Mrs Jayne B Carruthers

Profession: Occupational therapist

Registration Number: OT33194

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 29/08/2018 End: 16:00 29/08/2018

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

Panel: Conduct and Competence Committee
Outcome: Voluntary Removal agreed

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Allegation

Whilst registered and working as an Occupational Therapist at North Cumbria University Hospitals NHS Trust:

1. In relation to Patient 1:

A. On 28 October 2015, you sent Patient 1’s photograph to a wheelchair company

(i) using unencrypted email

(ii) without obtaining and/or recording Patient 1’s consent

B. On 28 October 2015, you sent Patient 1’s name and address to a wheelchair company using an unencrypted email

C. You did not respond to a quote for a seating system received on 14 November 2015 in a timely manner.

D. On 15 December 2015, your response to a quote for equipment

(i) was missing a signature

(ii) was sent to the wrong person

E. On or around 09 December 2015, your funding request did not make reference to equipment that had been previously recommended, such as,

(i) a manual wheelchair, and

(ii) a power pack

F. You took no further action when your erroneous response to an equipment quote was returned back to you on 15 December 2015.

G. Between December 2014 and May 2015

(i) you did not update Patient 1’s parent with regard to the progress of the additional funding request

(ii) (on 08 April 2015, you wrongly advised Patient 1’s parent that the delay in obtaining equipment was due to funds not being released

(iv) you did not record and/or inform Patient 1’s parent that the funding request for equipment had been agreed on 17 April 2015

H. Between 05 May 2015 and 29 April 2016,

(i) you did not record any record and/or respond to requests to contact Patient 1’s parent

(ii) you did not update the administration staff with regard to Patient 1’s case

I. On or around 30 October 2015, you did not make onward referrals to:

(i) Tissue Viability,

(ii) a consultant in rehabilitation medicine for Botox injections,

(iii) Paediatric Physiotherapist

J. You did not request the attendance of the private company who make Patient 1’s seating system to the clinic.

K. You did not complete a full assessment of Patient 1.

L. You did not apply for a Tilt-in-Space wheelchair, in a timely manner.

M. You did not record your clinical reasoning for the funding of a Tilt-in-Space wheelchair.

N. Between 02 November 2015 and 05 February 2016

(i) you did not record any notes/information relating to Patient 1

(ii) you did not evidence any active monitoring of Patient 1’s case

2. In relation to Patient 2 you did not keep contemporaneous records in that:

A. You did not record

(i) whether Patient 2 received a new cushion

(ii) a review of whether the new cushion was adequate for Patient 2’s needs

(iii) any entries between approximately September 2014 and 08 June 2015

(iv) a response to Patient 2’s mother’s request for an update on 05 January 2016

(v) an alert to the admin team advising that an Action 4 wheelchair had been ordered

(vi) your clinical reasoning to support the change in specification of equipment from action 3 wheelchair to action 4 wheelchair

(vii) whether handover of the action 4 wheelchair took place

3. In relation to Patient 3,

A. On or around 30 October 2015, you did not request a review of Patient 3, once being aware that he had been admitted to hospital to have a tracheostomy fitted.

B. You did not record,

(i) who was supposed to make a referral to Medical Physics and/or Technical Aids Service,

(ii) notes from home visit on 21 December 2015 on the clinical records

C. You did not ensure that a referral was made to the Technical Aids Service in a timely manner

D. You did not take appropriate actions to address Patient 3’s accident on or around March 2016, in that:

(i) you did not formally request an investigation of the accident, and

(ii) you did not complete the Trust’s incident form

E. You did not visit and/or record a home visit to Patient 3 which was agreed with the Paediatric OT on the 23 March 2016.

4. In relation to Patient 4

F. you did not record:

(i) Patient 4’s pressure mapping assessment which took place on 19 April 2015

(ii) Patient 4’s prescription and/or assessment of a new cushion

5. In relation to Patient 5

A. On or around 29 May 2015, you did not action an urgent request for discomfort relief.

B. Between 29 May 2015 and 13 July 2015, you did not record any observations and/or review in respect of Patient 5’s discomfort.

C. You did not record,

(i) any entries between 19 August 2015 and 25 January 2016

(ii) the reason why Patient 5 did not receive a pressure mapping assessment as per your recommendation on 01 March 2016.

6. The matters set out in paragraphs 1 - 5 constitute misconduct and/or lack of competence.

7. 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 using the appropriate postal service; that letter having been sent in sufficient time in advance of the hearing to the Registrant’s address shown on the HCPC Register.  The Notice had been sent by post and also by email.

2. The Legal Assessor emphasised the fact that at this stage the HCPC had to provide evidence of posting but it did not have to show receipt. The Panel accepted that the HCPC had discharged its responsibilities in bringing this matter to the Registrant’s attention.

3. The Panel noted from the correspondence within the main bundle dated 26 July 2018 from the Registrant’s UNISON representative that neither the Registrant nor her representative would be in attendance at the hearing. The Panel appreciated that in a hearing of this nature the Registrant’s interest in the matter proceeding in her absence coincided with the public interest in this hearing going forward today without delay or further cost.

4. The Panel received the HCPC’s representations that this matter should be heard today and accepted the Legal Assessor’s advice on the issues to be considered before reaching that decision. Given the evidence that the Registrant and her representative had made an informed decision not to attend, that it was in the Registrant’s and the public’s interest that this matter proceed, the Panel decided that it would hear the case in the Registrant’s absence.

Hearing in Private

5. The HCPC made an application for part of the hearing to be held in Private as there would be reference to health issues. It was submitted that this was to protect the Registrant’s right to a private life.  The Panel took legal advice.

6. Having had the opportunity before the hearing to read all relevant documentation relating to underlying health issues the Panel appreciated the need for any reference to these matters to be heard in private. The Panel therefore agreed to discrete parts of the hearing being heard in private should it be necessary.

Background

7. The Registrant is a registered Occupational Therapist.

8. The Registrant was employed as the Clinical Lead (Band 7) Occupational Therapist of Wheelchair Services at North Cumbria University Hospitals NHS Trust (“the Trust”). She was responsible for managing the Occupational Therapy element of the wheelchair services and held a clinical caseload, typically of the more complex cases. During a period of sickness leave, the Trust started to receive complaints from the Registrant’s patients regarding delays in their treatment, including the delivery of equipment.

9. When the Registrant’s caseload was reviewed, there were instances where matters had not been acted on, funding requests for equipment had not been progressed expediently, proper procedures had not been followed and patients had not been provided with updates on their treatment which resulted in delays in their treatment. The Deputy Head of Occupational Therapy was asked to undertake a clinical review and submit a report regarding five of the Registrant’s cases.

10. The Registrant subsequently resigned before the matter could progress to an internal disciplinary hearing.

11. On 6 December 2017, a Panel of the Investigating Committee determined that there was a ‘case to answer’ in respect of the Allegation set out above.

Application

12. Further contact between the HCPC and the Registrant identified the Registrant’s wish to leave the Register. In her email dated 29 March 2018 the Registrant confirmed that she wished to proceed with the voluntary removal process and did not contest the Allegation.

13. In an email dated 23 May 2018, the Registrant subsequently admitted the Allegation and confirmed that she is no longer working as an Occupational Therapist and, due to ongoing health issues, has no intention of doing so in the future.

14. On 8 August 2018 the Registrant signed the Voluntary Removal Agreement, thereby accepting that her current fitness to practise is impaired. 

15. The HCPC submitted that this was an appropriate case for disposal by way of a Voluntary Removal Agreement.  It stated that public protection would be ensured by this course of action and that it was not detrimental to the wider public interest.

16. It was submitted that the Voluntary Removal Agreement was an appropriate and expeditious way of dealing with this matter and the HCPC invited the Panel to approve the proposed agreement.

Decision

17. The process of disposing of a case by way of consent is an extra-statutory means of concluding a matter.  However, before agreeing to such a course the Panel has to be certain that by adopting this process there is the appropriate level of public protection and that there is no overriding public interest in this matter proceeding to a Final Hearing. 

18. Article 11(3) of the 2001 Order and Rule 12(3) of the Health and Care Professions Council (Registration and Fees) Rules 2003 prevent a registrant from seeking to resign from the Register whilst the registrant is the subject of an allegation.  This being the case the Panel would, if agreeing to this matter being dealt with in this way, be required to agree to a discontinuance of proceedings.

19. The Guidance issued by the Council states:

“In cases where the HCPC is satisfied that it would be adequately protecting the public if the Registrant was permitted to resign from the Register it may enter into a Voluntary Removal Agreement allowing the Registrant to do so, but on similar terms to those which would apply if the Registrant had been struck off.”

20. If the Panel is not satisfied that the above criteria have been met it appreciates that it has the ability to reject the application and allow the matter to proceed to a full Final Hearing.

21. The Panel was informed of the Investigating Committee Panel’s decision that there is a case to answer. It has seen the witness statements, comprehensive case records and minutes which have been gathered by the HCPC in preparation for a Final Hearing.  This evidence supported a view that the matters alleged in the Allegation were capable of being found.

22. The Panel noted the points made by the Registrant in her various communications with the HCPC . The Panel also noted the terms in which former colleagues had described the Registrant as having been an excellent practitioner whose practice had been of the highest standard. From this the Panel has concluded that had this matter gone to a Final Hearing the ground of lack of competence was unlikely to have been made out and this may therefore have been more obviously a case of misconduct or health. If the latter, then a strike off would not be available to a Final Hearing Panel.

23. Whilst the Panel noted the Registrant’s representative considered that it would be possible to make a strong case for no case to answer, in her email of 28 March 2018, it is clear from the Registrant’s email to her UNISON representative dated 23 May 2018 that the Registrant has chosen a different position. She states:

“I acknowledge and admit the allegations including that of impairment. As a result of my health I have no intention of practising as an occupational therapist in the future, I have read and understood the information provided in that voluntary removal has the same effect as a striking off and that it will be on the HCPC website for 5 years.

I understand the impact of this, and hope to draw a close to things for the good of my health.”

24. In her last communication the Registrant’s UNISON representative stated:

“Please advise us of the determination once it is made as it will put her mind at rest and allow her to move on.”

25. It is clear from this that the Registrant, despite independent advice, has reached a decision that her health, and bringing matters to a conclusion, outweigh her ability to return to her profession in the near future. The Panel does not consider that the matters raised in this case are such that a public hearing is warranted.

26. The Panel is satisfied that the Voluntary Removal Agreement will provide continued service user protection in that the Registrant will not be able to practise.  The Panel considered that the wider public interest has been appropriately dealt with and would not be affected by this matter not being publicly scrutinised at a Final Hearing. In this regard the Panel noted that the HCPC has reserved the right to publicise the terms of the agreement. Further the Registrant wishes to effectively retire from practice and there will be a saving of public funds through adoption of the process of voluntary removal. The Panel is of the view that the matters alleged are not so deplorable as to require the ultimate sanction of removal. Therefore, the acceptance of a measure equivalent to strike-off will not be seen by the public as the Registrant taking an easy way to leave past events behind.

27. The Panel has concluded that in all the circumstances of this case the approval of the proposed Voluntary Removal Agreement is the proportionate and appropriate course of action in this matter.  

28. The Panel notes the terms of the Voluntary Removal Agreement that is before it and the fact that it has been signed by both parties.  Accordingly, the Chair of the Panel has, on behalf of the Panel, signed and dated the attached Notice of Withdrawal which will take immediate effect.

Order

The Registrar is directed to remove the name of Mrs Jayne B Carruthers from the Register with immediate effect.

Notes

No notes available

Hearing History

History of Hearings for Mrs Jayne B Carruthers

Date Panel Hearing type Outcomes / Status
29/08/2018 Conduct and Competence Committee Final Hearing Voluntary Removal agreed