that there remains a risk of repetition. A Conditions of Practice Order would not be appropriate or workable where the Registrant is not engaging with the HCPC and the Panel cannot be confident that she would comply with conditions.
17. The Panel considered an extension of the current Suspension Order. Although a Suspension Order would provide protection for the public, the Panel considered that it was not the appropriate sanction in circumstances where the Registrant has not engaged with the HCPC during the entirety of the Suspension Order, there was no explanation for the Registrant’s failure to engage, and the misconduct involved a serious departure from the required standards and a continuing risk to the health and safety of members of the public.
18. The Panel considered that paragraph 48 of the HCPC Indicative Sanction Policy on Striking-Off Orders was applicable. In particular, there has been a persistent lack of insight, and the Registrant’s failure to address her misconduct in accordance with the guidance given by previous panels indicated that she is unable or unwilling to resolve matters, and therefore that a lower sanction is not appropriate.
19. In its deliberations the Panel took into account the Registrant’s interests, but decided that were outweighed by the public interest.
20. The Panel decided that the appropriate and proportionate sanction is a Striking Off Order.
History of Hearings for Mrs Jane M Little
|Date||Panel||Hearing type||Outcomes / Status|
|11/04/2018||Conduct and Competence Committee||Review Hearing||Struck off|
|17/07/2017||Conduct and Competence Committee||Review Hearing||Suspended|