Mr Alexander Fawcett
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As found proven at the final hearing on 1 November 2016:
During the course of your employment as a Physiotherapist at Medway NHS Foundation Trust between 21 January 2015 and 14 September 2015, you:
1. did not complete your probationary period due to concerns regarding:
a. your note keeping in that your;
i. patient records were consistently illegible;
ii. patient records frequently included spelling errors;
iii. patient records were not adequately structured;
iv. patient consistently did not include a subjective history;
v. patient notes consistently did not include clinical reasoning;
vi. problem lists consistently lacked sufficient detail.
b. your assessment skills in that you:
i. during your probation period frequently did not complete comprehensive
whole systems assessments;
ii. on at least two occasions, stated that two unknown patients chests were clear,
yet on assessment both patients had significant loads of sputum requiring invasive
iii. did not link patient history and then adapt your assessment skills accordingly.
c. your use of monitoring during treatment sessions, in that you:
i. on an unknown date and in relation to an unknown patient, despite
identifying a patient had a high Oxygen demand and a labile blood pressure,
removed monitoring equipment and instructed the unknown patient to sit at it the
side of the side of the bed.
ii. on an unknown date and in relation to an unknown patient, took a blood
pressure despite the patient being stable for several days;
iii. on an unknown date and in relation to an unknown patient, did not
reconnect an HDU patient back to the ECG monitoring equipment.
d. your identification of patient problems;
e. your clinical reasoning;
f. your treatment selection, in that you;
i. did not reflect patient needs in that your treatment plans;
ii. did not prepare bed space adequately;
iii. did not return a patient’s table within reach of an HDU patient;
iv. left Oxygen cylinders by an HDU patient’s the bed;
iv. did not sufficiently frequently provide patients with exercises for their trunk;
v. needed to be prompted regarding the safe placement of a catheter.
g. your communication skills, in that you:
i. did not adapt your communication style to patient age;
ii. did not adapt your communication style to patient needs;
iii. often raised your voice unnecessarily to patients;
iv. Found not proven
2. The matters set out in paragraph 1 constitute misconduct and / or a lack of
3. By reason of your misconduct and / or lack of competence your fitness to
practise is impaired.
Application to proceed in absence
1. The Panel was satisfied that it was appropriate to proceed in the Registrant’s absence because this is a mandatory review which must take place before 1 March 2019 and Mr Fawcett has written to the HCPC informing it that he is aware of the hearing and has decided not to attend. The Panel was satisfied that Mr Fawcett has voluntarily absented himself and that it would not be unfair to proceed in his absence.
2. The Registrant started work as a newly qualified practitioner in January 2015 and the matters identified in the Allegation arose during a period from January 2015 to September 2015. At the time of the Final Hearing the Registrant was undertaking a course in dementia care and working as a Band 3 Therapy support worker.
3. The panel identified that the Registrant’s practice had fallen short in relation to 10 of the 15 Standards of Proficiency for Physiotherapists expected of a practitioner and had made a finding of lack of competence. In the absence of evidence of remediation, the panel found impairment and imposed a period of suspension of twelve months.
4. At a review on 1 March 2018 the Panel saw a number of documents that were produced by the Registrant. They included the following:
• A reflective piece on his shortcomings signed by the Registrant and dated 4 February 2018.
• A number of testimonials and references.
• Evidence of recent training.
• Evidence of remediation of his shortcomings.
• Evidence of continued reading and learning.
5. The panel on that review found that Mr Fawcett’s fitness to practise was still impaired but that it was appropriate to replace the order of suspension with a conditions of practice order: The conditions were:
1. At all times during any employment as a Physiotherapist, you must place yourself and remain under the supervision of a workplace physiotherapist supervisor registered by the HCPC and supply details of your supervisor to the HCPC within seven days of the date of your employment. You must attend upon that supervisor as required and follow their advice and recommendations.
2. You must work with your supervisor to formulate a Personal Development Plan designed to address the concerns raised in the allegations including:
• Note Keeping
• Clinical Assessments, Clinical Reasoning, the identification of patient problems, and Treatment Selection
• Use of monitoring of Patients during treatment sessions
• Communication with Patients and Colleagues
• Caseload and Time Management Skills
• Participation in Feedback
3. Within three months of the date you are employed as a physiotherapist, you must forward a copy of your Personal Development Plan to the HCPC.
4. You must meet with your supervisor on a fortnightly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.
5. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.
6. You must provide to the HCPC a report from your supervisor no later than seven days before any review of this interim order detailing the progress you have made towards achieving the aims set out in your Personal Development Plan and in relation to compliance with this Interim Order.
7. You must inform the following parties that your registration is subject to these conditions:
a. any organisation or person employing or contracting with you to undertake professional work as a Physiotherapist;
b. any agency you are registered with or apply to be registered with as a Physiotherapist (at the time of application); and
c. any prospective employer of you as a Physiotherapist (at the time of your application).
Decision on Impairment
6. The Panel has considered the HCPTS Practice Note on Article 30 Reviews and accepted the advice of the legal assessor. The Panel has concluded that Mr Fawcett’s fitness to practise is still impaired. It has received no evidence from Mr Fawcett that he has complied with the conditions of practice and although he had engaged with the HCPC process in the past by attending hearings and/or providing information in writing to the Panel, the Panel today knows nothing of his current circumstances.
7. Therefore, the Panel concluded that an order is still necessary to protect members of the public, to maintain proper standards of clinical performance, to maintain public confidence in the profession and in the HCPC as its regulator.
Decision on Sanction
8. The Panel then went on to consider what order if any, is appropriate. It took into account the principles of proportionality balancing the interests of the Registrant with the public interest.
9. The Panel had regard to the HCPTS Indicative Sanctions Policy and approached the available sanctions in ascending order of severity. This Panel is aware that the purpose of sanction is not punitive but to protect members of the public and to safeguard the public interest by maintaining standards within the profession and public confidence in the profession and in its regulatory process.
10. The Panel decided that a Caution Order would be inappropriate because of the nature and gravity of the facts found proved such an Order would not sufficiently protect the public or is in the public interest.
11. The Panel next considered whether in the circumstances that now exist a Conditions of Practice Order remained the appropriate and proportionate sanction. The Panel noted that it would have expected to see evidence that Mr Fawcett had made a determined effort to comply with the conditions imposed a year ago but that since he contacted the HCPC to clarify the meaning of condition 1 and was told that he could apply for an early review of the order, the HCPC had received no contact from him. Therefore the Panel could not be satisfied that conditions of practice remained workable.
12. The Panel went on to consider an order of Suspension. The Panel found that Mr Fawcett’s failings were widespread and basic and that there was no evidence that his failings had been remediated despite the opportunity for him to do so. The Panel was satisfied that an order of Suspension was necessary to adequately protect the public and to maintain confidence in the profession.
13. The Panel was aware that because Mr Fawcett had been subject to Suspension and Conditions of Practice orders for more than two years, it had the power to impose a Striking Off order. The HCPC submitted that a Striking Off Order was the appropriate order today. However, the Panel took into account that at earlier hearings Mr Fawcett had shown that he has insight, and that at the last review the Panel was satisfied that he had shown that he was capable of remediating his failings. This Panel notes that having heard Mr Fawcett give evidence, that panel were impressed with him. Taking all that into account, this Panel decided that Mr Fawcett was not in the category of a registrant who persistently fails and has no insight, and has engaged in the past, and this led the Panel to conclude that a Striking Off order would be disproportionate on this occasion. The HCPC accepted that should the panel impose a suspension Order that it would be open to the Registrant to apply for voluntary removal from the Register.
14. This Panel considers that the panel at the next review hearing is likely to be assisted by any up-to-date information regarding Mr Fawcett’s current circumstances and any employment whether paid or unpaid.
15. The Panel decided that twelve months was the appropriate length of Suspension Order, which would give sufficient time for Mr Fawcett to pursue voluntary removal from the Register if he wishes. This Order will be reviewed by another panel before it expires.
The Registrar is directed suspend the registration of Alexander Fawcett for a period of 12 months on expiry of the existing order.
This order will be revewed again before its expiry on 1 March 2020.
History of Hearings for Mr Alexander Fawcett
|Date||Panel||Hearing type||Outcomes / Status|
|01/02/2019||Conduct and Competence Committee||Review Hearing||Hearing has not yet been held|
|01/11/2016||Conduct and Competence Committee||Final Hearing||Suspended|