Miss Nisha Bhardwaj

Profession: Biomedical scientist

Registration Number: BS40019

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 10/07/2019 End: 02:00 10/07/2019

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

Panel: Conduct and Competence Committee
Outcome: No further action

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Allegation

During the course of your employment as a Biomedical Scientist at Great Ormond Street Hospital, between 15 June 2009 and 9 June 2015

1. In or around October 2011 you did not communicate with your line manager about the results of staining.

2. On or around 28 October 2011, it became apparent that you had not updated the ongoing document as required.

3. Between June 2010 and December 2010, you conducted flow cytometry experiments which were not accurate enough to be considered for research.

4. Between 2009 and 2011, your productivity of biopsy samples entered within the institute’s computer system only accounted for 5.6% of the total samples entered within the ION centre.

5. In or around May 2011, you amended figures within reports for the NCG service and/or collated the figures inaccurately.

6. In or around July 2011, you did not complete FACS analysis triplicate of cells in a timely manner.

7. In or around June 2011, you did not label the biopsy slides fully.

8. On more than one occasion you did not top up the liquid nitrogen for the biopsy samples in accordance with the liquid nitrogen rota.

9. In or around December 2011, you did not achieve consistent inter experiment results for patient cells.

10. Did not keep contemporaneous records of your work, in that you:

a. Did not record details of your working time on 28 October 2011. b. Did not record details of your working time on 3 November 2011.

c. Did not record work completed after a completion of tissue culture work started at 1.30pm on 11 November 2011.

d. Did not record details of your working time on 14 November 2011.

e. Did not record details of your working time after 3.15pm on 21 November 2011.

f. Did not record details of your working time after 3.15pm on 24 November 2011.

g. Did not record details of the experiments which you conducted on 25 November 2011.

11. The matters set out in paragraphs 1-10 constitute misconduct and/or lack of competence.

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

Facts proved: 1 (in relation to Misconduct), 2, 3 (in relation to Lack of Competence), 5, 6 (In relation to Lack of Competence), 7 (In relation to Misconduct), 8 (In relation to Misconduct), 9, (In relation to Lack of Competence 10)

Facts not proved: 4

 

Finding

Preliminary Matters

Private Hearing

1. At the beginning of the hearing, the Panel considered a joint application by Ms Mbah, on behalf of the HCPC, and the Registrant, for parts of the hearing to be conducted in private, in the event that reference was made to the Registrant’s health. Having received advice from the Legal Assessor, the Panel granted that application in view of the principles set out in the HCPTS Practice Note, Conducting Hearings in Private. The Panel determined that those parts of the hearing that concern the Registrant’s health should be conducted in private.

Background

2. The Registrant was appointed as a Band 7 Cellular Scientist in the Neurosciences Division at Great Ormond Street Hospital from 15 June 2009. During the course of the Registrant’s employment, there were concerns raised about her work by different members of staff. The concerns mainly related to record keeping and communication skills.

3. A performance management process was followed to monitor and track the Registrant’s performance between 2010 and 2015. Two disciplinary proceedings were held. In 2015 the Registrant was dismissed from her post.

4. At the Final Hearing at the HCPC on 13-17 November 2017, 10, 14-15, 17-18 May 2018 and 19 July 2018, the Registrant attended and firstly represented herself; following an adjournment in order for her to seek legal advice and representation, the Registrant was represented. A panel of the Conduct and Competence Committee found that the failings identified in the Registrant’s professional practice constituted a lack of competence in relation to Particulars 3, 6 and 9 and misconduct in relation to Particulars 1, 7 and 8.
 
5. In terms of the Registrant’s insight at the Final Hearing, the panel commented as follows: “Throughout the proceedings there was no indication from the Registrant that the Particulars proved were due to acts or omissions on her part. Insight on the part of the Registrant is crucial. Without the Registrant recognising how problems that arise need to be addressed, similar issues could occur in future. There are different ways of insight being demonstrated. These can include the ability to step back from the situation and consider it objectively, recognising what went wrong, accepting their role and responsibilities at the material time, appreciating what could and should have been done differently, and understanding how to act differently in the future to avoid reoccurrence of similar problems. The absence of such insight calls into question her ability to work as a Biomedical Scientist without restriction. The Panel cannot be confident that she would not behave in a similar way in the future and concluded that there is a risk of repetition of a lack of competence if she were to work in a specialist research setting without the adequate training and support she requires. The Panel also considered that there is a risk of repetition of misconduct, if the Registrant fails to develop the necessary insight to appreciate that personal considerations cannot take priority over professional obligations.”

6. That panel considered the risk that the Registrant posed and commented as follows: “The concern was that of the Registrant’s ability to deal with future occurrences where she did not have the relevant training and/or encountered poor working relationships.” That panel found that the Registrant’s fitness to practise was impaired by reason of her lack of competence and her misconduct, both on the grounds of public protection and in the public interest.

7. That panel considered the mitigating and aggravating features of the case and commented as follows: “While heartened that the Registrant has acknowledged that she is not suited to research work, it was concerned that she only categorised a possible return to such an environment as “unlikely”. This suggested that her insight has yet to develop, given the difficulties she encountered during her time at GOSH. Further a lack of evidence of remediation in how she has addressed her misconduct increases the likelihood of repetition of events were she to find herself in a similar environment again. The Panel has taken into account the mitigation advanced by the Registrant, namely that the matters all occurred when the Registrant held a particular role for a particular employer during the period 2010 - 2011 and that three years have elapsed since she was dismissed from this role; that she has accepted the Panel’s finding of impairment and apologised; that she is committed to only taking on roles for which she has relevant training and noted that she is not suited to research. The Panel also considered that no further incidents have occurred or been reported to the HCPC, and that the Registrant has had a previously unblemished career of many years.”

8. That panel imposed a Conditions of Practice Order for a period of 12 months and considered that a reviewing panel may be assisted by an up to date reference from any employer.

9. This is the first review of the Conditions of Practice Order imposed on 19 July 2018.

Evidence

10. The Registrant attended the hearing and gave oral evidence to the Panel. She provided documentation to the Panel which included:

• A detailed reflective piece dated 23 May 2019 dealing with respectful communication and the challenging of inappropriate behaviour, completed following the Registrant’s attendance at a Respectful Communication (Active Bystander) training course supported by a certificate of attendance.

• A detailed reflective account dated 24 May 2019, based on the Registrant’s experiences while working at Dubowitz Neuromuscular Centre, and addressing conflict in difficult situations, how she has dealt with matters in the past and what she has learned.
 
• A detailed reflective piece dated 8 September 2018, completed following the Registrant’s attendance at a Conflict Resolution course.

• A detailed reflective piece dated 8 September 2018, completed following the Registrant’s attendance at a Communication training course.

• Updated CV

• Certificates of online training courses completed in September 2018.

11. The Registrant told the Panel that she had worked for 25 years as a Biomedical Scientist. She reminded the Panel that the role to which these proceedings relate was “a unique research position as a Cellular Scientist, not a Biomedical Scientist.” The Registrant stated that the situation that she encountered at Great Ormond Street Hospital was “a unique set of circumstances” and completely different from anything that she had experienced before.
 
12. Since her Final Hearing and the imposition of the Conditions of Practice Order, the Registrant stated that she has found it very difficult to secure employment as a Biomedical Scientist. She stated that, following initial interest from prospective employers, they did not pursue any employment with her once they became aware of the Conditions of Practice Order. She said that she had undertaken three Locum roles, through agencies, since July 2018 as she could not find a permanent position. The Registrant said that she had spent a significant amount time chasing the agencies for details of her training and for references, but that no references had been forthcoming. She said that she felt both worried and annoyed that she did not have any references to present to the Panel today.

13. The Registrant told the Panel about her current role, where she has worked since February 2019, as a Laboratory Research Scientist, Experimental Histopatholgy. She explained her role as providing a histology service to researchers, using non-clinical samples. The Registrant told the Panel that this role does not require HCPC registration as a Biomedical Scientist, but that the skills that she has developed in her professional training and practice are relevant. The Registrant stated that she had an excellent working relationship with her line manager but that she had not asked her for a reference.

14. The Registrant told the Panel that she would like to return to practise in the NHS as this is where her passion lies.

15. In terms of the failings identified by the original panel, the Registrant stated that there were no patient safety issues involved and that “there have never been any patient safety issues.” In response to questioning from the Panel about the difference between direct and indirect patient harm, the Registrant identified that the deficiencies highlighted in her practice could result in a wrong result or a misdiagnosis and that she was “fully aware of the consequences of not doing things properly.”

16. After a short adjournment, during which the Registrant made contact with her line manager, the Registrant provided the Panel with a reference from her current line manager, Experimental Histopathology Laboratory Head at The Francis Crick Institute. The reference, dated today’s date, stated: “Nisha has been performing been [sic] a number of histology techniques including sample preparation, embedding, paraffin sectioning, tinctorial staining and Immunohistochemistry. During her time working with the EHP lab, Nisha has shown that she has the knowledge, skills and attitude necessary for the post. She has contributed ideas and been extremely conscientious.”

Submissions

17. Ms Mbah, on behalf of the HCPC, submitted that the Registrant appeared to have complied with the Conditions imposed upon her practice and had provided evidence to address the issues of concern raised by the previous panel. Ms Mbah said that the HCPC adopted a neutral stance as to whether the Registrant’s fitness to practise was currently impaired.

18. The Registrant submitted that her fitness to practise was not currently impaired and asked the Panel to let the current Order lapse upon its expiry on 16 August 2019 or to revoke it.   

Decision 

19. This Panel accepted the advice it received from the Legal Assessor as to the proper approach it should adopt and had regard to the HCPTS Practice Note entitled “Review of Article 30 Sanction Orders”. It is has carried out a comprehensive reconsideration of the Conditions of Practice Order in light of the current circumstances. The Legal Assessor advised that, in practical terms, there was a persuasive burden on the Registrant to show that her fitness to practise is no longer impaired and that all the shortcomings which led to the original finding of impairment have now been overcome.

20. The Panel bore in mind that it must first decide if a finding of current impairment is necessary to protect the public from any risk of harm (assessing the extent of that current or future risk), maintain public confidence in the profession, or to declare and uphold the proper standards of conduct or behaviour. This is a matter for the Panel’s independent judgment and is essentially a risk assessment in light of all the information before the Panel today.

21. The Panel bore in mind that any approach to the issue of whether a Registrant’s fitness to practise should be regarded as impaired must take account of the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour. It accepted the advice of the Legal Assessor and carefully considered the HCPTS Practice Note on “Finding that Fitness to Practise is ‘Impaired’" and all the evidence before it.

22. In undertaking this review, the Panel took into account the new documentary evidence provided by the Registrant and considered her oral evidence. It considered the submissions of both parties. The Panel was impressed by the Registrant’s commitment to demonstrating compliance with her Conditions of Practice. There has been full engagement from the Registrant throughout her regulatory proceedings with the HCPC and the Panel was of the view that the Registrant has provided detailed evidence demonstrating meaningful reflection into her misconduct and her lack of competence.

23. The Panel considered that the Registrant’s insight had developed significantly since her Final Hearing and that, in her evidence at this review hearing, she demonstrated a greater recognition of her role in terms of the issues that arose in 2010-2011. The Panel considered the training that she has undertaken and the detailed reflective pieces that she has written and was of the view that the concerns underpinning her impaired fitness to practise have been overcome. The Panel was satisfied that the Registrant would act differently if faced with similar conflict issues in the workplace in the future and considered that the risk of the Registrant repeating matters similar to those found proved in this case was very low. Further, the Panel was satisfied that the Registrant’s evidence was clear that she would be highly unlikely to return to a research role as a Biomedical Scientist. In terms of her clinical skills, the Panel took into account the positive and supportive reference received today from the Registrant’s current line manager and was also satisfied that the Registrant had kept her clinical skills up to date, working in a number of Locum roles.

24. The Panel bore in mind that any approach to the issue of whether a registrant’s fitness to practise should be regarded as impaired must take account of the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour. The Panel was of the view that a member of the public, with a full knowledge of this case, would be satisfied that the substantive order imposed upon this Registrant’s practice a year ago had placed her misconduct and lack of competence under a sufficient degree of scrutiny and had addressed the public interest in the case.

25. The Panel concluded that neither the public nor the personal component of impairment were now engaged and that, although the Registrant’s fitness to practise had been impaired in the past, it was no longer impaired.

26. Accordingly, the Panel decided that under the provisions of Article 30(1) of the Order, the current Conditions of Practice Order should lapse upon its expiry.

Order

ORDER: The current Conditions of Practice Order on the registration of Miss Nisha Bhardwaj shall lapse upon its expiry on, 16 August 2019. 

Notes

No notes available

Hearing History

History of Hearings for Miss Nisha Bhardwaj

Date Panel Hearing type Outcomes / Status
10/07/2019 Conduct and Competence Committee Review Hearing No further action
19/07/2018 Conduct and Competence Committee Final Hearing Conditions of Practice
10/05/2018 Conduct and Competence Committee Final Hearing Adjourned part heard
13/11/2017 Conduct and Competence Committee Final Hearing Adjourned part heard