Miss Paru Vekaria

Profession: Occupational therapist

Registration Number: OT57462

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 21/06/2019 End: 12:30 21/06/2019

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

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

 

Whilst registered as an Occupational Therapist, you:

 

1. Prepared an Employment and Support Allowance Medical Report Form ("the report")   following meeting Service User A on 24 October 2016, and:

a) Did not conduct a physical examination of Service User A

b) The report was inaccurate and/or misleading in that it indicated a physical examination was conducted when this was not the case

c) The report was inaccurate and/or misleading in that it stated:

i) "[Service User A] walks to very local corner shop alone for 10

minutes at slow pace unaided. He walks back as well."

ii) "Can sit upright for over an hour to watch TV - soaps for an hour."

iii) "[Service User A] also writes screenplays on a PC computer for over an hour seated."

iv) "Hip Problem - Both"

 

2. Your actions described in paragraphs 1(b) and/or 1(c) were dishonest.

 

3. The matters set out in paragraphs 1 - 2 constitute misconduct.

 

4. By reason of your misconduct your fitness to practise is impaired.

 

Facts proved: 1(a) and 1(b)

Facts not proved: 1(c) (i-iv) and 2.

Finding

Preliminary Matters

Additional Documentation provided at the hearing

1.At the start of the hearing, the Panel was provided with additional documents by the Ms Iskander on behalf of the HCPC.

2.The HCPC provided the Panel with three documents:

I.a telephone attendance note dated 20 June 2019; 

II.an email from Ms Iskander to the Registrant dated 20 June 2019; and

III.an email from the Registrant to Ms Iskander dated 20 June 2019.

3.The Panel labelled these documents as bundle ‘B2’.

Service

4.The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent in a letter, by first class post, on 21 May 2019 to the address shown for the Registrant on the HCPC register.  The Notice of Hearing had also been sent to the Registrant by email on the same date.

5.The Panel accepted the advice of the Legal Assessor and was satisfied that Notice had been properly served in accordance with Rule 3 (proof of service) and Rule 6 (date, time and venue) of the Conduct and Competence Committee Rules 2003 (as amended).
Proceeding in absence of the Registrant

6.Mr Iskander, on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence, as permitted by Rule 11 of the Conduct & Competence Rules.

7.The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPTS Practice Note “Proceeding in Absence”.

8.The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:

I.The Panel found good service in terms of the Notice of hearing;

II.the Panel noted the contents of the HCPC bundle and Ms Iskander’s attempts to engage the Registrant, both by email and telephone;

III.the Panel also noted the contents of Registrant’s email, dated 20 June 2019, whereby she indicated “I confirm that I will not be attending in person or via telephone tomorrow due to personal circumstances, please proceed in my absence. Please email me with any correspondence. I informed the case manager of my wish to voluntarily relinquish my registration permanently due to personal circumstances, which they have passed on to the panel”.

IV.there has been no application to adjourn and no indication from the Registrant that she would be willing or able to attend on an alternative date and therefore re-listing the hearing would serve no useful purpose;

V.the Panel noted that the Registrant had engaged in a limited way throughout the proceedings. Whilst the Panel recognised that there may some disadvantage to the Registrant in not being able to make oral submissions, the Panel noted that she had been provided with every opportunity to attend and had failed to do so. The Panel therefore formed the view that she had voluntarily absented herself from the hearing; and

VI.finally, the Panel noted its duty to act in a manner which was in the public interest and in order to achieve that aim should act in a fair, economical and expeditious manner. Therefore, taking all of the aforementioned points into account and noting that the efficient disposal of cases concerning practitioners is of very real importance, the Panel determined that they should proceed in the absence of the Registrant because the public interest in proceeding with the case outweighed any detriment to the Registrant in not being present.

Background

9. The Registrant was an Occupational Therapist employed by Maximus Companies Limited to undertake Employment Support Allowance (‘ESA’) assessments.

10.Service User A attended a medical assessment on the 24 October 2016, in relation to his ongoing ESA entitlement. He attended the appointment accompanied by his daughter – Person B – and was seen by the Registrant.

11.Following this appointment and the assessment, the Registrant produced a report, which was passed to the decision maker acting on behalf of the Department for Work and Pensions. The decision maker concluded that Service User A did not qualify for ESA.

12.Service User A applied for reconsideration of this decision and, when this was unsuccessful appealed the decision with success in June 2017. As part of the appeal process Service User A was provided with a copy of the Registrant’s report.

13.Upon receipt of the report Service User A had a number of concerns about it. He visited his General Practitioner (‘GP’) and then made a formal complaint to the HCPC against the Registrant. His complaint to the HCPC against the Registrant was dated 27 March 2017.

14.Service User A and Person B gave evidence before the Substantive Hearing Panel. The Registrant also attended parts of the hearing by telephone. Opting to remove herself from proceedings when Service User A and Person B were giving their evidence to the Substantive Hearing Panel.

15.The substantive hearing of the HCPC Allegation took place between 12 and 15 June 2018. It was determined that particulars 1(a) and 1(b) were found proved and amounted to misconduct. However the Substantive Hearing Panel did not find facts 1(c) (i-v) proved.

16.The Substantive Hearing Panel determined that the Registrant was currently impaired and imposed a 12-month suspension order. The Substantive Hearing Panel provided the following reasons for their decision:

I.the Registrant had no recollection of the events relevant to the particulars and relied upon the contents of her report, which the Substantive Hearing Panel found to be inaccurate;

II.the Registrant demonstrated no insight into her shortcomings in relation to her practice, nor did she reassure the Substantive Hearing Panel that the risk of repetition was limited;

III.the Registrant did not demonstrate any expressions of remorse, nor did she acknowledge the impact of her actions on Service User A; and

IV.the Substantive Hearing Panel was satisfied for the reasons outlined above that the Registrant was impaired on both the personal and public components.

17.When imposing the twelve month suspension order, the Substantive Hearing Panel also made suggestions as to how a future review panel might be assisted. The review panel’s suggestions were as follows:

I.the Registrant could present evidence as to how she has developed and reflect on: record keeping, professional autonomy and the impact of her actions on service users and the profession as a whole; and

II.the aforementioned could be demonstrated by training and/or maintaining a reflective portfolio and/or receiving support from a mentor.

Submissions

18. Miss Iskander submitted, on behalf of the HCPC, that the Registrant remained currently impaired and that the current Suspension Order should be extended for a period of not less than 12 months.

19.She submitted that whilst the misconduct was not at the most serious end, the Registrant bore the persuasive burden in terms of satisfying the Panel that she had made progress in respect of the Substantive Hearing Panel’s concerns. Given her limited engagement throughout the process, Ms Iskander submitted that she had failed to do so.

20.The Registrant did not provide any submissions for the Panel to consider.

Panel approach

21.The Panel took into account the documents furnished to it by the HCPC and noted the comments made by the Registrant. The Panel had regard to the HCPC submissions.

22.The Panel considered the relevant Practice Note issued by the HCPTS, ‘Finding that Fitness to Practise is ‘Impaired’’, together with the HCPC’s Standards of Conduct, Performance and Ethics and the HCPC’s Standards of Proficiency Occupational Therapists in England.

23.The Panel accepted the advice of the Legal Assessor.

Decision

24.In making its decision, the Panel had regard to both the personal and public elements of impairment.

25.The Panel found that there was a lack of information or evidence before them to satisfy it that the Registrant had taken any steps towards addressing the concerns found by the Substantive Hearing Panel. In particular, the Panel noted that the Substantive Hearing Panel had indicated that the Registrant might provide up to date evidence of how she has developed and reflected on record keeping, professional autonomy and the impact of her actions on service users and the profession as a whole. The Substantive Hearing Panel also suggested that this might be achieved by the Registrant undertaking training and/or maintain a reflective portfolio. The Panel noted that the only engagement or contact made by the Registrant, since the Suspension Order was imposed at the substantive hearing is her email indicating that she would not be attending today’s review hearing.

26.The Panel considered therefore that they could not yet be confident that the Registrant has the required insight and that she has remediated her failings and therefore it could not be confident that the behaviour would not be repeated. The Panel is not satisfied that in all the circumstances the Registrant does not still pose a real and on-going risk to the public and that public confidence in the profession would not be undermined should the Registrant be permitted to return to unrestricted practice.

27.Accordingly, the Panel concluded that the Registrant’s fitness to practise remained impaired on both the public and personal components.

28.The Panel has borne in mind that sanction is a matter for its own independent judgment and that the purpose of a sanction is not to punish the Registrant but to protect the public. Further, that any sanction must be proportionate, so that any order must be the least restrictive order that would protect the public interest, including public protection.

29.The Panel considered the option of a Caution Order however, decided that it would not provide adequate protection for the public. It would not address the on going risk to the public identified by the Substantive Hearing Panel.

30.The Panel next considered the option of replacing the existing Suspension Order with a Conditions of Practice Order. The Panel considered this option carefully. Noting that the Substantive Hearing Panel indicated, in its determination, that a Conditions of Practice Order might have been appropriate had the Registrant recognised any possibility of error on her part, or accepted responsibility for the impact of her actions on Service User A. The Panel found that a Conditions of Practice Order may have been appropriate had the Registrant engaged in the process and provided evidence of insight and remediation. Given that the Registrant has failed to do so the Panel decided that conditions would not be appropriate at this time.

31.The Panel next considered extending the current Suspension Order versus imposing a Striking-off Order.

32.The Panel considered a Striking-off Order, but determined that this would be disproportionate at this time. Taking into account the detailed reasons and circumstances outlined by the Substantive Hearing Panel, which indicated that had the Registrant engaged and accepted her shortcomings a Conditions of Practice Order may have been appropriate. The Panel shares this view and believes that the Registrant could go on to make a valuable contribution to the Occupational Therapy profession.

33.Although, the Panel notes the Registrant’s limited engagement since the substantive hearing. It determined the Registrant should be afforded an further opportunity to satisfy a future panel that her fitness to practise is no longer impaired.

34.The Panel therefore decided that the appropriate and proportionate Order is to extend the current Suspension Order. The Panel decided that this should be for the maximum period of twelve months to allow the Registrant time to reflect further and to demonstrate remediation of her misconduct. The Registrant may apply for an early review of the Order if her circumstances allow her to demonstrate that remediation before the expiry of the Suspension Order.

35.The Panel also considered that a review panel may be assisted by the following:

I.a written reflection piece that she can submit to the panel focussing on the decision of the Panel and the impact of the Registrant’s actions on others; and

II.evidence that the Registrant has kept her skills and knowledge up to date such as any continuing professional development courses undertaken, or record keeping and/or professional autonomy.

36.The Panel was also of the view, noting the Registrant’s email outlining “personal circumstances” as her reason for her desire to “voluntarily relinquish” her registration, that the Registrant had not provided any information in respect of her request or her circumstances or reasons for wishing to be removed from the HCPC register.

37.The Panel would therefore strongly recommend to the Registrant that she takes time to reflect on whether she wishes to return to the profession, bearing in mind the decision of the Substantive Hearing Panel’s that her shortcomings are remediable and that there is a public interest for otherwise competent professionals to remain in practice. Conversely, if the Registrant chooses to leave the profession on a voluntary basis she would need to engage with the HCPC in order that this be facilitated. Clearly, a failure on her part to do so may result in a future review panel removing her from the Register.

Order

The Registrar is directed to suspend the Registration of Miss Paru Vekaria for a further 12 months from the date of the expiry of the current Order.

Notes

No notes available

Hearing History

History of Hearings for Miss Paru Vekaria

Date Panel Hearing type Outcomes / Status
21/06/2019 Conduct and Competence Committee Review Hearing Suspended
12/06/2018 Conduct and Competence Committee Final Hearing Suspended