Mr Konrad Sikorski
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During the course of your employment as a Physiotherapist for Western Sussex Foundation Trust:
1. Between approximately 21 October 2014 and 20 July 2015, you:
a) recorded information on patient front sheets:
i) without understanding the implications of recording the information;
ii) without understanding the medical terminology used;
iii) missing significant information that could lead to patient safety being compromised.
b) did not understand the complications and / or safety implications of potential cord compression to physiotherapy treatment, in that you planned to mobilise a patient
c) did not recognise that a patient was unsafe with a walking aid.
d) did not recognise and / or seek assistance when a patient was desaturating with a CPAP (continuous positive airway pressure) valve open
e) did not recognise and / or seek assistance when a patient had a vasovagal
2. The matters set out in paragraph 1 constitute lack of competence.
3. By reason of your or lack of competence, your fitness to practise is impaired.
Service of Notice
1.The Panel found that there had been good service of the Notice of Hearing by a letter dated 8 February 2018 which informed the Registrant of the date, time and location of the hearing.
Proceeding in the Absence of the Registrant
2.Ms Viriri made an application for the hearing to proceed in the absence of the Registrant.
3.The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPTS Practice Note “Finding that Fitness to Practise is Impaired”.
4.The Panel noted that the Registrant did not attend the Final Hearing and that he has not responded to recent correspondence from the HCPC. The Panel concluded that his absence is voluntary. He has not requested an adjournment of today’s hearing and the Panel considered that it was unlikely that an adjournment would secure his attendance. The hearing is to consider a mandatory review of a Suspension Order and there is a strong public interest that the hearing should proceed without delay. The Panel decided that the public interest outweighs the Registrant’s interests and that the hearing should proceed in his absence.
5.The Registrant was employed by Western Sussex Hospitals NHS Foundation Trust (‘the Trust’) on 7 May 2014, initially as a Band 3 Physiotherapy Technician. He was appointed as a Band 5 Physiotherapist in July 2014 and placed in a rotational role in order to develop his skills in different aspects of physiotherapy. His duties included the assessment of service users using investigative and analytical skills, to devise treatment plans, to be responsible for the safe use of equipment and to be responsible as an autonomous practitioner to undertake an independent clinical caseload.
6.The Registrant’s first rotation session was in the Musculoskeletal Physiotherapy Outpatients Department of Worthing Hospital until 21 October 2014 when he moved to the Respiratory Physiotherapy Team working in the Acute Medical Unit (‘AMU’). In this part of his rotation he was placed under the supervision of DE, a Band 6 Physiotherapist, and his Line Manager was EK, a Band 7 Team Leader for Respiratory Physiotherapy.
7.In the AMU, the Registrant was responsible for the assessment of medical service users and in particular elderly service users with respiratory complications. A number of learning objectives were given by DE to the Registrant on 28 October 2014 in view of concerns which had arisen during the first week of his work in the AMU, and as early as the first day of his work there.
8.The concerns included the carrying out of assessments, which first required completion of written ‘patient front sheets’. These are key documents, which set out in summary form the reason why the service user has been admitted to hospital and the significant features of their medical history (including medical conditions and other reasons that may contra-indicate certain physiotherapy techniques). This summary is compiled by the Physiotherapist after reading the service user’s medical notes. The front sheet also incorporates an assessment and a proposed plan of treatment. The document would be for use by the Physiotherapist treating the service user and other Physiotherapists who might treat the service user subsequently. It is a document that will be updated from time to time to reflect any necessary changes.
9.Concerns were picked up within the first two days of the rotation. These included an inability to write accurate front sheets, to extract relevant information from the medical notes and to apply appropriate clinical reasoning to the treatment of service users,. In view of the seriousness of those concerns, the Registrant was supervised on a one-to-one basis for the remainder of his time with the Respiratory Physiotherapy Team.
10.In November 2014, because of his difficulties in assessing service users in an acute setting, the Registrant was moved to the medical wards at Worthing Hospital. HC, another Band 6 Physiotherapist, became his supervisor until January 2015, when she rotated to another team. In February 2015 MKS, another Band 6 Physiotherapist, became his supervisor.
11.The Trust took steps to assess the performance of the Registrant under its Capability Policy in view of continuing concerns with the standard of his work. EK created a written Performance Improvement Plan (‘the Plan’) to address the areas of concern, setting standards to be attained with a timescale and an evaluation of progress to date. A supervision review meeting took place on 20 November 2014 at which the Registrant was present. The Plan was updated and further considered by EK with the Registrant on 16 December 2014 at a second supervision review meeting.
12.Formal Capability Review Meetings took place with the Registrant on 13 February 2015 and 16 March 2015. In that period the Plan was further updated and discussions took place between EK and the Registrant with a view to addressing continuing concerns in his practice. A formal letter of concerns, dated 16 April 2015, was sent to the Registrant following a Capability Review Meeting on that day. An informal review meeting took place with the Registrant on 28 May 2015. However, in view of the lack of progress, matters proceeded to a Capability Hearing, which took place on 20 July 2015.
13.A Panel of the Conduct and Competence Committee considered the Allegation against the Registrant at a Final Hearing which took place from 6-8 March 2017. The Registrant did not attend the Final Hearing. The Registrant made a full written admission to all the facts of the Allegation and the Final Hearing Panel found the facts proved. The facts found proved related to errors in recording information, inappropriate service user assessments, inadequate treatment plans, and inadequate communication. The Final Hearing Panel found that the standard of the Registrant’s work was unacceptably low by reference to a fair sample of his work. The facts therefore constituted the statutory ground of lack of competence. The Final Hearing noted the absence of evidence of any remedial steps taken by the Registrant or current insight. The Panel concluded that the Registrant’s fitness to practise was impaired by reason of the lack of competence.
14.The Final Hearing Panel decided that the minimum sanction which was sufficient to protect the public, to maintain public confidence in the profession and to uphold professional standards was a Suspension Order for a period of twelve months. The Final Hearing Panel stated that a Review Panel may be assisted by:
•the Registrant’s attendance at the hearing;
•any evidence he may wish to put before the reviewing Panel showing steps to bring his knowledge and skills up-to-date and to resolve the deficits in his practice;
•steps taken in advance of the review hearing to attempt to arrange a return to practice placement and the results of such attempts, with evidence of these matters.
15.Ms Viriri submitted that the Registrant’s fitness to practise is impaired and that a Suspension Order remained necessary for the protection of the public.
16.The Registrant did not submit any documents or written submissions for the consideration of the Panel. He has not engaged with the HCPC since the Final Hearing.
17.The Panel accepted the advice of the Legal Assessor.
18.The Panel carried out a comprehensive review. There is no evidence that the Registrant has taken any steps to address the deficits in his practice, nor is there any evidence of his current level of insight. There is no new material relevant to the consideration of the Registrant’s current fitness to practice.
19.The persistent competency issues identified by the Final Hearing Panel related to a broad range of concerns involving the basic skills and knowledge of a physiotherapist. There were serious and persistent deficiencies in the Registrant’s practice over a long period of time. There was no evidence that the Registrant had the ability to work as an autonomous practitioner. The identified deficiencies involve the risk of significant harm to service users and to the wider public who may use the Registrant’s services. Although the deficiencies are remediable, there is no evidence that they have been remedied. The Panel therefore concluded that the Registrant’s fitness to practise is currently impaired.
20.The Panel considered the option of allowing the current Suspension Order to expire, but decided it is necessary for the Registrant’s practice to be restricted to secure public protection. For the same reason mediation or a Caution Order would not be sufficient.
21.The Panel next considered whether the Suspension Order could be replaced by a Conditions of Practice Order. The Panel decided that it was not possible to formulate conditions of practice which would adequately protect the public, while not being so restrictive that they amounted to a Suspension Order. Further, there was no evidence to persuade the Panel that conditions would be effective. When employed by the Trust the Registrant was subject to a nine month period of supervision and support, but he still failed to meet the required standards.
22.The Panel therefore decided that the appropriate Order is to extend the current Suspension Order. The Panel decided that this should be for a period of twelve months. The Registrant has not been practising as a Physiotherapist for a significant period of time. The Panel considered that the Registrant will need time to address the deficiencies in his practice, to bring his knowledge and skills up to date, and to gather the evidence for a future reviewing panel.
23.Before the suspension expires the Registrant’s case will be reviewed by another panel at a further hearing. A future reviewing panel may be assisted by;
•the Registrant’s attendance
•any evidence he may wish to put before the reviewing panel showing steps he has taken to resolve the deficits in his practice
•any evidence he may wish to put before the reviewing panel showing steps he has taken to keep his knowledge and skills up to date.
•any steps he has taken to attempt to arrange a return to practice placement and the results of such attempts, with evidence.
24.The Panel decided that the appropriate and proportionate Order is to extend the Suspension Order for a period of twelve months.
Order: That the Registrar is directed to suspend the registration of Mr Konrad Sikorski for a further period of 12 months on the expiry of the current Order.
The order imposed today will apply from 5 April 2018.
This order will be reviewed again before its expiry on 5 April 2019.
History of Hearings for Mr Konrad Sikorski
|Date||Panel||Hearing type||Outcomes / Status|
|28/02/2020||Conduct and Competence Committee||Review Hearing||Struck off|
|01/03/2019||Conduct and Competence Committee||Review Hearing||Suspended|
|09/03/2018||Conduct and Competence Committee||Review Hearing||Suspended|
|06/03/2017||Conduct and Competence Committee||Final Hearing||Suspended|