Miss Angela Pryde

Profession: Physiotherapist

Registration Number: PH48983

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 29/10/2018 End: 17:00 31/10/2018

Location: Novotel Glasgow, 181 Pitt Street, Glasgow G2 4DT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

Allegation (as amended)

 

Whilst registered as a Physiotherapist and employed by NHS Greater Glasgow and Clyde in the MSK Physiotherapy Service between April 2012 and July 2017:

 

1. On or around 28 June 2016, you stored case files in relation to approximately 20 patients in the boot of your car;

 

2. On or before 29 November 2016 in relation to patient A you did not:

 

a) complete patient records or

 

b) correctly store patient records

 

3. On or before 21 February 2017 in relation to patient B you did not:

 

a) complete patient records or

 

b) correctly store patient records

 

4. On or before 7 March 2017 in relation to patient C you did not:

 

a) complete patient records or

 

b) correctly store patient records.

 

5. On or before 11 April 2017 in relation to 10 patients you did not:

 

a) complete patient records or

 

b) correctly store patient records

 

6. Your actions described at particulars 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:

Proof of Service

1. The Panel was satisfied that good service of notice of hearing had been given by letter from HCPC dated 16 August 2018 addressed to the Registrant at her registered address informing her of the date, time and location of the hearing and also by email dated 16 August 2018.

Proceeding in Absence

2. Mr Foxsmith for the HCPC made an application to proceed in the absence of the Registrant. The Registrant has not engaged and had not responded to any of the correspondence and notices from the HCPC.  

3. Mr Foxsmith sought that the hearing proceed in the absence of the Registrant.  He referred to guidance in R v Jones [2001] EWCA CRIM. 168 and Adeogba v GMC [2016] EWCA Civ 162. He advised the Panel that the Registrant had not engaged with the HCPC.  She did not reply to the HCPC letters sent on 12 September 2018 and 9 October 2018 advising that there was a Case to Answer, nor to the Notice of Allegation on 2 February 2018. The hearing bundle sent to the Registrant was returned by the Post Office as “not called for”. An email of 15 October 2018 from the HCPC solicitors to the Registrant was not responded to.  Mr Foxsmith referred to the public interest in proceeding and the need to balance the interests of the Registrant with the public interest in proceeding.  He advised that four witnesses were in attendance. 

4. The Panel is aware that its discretion to proceed in absence is one which should be exercised with care.  The Legal Assessor referred the Panel to the HCPTS Practice Note on Proceeding in Absence, and to the case of Adeogba.  This case makes clear that the first question the Panel should ask is whether all reasonable efforts have been taken to serve the Registrant with notice. Thereafter, if the Panel is satisfied on notice, the discretion whether or not to proceed must be exercised having regard to all the circumstances of which the Panel is aware, with fairness to the Registrant being a prime consideration, but with fairness to the HCPC and the interests of the public also considered.  

5. The Panel accepted the advice of the Legal Assessor. It decided to proceed in the absence of the Registrant.  The Panel was satisfied that the Registrant had voluntarily absented herself.  Nothing suggested that an adjournment or postponement of the hearing would result in the Registrant’s attendance and the Panel considered that four witnesses were in attendance for the hearing.  The Registrant had made no request for an adjournment of the present hearing, she had not engaged and there was a public interest in the hearing proceeding.

Application to Amend the Allegation

6. Mr Foxsmith sought to amend the particulars of the allegation. He sought to revise the structure of the allegation and add new sub-particulars 2, 3, 4 and 5.  This served to more fully specify the individual patient records. The allegation covered the same 13 patients and he submitted that the proposed amendment served to more fully and clearly reflect the evidence. Mr Foxsmith submitted that this amendment did not increase the gravity of the allegation but served to provide more detail. Notice of the amended allegation was sent to the Registrant on 2 February 2018.  There had been no response from her.  

7. Mr Foxsmith also sought to add in a new sub-particular 4 (c).  This sought to add in an allegation that the Registrant did not refer patient C for an orthopaedic appointment.  Whilst this was reflected in the evidence, Mr Foxsmith pointed out that the Registrant had not received notice of this proposed amendment and he accepted it was a new category of allegation. Mr Foxsmith referred to the importance of fairness and the need to avoid prejudice to the Registrant

8. The Panel heard and accepted the advice of the Legal Assessor as to fairness and the avoidance of prejudice.  The Panel considered that it was fair to allow the application, except in respect of particular 4(c). Notice had been given and the proposed amendment did not alter the nature or gravity of the allegation as a whole, and more fairly and specifically reflected the evidence.

9. The Panel noted that the proposed amendment to paragraph 4(c) had not been sent to the Registrant and she has had no notice as a result.  It would be inherently unfair to the Registrant to allow the proposed amendment by adding 4(c) and that part of the application to amend was refused.

Background

10. The Registrant is a band 7 Physiotherapist who worked for the East Quadrant of NHS Greater Glasgow and Clyde (“GGC”) as a Physiotherapist Team Leader. The Registrant was placed on a Supported Improvement Plan (SIP) on 15 June 2015 due to an incident with documents being incomplete and incorrectly stored. 

11. On 28 June 2016 the Registrant’s car was stolen. The Registrant compiled a list of patient records for 22 patient files which were missing and which she understood to have been in the boot of her car. When the vehicle was recovered some, but not all those patient records on the list compiled by the Registrant, were found in the boot of her car and some were subsequently found in the department. There were then a further three incidents involving missing patient records on 29 November 2017, 21 February 2017 and 7 March 2017.  Two investigations were carried out by GGC and a further 10 sets of patient notes were also found to be missing.  Mr Foxsmith opened the HCPC case and summarised the background for the Panel.

Witness 1 - CH

12.  The witness took the affirmation. She was referred to her witness statement of 12 March 2018 and confirmed that the contents were true and accurate to the best of her knowledge and belief.

13. CH is a Physiotherapy Manager with GGC. She was appointed as an investigating officer regarding the alleged breach of patient confidentiality and record keeping policies by the Registrant. Her investigation was restricted to the incident on 28 June 2016 regarding the Registrant’s car being stolen.  She said she had worked with a colleague and produced the investigation report which is before the Panel.

14. CH explained her report and confirmed that the Registrant had said to her that she understood patient confidentiality and patient record keeping. CH told the Panel that the Registrant had clearly admitted that she knew she ought not to have taken the patient files home and that they should not have been in her car boot. The Registrant had also told CH that she had taken the patients files in error and had intended to keep them in a locked place in her home.

15. CH explained to the Panel that such an arrangement was not acceptable for the storage of patient records and would have breached the GGC policy on storage of patient records.  CH told the Panel that the Registrant’s actions also breached standard 10.3 of the HCPC Standards of conduct, performance and ethics and the GGC Data Protection Policy. CH said that there was no evidence of the misuse of the patient records but there was a risk that the records were not accessible to other health professionals involved in the care of the patients, and there also was a risk of misuse by unauthorised persons.

16. In response to Panel questions, CH explained that the paper files were originals and were not stored elsewhere, or on computer.  If they had been lost, the records could not have been recovered or reconstructed from elsewhere.  All the records were eventually accounted for.


Witness 2 - TC

17.  The witness took the affirmation and was referred to her witness statement of 6 March 2018 and confirmed the contents were true and accurate to the best of her knowledge and belief.  She was a Team Lead with GGC and now a manager at the West Quadrant of GGC.

18. TC had known the Registrant for about 8 years but did not work closely with her.  TC explained she was appointed an investigating officer on 24 March 2017 and was asked by GGC to investigate missing patient notes.  She referred to and explained her investigation report dated 7 June 2017 (her conclusions were redacted from the report before the Panel.) She did not investigate the issue of the records in the Registrant’s stolen car. 

19.  TC explained the supported improvement plan (SIP) under which the Registrant was working at the time. TC said that as part of her investigation she discovered that a further 10 sets of patient notes were missing.  TC explained that she interviewed a colleague AB who had searched for and failed to find the patient records.  These were patients who had last been seen by the Registrant and these records were never located.

20. TC interviewed the Registrant as part of her investigation on 28 April 2017. The Registrant had not signed the interview record, although it had been sent to her. TC stated the records of the interview were accurate.  TC told the Panel that the Registrant said at the interview that she knew the procedure for filing patient records.  The Registrant had seemed unconcerned.

21. The Registrant’s patients during her absence on sick leave, would have been allocated to another Physiotherapist by a manager. They did not have access to the missing patient records which should have been kept by the Registrant in a filing cabinet. TC said that the “Track Care” system logged patients to a particular Physiotherapist, so you would know which Physiotherapist was treating the patient. She said that an audit of patient records was carried out twice yearly, and the files selected by either a peer or Team Leader. TC said she understood that the Registrant has not reported any health issues to GGC.

Witness 3 – AO

22. AO took the oath and was referred to her witness statement of 5 March 2018 and confirmed the contents were true and accurate to the best of her knowledge and belief.  She is a Physiotherapy Manager with the East Quadrant of GGC. She explained that she was the Registrant’s Line Manager, but the Registrant also had her own team to lead. She worked with the Registrant for about 5 years and had weekly meetings with her as a Team Leader.

23. AO met the Registrant daily for 8 weeks after the Registrant’s return from sick leave and following occupational health advice. AO attended the investigatory meetings regarding the Registrant with TC. AO explained the GGC policy and procedures on document keeping, storage and management. AO said that the policies were well known and were standard practice for a health professional.

24. AO explained that a record should be completed the day that a patient is seen, and there is administrative time factored into the day for completing outstanding patient notes. The Registrant in addition sought, and was given, extra time for completing patient notes.  AO explained the filing system, the use of filing cabinets and the completion of discharge records, which should be made in the patient notes and on the computer system on the day of discharge.  AO said that patient records should never be taken home.

25. AO explained that the Registrant as Team Leader had been responsible for the revision of and the roll out of the standard operational procedures for patient confidentiality and patient record keeping.  AO said that the Registrant had confirmed to her in the SIP that she understood the various policies, including those for Data Protection and patient confidentiality.  AO told the Panel that the SIP commenced on 15 June 2015 and the Registrant showed mixed results, and never achieved all aspects of the SIP at one time. As the Registrant was not achieving the required levels in the SIP, AO explained that the informal SIP was extended.

26. AO explained the incident regarding the stealing of the Registrant’s car and the records that the Registrant said she thought were in her car and had compiled a list of 22 patients. AO confirmed that under no circumstances should patient records ever have been in her car.  When the car was recovered, the patient records in the boot were recovered and it came to light that some of the patient records on the compiled list did not match those records found in the car.  An extensive search for the missing records by several people was undertaken.

27. AO said that the Registrant had assisted to some extent and she had told her managers at the time. AO said the Registrant told her she had intended to leave the records in the hot desking area, which still failed to meet the professional standards and policies on patient records.  She said there was a potential risk to patients. One patient had queried what had happened to a referral.  Records were also not available when required and that necessitated extra time and duplication of effort by colleagues, and there was an impact on patient safety and added stress for the clinician.

28. AO explained it had come to light that three sets of patient notes were missing, resulting in three Datix reports being raised.  This gave rise to concerns about a further missing 10 patient records handled by the Registrant. AO explained that any intervention on a file is logged on a tracking system which it records all people who access the file. 

29. In response to Panel questions, AO told the Panel that the Registrant never raised any concerns with her as her Line Manager, despite having many opportunities to do so. She explained that Datix incidents were very uncommon and three in a short period was exceptional. AO confirmed audits were done twice a year on 10 patient records for each Physiotherapist. In the year previous to the allegation, AO said that the audit had raised issues regarding the Registrant and that led to an informal improvement plan. She explained that only discharge letters and the diary for patient appointments were kept on a computer system. 

Witness 4 – AB

30.  AB took the oath.  She is a registered Physiotherapist with GGC and the Registrant was her Line Manager. She is now a Team Leader.  She was referred to her witness statement of 2 March 2018 and confirmed the contents were true and accurate to the best of her knowledge and belief. 

31.  AB explained the standards for completing patient notes was the day on which the patient is seen. In 99% of cases staff would complete patient notes on the day they saw the patient.  She explained the filing and note storage system, with each Physiotherapist having a section in a filing drawer.  Each was responsible for keeping their own patient notes.

32. AB explained that the Registrant knew all the note-keeping and storage policies at GGC.  She explained that she knew the Registrant was under a SIP to deal with previous issues regarding note-keeping and storage.

33. On 20 July 2015 AO asked AB to be the Registrant’s mentor, with AO leading the SIP. The SIP was all agreed and signed off by the Registrant.  AB said she had done a number of files audits.  There was an audit of ten patient records per year, 5 in March and 5 in September. A record was made of each audit which gave a percentage score. AB told the Panel that 5 of the Registrant’s patient records were audited in September 2016 and had scored 100%.

34. AB told the Panel about the three Datix reports that arose on 29 November 2016, 21 February 2017 and 7 March 2017.  This system was used to report anything adverse that happens which should not happen. AB submitted all three Datix reports. The first incident on 29 November 2016 happened after the Registrant had been off sick from work since October 2016. One patient treated by the Registrant required a new appointment but the patient notes could not be located.  A careful search was undertaken and the files were not found. AB said that the Registrant had not stored patient notes correctly, as they were never found, and as a result AB could not say if the notes had ever been completed.

35. The second Datix incident on 21 February 2017 arose when a patient’s discharge letter could not be found.  The tracking system showed the Registrant was the treating Physiotherapist but she had not followed storage policy.  No discharge letter was ever found. 

36. A third Datix incident arose on 7 March 2017 when no referral letter or notes could be found for a patient last treated by the Registrant. AB said she emailed the Registrant on   two occasions to ask about the patient notes and got no reply from her on either occasion. Ultimately, AB was asked to make the referral for the patient as the Registrant had been suspended. AB understood that the Registrant had made no notes when seeing the patient but when she was suspended the Registrant had made a scribbled note which was passed to AB to allow her to refer the patient to orthopaedics.

37. AB explained her involvement in the subsequent investigation of the Registrant. AB said she had tried to engage with the Registrant but felt that the Registrant did not engage and she had found her hard to work with.

38. In response to Panel questions, AB explained that patient notes never left the hospital site, and even if another hospital was involved a photocopy would be sent. She explained that patient appointments and referrals were recorded electronically on a system called “Track Care” which also holds contact details for patients. 

39. As the Registrant’s mentor, AB explained that she had discussed the impact of missing notes with the Registrant. AB recalled that when discussing some missing notes, the Registrant did not seem to engage and the issue did not seem important to her. AB said that the Registrant had not passed any of the other audits that AB carried out and that when this was raised with her the Registrant did not seem bothered about the audit results or the feedback provided. Developmental support was provided by her as a mentor after discussion with the Registrant and AO, but AB explained that the Registrant was a manager and was in fact senior to AB.

40. AB explained the delivery of training and the induction process when people joined the department. Knowledge of the GGC policies on completion and storage of patient notes were part of the role of a manager, such as the Registrant.

Closing Submissions for the HCPC

41. Mr Foxsmith reminded the Panel of its role, the balance of probabilities and that the onus of proof rested on the HCPC.  He asked the Panel to exercise caution when considering the Registrant’s replies in the investigatory interviews as she was absent and urged it to carefully assess and weigh all the live evidence.  Mr Foxsmith summarised the relevant evidence about file completion and storage and he submitted that all four witnesses were fair, impartial, credible and reliable.

42. Mr Foxsmith submitted that, with reference to the definition in Roylance v GMC (no 2) [2001] 1 AC 311, the Registrant’s actions amounted to misconduct.   He submitted that the Registrant had also breached the HCPC Standards of conduct, performance and ethics 1.1, 5, 9.1 and 10. He also referred to the Standards of Proficiency for Physiotherapists and submitted that the Registrant had breached standards 1.1, 2.1, 7 and 10.  

43. Mr Foxsmith submitted that the Registrant’s actions amounted to misconduct and also may indicate a lack of competence, but the evidence suggested that the Registrant was well aware of the policies she is alleged to have breached. He submitted that lack of competence and misconduct were a matter for the Panel in its professional judgement.

44. On impairment Mr Foxsmith reminded the Panel of its role and the need to assess current impairment both on the personal and public components of impairment.  He submitted that on both components there was a need for a finding of impairment.

45. The Panel heard and accepted the advice of the Legal Assessor as to facts, lack of competence, misconduct and impairment. He reminded the Panel of the fact finding exercise applying the balance of probabilities to the evidence. He referred the Panel to the guidance in Roylance as to misconduct.  As to lack of competence, he reminded the Panel that there required to be evidence of a fair sample of the Registrant’s work and that the conduct must be judged to the standard of a Physiotherapist in the Registrant’s position.  He referred to the guidance on lack of competence in Holton v GMC [2006] EWHC 2960.   On impairment, the Legal Assessor referred to the HCPTS Practice Note on Finding Fitness to Practice Impaired and to the guidance in CHRE v Grant [2011] EWHC 927 (Admin).  He stressed the importance of the public interest.

Decision on Facts 

46. The Panel carefully considered all the evidence and the submissions from Mr Foxsmith to facts, lack of competence, misconduct and impairment.   The Panel was aware that on matters of fact, as distinct from issues of lack of competence, misconduct and impairment, the burden of proof rested on the HCPC and that the standard of proof was the civil one, namely on the balance of probabilities.

The Witnesses

47. The Panel found all four witnesses to be honest, clear, consistent and compelling. There was also a compelling consistency between all four witnesses and their recollection of events was good, and was fair to the Registrant. 

48. The Panel also considered the reports from both of the investigations which it found were highly consistent with, and supportive of, the live evidence heard from all four witnesses.

Findings of Fact

Particular 1 - Proved

49. CH and AO were both very clear in their evidence with respect to this particular.  It was satisfied that their evidence clearly indicated that this incident was reported to AO by the Registrant and investigated by CH. The Panel found this particular proved.

Particulars 2 (a), 2 (b), 3(a) , 3 (b) , 4(a) , 4 (b)  - Proved

50. TC and AB gave detailed and cogent evidence about the steps they had taken in respect of the patient records for patients A, B, and C. They were clear that the Registrant did not complete or correctly store the patient’s records for each of the patients in terms of the GGC policies and professional standards. The Panel considered the terms of the Professional Standards for Record Keeping Policy issued by NHS GGC which make clear the standards required.  It also considered the professional standards and the evidence of the Registrant’s knowledge of those standards as a manager.

51. In addition, on sub-particulars 4 (a) and 4 (b), AB gave evidence about emails she sent to the Registrant which were not replied to.  AB also confirmed that records for patient C were not found and that AB required to rely on a “scribbled note” by the Registrant done on the day she was suspended from duty. The Panel found these particulars proved.

Particular 5 (a) and (b) – Proved

52. TC gave clear evidence about the 10 files which were not completed nor correctly stored by the Registrant who, as manager, knew and understood the correct policies. TC explained the investigation she undertook and this was fully supported by the documentary evidence including the investigation report dated 28 April 2017. The Panel found this particular proved.

Decision on Grounds - Misconduct and/or Lack of Competence

53. In considering the statutory grounds the Panel adopted an overall view of the particulars it has found proved.  It was mindful of the guidance in Roylance.  The evidence was that the Registrant knew she was in breach of the GGC policies and her professional standards.  She was a senior Physiotherapist in a managerial position. The allegation found proved is a series of repeated acts over a period of some months during which there was support in place in a SIP, and there was training and a mentor in place. Collectively, the facts found proved amount to a series of acts and omissions which the Panel found fall seriously short of what would be proper in all the circumstances.  

54. The Panel also found that the Registrant was in breach of the HCPC’s Standards of conduct, performance and ethics standards (2016):

• 5 - “Respect Confidentiality” ;

• 9.1  - “You must make sure that your conduct justifies the public’s trust and confidence in you and your profession” ; and

• 10 - “Keep Records of your work”.

55. On the HCPC Standards of Proficiency for Physiotherapists (2013) the Panel found the Registrant breached the following standards

• 2.1 - “understand the need to act in best interests of service users at all times”  

• 7 - Understand the importance of and be able to maintain confidentiality

• 7.2 - “understand the principles of information governance and be aware of the safe and effective use of health and care information”

• 10.1 - “be able keep accurate, comprehensive and comprehensible records in accordance with applicable legislation, protocols and guidelines”

• 10.2. - “recognise the need to manage records and all other information in accordance with the applicable legislation, protocols and guidelines

• 12.3 -“be aware of the role of audit and review in quality management including quality control, quality assurance and the use of appropriate outcome measures”

• 12.4. – “be able to maintain an effective audit trail and work towards continual improvement”

56. Accordingly, exercising its own professional judgement, the Panel found that in all the circumstances that the ground of misconduct is made out.  The misconduct is sufficiently serious to lead to a consideration of impairment of fitness to practise. 

57. The Panel did not consider it necessary to further consider the alternative ground alleged, that of lack of competence.  It was not, in any event, satisfied that it had evidence of a fair sample of the Registrant’s work and the evidence was that the Registrant was well aware of the proper procedures and policies to follow.

Decision on Impairment 

58. The Panel having found misconduct, next considered whether the Registrant’s fitness to practise is currently impaired.  It kept in mind the central importance of the protection of the public, the wider public interest and the guidance provided in the Grant case.

59. The Panel has not heard from the Registrant who has not engaged with these proceedings. It has no evidence that her failings have been addressed and remedied and it has no evidence of her current circumstances.  The Panel has no evidence of any remorse or apology.

60. The Panel heard evidence of the SIP in place for the Registrant in order to deal with her continuing issues in respect of record keeping and storage. There was evidence that efforts had been made to support the Registrant, but that she continued to fall short.  There was evidence that she appeared to wilfully disregard the relevant policies despite her knowledge of them.  Both AB and TC  said in their evidence that the Registrant did not appear to be interested in the incidents and that she showed an apparent “lack of concern” that patient notes could not be located and had not been completed. The Panel was also concerned about the evidence of the lack of engagement by the Registrant with the SIP and her mentor, AB.

61. The Panel considered that the evidence indicates a serious lack of insight by the Registrant into her repeated failings and professional performance. The Panel found no evidence to suggest that the Registrant has developed any insight into the consequences of her actions for patients, colleagues or her profession. The Panel accordingly found that, although the failings are remediable, there has in the past, and continues to be, a high risk of repetition of the Registrant’s behaviour giving rise to the misconduct.  Further, that behaviour puts patients at risk of harm. 

62. There was evidence of one patient not receiving treatment in a timely manner.  There was evidence from all four witnesses of a direct impact on colleagues who had to duplicate work, re-assess patients and spend valuable time trying to locate missing patient records.

63. The Panel considered that the misconduct will have impacted on public confidence and that any failure to find impairment would undermine public confidence in both the profession and the regulatory process. The extent of the Registrant’s misconduct was significant and a member of the public would be concerned were the Registrant not to be found impaired.  The Panel found that a finding of impairment is necessary in this case in order to maintain and uphold proper standards of conduct and behaviour, and to send a clear message to the profession about the unacceptability of the Registrant’s actions. 

64. The Panel accordingly found that the Registrant’s fitness to practise was and is currently impaired on both the private and public component.

Decision on Sanction

65. The Panel heard from Mr Foxsmith who referred it to the HCPC’s Indicative Sanctions Policy (ISP) and reminded it of the need to balance the public interest with the interests of the Registrant. Mr Foxsmith referred the Panel to its findings on misconduct and impairment but made no submission as to the particular sanction the Panel should impose. He reminded the Panel it should act proportionately.  

66. The Panel took the advice of the Legal Assessor who reminded it that the primary purpose of sanction is protection of the public and he referred it to the ISP.  He reminded the Panel it might consider aggravating and mitigating factors and that it should carefully consider the public interest. It should act proportionately, applying the least restrictive sanction it considered necessary to protect the public and the wider public interest. 

67. The Panel first identified what it considered to be the mitigating and aggravating factors in this case. The following mitigating factor was identified:-

• The Registrant’s personal circumstances (although there was no medical evidence presented to support this)

68. The following aggravating factors were identified : -

• The Registrant’s failure to engage with the SIP and the concerted efforts of colleagues to assist and support her

• The Registrant’s misconduct was persistent and repeated

• The Registrant was a Manager and Team Leader

• As a Manager, the Registrant was responsible for instructing and training her team on document storage

• The Registrant’s failure to recognise and address the deficiencies in her practice

69.  The Panel approached sanction, beginning with the least restrictive first. The sanctions of taking no further action or a Caution Order would fail to address the need to provide public protection.  They would not reflect the seriousness of the allegation, the risk identified, or be adequate given the wider public interest in maintaining confidence in both the profession and the regulatory process. These sanctions are neither appropriate nor proportionate in the circumstances of this case.

70. The Panel was unable to formulate workable, realistic or verifiable conditions of practice. The Registrant failed to meaningfully engage with the SIP which was effectively conditions of practice with which the Registrant failed to comply. She also failed to engage with her colleagues who tried to support her. Further, the Panel know nothing of the Registrant’s current circumstances.  A conditions of practice order is not appropriate or proportionate.

71. The Panel next considered the making of a Suspension Order, for up to 12 months.  Whilst a Suspension Order would provide public protection for its duration, the Panel determined that it would not be sufficient given the serious and wide ranging nature of the allegation and the Panel’s earlier findings as to the high risk of repetition in addition to the absence of any evidence of insight or remediation.

72. The Indicative Sanctions Policy advises at paragraph 41 that where “the Registrant will be unable to resolve or remedy his or her failings then striking off may be the appropriate option.”  In this case, the Panel finds that a Suspension Order would not reflect the seriousness of the case and the high risk identified. The Registrant has not engaged with these proceedings and there is no evidence that she would be willing, or able, to resolve her failings.  The Registrant failed to engage with the SIP and she appeared to wilfully disregard the applicable policies and her professional responsibilities on document completion and storage.  There is no evidence of any insight by the Registrant into the impact of her actions on patients, colleagues or the profession. The evidence was that she appeared unconcerned even when concerns were raised and patient records were lost.

73.  The Panel considered a Striking Off order.  The Panel consider that this sanction reflects the seriousness of the case and the persistent failures of the Registrant, which she appeared unwilling to address. The Panel found that the lack of any evidence of insight, the high risk of repetition and the absence of any evidence of remediation are key factors. In addition to providing protection to the public, a Striking Off Order will send a clear message to the public and to the profession as to the unacceptability of the Registrant’s behaviour, and would serve to maintain confidence in the profession and the regulator.

74. The Panel finds that a Striking Off order is the appropriate and proportionate response.

Order

ORDER: That the Registrar is directed to strike the name of Angela Pryde from the Register on the date this order comes into effect

Notes

No notes available

Hearing History

History of Hearings for Miss Angela Pryde

Date Panel Hearing type Outcomes / Status
29/10/2018 Conduct and Competence Committee Final Hearing Struck off