Mr Andrew Thomas Garrett

Profession: Chiropodist / podiatrist

Registration Number: CH14955

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 05/10/2018 End: 12:00 05/10/2018

Location: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

During the course of your employment as a Chiropodist/Podiatrist for South Warwick NHS Foundation Trust:


1) Between approximately 11 May 2015 and 23 September 2015, you failed to keep adequate records in that you did not consistently input patient information on to the electronic system (Lorenzo) in a timely manner and/or at all.


2) Between approximately September 2013 and December 2015, you did not consistently return patient appointment cards to the single point of access within a reasonable timeframe following treatment sessions.


3) The matters set out in paragraphs 1 - 2 constitute misconduct and/or lack of competence.


4) By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Preliminary Matters

1. The Panel was satisfied that proper notice of this hearing had been sent to the Registrant at his registered address on 4 September 2018.  The Registrant had been contacted by the HCPC again by letter by email on 19 September 2018 to seek up to date information for the hearing today.

2. Ms Senior sought that the Panel proceed in the absence of the Registrant, all reasonable efforts having been made to serve notice.  The Registrant was aware of the hearing.  Ms Senior advised the Panel that the Registrant had not responded and she advised that he has not engaged with the HCPC since 25 September 2016.  He did not attend or engage with the HCPC at the Final hearing. This was a mandatory review hearing and Ms Senior submitted that the Registrant had voluntarily absented himself and has not sought an adjournment.

3. The Panel heard and accepted the advice of the Legal Assessor. He advised that if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the hearing then the Panel has the discretion to proceed in the absence of the Registrant. He reminded the Panel that it should exercise that discretion with care. The Legal Assessor referred the Panel to the HCPC Guidance Note on Proceeding in the Absence of the Registrant and to the case of GMC v Adeogba [2016] EWCA Civ 162.  This case makes clear that the first question the Panel should ask is whether all reasonable efforts have been made to serve the practitioner with notice.  If the Panel is satisfied that proper notice has been given, 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 taken into account.

4. The Panel decided to proceed in the Registrant’s absence as it is satisfied that it is in the public interest to do so. In reaching this decision, the Panel has noted there has been no request for an adjournment. It balanced fairness to the Registrant with fairness to the HCPC and the public interest. It is of the view that the Registrant has voluntarily absented himself and that no useful purpose would be served by adjourning the hearing.  This is a mandatory review and the Panel weighed its responsibilities for public protection and the expeditious disposal of the case with the Registrant’s right to be present at the hearing. In these circumstances the Panel is satisfied that it is appropriate and fair to proceed in his absence. 

Background


5. The Registrant is a registered Chiropodist/ Podiatrist. The allegation found proved related to failures by the Registrant to complete data on the electronic system regarding patients with long term conditions with a high risk of ulceration. He also failed to return patient appointment cards to te single point of access within a reasonable timeframe. After an investigation by the Registrant’s employer he was dismissed.


Submissions for the HCPC


6. Ms Senior summarised the case and the allegation found proved at the Final hearing.  It made a finding of misconduct and imposed a 12 month Suspension Order. The panel at the Final Hearing found that the Registrant had put patients at risk of harm and had breached his obligations which were a fundamental departure from his professional duties.  Due to a lack of any engagement that panel concluded there was a complete lack of remorse, insight and remediation and a risk of repetition.  That panel also gave guidance to the Registrant as to what may assist a Reviewing Panel.

7. The Registrant has not engaged and Ms Senior told the Panel that there remains no evidence of insight and no evidence of any steps taken by the Registrant to remediate his practise. The risk of harm to patients remained and Ms Senior submitted that the Registrant’s fitness to practise remains impaired. There was no evidence that any of the concerns raised by the panel at the Final Hearing had been addressed by the Registrant. 

8. Ms Senior referred to the HCPC Indicative Sanctions Policy (ISP).  She submitted that a Conditions of Practice Order might be possible, in principle, to require, for example, further training.  However, given the lack of engagement, Ms Senior submitted that conditions were not appropriate as the Registrant has not engaged. In the circumstances, Ms Senior submitted that the Panel could impose a further Suspension Order. However, she submitted that there appeared little to be gained by suspending the Registrant for a further period. She referred the Panel to paragraph 41 of the ISP regarding Suspension which suggests that Striking Off may be appropriate where the Registrant is unable to resolve or remedy his failings. She submitted that Striking Off Order may be appropriate in this case.

9. The Panel accepted the advice of the Legal Assessor. He reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if he is fit to return to unrestricted practice. Its role is not to conduct a rehearing of the allegations or go behind the previous findings but to consider impairment of fitness to practice and, if relevant, sanction. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment and have regards, if relevant, to the ISP. 

10. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired all the options as to sanction could be exercised by the Panel. He advised the Panel that it should bear in mind the principles of fairness and proportionality. 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.


 Decision  


11. The Panel considered matters carefully and the information before it.  The Panel noted that the Registrant has not provided any information and he has not engaged with the HCPC to any extent for some two years. There is no evidence before the Panel of any remediation or insight and nothing before the Panel to assist it in the review of the substantive order.  In these circumstances, the Panel has decided that the Registrant’s fitness to practice remains impaired as previously, on both the personal and public components. 

12. The Panel considered sanction and the ISP.  It was mindful of the need to act proportionately and kept the public interest at the forefront of its mind.  Neither a Caution Order nor a Conditions of Practice Order are appropriate in this case, given the seriousness of the findings and the lack of any engagement by the Registrant.  There was a lack of evidence of any insight or remediation of his practise.  There is nothing to suggest that conditions would be realistic, workable or verifiable as there was no evidence of any willingness by the Registrant to commit to and engage with any conditions which might be devised. 

13. The Registrant has not meaningfully engaged and has not provided information to this Panel. There is no evidence of remediation, insight or remorse and no willingness to resolve matters since the Suspension Order was imposed. In these circumstances the Panel see nothing to be gained by the imposition of a further period of Suspension. There is no evidence of any willingness or ability by the Registrant to engage with the HCPC and to remediate his practise.  In addition, a further period of Suspension would not serve the wider public interest because of his lack of engagement with his regulator and the fitness to practise procedures. 

14.    The Panel consider that in all the circumstances a Striking Off is the proportionate and appropriate sanction which both protects the public and satisfies the wider public interest in upholding proper standards and maintaining public confidence in the profession. 

Order

ORDER:  That the Registrar is directed to strike the name of Mr Andrew Thomas Garrett from the Register on the date this order comes into effect. 

Notes

 


This Order imposed will come in to effect upon the expiry of the current Suspension Order. 

Hearing History

History of Hearings for Mr Andrew Thomas Garrett

Date Panel Hearing type Outcomes / Status
05/10/2018 Conduct and Competence Committee Review Hearing Struck off