Mrs Cavel Callender
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While employed as an Operating Department Practitioner by the Heart of England NHS Foundation NHS Trust:
1. Between 16 June 2014 and 4 July 2014 you:
a) Did not check the anaesthetic machine correctly during a simulation exercise with Colleague A.
b) Did not demonstrate to Colleague C general knowledge about anaesthetic machines and how to check them.
2. On or around 4 July 2014, whilst recovering post-theatre patients, you copied observations and/or documentation from a previous recovery phase instead of taking and recording new observations and/or documentation of the patient.
3. On or around 28 July 2014, whilst being supervised by Colleague A:
a) you were unable to distinguish between safe and unsafe thoracic suctioning.
b) you incorrectly measured a patient’s respiration rates.
c) regarding at least one of your patients that day, you:
i) did not regularly measure the patient's respiration rate;
ii) did not regularly measure the patient's temperature ;
iii) did not accurately record the patient's respiration rate;
iv) did not accurately record the patient's temperature.
4. On or around 31 July 2014, while recovering a patient who had undergone surgery, you did not conduct a complete handover to the medical team.
5. Not proved.
6. On or around 27 October 2014, whilst observed by Colleague C, you:
a) suggested an inappropriate and/or unsafe treatment plan for a patient with high blood pressure.
b) gave an incorrect handover to a medical team.
c) were unable to state the side effects of and/or appropriate dosages for cyclizine.
d) did not identify that the wrong pressure had been set and/or implement the correct chest drain pressure for a patient.
7. On or around 4 November 2014, while working with Colleague A, you:
a) did not regularly measure the respiratory rate for at least one patient.
b) did not accurately record the respiratory rate for at least one patient.
8. On or around 21 November 2014, while being observed by Colleague C and/or Colleague D, you:
a) did not set up the theatre correctly.
b) did not complete the required paperwork as requested.
9. On or around 27 November 2014, while working with Colleague C, you did not load the echelon gun correctly.
10. On or around 3 December 2014, while working with Colleague D, you did not recall that a large swab was in the chest of a patient when performing a swab check.
11. The matters described in paragraphs 1-11 constitute misconduct and/or lack of competence.
12. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Proof of Service
1. On 12 February 2018, the HCPC sent the notice of this hearing by first class post to the Registrant’s registered address. A copy of the notice was also sent to the Registrant by email. The notice contained the required particulars.
2. Having heard and accepted the advice of the Legal Assessor, the Panel was satisfied on the documentary evidence provided, that the Registrant, had been served notice of this hearing in accordance with the Rules.
Proceeding in the absence of the Registrant
3. Mr Mason, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence. The Panel heard and accepted the advice of the Legal Assessor, who advised that the discretion to proceed in a Registrant's absence should only be exercised with the utmost care and caution.
4. The Panel noted that the Registrant had contacted the HCPC by telephone on 1 March 2018 asking what was required for the review hearing. In that telephone call she said that she would not be able to attend the hearing in person. She was informed that she could participate in the hearing by telephone, or she could submit written submissions. The Registrant was invited to let the HCPC know by 8 March 2018 if she wished to participate by telephone and to send any written submissions by that date. The information provided by the HCPC over the telephone was followed in an email to the Registrant on the same date. No further response was received from the Registrant. It follows that the Registrant has not applied for an adjournment, nor has she submitted any representations. The Panel noted that the Registrant had not attended the substantive hearing between 20 and 22 March 2017.
5. The Panel was satisfied that the HCPC had fulfilled its obligations and taken all reasonable steps to serve the notice on the Registrant in accordance with the Rules.
6. In light of the telephone call of 1 March 2018, the Panel was satisfied that the Registrant was aware of today’s hearing. The Panel, therefore, concluded that the Registrant had voluntarily waived her right to attend and there was no evidence that she would attend an adjourned hearing. The Panel also considered that it was in the public interest for the hearing to take place, as this was a statutory review of a substantive order due to expire on 19 April 2018.
7. The Registrant is registered with the HCPC as an Operating Department Practitioner (ODP). The Registrant started her employment as an ODP at the Heart of England NHS Foundation Trust on 16 June 2014. She was a Band 5 Practitioner.
8. During the course of the Registrant’s employment with the Trust she was exposed to all the areas in which she would be expected to work, ie Scrubs (surgery), Anaesthetics and Recovery. Her probationary period was meant to last for a period of 12 weeks but this was extended for a further 3 months due to both the Registrant’s lack of progress and her sick leave. This additional time was to give her the best chance to improve her performance. Notwithstanding the additional support, the Registrant did not pass her probation.
9. The substantive hearing took place between 20 and 22 March 2017. The Panel heard from colleagues of the Registrant, including the Trust’s Student Educator, the Registrant’s mentor and a Staff Recovery Nurse. Each described areas (the subjects of the particulars) in which the Registrant had worked, but had not demonstrated the necessary level of skill and understanding, nor improvement for the safe and effective practice of an ODP. The Panel found the facts proved (save particular 5). It found that the Registrant had been provided with considerable support, supervision and advice, yet consistently failed over 6 months, to practise safely, autonomously and competently in all areas of her practice. It was satisfied that the facts found proved amounted to multiple examples of a serious and wide ranging lack of competence on the part of the Registrant.
10. The substantive panel had regard to the Practice Note on Impairment, and concluded that the Registrant’s fitness to practise at that time was impaired. In coming to this conclusion, the substantive panel considered that the Registrant had in the past presented and continued to present a risk to the safety of patients. It noted that it had no evidence to indicate otherwise and nothing to indicate that the Registrant had developed any understanding or insight into her serious failings, nor did it have any information about her then circumstances.
11. The substantive panel imposed a Suspension Order of 12 months. In reaching this conclusion, it found that the Registrant had breached fundamental standards of the profession and had failed to acknowledge her failings or to show any insight, remorse or remediation. The substantive panel considered that a less restrictive sanction would fail to protect the public and would undermine public confidence in the profession and the Regulator.
12. Mr Mason, on behalf of the HCPC submitted that there was insufficient evidence before the Panel of insight and remediation. He submitted that consequently the Registrant’s fitness to practise remained impaired and that it was the HCPC view that a further Suspension Order for 12 months was the appropriate outcome.
13. The Panel heard and accepted the advice of the Legal Assessor. The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired. It had regard to the HCPTS Practice Note on Impairment and the Indicative Sanctions Policy (the Policy).
14. This reviewing Panel had regard to the findings of the substantive panel to the effect that the facts found proved were multiple examples of serious and wide ranging failings which demonstrated a lack of competence on the Registrant’s part. The Panel had no information before it to demonstrate that the Registrant had reflected on her practice or had gained insight into the extent of her deficiencies or how her lack of competence may have had serious potential consequences for the safety of patients.
15. Accordingly, the Panel is of the view that the risks identified at the substantive hearing remain and that the Registrant’s fitness to practise consequently remains impaired on the grounds of both public protection and the wider public interest in maintaining public confidence in the profession and declaring and upholding proper standards of conduct, competence and behaviour.
16. In relation to sanction, it was the Panel’s view, that there was a need to impose a sanction which would provide public protection, and would otherwise address the public interest of maintaining public confidence in the profession and declaring proper standards of conduct, competence and behaviour. The Panel therefore concluded that taking no further action would not achieve this.
17. The Panel was also of the view that a Caution Order would not restrict the Registrant’s practice and, so would also fall short of protecting both the public and the wider public interest. As such, the Panel finds that a Caution Order would be neither appropriate nor proportionate in the circumstances of this case.
18. In respect of a Conditions of Practice Order, the Panel agreed with the views of the substantive panel. The six months of support through mentoring and a Practice Educator provided by the Trust had meant that the Registrant had effectively been operating under a type of Conditions of Practice Order, but with no significant improvement. In light of this, and in the absence of evidence of insight, the Panel was not reassured that the Registrant would be either willing or able to cooperate with such an Order
19. Accordingly, the only option available to the Panel today was a further Suspension Order and the Panel determined to make such an Order for 12 months. In determining this length, the Panel has considered that no lesser period would both protect the public and maintain public confidence in the profession given the serious and wide ranging deficiencies that need to be addressed in this case.
20. The Panel was encouraged that the Registrant had contacted the HCPC on 1 March 2018, with a view to finding out about the process and procedure for the review hearing, and she had provided some information about her current circumstances. The Registrant identified that she had suffered a bereavement of a close member of her family in November 2017 and had some personal health issues. She also said that she had been doing some volunteer work for an organisation which sent medical equipment overseas and had been reading industry specific information on line.
21. The Panel did not seek to fetter the discretion of the next reviewing panel, but was of the view that the following information may be of assistance it:
• Participation at the next hearing either through attendance or by telephone;
• A reference in respect of the Registrant’s voluntary work;
• Up to date information about the Registrant’s health;
• A reflective piece about her practice at the Trust and the potential impact of her performance on the safety of patients and the impact it would have in public confidence in the profession; and
• Substantive evidence of any steps taken, through for example education or reading in order to improve her knowledge and understanding.
The Order imposed today will apply from 19 April 2018.
This Order will be reviewed again before its expiry on 19 April 2019.
History of Hearings for Mrs Cavel Callender
|Date||Panel||Hearing type||Outcomes / Status|
|16/01/2020||Conduct and Competence Committee||Voluntary Removal Agreement||Voluntary Removal agreed|
|13/09/2019||Conduct and Competence Committee||Review Hearing||Suspended|
|14/03/2019||Conduct and Competence Committee||Review Hearing||Suspended|
|12/03/2018||Conduct and Competence Committee||Review Hearing||Suspended|
|20/03/2017||Conduct and Competence Committee||Final Hearing||Suspended|