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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.
1. The notice of this hearing was sent to the Registrant at her address as it appeared in the Register. 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 Simpson on behalf of the HCPC 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 letters and emails sent to the Registrant have been returned or undelivered.
4. 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. 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 previous substantive or review hearings. The Panel also took into account the public interest that this substantive Order is reviewed before it expires. 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.
5. 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 Theatre when she was under the influence of alcohol. On 25 April 2013, she attended work at 6.30pm and was described by witnesses as being incoherent, having difficulty in focussing and did not seem lucid. She stated she had been to lunch and had one glass of wine. On 25 April 2015, she again attended work under the influence of alcohol creating a significant risk to patient safety. The Registrant’s misconduct on 25 April 2015 was particularly serious in that she was working in a Cardiovascular Theatre where a lengthy and complicated operation was being performed. The Registrant’s inability to perform her role properly greatly increased the risk to the patient and the burden imposed on her colleagues. This was a serious departure from the HCPC Standards of Conduct Performance and Ethics and was described by the substantive hearing panel as “a serious incident of misconduct”. Following this second incident, both matters were referred to the HCPC and a substantive hearing was held on 15 May 2017 when the panel found the Allegation proved and imposed a Suspension Order for 12 months.
Substantive Review Hearing on 11 May 2018
6. The reviewing panel 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 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.
7. There was nothing before the panel that could satisfy it that the Registrant’s fitness to practise was no longer impaired. She had not engaged with the final hearing nor had she engaged in the review process. Therefore the Panel did not have any information as to what were the underlying causes of the Registrant’s misconduct. Similarly, it had received no evidence of insight, remorse or remediation. In these circumstances, it could not be satisfied that those issues had been addressed or that there was a low risk of repetition. There was still a risk to patient safety, the reputation of the profession and potential breaches of a fundamental tenet of the profession and the panel determined that the Registrant’s fitness to practise remained impaired. The reviewing panel then went on to consider the appropriate and proportionate sanction. In the light of the lack of engagement the panel determined that taking no further action or imposing a Caution Order would not be sufficient to protect the public or in the public interest. The panel considered whether to impose conditions of practice but noted that a Conditions of Practice Order was not suitable, principally because of the lack of information from the Registrant about her current circumstances. The reviewing panel noted that the position remained unchanged and in the absence of further information, determined that a Conditions of Practice Order remained inappropriate.
8. The reviewing panel then went on to consider imposing a further period of suspension and concluded that the Registrant’s misconduct was remediable. The panel noted a striking feature was that Particulars 1 and 2, although 2 years apart occurred on 25 April. This suggested to the panel that there is some significance in that date for the Registrant and this may have been one of the triggers for the Registrant’s misconduct. If the Registrant was receiving treatment or support for a health condition, she may have been at a stage when she was not yet able, or ready to re-engage with the HCPC.
9. The substantive hearing 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 was receiving treatment or care for any health concerns, a reflective piece and up to date testimonials. In the light of the above, the reviewing panel determined that it would be appropriate to provide the Registrant with a further opportunity to demonstrate insight, remorse and remediation and to re-engage with the HCPC by imposing a further period of suspension.
10. The Legal Assessor reminded the Panel that its purpose today 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. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note on Article 30 reviews dated June 2018. The Panel first considered whether the Registrant’s fitness to practise is currently impaired and the Panel determined that the Registrant’s fitness to practise remains impaired.
11. The Panel then went on to consider what the appropriate and proportionate sanction should be. It had regard to the Indicative Sanctions Policy (ISP) issued by the HCPTS 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 or be in the public interest.
12. The Panel considered whether to impose a Conditions of Practice Order. The Panel noted that the previous panels determined that a Conditions of Practice Order was not suitable, principally because of the lack of information from the Registrant about her current circumstances. 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.
13. The Panel then went on to consider imposing a further period of suspension. A Suspension Order would protect the public but would not be in the public interest or in the Registrant’s own interests because she has actively disengaged from the HCPC process and therefore failed to respond to the opportunity to engage with the Panel following the further Suspension Order imposed on 11 May 2018. A further suspension would not serve any useful purpose and it is not in the public interest to prolong this process. Striking off is a sanction of last resort but the ISP states it is appropriate where a registrant has demonstrated an inability or unwillingness to resolve matters suggesting that a less serious sanction is not appropriate. The Panel finds this to be the case in respect of the Registrant and a Striking Off Order is therefore necessary and proportionate in accordance with the ISP. The Panel therefore imposes a Striking Off Order to take effect on the expiry of the current Suspension Order.
The Registrar is directed to strike the name of Mrs Catrina Thomson from the Register on the date this Order comes into effect.
The Order imposed today will apply from 12 December 2018.