Miss Yvonne M Hall

Profession: Biomedical scientist

Registration Number: BS36385

Interim Order: Imposed on 07 Mar 2018

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 12/04/2019 End: 17:00 16/04/2019

Location: Health and Care Professions Tribunal Service, 405 Kennington Road

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Whilst employed at Wirral Teaching Hospitals NHS Foundation Trust in the capacity of Chief Biomedical Scientist: 

1)On 9th November 2017 you:

a)Cconsumed alcohol at work

b)Were under the influence of alcohol whilst at work

2)On 10th November 2017 you consumed alcohol at work were under the influence of alcohol at work

3)The matters set out in paragraphs 1 – 2 amount to misconduct

4)By reason of your misconduct, your fitness to practise is impaired

 

Finding

Preliminary matters

Service and Proceeding in Absence

1.The Panel was satisfied that the letter dated 15 February 2019 addressed to the Registrant at her registered address informing her of the date, time and location of the hearing, constituted good service of notice of hearing.  The Panel noted that an email was also sent  on  15 February 2019 to the Registrant providing her with the details of the Final hearing.

2.Mr Millin made an application to proceed in the absence of the Registrant and referred to the relevant rules, the case law and the HCPTS Practice Note on Proceeding in Absence. He confirmed that the Registrant has not engaged with the HCPC and no response had been received to the Notice of Hearing.

3.The Panel considered that service had been carried out and that reasonable steps to contact the Registrant had been made. It accepted the advice of the Legal Assessor.  He referred the Panel to the HCPTS Practice Note on Proceeding in Absence and to the case of GMC v Adeogba [2016] EWCA Civ 162 and the guidance therein as to the importance of fairness to the Registrant and balancing that with fairness to the HCPC and the public interest. 

4.The Panel noted that no adjournment had been sought by the Registrant. The Registrant has not engaged with the HCPC, although she is aware of these proceedings.  There was nothing to suggest an adjournment would secure the Registrant’s attendance and there was a public interest in proceeding expeditiously.  The Panel considered that the Registrant has voluntarily absented herself and waived her right to attend. In all the circumstances the Panel decided it was fair and appropriate to proceed in the absence of the Registrant.

Application to amend the allegation

5.Mr Millin sought to amend the allegation by adding two new particulars to the allegation namely that the Registrant was “under the influence of alcohol”  whilst at work and deleting one Particular that on 10 November 2017 the Registrant consumed alcohol at work.  He submitted that this better reflected the evidence.  He submitted that it was not unfair or prejudicial to the Registrant in that she had received notice of the proposed amendments by letter of 30 November 2018 and had not objected.

6.The Panel took advice from the Legal Assessor. He advised that the Panel had discretion to allow amendment, but must be mindful of the interests of justice and the need to ensure fairness to all parties. It should consider whether the changes proposed are significant and whether they alter the nature or gravity of the allegation. The Panel should also be mindful of the public interest.

7.The Panel determined that the proposed amendment did change the gravity, but not the nature, of the allegation.  Whilst the proposed amendment does make the allegation more serious, the Registrant had received notice on 30 November 2018 and had made no reply or objection. It accepted Mr Millin’s submission that the proposed amendments better reflect the HCPC’s case. On balance therefore the  Panel concluded that it was fair and appropriate to allow the proposed amendment of the allegation. 

Hearing in Private

8.The Panel heard that health or personal matters may arise in the course of the hearing.  The Panel of its own volition decided, after taking legal advice and having considered the HCPTS Practice Note on Conducting Hearings in Private, that if and when matters of such a nature arise it will hold that part of the hearing in private to protect the private life of the Registrant.

Background

9.Mr Millin referred the Panel to the terms of the allegation.  The Registrant was a Chief Biomedical Scientist at the Wirral Teaching Hospitals Foundation Trust (“the Trust”). Her role in 2017 was Quality Manager.

10.It is alleged that whilst at work on 9 November 2017 the Registrant’s colleague JG heard the Registrant unscrew a metal lid and saw the Registrant pouring liquid into a tea cup from a bottle covered by a plastic bag and on two occasions drinking from the cup. When the Registrant left the room JG checked the plastic bag and found an almost empty vodka bottle.  JG reported the incident to management. 

11.AQ the Associate Director of Nursing then met the Registrant on 10 November 2017 to discuss the incident. AQ reported that the Registrant smelt of alcohol but the Registrant claimed she had consumed alcohol the previous night. The Registrant is said to have admitted to bringing alcohol to work on 9 November 2017 to consume later at home.  She initially denied drinking alcohol at work.

12.On 10 November 2017 a further two plastic bottles of clear liquid were found on the Registrant’s desk.  AQ smelt one of the bottles and confirmed that she could smell alcohol.  At the interview with AQ that  day, the Registrant denied the existence of these bottles or that she had consumed alcohol at work. AQ suspended the Registrant from work on 10 November 2017, and HW thereafter conducted an investigation in to the incidents for the Trust.

13.On 30 November 2017 the Registrant was interviewed as part of the Trust’s investigation and admitted bringing alcohol into work on 9 November 2017 and having two alcoholic drinks at her desk. Subsequent to that interview the Registrant acknowledged that she may have had alcohol in her bag on 10 November 2017.

14.The Panel heard from three witnesses for the HCPC :- HW, the Investigating Officer from the Trust;  JG the Registrant’s colleague and AQ the Registrant’s manager, a registered Nurse.

Witness 1  - JG

15.JG took the oath.  Mr Millin for the HCPC took the witness to her witness statement which she confirmed was true to the best of her knowledge and belief. JG is a Support Secretary at the Trust and shared an office with the Registrant at the time of the allegation.

16.JG told the Panel she sat at a desk next to the Registrant facing a window. On 9 November 2017 JG said the Registrant seemed flustered and flushed.  She explained how on two occasions on that day she had heard the Registrant opening a screw top bottle, pouring from it and drinking it with some lemonade in  a tea cup.  She said the Registrant had taken the screw top bottle from a plastic bag on the floor next to her desk. 

17.JG told the Panel she checked the bag on the floor of the office when the Registrant left the room that afternoon. She said that she was shocked to see a vodka bottle in the plastic bag about the size of a litre.  It had only 2-3 inches of clear liquid remaining in it.  She knew it was vodka as the bottle was a labelled, branded vodka bottle. JG said that the Registrant later that day took the bag with the vodka bottle in it home. She said her colleague IG had also seen the vodka bottle in the Registrant’s plastic bag that afternoon.

18.JG said that she had not smelt alcohol on the Registrant that day, despite having hugged her on her arrival at work. JG said that she had made her original statement on that date, 9 November 2017 and accepted that in that statement she said ‘the Office as far as I was concerned did smell of alcohol…’.  She said she was on good terms with the Registrant,  and had never had any disagreement with her.  JG said that the Registrant did sometimes sleep at her desk and on those occasions the office sometimes smelt of alcohol.

Witness 2 - HW

19. HW took the oath and Mr Millin took her to her witness statement which she confirmed was true to the best of her knowledge and belief. She was the Allied Health Professionals  Manager at the Trust, and has since been promoted.

20.HW did not work with the Registrant and did not know her.  She was appointed by the Trust to carry out the investigation into the concerns regarding the Registrant. She received the witness statements from the HR department. 

21.HW interviewed the Registrant on 30 November 2017.  She told the Panel that the Registrant had admitted to her that she had drunk two alcoholic drinks at her desk on 9 November 2017, but she had denied drinking alcohol at work on the 10 November 2017 or having alcohol in the two plastic bottles at her desk.

22.HW said that although the Registrant had been willing to say she had consumed alcohol on 9 November 2017, she had not been willing to say how much and she appeared to understand that what she had done was wrong. HW referred to the Trust policy on Substance Misuse and said it was generally known at the Trust that one must not consume alcohol at work or be under the influence of alcohol whilst at work.

Witness 3  - AQ

23.AQ took the oath and Mr Millin took her to her witness statement which she confirmed was true to the best of her knowledge and belief. AQ is an Improvement Manager with the Trust and a registered Nurse with the NMC. 

24.AQ explained her specific role in the investigation of the concerns regarding the Registrant with whom she had had no previous working relationship.  She had conducted a detailed interview with the Registrant on 10 November 2017. AQ explained that the interview notes were made during the meeting by a colleague and then checked by AQ for accuracy.

25.AQ said that when the Registrant entered the room for the interview on 10 November 2017 there was a strong smell of alcohol. AQ said that when the Registrant spoke to AQ the smell of alcohol was also noticeable.  AQ said the Registrant eyes were glazed, and that she was unkempt in appearance and was shaking, however she spoke steadily and her speech was not slurred and AQ said the Registrant was probably nervous.

26.AQ said she had worked in emergency care for some years as a Nurse and had experience of people under the influence of alcohol. AQ said that she could not say categorically whether or not the Registrant was under the influence of alcohol.

27.AQ told the Panel that she was concerned about professional values and behaviour and the safe delivery of patient care. AQ explained that patient safety issues arose because the Registrant worked in quality assurance in the testing of bloods and other patient materials for the Trust, and failures there could impact on patient safety. AQ said the Registrant had stresses at both home and work and that led her to be most concerned about the Registrant’s ability to practise safely and competently.

28.AQ said she was concerned about the Registrant, who was a quality assurance manager and was concerned to hear that the Registrant had driven in to work that morning and intended to drive home given the smell of alcohol from her.  AQ said that she was also concerned about the impact of the Registrant’s behaviour on colleagues who had reported the matter. 
 
29. AQ said the Registrant had admitted at that time that she had brought alcohol into the Trust premises. AQ said she was concerned as to why the Registrant had not left the alcohol in the car if it was, as the Registrant claimed, for consumption that evening. AQ told the Panel that on that day she had decided to suspend the Registrant after a lengthy discussion with her about the stresses in the Registrant’s home life. The Registrant was shortly thereafter referred to Occupational Health by AQ.

30.In response to Panel questions, AQ explained that two plastic bottles were found on the Registrant’s desk before the interview took place on 10 November 2017.  She and colleagues had smelt one of the bottles and they had smelt alcohol.  One bottle had about one quarter of its contents missing and contained a clear liquid, despite the label saying it was fruit juice. AQ said she also had concerns about the Registrant driving home that day given the smell of alcohol from her,  but she had refused to leave and take a taxi home.

31.AQ said that she considered the Registrant had definitely consumed alcohol but she could not categorically say when the Registrant consumed it and whether she was impaired. However, AQ had concerns about the Registrant undertaking her duties safely and competently and was concerned about her well- being.  AQ said the Registrant was not “in a good place” to be at work.

32.AQ said she had spoken to a colleague, the Registrant’s previous manager. He had told her that the Registrant had previously had alcohol related issues and concerns had been raised about her behaviour in the work place at that time. She was not clear when those concerns were raised but it was at least a year before this incident.  AQ said it was not Trust policy to breathalyse staff.
 
HCPC Submission on Facts and Misconduct

33.Mr Millin referred to his written submission and to the evidence of the three witnesses.  Mr Millin cautioned against reliance on the previous incident mentioned by AQ as there was no direct evidence about that. He submitted that even if there was a previous incident that did not go to proof of the allegation before the Panel. He submitted that he did not rely upon any previous incident to any extent. Mr Millin summarised and set out for the Panel the evidence in support of each part of the allegation.

34.Mr Millin submitted that the evidence as to the Registrant being “under the influence” was heard from JG and AQ.  He submitted that such a finding could only be made by inference or implication from the circumstances described in the evidence of those witnesses. He said that if alcohol was consumed at work by the Registrant on the 9 November 2017, then any amount consumed would have an affect and that, therefore, the Registrant was under the influence of alcohol at work, as alleged.

35.As regards the interview with AQ on 10 November 2017, Mr Millin relied upon the evidence of AQ that the Registrant smelt of alcohol, had “glazed” eyes and was shaking. He submitted that there was evidence that the Registrant was under the influence of alcohol on 10 November 2017, whether that was from the night before or the morning was not relevant.

36.Mr Millin submitted that “under the influence” of alcohol did not mean the Registrant required to be in excess of any particular limit, such as the drink driving limit. It was a matter of degree and the Collins Dictionary definition of “under the influence” was being affected by or controlled by something.  He submitted that “under the influence” did not necessarily require a loss of function.

37.On the issue of misconduct, Mr Millin referred to the case law including Roylance v GMC (No 2) [2000] 1 AC 311 and Nandi v GMC [2004] EWHC 2317 (Admin). He quoted the following from Nandi “the obligation to take responsibility for the care of patients does not cease simply because the [doctor] is exercising managerial or administrative functions one step removed from direct patient care. Depending upon the nature of the duties being exercised, a continuing obligation to focus to patient care may co- exist with a range of distinct administrative duties…”He submitted that the allegation if proved amounted to misconduct. He stressed the need to consider patient safety even where the Registrant did not work directly with patients.  He referred to the Trust Substance Misuse Policy which made it a disciplinary offence to be in the possession of alcohol at work. The HCPC Standards of conduct, performance and ethics should also be considered and he submitted that Standards 6 and 9 had been breached. 

38.The Panel heard and accepted the advice of the Legal Assessor.  He reminded the Panel to assess the evidence carefully and apply the balance of probabilities. The onus rested on the HCPC to prove its case. He reminded the Panel to take care in assessing and placing weight on hearsay evidence and on the untested evidence of alleged previous incidents. He advised that the phrase “under the influence” was not a technical or legal term and that the Panel should use the ordinary, natural meaning of those words.  In the absence of direct evidence, the Panel should consider whether it could properly draw the necessary inferences from the evidence to make a finding, on the balance of probabilities, that the Registrant was “under the influence” of alcohol as alleged. He also referred the Panel to the case law on misconduct. 

Decision on Facts and Misconduct

39.The Panel considered the submissions from Mr Millin and heard and accepted the advice of the Legal Assessor. The Panel was aware that on matters of fact, as distinct from issues of misconduct, the burden of proof rests on the HCPC and that the standard of proof is the civil standard, that is the balance of probabilities.

40.The Panel assessed each of the witnesses. JG described herself as a good work friend of the Registrant for some two years. In advance of the hearing JG had expressed reservations about giving evidence in front of the Registrant and she clearly found it uncomfortable to give evidence. Whilst there were inconsistencies in her accounts of the incident, the essential features of her account were consistent and reliable.

41.HW was the investigating officer. Her live evidence was consistent with her witness statement and notes of the investigation meeting with the Registrant on 30 November 2017. The Panel was mindful that HW was not a factual witness to the events and to this extent her evidence was limited, although of assistance.

42.AQ was a credible and reliable, professional witness with experience of treating patients and others under the influence of alcohol as an A&E Nurse. She was fair and consistent in her account.  She had concerns when she interviewed the Registrant on 10 November 2017 about her being under the influence of alcohol. However, she was carefully balanced and could not say categorically that the Registrant had been under the influence of alcohol.

The Allegation

Particular 1 a) -  Proved

43.The direct evidence of JG was that she observed the Registrant drinking a soft drink mixed with liquid from a metal capped vodka bottle in her bag on two occasions on 9 November 2017 in the office she shared with her. She said she had looked in the bag and seen a bottle with a metal cap with a vodka label on it.  

44.The Panel took into account the Registrant’s signed acceptance contained in the interview notes of her interview with HW on 30 November 2017. The Registrant admits in those notes to having drunk two alcoholic drinks at work on the 9 November 2017.  The Panel found this proved.

Particular 1 b) - Proved

45.The Panel was provided with no working definition of the phrase “under the influence of alcohol” or case law guidance as to any formal, legal meaning of that phrase.  The HCPC asked the Panel to give the words their ordinary meaning and referred to the Collins Dictionary definition of being “under the influence.” The Legal Assessor advised that the Panel may be assisted by considering whether the Registrant was “affected”  by alcohol.

46.The Panel was of the view that there is clearly a broad spectrum of “influence” between slightly affected and being completely controlled by something. The Panel is of the view that the purpose of the allegation must be to refer to being adversely affected by alcohol to some degree such that it impacts on the Registrant’s ability to carry out her normal duties safely and efficiently.

47.There was some hearsay evidence before the Panel of similar concerns being raised by colleagues in the months preceding the events on 9 and 10 November 2017 which gave rise to the allegation.  This was regarding the Registrant’s behaviour at work which one colleague thought may be due to the effects of alcohol. The HCPC made clear that they were not relying on that evidence or any previous history.  The Panel did not do so.

48.The evidence from JG was of the Registrant drinking two alcoholic drinks on 9 November 2017. However, she said in her contemporaneous notes that the Registrant’s speech was not slurred. The written statement of a colleague, AB, was that on 9 November 2017 when he attended the meeting with the Registrant that “When Yvonne spoke I could smell alcohol on her breath… I turned to her and her eyes were glazed”

49.On balance, and having found 1a) proved, the Panel found that the Registrant was affected by alcohol and it determined that the Registrant was under the influence of alcohol at work on 9 November 2017 and finds this Particular proved.

Particular 2  - Proved

50. AQ said in live evidence that she could not say “categorically” that the Registrant was under the influence of alcohol on 10 November 2017, but she had concerns about the Registrant. Having discussed matters at length that day face to face with the Registrant, AQ was not reassured that the Registrant was not under the influence of alcohol and said she was “not in a good place”. AQ said she observed and noted the following :-

a.It was apparent when the Registrant entered the interview room and sat opposite AQ at a small table that there was an overwhelming smell of alcohol.

b.The Registrant’s eyes were glazed.

c.The Registrant was unkempt in appearance.

d.The Registrant was visibly shaking.

e.There was at least one 500ml plastic bottle on her office desk that contained alcohol.  AQ recalled that the bottle was labelled as a fruit juice drink but the contents were clear. She and other colleagues smelt the open bottle and confirmed that it smelt of alcohol.

f.The Registrant disclosed significant personal issues.

51.AQ had a number of concerns which included:

•patent safety, albeit the Registrant’s patient contact was indirect;

•personal and public safety regarding the Registrant’s ability to drive safely having consumed alcohol

•the risk of damage to the Trust’s reputation

•the impact on staff, and

•the Registrant’s own wellbeing.

52. AQ was fair and balanced and accepted that the Registrant could have been nervous due to stresses at work and at home.   She also emphasised that notwithstanding the strong smell of alcohol from the Registrant, she could not say when the alcohol had been consumed. It was plausible that the Registrant had been drinking the previous night, but she noted the smell of alcohol was very prevalent at the meeting at 11am on 10 November 2017.

53.The Panel makes no finding as to when the Registrant consumed alcohol.  Having assessed and weighed all the evidence, particularly the evidence of AQ who had observed the Registrant closely, and taking into account the Panel’s own findings in respect of Particular 1 b), the Panel has drawn the inference that on 10 November 2017 the Registrant was affected by, and was under the influence of alcohol at work.  It finds this particular of the Allegation proved.

Misconduct

54.The Panel first considered the HCPC Standards of performance, conduct and ethics and found that the Registrant’s’ behaviour breached the following standards :-

“6.1 You must take all reasonable steps to reduce the risk of harm  to service users, carers and colleagues as far as possible.

6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.

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

55.A key role of an NHS laboratory Quality Manager is to develop the laboratory service, ensuring national standards on quality are met. The Registrant’s job description also required her to support the departmental managers and quality leads with safe service provision and governance. With this in mind, the panel noted the case law referred to above where a professional is one step removed from direct patient care.

56.The Panel also took into account the Trust’s Substance Misuse Policy which states “Employees are expected to report for duty able to carry out their work professionally and safely at all times. The Trust forbids staff to attend for work under the influence of drugs or alcohol. It is a disciplinary offence to consume alcohol or to be under the influence of alcohol or use drugs (prescribed or non-prescribed) inappropriately during working hours or when available for work, including on-call. It is also a disciplinary offence to be in possession of alcohol or illegal drugs for the purpose of consumption during working hours, on Trust premises or while undertaking Trust business. These offences are considered examples of gross misconduct under the Trust’s Disciplinary Procedure and are strictly forbidden”.

57.In the judgement of the Panel the facts found proved are sufficiently serious to amount to misconduct because consuming alcohol at work and being under the influence of alcohol at work puts patients at risk, even indirectly as in this case, is a serious breach of the standards of conduct and behaviour expected of a Biomedical Scientist and brings the profession into disrepute.  The Panel found that the Registrant’s behaviour fell far below what would be proper in the circumstances and would be considered deplorable by fellow professionals.

HCPC Submissions on Impairment

58.Mr Millin referred to his Skeleton Submissions and to the HCPTS Practice Note on Impairment and to the personal and public elements of impairment.  He referred the Panel to case law and to the guidance in Cheatle v GMC [2009] EWHC 645 (Admin) and Council for Healthcare Regulatory Excellence v Grant [2011] EWHC 927 (Admin). 

59.Mr Millin reminded the Panel of the need to consider impairment and the risk presented by the Registrant. He also referred the Panel to the need to have regard to the public interest and the need to declare and uphold proper standards of the profession and the Regulator.

60.The Legal Assessor referred the Panel to the HCPTS Practice Note on Impairment and to the guidance in the case law, in particular Grant. He stressed to the Panel the central importance of the public interest in its consideration of current impairment of fitness to practise.

Decision on Impairment

61.The Panel next considered whether the Registrant’s fitness to practise was 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. The Panel was mindful of the over-arching purpose of the Regulator to protect the public and to safeguard public confidence in both the profession and the HCPC. 

62.On the personal component of impairment of fitness to practice, the Panel has very little information from the Registrant to demonstrate remorse, insight or remediation and it has no current information from her. The Panel considered that the conduct found proved is remediable, but there is no evidence that the Registrant has taken steps to do so and there is no evidence before the Panel that the Registrant is keeping her skills and practise up to date.  There has been no engagement by the Registrant with the HCPC and she  has not provided any evidence of her current circumstances to the Panel. 

63.As regards insight, the Panel noted that HW said the Registrant at the time clearly knew what she had done was wrong and HW said she could “tell she [the Registrant] knew it was wrong as she was willing to say she had had an alcoholic drink at work but she was less willing to say how much”.  AQ said that on 10 November 2017 she and the Registrant had a “very open and common sense” conversation but the Registrant had denied drinking.  

64.The Registrant did appear at the time to accept she had underlying issues and she was seeking to address them. She expressed some remorse for her actions. Unfortunately, the Panel has no further evidence of the Registrant’s developing or current insight, and it has no evidence of any remediation of her practise. The Panel knows nothing of the Registrant’s current circumstances as there has been no engagement by her with the HCPC.  The Panel do not know the outcome of the Registrant’s steps in 2017 to remedy her practise and it determined that it could attach only very limited weight to those “green shoots” of the Registrant’s insight and her steps to remedy her practise at that time. 

65.The lack of any current evidence of insight and remediation leads the Panel to conclude that there is risk of repetition. The Panel determined therefore that there is a potential risk to patient safety, albeit indirect. The Panel concluded on the private component of impairment that the Registrant’s fitness to practice is currently impaired.

66.With regard to the public component the Panel was mindful of the critical public interest aspects.  It considered the need to protect service users, to declare and uphold proper standards of behaviour and to maintain confidence in the profession. The public would be very concerned that a Biomedical Scientist, including in the role of this Registrant with responsibilities to ensure quality and safety, was consuming alcohol at work.

67.In these circumstances there is a clear need to protect service users and to uphold proper standards.  The Panel determined that public confidence would be seriously undermined were it not to find that the Registrant’s fitness to practise was currently impaired.

68.In order to maintain public confidence in the profession, and in the Regulator, and to uphold and declare proper standards, the Panel determined that a finding of impairment is also required on public interest grounds.

 
Submissions on Sanction

69.The Panel heard from Mr Millin.  He referred to the HCPC’s Indicative Sanctions Policy (ISP) and reminded the Panel that the primary purpose of sanction is to protect the public.  Mr Millin remained neutral as regards the sanction, if any, to be imposed and made no submissions as to the appropriate sanction. He referred the Panel to its findings on the Registrant’s insight and reminded it that sanctions should not be imposed to provide a Registrant with time to develop insight. He submitted that the Panel should consider the degree of public protection required and stressed the proportionality of any sanction imposed and submitted that the Panel should consider the sanctions in ascending order.  

70.Mr Millin suggested that aggravating features were the potential for patient harm, limited insight, a lack of remediation and that two incidents occurred.  As to mitigating features, he submitted that the Registrant had cooperated with the Trust and had made some early admissions and showed some insight.  He advised that the Registrant had no previous regulatory history. 

71.The Panel took the advice of the Legal Assessor.  He referred it to the HCPC Indicative Sanctions Policy (ISP) and reminded it to consider any sanction in ascending order and to apply the least restrictive sanction necessary in order to protect the public. It should act proportionately and consider any aggravating and mitigating factors and bear in mind the public interest. He reminded the Panel that the primary purpose of sanction was protection of the public. 

Decision on Sanction

72.The Panel accepted the advice of the Legal Assessor and reminded itself that the primary purpose of sanction is to protect the public. The Panel had regard to its findings. The Panel approached sanction, beginning with the least restrictive first, bearing in mind the need for proportionality.

73.As regards aggravating features the Panel found the following :-

a.The premeditation involved in bringing and concealing alcohol in the work place on two consecutive days.

b.Limited insight and non-engagement with the HCPC

c.The potential for harm to patients and the public

74.The Panel identified a number of mitigating features :-

a.Difficult personal circumstances

b.Previous good character and no previous regulatory concerns

75.The Panel decided that taking no further action and the sanction of a Caution Order would not reflect the seriousness of the allegation proved and the finding of a risk of repetition.  The findings are not limited, minor or isolated. There is very limited evidence of remedial action and limited evidence of insight.  Further, such orders would not be adequate or proportionate given the wider public interest in upholding proper standards and maintaining confidence in the profession and the regulatory process. The Panel found that neither order is appropriate or proportionate in the circumstances of this case.

76.The Panel next considered a Conditions of Practice Order. The allegation found proved is serious.  The Panel considered paragraph 33 of the ISP.  It requires the Panel to be satisfied that the Registrant is committed to resolving the issues that gave rise to the Allegation and is able to do so.  The Panel knows nothing of the Registrant’s current circumstances and given the complete lack of engagement by the Registrant, there is no evidence that the Registrant is either willing or able to comply with Conditions.  In any event, the findings of the Panel are not amenable to the imposition of realistic, verifiable and workable Conditions of Practice at this stage.

77.The Panel has determined that a Conditions of Practice Order is not appropriate or proportionate and would not address the risk identified or satisfy the public interest.

78.The Panel next considered a Suspension Order. It has found a serious allegation proved that gives rise to a risk to patient safety. There is no engagement, limited insight and very limited remediation.  A Suspension Order would protect the public and uphold proper standards. It would also have a deterrent effect on other professionals.

79.The Panel does not find that it can conclude that the Registrant is unable to resolve the behaviour which led to the Allegations. It was mindful of the terms of paragraph 41, 42 and 43 of the ISP which indicate that a Suspension Order may be appropriate where a lesser sanction would undermine public confidence and be unlikely to provide the required level of public protection.

80.The Panel decided that the nature and gravity of the Allegation is such that to maintain confidence, protect the public and provide a deterrent effect, a Suspension Order for a period of 12 months is the appropriate and proportionate sanction.
 
81.The Panel consider that a Panel reviewing the Suspension Order would be assisted by  the Registrant providing the following :-

i.The Registrant’s engagement

ii.Up to date evidence from any treating health professionals regarding her wellbeing and fitness for work.

iii.Any evidence of remediation

iv.Any evidence of keeping her knowledge and skills up to date

v.Any relevant testimonials from paid or unpaid work which she may wish to place before the Panel

82.The Panel consider that a Striking Off Order is not proportionate at this stage as a Suspension Order sufficiently and proportionately protects the public and the wider public interest.  Further, the nature and gravity of the Allegation, although serious, are not so serious as to call for Striking Off.

Order

The Registrar is directed to suspend the name of Yvonne M. Hall from the register from the date this order comes into effect for a period of 12 months.

Notes

The Panel makes an Interim Suspension under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. 

This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

Hearing History

History of Hearings for Miss Yvonne M Hall

Date Panel Hearing type Outcomes / Status
12/04/2019 Conduct and Competence Committee Final Hearing Suspended
22/03/2019 Investigating Committee Interim Order Review Interim Suspension
06/12/2018 Conduct and Competence Committee Interim Order Review Interim Suspension
06/09/2018 Investigating committee Interim Order Review Interim Suspension
07/03/2018 Investigating committee Interim Order Application Interim Suspension