Mr Gareth E Williams
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Allegation
As found proven at the final hearing on 7 September 2018:
Between 11 March 2013 and 18 November 2014, during the course of your employment as a Speech and Language Therapist by the Dudley Group NHS Foundation Trust:
1. On or around the 02 October 2014, during and/or following a visit to Patient B:
i. you did not contact the GP service to update them of the outcome of a second food trial;
ii. you did not record complete clinical notes in relation to the visit, within the required timescales;
iii. you contacted the GP service and discussed ‘feed at risk’ and/or ‘enteral feeding’ without getting advice from a senior speech and language therapist;
iv. you did not document a telephone call with a senior speech and language therapist and/or the clinical advice which was given;
v. you did not set goals within your follow up notes;
vi. you did not record the outcome of the session in the East Kent Outcome System (EKOS).
2. You did not keep accurate and/or contemporaneous records, in that:
a) In or around October 2013 or November 2013, in relation to Patient C, you recorded the patient had declined an assessment when this was incorrect.
b) Between August and November 2014 you did not record complete notes for the following patients in a timely manner;
i. Patient H;
ii. Patient I;
iii. Patient J;
iv. Patient K.
c) On or around 9 October 2013 you duplicated notes for Patient L.
d) In relation to Patient I, you did not document when the following were sent:
i. a letter sent to the GP.
ii. a fax sent to the GP. 3
e) Following a visit to Patient G on or around 9 April 2014, you did not complete the patient follow up document within 24 hours.
3. In or around October 2014, you inappropriately took home patient notes belonging to Patients D, E and/or F.
4. The matters described in paragraphs 1 – 3 constitute misconduct and/or lack of competence.
5. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Finding
Preliminary Matters
1. The HCPC was represented by Miss Ktisti, Presenting Officer. The Registrant was present and was not represented. The Registrant accepted that he had been served with notice of the hearing.
Background
2. The Registrant’s first, post qualification, employment was with the Dudley Group NHS Foundation Trust (the Trust) as a Speech and Language Therapist (SLT), which started on 11 March 2013.
3. The Registrant’s post as a Band 5 SLT included 6 monthly rotations through various clinical specialties. The rotation commenced in May 2013. Mr Williams’ first rotation was working across ‘acute in-patient stroke wards’ for 1 day per week and 3 days in community services where his clinical caseload included working with patients in a clinical setting and in their homes. During this rotation the community SLT services transferred to a new multi-disciplinary service, Dudley Rehabilitation Service, which remains part of the Dudley Group, and, as his rotation was in part with community service, the Registrant moved with the rest of the SLT team.
4. The Registrant was responsible for assessing, treating and managing adult patients with communication disorders and, once he had completed his post graduate dysphagia training, this also included patients with swallowing difficulties.
5. Concerns were first raised about the Registrant’s note keeping in October 2013 and Stage 1 Capability Proceedings commenced in accordance with the Trust’s Capability Policy. To support the Registrant’s development it was decided to reduce patient contact and supervision was increased to weekly structured supervision.
6. On 8 November 2013, concerns were raised that the Registrant’s record keeping was not up to the required standards. In his notes for Patient C, he recorded that the patient had declined an assessment and that the visit had ended early. On investigation, however, it transpired that the Registrant was, in fact, late in arriving for the visit and did not undertake the assessment (this is the subject of particular 2(a)). On 13 November 2013, the Registrant admitted that this record was not a true reflection of events.
7. As a result of this matter coming to light, in December 2013 a review of the Registrant’s caseload was undertaken. This revealed that a number of entries in patients’ records had not been made contemporaneously with appointments.
8. The Trust’s Standing Operating Procedure (SOP) stipulates that ‘records should be written as soon as possible after an event has occurred (but not later than 24 hours) to ensure information is current and accurate.’
9. Upon examination of the Registrant’s work, shortcomings were found in areas of record keeping, follow up of appointments, and information security.
10. The Registrant was suspended from work on 3 October 2014.
11. These matters were referred to the HCPC and formed the subject of the Allegations, which were found proved at the final hearing held on 22 – 22 February 2017. The substantive panel found that the factual particulars amounted to lack of competence, but did NOT amount to misconduct.
Decision
12. The Panel heard submissions from Ms Ktisti who referred it to the skeleton argument in support of the application. Ms Ktisti also referred the Panel to the contents of an email from the Registrant which was sent to the HCPC dated 13 August 2019 in which the Registrant, in asking for a voluntary removal stated that, “I currently have no intention of returning to the profession of speech and language therapy”.
13. Ms Ktisti submitted that the HCPC was satisfied that voluntary removal from the Register was an appropriate disposal of this case and would protect the public and was in the public interest. This was because its effect was the same as a strike-off from the Register following a finding of impairment of fitness to practise in that it would prevent the Registrant from practising or applying to re-join the Register for a period of five years. Further, any application for re-registration after 5 years would require a return to practise validation.
14. Following the HCPC submissions, the Registrant confirmed that he did not wish to make any submissions or give evidence.
15. The Panel received and accepted the advice of the Legal Assessor.
16. The Panel first reminded itself of the guidance offered in the HCPC Practice Note entitled “Disposal of Cases by Consent”. The Panel noted that it had the power to adopt one of two courses of action:
i. to deal with the case in an expedited manner by approving the proposal set out in the Voluntary Removal Agreement;
ii. to reject the proposal and allow the current suspension order to be reviewed.
17. The Panel noted that the Registrant’s fitness to practise has been found to be impaired, and that since the conclusion of the substantive hearing on 22 February 2017, the Registrant has been subject to conditions of practise and has been suspended from the Register since 7 September 2018.
18. Accordingly, the Panel was satisfied that the public has been protected and the public interest was satisfied by the finding of impairment and the sanctions which have been imposed. Whilst a striking off order could be considered at a further review hearing, the Panel was satisfied that the public would be protected, and the public interest served, by the Voluntary Removal Agreement which has the same effect as striking off. Accordingly, the Panel was satisfied that the signed Voluntary Removal Agreement was a proportionate and appropriate response.
19. For all these reasons, the Panel considered it appropriate to approve the signed Voluntary Removal Agreement dated 16 August 2019.
on Signed Consent Order and Discontinuance Agreement
Order
ORDER: The Panel directs that the Suspension Order (the Existing Order) be revoked and approves the Voluntary Removal Agreement on the basis that the Registrar will remove the name of Mr Gareth E Williams from the Register with immediate effect.
Notes
No notes available
Hearing History
History of Hearings for Mr Gareth E Williams
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 20/08/2019 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |