Ms Surinder Kaur

Preliminary Matters

Proof of Service

1. The Panel found that there had been good service of the Notice of Hearing by a letter dated 4 April 2019 which informed the Registrant of the date, time and venue of the Hearing.

Proceeding in the Absence of the Registrant

2. Ms Senior made an application for the hearing to proceed in the absence of the Registrant. She referred the Panel to an email from the Registrant dated 26 April 2019. The Registrant stated she would not be able to attend a hearing due to her current health problems and that she would not have a representative present at the hearing. The Registrant had been advised by the HCPC of the option to apply for a postponement of the hearing, but she did not do so.

3. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.

4. The Panel decided to exercise its discretion to proceed in the absence of the Registrant. The Panel noted that the Registrant had clearly explained in her email that she would not attend the hearing. The hearing is to consider joint application by the HCPC and the Registrant for the approval of a Consent Order. In the circumstances, it was in the interests of both parties for the hearing to proceed without delay.

Hearing in private

5. Ms Senior made an application for the whole of the hearing to be heard in private to protect the Registrant’s private life. The Registrant had also made a request that information about her health should not be published.

6. The Panel considered and applied the guidance in the HCPTS Practice Note “Hearings in private”. The Panel decided that it was appropriate for the whole of the hearing to be heard in private to protect the Registrant’s private life. The case is before the Health Committee and health matters are central to the issues.

Background

7. On 7 May 2016 the HCPC also received a referral from the Trust in which they raised concerns in relation to the Registrant’s practice in the following areas:

(a) Clinical risk management;

(b) Manual handling;

(c) Analysis, treatment planning & goal setting;

(d) Discharge setting;

(e) Prioritising caseload;

(f) Documentation; and

(g) Delegation of work.

Decision

8. Ms Senior submitted that the proposed conditions of practice provided an adequate measure of public protection and were also sufficient to address the wider public interest considerations including the need to declare and uphold proper standards of behaviour and maintain public confidence in the profession.

9. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note on Consent Orders. It is open to the Panel to conclude the case on an expedited basis on the terms in the draft Consent Order, or it may reject the proposal and the matter will be referred to a differently constituted Panel for a full hearing.

10. The Panel noted that the Registrant has admitted the Allegation, and that the Registrant’s fitness to practise is impaired by reason of her health.

11. The Panel carefully reviewed the documents and noted evidence to support the Allegation. In particular there was evidence of the Registrant’s health issues and evidence that those issues had an impact on her practice. The updated information provided by the Registrant about her health is consistent with the information in the documents relating to the health matters.

12. The documents provided by the Registrant’s employer identified a number of concerns about the Registrant’s day to day practice as listed in paragraph 7 above. Those matters, such as manual handling and infection control, had the potential to impact on the safety and well-being of the Registrant’s patients and other patients who might be indirectly impacted. There was evidence that the Registrant was not meeting the needs of patients by failures in her analysis and planning and failure to prioritise her caseload. The concerns were sustained over a period of time despite substantial support provided by the Registrant’s employer.

13. The Registrant has been engaging with the HCPC since her self-referral in May 2016. There is no information which suggests that she has practised as an Occupational Therapist since May 2016. The Registrant has demonstrated insight by her admission of the Allegation, and her constructive engagement in the process of agreeing the proposed conditions of practice.

14. The Panel considered carefully whether the proposed Consent Order provided an adequate measure of protection for the public against the risks the Panel identified.

15. Condition 1 is important because it ensures that the Registrant completes a refresher training course with elements of face to face learning and that she provides evidence of completion to the HCPC. The requirement for face to face learning is an important safeguard, because the training provider will make an individual assessment of the Registrant’s skill and ability when they certify satisfactory completion of the course. The course must be completed before the Registrant works as an Occupational Therapist.

16. If this condition is satisfied and the Registrant practises as an Occupational Therapist, she is required to be supervised by an Occupational Therapist of Band 6 grade or higher. If the Registrant was not working within the health service the Panel considered that this condition should be interpreted to extend to the equivalent of an NHS Band 6 grade for the relevant employer. Supervision within the work place would be an important safe guard. The Panel noted that the typographical error in the Consent Order listing two Condition 6s. Condition 6B requires the Registrant to provide a report from her supervisor. The Panel would expect that this report would be available at a Review Hearing if this condition came into effect.

17. The proposed conditions of practice also include conditions relating to the Registrant’s health which ensure that the Registrant’s GP is aware of the conditions of practice and that information can be provided to the HCPC by the GP. The conditions also ensure that the Registrant ceases practising if she is advised to do so by her GP or a medical professional. These conditions are important for the protection of the public because they address the Allegation, which is Registrant’s underlying health condition. The conditions also provide for early notification to the HCPC of significant developments which provided an additional safeguard.

18. In the Panel’s judgment the proposed conditions of practice are realistic, workable and verifiable and they are compatible with the guidance in the HCPC Indicative Sanctions Policy (ISP). The Panel noted the Registrant’s engagement with the HCPC and her full and early admission of the Allegation. The Panel therefore had sufficient confidence that she understands and would comply with the conditions of practice. The Panel did not have concerns about the adequacy of the Registrant’s insight.

19. The Panel noted that the conditions of practice would be subject to a mandatory review before the expiry of the two year period. A reviewing Panel would consider evidence presented by the Registrant and assess whether her fitness to practise remains impaired and whether or not any further order was required. In the Panel’s judgment the review mechanism was an additional safeguard to protect the public. The Registrant would not be permitted to return to unrestricted practice until a Review Panel decided that her fitness to practise was not impaired.

20. The Panel considered the other sanctions which would be open if this matter proceeded to a Final Hearing. The most restrictive sanction available would be a Suspension Order. In the Panel’s judgment a Suspension Order was not necessary and would be disproportionate because conditions of practice provide a sufficient measure of public protection.

21. Having carefully reviewed the evidence, the risks to the public and the proposed conditions of practice the Panel concluded that the proposed conditions of practice provide an adequate measure of public protection.

22. The Panel next considered the wider public interest considerations including the need to maintain confidence in the profession and to uphold standards of conduct and behaviour.

23. The Panel considered that the proposed Consent Order was sufficient to uphold standards of conduct and behaviour. This is a case before the Health Committee. It does not include a conduct matter involving a high degree of culpability or a breach of a fundamental tenet of the profession. The disposal of the matter expeditiously is appropriate and proportionate. The Panel did not identify any public interest considerations which require the matter to be determined at a full hearing.

24. The Panel also decided that the resolution of this matter through a Consent Order was sufficient to maintain confidence in the profession. Members of the public would be reassured that the conditions of practice provide sufficient protection for the public and that the conditions of practice will be subject to review.

25. The Panel therefore decided to approve the Consent Order.

26. The Panel anticipates that a reviewing panel may be assisted by:

• An updated medical report on her health, treatment and medication;

• Evidence of any training and CPD undertaken;

• Evidence of any relevant work experience, paid or unpaid, she has gained including work place testimonials.

That the Registrar is directed to annotate the register to show that for a period of two years from the date this Order comes into effect, 3 June 2019, (the Operative Date), Surinder Kaur must comply with the following Conditions of Practice:

1. Before undertaking work as an Occupational Therapist you must:

A. Satisfactorily complete an Occupational Therapist refresher training course;

i) the refresher training course must include elements of face to face learning.

B. Provide the HCPC with evidence of completion of your individual assessments and overall completion of the training course.

2. You must remain under the care of your general practitioner and inform him or her that you are subject to these Conditions of Practice and authorise that person to provide the HCPC with information about your health and any treatment you are receiving.

3. You must keep your professional commitments under review and limit your professional practice in accordance with the advice of your general practitioner/treating health specialist.

4. You must cease practising immediately if you are advised to do so by your general practitioner/designated medical professional.

5. You must inform the HCPC of any new employer/organisation contracting with you to provide professional services as an Occupational Therapist, within 7 days of accepting any post.

6. You must be supervised by an Occupational Therapist of a Band 6 grade or higher and:

A. Provide a report from your supervisor commenting on your progress, abilities and competence on:

i) clinical risk management;

ii) manual handling;

iii) analysis, treatment planning and goal setting;

iv) discharge setting; and

v) prioritising caseload, record keeping and effective delegation of work.

B. The report should specify the basis on which the opinion of the supervisor has been formed.

6. You must inform the HCPC if you cease employment or contractual arrangements with any organisation for which you provide professional services as an Occupational Therapist within 7 days.

7. You must promptly inform the HCPC of any disciplinary proceedings taken against you by anyone you are providing professional service for, and in any event, no later than 7 days from any such proceedings commencing.

8. 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 application); and

C. Any prospective employer (at the time of your application)

This order will be reviewed before its expiry.

History of Hearings for Ms Surinder Kaur