Allegation found proved at the substantive hearing on 22 January 2018:
During the course of your employment as a Physiotherapist at University Hospital Birmingham NHS Foundation Trust between June 2012 and 31 March 2015, you:
1. Were unable to consistently work as an autonomous Band 5 physiotherapist, in that you:
a) required a sustained level of guidance whilst working with patients;
b) were unable to consistently hold a full case load as expected of a Band 5 Physiotherapist.
2. Did not consistently maintain accurate and/or adequate and/or contemporaneous records in that you:
a) between June 2012 and December 2012, did not consistently provide sufficient information in patient notes;
b) between June 2012 and December 2012, produced Patient notes which lacked subjective and/or objective measures;
c) between June 2012 and December 2012, did not consistently record subjective markers;
d) on or around February 2013, in relation to Patient C, did not document:
i. which hip had been mobilised;
ii. your reasoning as to why the hip mobilisations were performed on Patient C;
iii. which specific mobilisation was performed.
e) on or around October 2013, required consistent reminding and/or prompting to maintain patient records;
f) on or around June 2014, completed a manual assessment of neck accessory movements on Patient E and did not record:
i. which joints had been palpated;
ii. the grade of palpation;
iii. what range of accessory movement issue was found.
g) on or around October 2014, you:
i. were unable to accurately record assessment and treatment sessions for patients;
ii. omitted information from records including gait pattern and/or hands on treatment.
h) on or around December 2014, did not consistently record evidence of clinical reasoning on patient records.
i) In or around October/November 2013, in relation to Patient D your records did not identify:
i. the exercises performed in relation to the patient;
ii. your clinical reasoning for the insertion of the nasophararyngeal airway (NPA);
iii. any treatment/management plan in respect of the NPA.
3. Demonstrated poor assessments and/or treatment to patients, in that you:
c) did not consistently read patient notes prior to treating the patient;
d) did not consistently provide appropriate treatment to patients;
e) did not consistently provide reasoning for:
ii. straight leg raise;
iii. leg length;
iv. gait analysis.
f) did not consistently form hypotheses from the assessments you conducted on patients;
g) on or around August 2013, you were unable to and/or could not demonstrate measuring range of shoulder movement;
h) on an unknown date, during your rotation at the Royal Orthopaedic Hospital, you inaccurately measured a patient’s leg length following hip surgery;
i) on or around 15 August 2012, during your rotation at the Royal Orthopaedic Hospital, you did not ask a patient had had a microdisectomy about red flags including:
iii. Bladder function; and/or
iv. Bowel function.
4. Did not consistently demonstrate adequate clinical reasoning:
a) in relation to treatment planning;
b) in relation to modification of the patient’s treatment;
c) in that during a discussion with your colleague in relation to Patient B, you were unable to independently provide clinical reasoning for applying manual resistance as part of the patient assessment conducted on 4 January 2013;
d) in that on or around 24 October, when completing the gym transfer form in relation to Patient H, you did not record the patient’s diagnosis and/or treated Patient H without knowing their diagnosis.
e) on or around June 2014, in relation to patient E, you were unable to provide clinical reasoning for your manual assessment of neck accessory movements on Patient E;
f) on or around October 2014, you were unable to clinically reason why a patient may be presenting with a deficit.
5. Demonstrated poor patient safety, in that you:
a) on or around August 2012, prescribed excises to patients in a hip class without checking the patients’ conditions and/or the appropriate precautions;
b) on or around 14 September 2012, in respect of Patient A, you:
i. did not consider and/or demonstrate clinical reasoning in respect of which leg the patient should lead with on climbing stairs;
ii. did not provide the patient with specific instruction prior to asking them to climb the stairs;
d) on or around 4 January 2013, in relation Patient B, who had had rotator cuff repair surgery, you applied manual resistance for strength;
f) on or around October 2014, conducted physiotherapy exercise with Patient F which was unsafe;
g) on 17 October 2014, requested Colleague A’s assistance to move Patient G on and/or off the floor but proceeded to move Patient G despite the risk;
h) on a unknown date, during your rotation at the Royal Orthopaedic Hospital, you asked a patient with a hip replacement to use the leg press machine;
i) on or around 24 August 2012, you placed a patient who had had a microdisectomy into a slump position
7. Did not consistently communicate effectively with patients and/or colleagues in that you:
c) on or around 27 May 2014, were aggressive towards Colleague A and Colleague B when they discussed discharge planning with you.
8. Did not consistently demonstrate adequate time management.
9. The matters set out in paragraphs 1 – 8 constitute lack of competence.
10. By reason of your lack of competence your fitness to practise is impaired.