Mr Arul Rathina
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The following allegation was considered by a Panel of the Conduct and Competence Committee at a Substantive Hearing on 28 July 2008.
Your fitness to practise as a registered health professional is impaired by reason of your misconduct and / or lack of competence, in that:
1. At all material times you were employed as a Physiotherapist by Devon Primary Care Trust.
2. On 8th March 2006 you were instructed to arrange and attend regular clinical supervision sessions with senior colleagues and you failed to comply.
3. In or before August 2006 you incorrectly treated a patient referred with a neurological condition, leading to a complaint from a specialist neurological physiotherapist.
4. In or before September 2006 you were instructed not to undertake unsupervised treatment of patients with neurological complaints, however:
a. You treated another patient with a neurological condition, contrary to the instruction given
b. You treated the patient incorrectly.
5. Between January 2006 and 31 January 2007 you were unable to demonstrate attainment of the level of competency required for your grade in:
b. Health & Safety
c. Planning & Preparation
f. Clinical Reasoning
g. Record Keeping & Information Provision
1. The Applicant qualified as a Physiotherapist in 2004. He was employed by Devon Primary Care Trust at Totnes Community Hospital between 3 October 2005 and 1 February 2007. The Applicant resigned from his employment on 1 February 2007.
2. On 28 July 2008, the allegations against the Applicant narrated above were found to be proved. It was accepted that during 2006, the Applicant was involved in incidents when he treated patients incorrectly. He failed to follow instructions to undergo regular clinical supervision and to refrain from treating patients with neurological conditions. Despite extended periods of supervision, he was found to have fallen below the level of competence expected of a physiotherapist of his grade.
3. The final hearing panel found that the failings identified above constituted misconduct and lack of competence. The Applicant’s fitness to practise was impaired. The panel determined that the Applicant’s name should be struck off the HCPC Register.
4. On 26 October 2016, the Applicant applied for his name to be restored to the HCPC Register. Following a hearing on 14 July 2017, the panel refused to make an order restoring the Applicant’s name to the Register.
5. Today’s hearing was the Applicant’s second application to have his name restored to the Register. The hearing was convened in terms of Article 33 of the 2001 Order. The burden was upon the Applicant to satisfy the Panel that he is now fit to practise and that his name should be restored to the Register.
6. The Panel bore in mind that its primary function is to protect the public and to maintain confidence in the profession. It has not gone behind the decision made in 2008. It has referred to the HCPTS Practice Note on “Restoration to the Register”.
7. In reaching its decision, the Panel has taken into account all the information before it, together with the evidence of the Applicant and the submissions made by him and by Ms Senior, on behalf of the HCPC. It has accepted the advice of the Legal Assessor.
8. Since his first application for restoration in 2017, the Applicant has undertaken physiotherapy related work. The Applicant is employed by Royal Surrey County Hospitals NHS Foundation Trust as a Technical Instructor. He began employment on 18 September 2017. He was initially employed on a fixed term contract from 18 September 2017 until 20 May 2018. On 21 May 2018, the Applicant was taken on as a permanent member of staff.
9. A document was provided from RB, Clinical Specialist Physiotherapist. It confirmed that the Applicant’s job responsibilities include: (i) completing first line assessments for patients requiring mobility assessment and rehab following screening required by a qualified member of staff; (ii) appropriate progression and rehab of routine mobility patients; and (iii) and discharge planning and onward referral for patients following discussion with a qualified member of staff. RB confirmed that the Applicant has worked as part of the surgical and critical care physiotherapy teams. There have been no concerns with the Applicant’s performance in the role and he is a well-regarded member of the team.
10. During the Applicant’s probationary period, concerns were raised in relation to caseload management. However, the Applicant did pass the probationary period.
11. The Applicant’s most recent appraisal related to the period from September 2017 to September 2018. The reviewer, AP (a Senior Physiotherapist), assessed the Applicant as being “proficient/ successful”. This meant that he met the expectations of that job.
12. The Applicant provided a variety of additional documentation including certificates for courses and training completed, and a work based activities log book for the period from 27 September 2017, which outlined training that had been undertaken with his current employer.
13. In relation to returning to practice, the Panel noted the minimum requirements of those returning to work after more than 5 years. A person not registered for a period of 5 years, must undertake 60 days of profession related activities, in accordance with the HCPC requirements for professionals returning to practice.
14. The Panel considered the Legal Assessor’s advice that, in relation to someone previously struck off, it is not sufficient for an applicant merely to establish that he meets the requisite standard of clinical proficiency for registration.
15. The Panel has taken into consideration the circumstances of the Striking Off Order made in 2008 and the serious concerns identified about the Applicant’s conduct and competence, in particular, that his level of competence was assessed as being only at a level of a student in a first year placement.
16. The Panel notes that the HCPC does not seek an order preventing the Applicant from making further applications for restoration. Moreover, there was a recognition that the Applicant had taken steps to address the issues highlighted by the previous panel when it considered the Applicant’s last application for restoration.
17. The Panel was satisfied that the Applicant has undertaken significant steps to address the concerns that were highlighted at the time of his striking off from the Register. The Applicant has worked as a Technical Instructor and has performed well in this role. On the basis of the Applicant’s evidence in relation to the work that he has undertaken in his current role, coupled with the logs demonstrating the training that he has undertaken, and the statements from RB, the Panel was satisfied that the Applicant meets the standard of proficiency for registration.
18. The Panel was satisfied that the Applicant has reflected on the incidents that resulted in his original striking off and has shown a degree of insight. The Registrant stated in his evidence that he had reflected on the differences in practice between where he trained, in India, and here in the UK. He explained that if faced with circumstances similar to the ones which led to his being struck off the Register he would do things differently. He understood the importance of supervision by a physiotherapist and, if permitted to return to the Register, he would seek a physiotherapist supervisor in a neighbouring NHS Trust if necessary. The Panel considers that the Applicant has taken significant steps since his last restoration application to address the issues identified, including in relation to health and safety and adequate record keeping.
19. However, the Panel is not satisfied that it is yet appropriate for the Applicant to return to unrestricted practise. The Panel does have some residual concerns in relation to his level of insight into the potential impact that his actions might have had on patients and the profession. The Panel notes that although the Applicant has been successfully working in a role related to physiotherapy, he has no recent experience working as an autonomous Physiotherapist. The Panel was nevertheless satisfied that conditions could be formulated to adequately address these concerns. Demonstration of successfully working under supervision and appropriate commitment to a Personal Development Plan would be necessary before a panel could consider his returning to unrestricted practise.
20. The Application for restoration shall be granted with a Conditions of Practice Order being imposed.
21. The Applicant must complete the recognised return to work procedures. That is due to the length of time since his name was struck from the Register.
The Registrar is directed to restore the name of Mr Arul Rathina (the Applicant) to the Physiotherapist Part of the Register, but restoration is only to take effect once the Applicant has:
A. Provided the Registrar with any information and declarations required for admission to the Register;
B. Paid the prescribed fee;
C. Satisfied the Registrar that, in relation to the Applicant, there is or will be in force appropriate cover under an indemnity arrangement; and
D. Provided evidence which satisfies the Registrar that the Applicant has successfully completed a 60 day period of professional updating in accordance with the HCPC Standards for Return to Practice.
The Registrar is further directed to annotate the Register to show that for a period of 12 months from the date of his restoration to the Register (the “Operative Date”), you Mr Arul Rathina, must comply with the following conditions of practice:
1. You must inform the HCPC of the details of your current employer.
2. Promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.
3. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
4. 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;
B. Any agency you are registered with or apply to be registered with (at the time of your application); and
C. Any prospective employer (at the time of your application)
5. Within 3 months of the Operative Date, you must: produce a reflective piece of writing which addresses the potential impact of your actions, which resulted in your name being struck off form the Register, on: (1) the patients involved; and (2) the physiotherapy profession; and forward a copy of your reflective piece of writing to the HCPC no later than 28 days before the date of any review of this Order.
6. You must: produce a reflective piece of writing addressing your reflections on your treatment and observations in respect of three patients with neurological conditions; and forward a copy of this to the HCPC no later than 28 days before the date of any review of this Order.
7. You must place yourself and remain under the supervision of a workplace supervisor, being a Physiotherapist registered by the HCPC (the “Supervisor”) and supply details of your Supervisor to the HCPC within 28 days of taking up employment. You must attend upon that Supervisor as required and follow their advice and recommendations.
8. You must work with your Supervisor to formulate a Personal Development Plan (PDP) designed to address the following areas of your practice:
B. Planning & Preparation
E. Clinical Reasoning
9. Within 3 months of the Operative Date you must forward a copy of your Personal Development Plan to the HCPC.
10. You must meet with your Supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.
11. You must provide copies of your Supervisor’s records of supervisions, including those addressing your progress towards attaining the goals set out in the Personal Development Plan, to the HCPC no later than 28 days before the date of any review of this Order.
12. You will be responsible for meeting any and all costs associated with complying with these conditions.
13. The conditions requiring you to provide any information to HCPC are to be met by you sending the information to the Offices of the HCPC marked for the attention of the Director of Fitness to Practise or Head of Case Management.
No notes available
History of Hearings for Mr Arul Rathina
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