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During the course of your employment as a Senior Operating Department Practitioner at the Trust with Guys and St. Thomas’ NHS Trust, you:
1. On or around 25 April 2013, whilst on-call, attended work in the Cardiovascular Theatres whilst under the influence of alcohol.
2. On or around 25 April 2015, whilst on-call, attended work in the Cardiovascular Theatres whilst under the influence of alcohol.
3. The matters set out in Paragraphs 1 and 2 constitute misconduct.
4. By reason of that misconduct, your fitness to practise is impaired
Service of Notice
1. The notice of this hearing was sent to the Registrant at her address as it appeared in the register on 11 April 2018. The notice contained the date, time and venue of today’s hearing.
2. The Panel accepted the advice of the Legal Assessor, and is satisfied that notice of today’s hearing has been served in accordance with Rule 6(1) of the Conduct and Competence Committee Rules 2003 (the “Rules”).
Proceeding in the absence of the Registrant
3. The Panel then went on to consider whether to proceed in the absence of the Registrant pursuant to Rule 11 of the Rules. In doing so, it considered the submissions of Ms Scholz on behalf of the HCPC.
4. Ms Scholz submitted that the HCPC has taken all reasonable steps to serve the notice on the Registrant. She further submitted that the Registrant has not engaged with the HCPC, and that an adjournment would serve no useful purpose. Ms Scholz told the Panel that two attempts had been made to contact the Registrant by telephone, one being made today, but these calls were not answered. She reminded the Panel that there was a public interest in this matter being dealt with expeditiously.
5. The Panel accepted the advice of the Legal Assessor. He referred the Panel to the case of GMC v Adeogba and Visvardis  EWCA Civ 162 and advised the Panel that the Adeogba case reminded the Panel that its primary objective is the protection of the public and of the public interest. In that regard, the case of Adeogba was clear that “where there is good reason not to proceed, the case should be adjourned; where there is not, however, it is only right that it should proceed”.
6. It was clear, from the principles derived from case law, that the Panel was required to ensure that fairness and justice were maintained when deciding whether or not to proceed in a Registrant’s absence.
7. The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of the hearing.
8. In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPTS practice note entitled ‘Proceeding in the Absence of a Registrant’. The Panel weighed its responsibility for public protection and the expeditious disposal of the case against the Registrant’s right to a fair hearing.
9. In reaching its decision the Panel took into account the fact that the Registrant had not engaged with these proceedings from the beginning, and did not attend the substantive hearing. The Panel also took into account that there is a public interest that this substantive order is reviewed before it expires.
10. The Panel was satisfied that it was unlikely that an adjournment would result in the Registrant’s attendance at a later date, in the light of the non-engagement of the Registrant. Having weighed the public interest for expedition in cases against the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.
11. The Registrant was employed by the Guy’s and St Thomas’s NHS Trust as a Band 6 Operating Department Practitioner. It was alleged that on the two occasions specified she attended work in the Cardiovascular Theatres when she was under the influence of alcohol.
12. Following the second incident, these matters were referred to the HCPC and a substantive hearing was held on 15 May 2017 when the tribunal found the Allegation proved and imposed a Suspension Order as a sanction.
13. Ms Scholz, outlined the background of the case and submitted that in the light of the lack of substantive engagement on the part of the Registrant she remains impaired. She also submitted that an extension of the Suspension Order would serve no useful purpose and would not further the public interest. Therefore the HCPC submitted that the Registrant’s name be struck off the register.
14. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive review to determine if the Registrant is fit to return to unrestricted practice. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment.
15. The Legal Assessor advised that the Panel might find the questions formulated in the case of CHRE v NMC and Grant (2011) EWHC 927 (Admin) of some assistance, albeit slightly modified for these proceedings:
Does the evidence before the Panel today show that the Registrant’s fitness to practice remains impaired by reason of his misconduct in the sense that he:
a) is liable in the future to act so as to put a service user at unwarranted risk of harm; and/or
b) is liable in the future to bring the Operating Department Practitioner profession into disrepute; and/or
c) is liable in the future to breach one of the fundamental tenets of the profession?
16. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel must go on to consider what sanction, if any, should be imposed. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired any of the options under Article 30 of the 2001 Order could be exercised by the Panel. He also advised the Panel that it should bear in mind the principle of fairness and proportionality and have regard to the Indicative Sanctions Policy issued by the HCPC. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.
Panel’s considerations and decision
17. The Panel accepted the advice of the Legal Assessor. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Ms Scholz. In particular it noted the following factors:
(a) This is a case of misconduct and there is no suggestion that the Registrant lacked the requisite competence to carry out the role of a Operating Department Practitioner. This is a case involving underlying issues.
(b) The lack of engagement of the Registrant with the process, resulting in the absence of any information regarding the Registrant or her current circumstances, including any continuing professional development.
18. There is no evidence before the Panel today that could satisfy it that the Registrant’s fitness to practise is no longer impaired. She did not engage with the final hearing nor has she engaged in this review process. Therefore the Panel does not have any information as to what were the underlying causes of the Registrant’s misconduct. Similarly, it has received no evidence of insight, remorse or remediation. In these circumstances, it could not be satisfied that those issues have been addressed and that there was a low risk of repetition. There is still a risk to patient safety, the reputation of the profession, and potential breaches of a fundamental tenet of the profession.
19. In the light of all the above, the Panel determined that the Registrant’s fitness to practise remains impaired.
20. The Panel then went on to consider what the appropriate and proportionate sanction should be. It had regard to the Indicative Sanctions Policy issued by the HCPC and considered the available sanctions in order of severity, starting with the least restrictive. In the light of the lack of engagement the Panel determined that taking no further action or imposing a caution would not be sufficient to protect the public, nor would either be in the public interest.
21. The Panel considered whether to impose a Conditions of Practice Order. The Panel noted that the previous panel determined that a Conditions of Practice Order was not suitable, principally because of the lack of information from the Registrant about her current circumstances, and that there was information that she had not been fully compliant with requirements placed upon her by those treating her. This Panel noted that the position remains unchanged and in the absence of further information it determined that a Conditions of Practice Order remained inappropriate at this stage.
22. The Panel then went on to consider imposing a further period of suspension Taking all the information before it into consideration, the Panel concluded that the Registrant’s misconduct is remediable. The Panel also noted that a striking feature of this case, is that particulars 1 and 2, although 2 years apart, occurred on or around 25 of April. This suggests that there is some significance in that date for the Registrant, which may have been one of the triggers for the Registrant’s conduct on these two occasions.
23. If the Registrant is receiving treatment or support for a health condition, she may be at a stage when she is not yet able, or ready to re-engage with the HCPC. The previous panel gave guidance as to what would be helpful for a reviewing panel to receive. This included reports from any medical advisers or other professionals if she is receiving treatment or care for any health concerns. These would still be of assistance to a future reviewing panel as would a reflective piece and up to date testimonials.
24. In the light of the above, the Panel determined that it would be appropriate to give the Registrant a further opportunity to demonstrate insight, remorse and remediation. Therefore, the Panel determined that a further period of suspension of six months would provide the Registrant a further opportunity to demonstrate insight, remorse and remediation and re-engage with the HCPC.
Order: The Registrar is ordered to further suspend the name of Mrs Catrina Thomson from the Operating Department Practitioner part of the HCPC register for a period of six months.
The order imposed today will apply from 12 June 2018