Miss Nicola Ann McColm
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(As amended at the substantive hearing which commenced on 5 November 2018)
During the course of your employment as a Social Worker at Priory Group you:
- On 3 January 2017:
a) Obtained a controlled drug from Priory Group stock for personal use;
b) Allowed dispensing nurses to believe the controlled drug was for another ward at the Priory Group and not for your personal use.
- On 6 January 2017:
a) Received a controlled drug from Colleague A;
b) Received the controlled drug knowing that Colleague A had obtained the controlled drug on the pretence of disposing of it;
- Obtained a controlled drug as set out in paragraphs 1(a) and 2(a) knowing that:
a) It was a controlled drug;
b) It was against Trust policy to obtain controlled drugs from the hospital for personal use.
- Your actions in 1 - 3 were dishonest.
- The matters set out in paragraphs 1 – 4 constitute misconduct.
- By reason of your misconduct your fitness to practise is impaired.
1. The Registrant was employed as a Social Worker and Safeguarding Lead for the region based at the Royal Cheadle Hospital, which formed part of the Priory Group from October 2007 (“the hospital”). The Registrant was part of the Clinical Governance committee at the hospital and was a senior member of staff dealing with safeguarding issues for patients in hospitals across the region. She chaired twice weekly safeguarding meetings at the hospital and dealt directly with young people or adults about safeguarding concerns.
2. It is alleged that on 3 January 2017 the Registrant obtained a controlled drug, Tramadol, for her personal use from Maple ward. It is further alleged that she allowed two nurses SG and JR on the Maple ward to believe that the Tramadol was for another ward, Meadows ward, rather than for her personal use.
3. It is alleged that the Registrant again received a controlled drug, Tramadol, on 6 January 2017 from Colleague A. It is alleged the Registrant knew that it was against Trust policy to obtain a controlled drug from the hospital for personal use, and that the Registrant knew that Colleague A had obtained the Tramadol on 6 January 2017 under the pretence of disposing it by denaturing it. It is alleged that the actions of the Registrant in doing so on both dates were dishonest.
4. During an audit an irregular entry was identified in the controlled drugs (CD) register for Maple ward by the ward manager. This was raised with the Hospital Director, the Registrant’s manager, AB who spoke with Colleague A and with the Registrant on Monday 9 January 2017. Controlled drugs are prescription medications classified and controlled by law with specific requirements for safe custody and use.
5. On Monday 9 January 2017 the Registrant admitted to AB that she had obtained Tramadol tablets for personal use from SG and JR on Maple ward on 3 January 2017. However, the Registrant denied receiving more tablets from Colleague A on 6 January 2017, she denied misleading nurses SG or JR about the drug being for Meadows ward rather than for her personal use, and she denied that she knew Colleague A had on 6 January 2017 obtained the controlled drug for the Registrant’s personal use on the pretence of disposing of it. When CD medication is out of date or a patient no longer requires the medication, it needs to be disposed of by denaturing.
Amendment of Allegation:
6. The Panel heard from Ms Sheridan who sought to amend the allegation to clarify the case. This amendment was agreed with the Registrant who had received notice of it. The Panel accepted the advice of the Legal Assessor as to the interests of justice and agreed to the amendment.
7. The Registrant admitted particular 1(a) and denied the remainder of the allegation.
8. The Panel heard from five live witnesses. JW, a registered nurse and the investigating officer at the hospital; Colleague A, practice development nurse at the hospital; SG, the Deputy ward manager of Maple ward, JR a registered nurse on Maple ward and AB, a registered nurse and the Acting Hospital Director.
Witness 1 - JW
9. The Panel heard from JW. He adopted his Witness statement as his evidence and confirmed it was made to the best of his knowledge and belief. He is a registered Nurse and was a Therapy Services Manager at the Altrincham Priory Hospital. He is now Deputy Hospital Director at the hospital. He was the investigating officer in respect of the alleged incidents.
10. JW explained his role on the Clinical Governance Committee and his understanding of the Registrant’s role in her safeguarding capacity as a Social Worker. He explained his understanding of the Priory Medicines Management policy (“the policy”), and the storing and dispensing of controlled drugs in the hospital which require to be signed for and dated. He explained that he would expect the Registrant to be familiar with medications given her safeguarding role.
11. JW explained his understanding of the law as to controlled drugs and compliance with the hospital drug policy. He said it was never acceptable for a member of staff, such as the Registrant, to access controlled drugs for personal use, and that the nurses were also at fault in supplying them.
12. On re-examination JW, told the Panel that he had previous experience of conducting internal investigations. He advised the Panel that there were two forums through which the policy and any changes to it, were made known to staff which included the distribution of meeting minutes. He also explained the arrangements for access to a medicine stock cupboard by nurses who hold keys. He accepted that the policy does not in terms say that Tramadol is a controlled drug, but does make it clear it was a drug with the potential to be abused and to be treated as a controlled drug. He conceded that there was a possibility that the Registrant may not have known that Tramadol was a CD when she asked Colleague A for it, but must have known that it was a CD when she witnessed the filling in of the CD book by SG and JR.
Witness 2 – Colleague A
13. The witness was sworn and she adopted her Witness statement as her evidence and confirmed that it was made to the best of her knowledge and belief. She is a registered Nurse and is currently Practice Development Nurse at the hospital.
14. Colleague A was positive that she did not say any words to the Registrant on 3 January 2017 to the effect that the Registrant could take however many Tramadol tablets she needed. She told the Panel that she did not know that the Registrant had actually taken 20 tablets until the morning of Friday 6 January 2017 having told her to take only one dose – 2 tablets. She admitted that she later lied to several colleagues about denaturing the drug and was sorry she had done so.
15. Colleague A said she had been telephoned by the Registrant around 9.30am on Friday 6 January 2017 asking for more Tramadol. It was at that point that Colleague A went to the CD cupboard and discovered that the Registrant had actually received 20 tablets of Tramadol on 3 January 2017. The CD book shows that at 9.35 Colleague A signed out the remaining 32 Tramadol tablets.
16. Colleague A said that on 6 January 2017 she had gone to the Registrant’s office and given her 32 Tramadol tablets. The Registrant had put them either in her desk or hand bag, she could not clearly see which as she was on the other side of her desk. She said that she had realised that the Registrant had actually taken 20 Tramadol tablets from Maple ward on the 3 January 2017. She told the Registrant she was really “disgusted” and that she should not have taken those tablets.
17. Colleague A told the Panel about the discussions she had with the Registrant on the stairs on 6 January 2017 when she told her that she could not get anymore Tramadol for her as it was a controlled drug and they would be in trouble if found out. She told the Panel that she definitely had that conversation with the Registrant and told her to say that the Tramadol she gave her that day had been denatured if anyone asked about it.
18. Later on 6 January 2017 Colleague A met the Registrant on the stairs and told her that two colleagues knew about the Tramadol supplied on 3 January 2017 as a result of an audit. She said that there would possibly be an investigation. Colleague A said she told the Registrant that she was going to tell her manager, AB, about the incident and had reiterated to the Registrant that, if asked, she should say that Colleague A had denatured the tablets. She said that the Registrant had agreed to do so.
19. Colleague A said she had been very concerned about her actions over that weekend and that she was an honest person. She phoned AB on Saturday 7 January 2019 and told her she had lied and not denatured the Tramadol but given it to Colleague A. She met with AB on Monday 9 January 2017 about the incident. She knew what she had done was completely wrong. The Registrant later on 9 January 2017 came to Colleague A’s office angry and banged on her door, shouting you have “stitched me up”. She said that the Registrant could be extremely forceful and aggressive and often swore and she found her intimidating.
20. Mr Calder cross examined Colleague A. She explained her role in managing medication, which could include denaturing them and her understanding of the hospital policy. She had told the Registrant to take one dose, two tablets, and understood from her that the Registrant had not been able to collect her prescription.
21. Colleague A told the Panel that the Registrant frequently asked her for medicine, but not controlled drugs, and she had previously given her
co-codamol. She had felt coerced by the Registrant to obtain the Tramadol. She felt that the Registrant was behaving such as to make Colleague A more receptive to her needs by making her feel scared, threatened and coerced.
22. Colleague A explained her discussions with AB on 9 January 2017. She told the Panel that she had never seen the Registrant’s prescription. The hospital CCTV recording of a conversation between Colleague A and the Registrant was admitted in to evidence and excerpts were viewed by both parties and the Panel.
Witness 3 – JR
23. The witness was sworn and she adopted her Witness statement as her evidence and confirmed that it was made to the best of her knowledge and belief. She is a registered nurse and works at the hospital.
24. She explained her recollection of the Registrant attending Maple ward where she was working. She said that on 3 January she recalled the Registrant asking for the Tramadol for Meadows ward and saying it was all “really hectic” on Meadows ward. She said she understood the drug was for a patient on Meadows ward and that there was no scope for any misunderstanding about that. If she had known it was for the Registrant’s personal use she would not have signed for it as personal use was “against everything”. JR explained that she held the key for the controlled drug cabinet on the 3 January 2017.
25. JR and witness SG both signed the controlled drug book, as required, in the presence of the Registrant, and both had also counted out the tablets in the presence of the Registrant. JR said she had not been entirely comfortable with the situation, but she was trying to be helpful as the Registrant had been flushed and flustered. She said she felt in hindsight she ought to have refused.
26. Under cross examination JR said she was absolutely confident about her recollection of what the Registrant had said and was not confused. She said the Registrant was senior and JR had wanted to assist. JR said on reflection, she should have asked a nurse from Meadows ward to come and sign for the Tramadol. (JR attended by conference telephone on 8 November 2018 and completed her evidence).
Witness 4 – SG
27. The witness was sworn and she adopted her Witness statement as her evidence and confirmed that it was made to the best of her knowledge and belief. She is a registered nurse and works at the hospital. She explained the controlled drugs procedures. This required the drug to be stored in a locked cabinet and signed out by two nurses on a controlled drug book. She explained that was what was required when dispensing Tramadol. The keys to the drugs cabinet were held by nominated nursing staff, and in this case the controlled drug cupboard keys were held by witness JR.
28. SG told the Panel about the events of 3 January 2017 and the Registrant attending at Maple ward for Tramadol. She said the Registrant appeared rushed. She understood the drug was for Colleague A on Meadows ward, a busy ward with patients with urgent needs. That was the clear understanding SG had from the Registrant. She did not consider there was scope for any misunderstanding about that. The Registrant gave her no indication that it was actually for her personal use.
29. SG said that she told the Registrant that Colleague A should return any of the Tramadol that was not needed and sign it back in. She did not recall the Registrant’s response, if any. SG recalled that she gave the Registrant one strip of the Tramadol, being 20 tablets. She was clear that the Registrant did not say it was for her personal use.
30. SG confirmed under cross examination that the controlled drug book had been signed by her and JR in the presence of the Registrant. She explained that JR may not have heard the comments about Colleague A as she had attended to sign the drug book only, and was not present for her conversation with the Registrant. SG said it was also obvious that the Tramadol was taken from the controlled drug cupboard and it had a label on it saying “Controlled drugs cabinet”. She said that the emergency drug book and the controlled drugs book looked different and were laid out differently.
31. SG said that the Registrant was a senior member of staff, was in a position of authority and it appeared to be an urgent request. She had therefore complied with her request for the Tramadol as she had no reason to doubt her, but it was an unusual request. She said she did feel she had been “caught off guard” by the Registrant. The whole incident had only taken two minutes.
Witness 5 – AB
32. The witness was sworn and she adopted her Witness statement as her evidence and confirmed that it was made to the best of her knowledge and belief. She has been the Hospital Director since June 2014. She is a registered Nurse.
33. AB explained the approach from colleagues following the drug audit of 6 January 2017 and the email she received from the Registrant on that day. She said she was surprised that the Registrant appeared not to know the proper drug protocol. The Registrant was senior and was the regional safeguarding lead and she also chaired two safeguarding meetings each week which dealt with medication issues. AB said she would expect the Registrant to have some knowledge of drug procedures including the use of a controlled drug book, although she was not actually involved in managing or administering drugs.
34. AB explained the denaturing process. This involved the disposal and destruction of unused medicines by qualified nursing staff and required two nurses to be present for the process. The process of denaturing also required recording in a drug book signed by both nurses.
35. AB explained the reference in the hospital policy to Tramadol being managed as a controlled drug and the need for careful records to be kept and a doctor’s signature. It would be kept in the controlled drug cupboard. She expected the Registrant would be familiar with that policy. The policy would be discussed in hospital clinical governance meetings which the Registrant attended, as well as cascaded by email to all staff. If the Registrant did not attend she would be sent the minutes.
36. AB told the Panel about her telephone conversation with Colleague A on Saturday 7 January 2017. Colleague A was very upset and told AB that she had not told her the truth on the Friday and she had not actually denatured the 32 Tramadol tablets but had given them to the Registrant. She was apologetic, upset and said she knew it was a breach of the hospital policy.
37. On 9 January 2017 AB had spoken with the Registrant who had told her that she had obtained 20 tablets of Tramadol on Friday 3 January 2017 for personal use. She had denied misleading SG or JR. AB instructed the Registrant not to discuss matters with Colleague A or to go into any clinical areas.
38. AB told the Panel that it would be unusual practice for patient drugs to be transferred between wards. When cross examined AB explained the Registrant’s safeguarding role and said the Registrant had been involved in implementing some good practice following a Care Quality Commission visit.
39. AB told the Panel that taking a drug from the hospital for personal use was against policy, unacceptable and that it was theft. She said the Registrant’s email to her on Friday 6 January 2017 had seemed odd and defensive. The incident seemed to be a very serious breach of policy and a breach of trust in a team she managed. The Registrant’s position conflicted with other information and the Registrant denied obtaining any more than the 20 tablets on the 3 January 2017. AB then initiated an investigation.
40. On the fourth day of the hearing, at the conclusion of the HCPC’s case, the Registrant indicated that she wanted to request what were effectively special measures, namely that when she was giving evidence she be allowed to check upon the progress of her partner’s operation. She indicated that she wanted to commence giving her evidence and that she did not believe that she would be unduly distracted by her partner’s situation provided that she was able to make regular checks by telephone upon her progress.
41. After retiring for a brief discussion, the Panel indicated that it was concerned that giving evidence was stressful enough without having the additional concern of worrying about a partner who was undergoing a clinical procedure and therefore that it was minded to consider adjourning the hearing at this stage, on its own volition, without hearing any evidence from the Registrant. The Panel invited the parties to consider their respective responses to this suggestion and retired.
42. At the resumption of the hearing Mr Calder referred to the relevant HCPTS Practice Note which outlined the need for expediency in these proceedings. He said that the Registrant had spoken to her partner and that together they wished to continue with the hearing. They had had since Monday to accustom themselves to the procedure. The Registrant was concerned the HCPC investigation had been going on for two years and was detrimental to her career (the allegations having been published on the HCPC website). In effect, the Registrant asked to be treated the same as Colleague A, who had been accepted as a vulnerable witness, by being given regular breaks. In particular the Registrant requested a break to check the situation about her partner between 15.00 and 16.00.
43. In reply, Ms Sheridan indicated that she had been instructed that, even though the HCPC was not making any application to adjourn the hearing, it had no objection to the Panel’s indication that the matter be adjourned. She stated that, even if the Registrant started her evidence the next day, it was, in her estimation, unlikely that the Registrant would conclude her evidence in the time available, particularly taking account of the pace of the hearing to date. Indeed, even if the Registrant started her evidence that afternoon, in Ms Sheridan’s estimation it was likely that it would take a day and a half to conclude her evidence. Furthermore, there was also the risk that the Registrant might not conclude her evidence and therefore would be on oath, unable to give Mr Calder instructions, for a number of months before the resumed hearing, which would be undesirable. The HCPC therefore believed that it was sensible to have the hearing adjourned, especially as it was going to go part heard in any event. The HCPC accepted that there would be additional stress caused to the Registrant but as the matter was going to be adjourned in any event, there would be no resolution to the case and therefore the issues surrounding publicity about her case would not change. Finally, Ms Sheridan agreed with the Legal Assessor’s suggestion that, even with the Registrant’s evidence to come, the estimate of five additional hearing days was sensible.
44. In reaching its decision, the Panel has taken account of the HCPTS’ Practice Note entitled “Postponement and Adjournment of Proceedings” and in particular to the direction that “A Panel must exercise its discretion judicially, the crucial factor is that the registrant is entitled to a fair hearing…”
45. The Panel noted that Mr Calder had suggested that, in general, every witness underestimates the stress of giving evidence, a sentiment with which the Panel agreed. It appreciated that the Registrant wished to make progress and get her evidence concluded as soon as possible, but the Panel considered that she would not be able to perform at her optimum. She should be given the opportunity to give her best evidence without any unnecessary distractions particularly as she faces serious allegations.
46. The Panel noted that, as the case was going to be adjourned part-heard in any event, the publicity about her case on the HCPC’s website would remain. Moreover, any reduction in her recall of the evidence given by the HCPC’s witnesses caused by the adjournment would be compensated for by the availability of transcripts of the evidence which would be distributed before the next hearing. Finally, the Panel appreciated that, notwithstanding what would be all parties’ best efforts to conclude the Registrant’s evidence before the end of the following day, there remained the risk that she might unavoidably remain on oath for a number of months without being able to give instructions to her representative which, the Panel agreed, would be extremely undesirable.
47. Taking all these factors into consideration, the Panel therefore concluded that it would not be fair on the Registrant to allow the hearing to proceed and that the appropriate course was to adjourn the hearing at this stage for resumption at a later date. Indeed, the Panel considered that, had the Registrant applied for an adjournment of the case because of the unforeseen circumstances she found herself in, it would have granted such a request.
Half time Submission:
48. On the case resuming on 4 March 2019, Mr Calder advised the Panel that he was making a half time submission in respect of allegations 1(b), 2 (a) and 2 (b). He submitted a detailed written submission to the Panel cross-referenced to the transcript. He said that Colleague A’s evidence could not be relied upon as it was too inconsistent and SG and JR who signed out the drug were also inconsistent and could not be relied upon.
49. Ms Sheridan submitted that there was a case to answer. She referred to the evidence of Colleague A and submitted that it was evidence in support of the allegation. She submitted that evidence was detailed and credible and summarised that evidence by reference to the transcript of the first part of the hearing in November 2018.
50. Ms Sheridan referred to the submissions by Mr Calder where he submits that the Registrant would have to be aware that Tramadol was a controlled drug in order to find particular 1(b) proved. Ms Sheridan submitted that was incorrect as that was a misinterpretation of the wording of the allegation. She referred to the evidence of SG who had told the Panel that the Registrant had told her the Tramadol was for Meadows ward. SG and JR had clearly given evidence that they did not know the drug was for the Registrant’s personal use and that the Registrant had told them it was for Meadows ward.
51. Further, Ms Sheridan submitted that there was evidence that the Registrant would have known that Tramadol was to be treated as a controlled drug as set out in the hospital policy. She also referred the Panel to the evidence of AB who had told the Panel that she would be “very surprised” if the Registrant did not know that Tramadol was a controlled drug, and that view was shared by JW in his evidence.
52. Ms Sheridan referred the Panel to the HCPTS Practice Note on Half-time submissions and to the guidance in the leading authority of R v Galbraith  1 WLR 1039.
53. Mr Calder made a further submission in respect of particular 3. He submitted that if the Panel agreed with him on 1(b), 2(a) and 2(b) that there was also no case to answer in respect of particular 3. He submitted that particular 3 relied upon proof of particulars 1(a) and 2(a). He submitted that particular 3 could only stand if there was a case to answer in respect of both particular 1 (a) and 2 (a). He submitted that particular 3 did not say “and/or” only “and” and so both had to be capable of proof, and survive the half time submission, in order for particular 3 to be able to proceed further.
54. Ms Sheridan submitted that the Panel was entitled to find part of an allegation proved. If the Panel was not in agreement with that she submitted that the Panel could amend the allegation to “and/or” instead of “and”. In her submission this would serve to reduce the gravity of the allegation and would not increase the seriousness.
55. The Panel accepted the advice of the Legal Assessor. He reminded it of the need to act fairly with the interests of justice in mind and bear in mind the overarching purpose of the regulator is to protect the public and maintain confidence in the profession. He advised that the Panel is entitled to find part of a particular proved and that its approach is not one in which it must find all or no part of a particular of an allegation proved. He reminded it that it has the power to amend an allegation and to be mindful of the risk of under prosecution in a case.
Decision on the approach to Particular 3
56. The Panel considered the matter carefully. It considered the interests of justice and fairness. It determined that it was appropriate and fair to approach particular 3 as one with the potential to be proved in part, that is in respect of particular 1(a) or 2(a). To do otherwise would risk under prosecution. Further, such a technical approach to the construction of particular 3 as submitted by Mr Calder, would not be in the interests of justice and would fail to meet the overarching objectives of the regulator and to satisfy the public interest. It was therefore open to the Panel to reach the view that particular 3 could potentially be proved by either, or both, of particular 1(a) or 2(a). It was not an “all or nothing” scenario.
57. As regards fairness to the Registrant, to treat particular 3 in this way would not alter the gravity or nature of the allegation and would not make it more serious. The Panel decided that it was not unfair to the Registrant to do so. To allow for the possibility of the allegation to be proved in part would narrow the particular and lessen the seriousness of the allegation.
Decision on Half-Time Submissions
58. The Panel heard the advice of the Legal Assessor as to half time submission. He reminded it of the guidance in R v Galbraith and the HCPTS Practice Note on a Half Time Submission. The Panel must consider all the evidence carefully and apply the tests set out in that case, taking the evidence it has heard from the HCPC at its highest.
59. The Panel accepted the advice of the Legal Assessor and considered the Galbraith case and the relevant Practice Note. It applied the tests carefully to the evidence of the five witnesses it had heard from in the HCPC case.
60. The Panel considered each of the particulars of the allegation to which the half time submission was directed. With regard to particular 1(b) the Panel considered the evidence of SG and JR who were consistent in key parts of their evidence. The Panel determined that this evidence, given in support of the particular was, taken at its highest, capable of proving the particular. As such there is a case to answer in respect of this particular.
61. The Panel considered particular 2 (a) and 2 (b) and the evidence it heard from Colleague A. That evidence was detailed. The Panel was conscious that there were inconsistencies in the evidence of Colleague A. However, it considered that this did not render the evidence of Colleague A of such poor quality, reliability or credibility that, taken at its highest, it was not capable of proving these particulars. Further, the Panel also heard evidence of AB and JW on these particulars. At its highest this evidence was capable of proving these particulars. The Panel accordingly decided there is a case to answer on these particulars.
62. The Panel decided that there is a case to answer in respect of particular 3, as there was some documentary evidence as to the hospital policy in addition to Colleague A, and that of AB and JW. (Particular 1(a) is admitted by the Registrant).
63. The Panel next heard live evidence from the Registrant. She took the oath. She told the Panel that prior to qualifying as a Social Worker she was a Prison Officer. She qualified as a Social Worker in 2007 and went to work at Children’s Services in the hospital that year. She worked in a senior safeguarding lead role at the hospital and was regional safeguarding lead covering 12 hospitals. She stated she had no disciplinary issues during her time there.
64. The Registrant said she was senior management as regards safeguarding responsibilities. She explained the supervision she received from an external person, but 10 months before the incidents giving rise to the allegation, her supervisor had retired and had not been replaced. She explained to the Panel her role in considering medication errors in the hospital given her responsibility for patients and how she conducted safeguarding meetings.
65. The Registrant was taken to the record of her interview with JW the investigating officer. She had not seen or agreed this at the time. She disagreed that Colleague A had met her at the bottom of the stairs, it had been at the top.
66. The Registrant told the Panel about her meeting with Colleague A on 3 January 2017. The Registrant said Colleague A had suggested that she go to Maple ward and ask for some Tramadol. She was certain that no number of tablets had been mentioned. No mention was made of Tramadol being a controlled drug. She said there had been no mention by anyone that asking for that drug was not appropriate. She said that she had mentioned her knee pain to Colleague A, but not to SG.
67. The Registrant said that JR was in Maple ward and agreed to assist. SG, JR and the Registrant went into the clinical room and the Registrant told them that Colleague A had said she could come and get some Tramadol. SG had offered her a strip of 20 tablets and the Registrant said that number would “see her through”. She said she took 20 tablets as that was in line with her prescription, which had run out. The 20 tablets would have lasted until her prescription was due to be renewed. The Registrant said that SG had completed something in a book, but she did not see what she wrote and said that she did not remember what the book looked like.
68. The Registrant said she had not been explicit in explaining that the tablets were for personal use, but said she had no reason to lie about that. With hindsight, she said she ought to have been clearer with her colleagues that the Tramadol was for her personal use. The Registrant explained she later took two tablets in her office and took the rest home and took them as prescribed by her GP. She said she was not aware that Tramadol was a controlled drug or that it was against hospital policy to have obtained them.
69. The Registrant said she had not previously seen the employee handbook as originally she was employed by another company and when the Priory took over she was not given this handbook. She had not considered the medication management policy as that was not part of her role as she was not involved with medicines in the hospital. She knew very little about controlled drugs.
70. As regards 6 January 2017, the Registrant said she had met Colleague A at the top of the stairs. She told the Panel that Colleague A was angry and aggressive. Colleague A said she, herself, had made an error. Colleague A then left a voice-mail and pressed her to speak to AB. The Registrant did not call her back. She next saw Colleague A the following Monday 9 January 2017 when the Registrant went to her office and she had asked Colleague A to come with her to see AB. The Registrant said she felt angry and upset as she had found out that Tramadol was a controlled drug and her supply had been contrary to the hospital policy. She said she had relied upon her colleagues to advise her. She said she felt she had not been treated fairly.
71. The Registrant explained her understanding of a prescription drug. She agreed that it meant she could not buy the medicine over the counter. She said she had a prescription but did not have the prescription to give to Colleague A on 3 January 2017. She accepted that Colleague A was not her prescribing doctor, but thought that Colleague A would have the knowledge to give her the drug. She said people asked for medication all the time in the hospital, it was common practice. As regards the hospital policy the Registrant said she did not know it. With hindsight she said she had not thought about it.
72. As regards the dosage, the Registrant said Colleague A mentioned no dose, despite Colleague A’s evidence to the contrary. The Registrant said she had told JR and SG on 3 January 2017 that she needed the Tramadol for her knee. She accepted that she had not mentioned this to the hospital investigation. The Registrant said she was confused about what she had said to JR and SG at the time. She was not told by them that what she was doing was wrong. She accepted that she may not have referred to her knee pain in her discussions with SG and JR. She said she had no reason to mislead anyone and disputed the evidence of both witnesses. She could not explain why in her evidence today she first mentioned the comment she allegedly made to SG and JR of “that will see me through”.
73. The Registrant accepted that she had taken from SG significantly more Tramadol than required for her immediate needs. She said she saw nothing wrong with what she was doing. She said that she knew nothing of the fact that Tramadol was a controlled drug, or that is was an addictive drug. Her GP has never raised that with her. She has taken it for lengthy periods as she had had several surgeries. The Registrant was unable to explain why she had not provided evidence of her Tramadol prescription for the Panel, which she said she collected on 5 January 2017.
74. The Registrant said she knew very little of controlled drugs and medicine management. She accepted medicine errors were a standard part of the meetings she regularly chaired in her role, but it was only the numbers that she noted. She disputed the evidence of her manager, AB, who told the Panel that she would be very surprised if the Registrant did not have detailed knowledge of controlled drugs. The Registrant disputed that she had received emails or meeting minutes about Tramadol becoming a controlled drug in 2014 as part of her safeguarding role or the clinical governance role in the hospital.
75. The Registrant was taken to the Medicines Management policy. She accepted it said that Tramadol was to be treated and recorded as a controlled drug. She said she had never read this policy despite the evidence of JW and AB that she would have been aware of it. She accepted the policy was clear having now considered it.
76. The Registrant could not explain why, in her email to AB on 6 January 2017 and at and the meeting with her on 9 January 2017 that the Registrant had not mentioned the 32 tablets of Tramadol. She said the quantity had not been raised, but accepted that she had told the hospital investigation at interview that Colleague A had told her not to tell AB about the 32 tablets of Tramadol.
77. The Registrant stated that SG had not asked her to return the Tramadol that she did not need. She said she was not as explicit as she should have been with JR and SG about the Tramadol being for her personal use.
78. The Registrant in response to Panel questions said that she had had several surgeries and had most recently had surgery in July 2016. She returned to work in October 2016 but found that she had a lot of pain and was prescribed Tramadol by her GP.
79. As regards the strip of 20 Tramadol tablets from Maple ward, the Registrant did not think about returning any and nothing was said about that. The normal prescription was for 56 tablets. The Registrant said that at no time had her GP mentioned any issue regarding addiction to Tramadol, although it had been mentioned in respect of Co-Codamol. Looking back she considers that Tramadol may have made her tired and less motivated but she had not been aware of that at the time.
80. The Registrant said that the record of her interview with JW was unclear and she said she had not seen any counting of tablets just a mention by SG and JR that 32 tablets were left in the packet.
81. The Registrant said she had reflected on her actions and said it was difficult to be aware of all the policies and procedures and she ought not to have relied upon her fellow professionals. She said she now realises that Tramadol is a controlled, prescribed drug and she would never ask for any drug at work. The Tramadol she received was part of the hospital stock and probably was assigned to a patient, although she did not enquire at that time. She had also placed her colleague in a difficult position. She now knew she had made a mistake and she had reflected. The Registrant said it did not occur to her that she had obtained the Tramadol from the hospital without any payment, unlike a prescription, and it just had not occurred to her to pay for it or return it.
82. The Registrant accepted that her manager AB at the meeting on 9 January 2017 had told her not to speak to Colleague A. She said she had approached Colleague A on the 9 January 2017 but that she had not banged on her door or raised her voice. She was concerned and upset but did not think she had been aggressive. As part of her role the Registrant said that she did not have daily discussions about medicines but she only collated information about medication errors, assaults and the like. She did not get involved in clinical governance.
83. The Registrant told the Panel that she had made one mistake in a 20 year career and she would never again do what she did, instead if she was in pain, she would leave work and see her GP. She would be more self-aware and recognise if she was not fit for work. She had not taken Tramadol for about 18 months. Such an incident would never happen again. The Registrant said she did not consider Colleague A to be a timid person and she had been shocked at what Colleague A had said about her behaviour.
84. The Registrant did not know until she met AB on Monday 9 January 2017 that Tramadol was a controlled drug, despite knowing something was wrong when she met Colleague A on the stairs the previous Friday, 6 January 2017. She now knows Tramadol is an opiate but said she did not know that at the time. The Registrant accepted that she did not make a full disclosure to AB at that time as she did not understand what denatured meant. She also said that Colleague A had told her that she was “sorting it out”.
85. The Registrant also explained that any medication she kept in her office was kept in a locked drawer to prevent anyone taking them. She explained her role at the hospital and said that it was largely dealing with mental health patients rather than those with substance misuse. Many patients took anti-psychotic drugs. In her previous career as a Prison Officer she said she had not dealt with health care issues.
86. In response to further questions from Ms Sheridan, the Registrant said that she had sent an email on 6 January 2017 and that time she had not known what denaturing meant. She took no steps over the weekend to find out. She did not disclose the position fully to AB on Monday 9 January 2017 as she did not fully understand the seriousness of the position. She denied that this was part of her deception.
87. Mr Calder closed the Registrant’s case.
88. Ms Sheridan summarised the HCPC’s case. She reminded the Panel that it must apply the balance of probabilities and summarised the evidence relevant to each of the particulars of the allegation and referred the Panel to those parts of the evidence in support of each. She submitted that SG was clear and consistent in her evidence about the dispensing of the Tramadol and this was corroborated by the evidence of JR. Both were clear that they were unaware that the drug was for the Registrant’s personal use, and both understood it was required for another ward. JR gave evidence that the Registrant seemed rushed, flustered and uncomfortable. SG said the Registrant was in a rush and there was a sense of urgency.
89. Ms Sheridan submitted that there were inconsistencies between the investigation interviews at the time and the Registrant’s evidence before the Panel, particularly the conversations with SG and JR regarding the drug. Ms Sheridan submitted this indicated that the Registrant was significantly departing from her original account and indicative of a Registrant who cannot “keep their story straight”. Ms Sheridan submitted that the Registrant had acted dishonestly in not disclosing the true position about the drug to SG and JR and had sought to alter her position in her evidence from that she gave when interviewed by JW.
90. Ms Sheridan submitted that Colleague A was reliable and credible. Her version of events was more credible than that of the Registrant and had no reason to lie. The Registrant has failed to produce the prescription for Tramadol and she altered her story about the failure to collect the prescription. Ms Sheridan submitted that the Registrant was changing her story. She urged the Panel to prefer the evidence of Colleague A as the Registrant’s evidence was not credible. To find dishonesty she submitted it was not necessary to find that the Registrant knew that Tramadol was a controlled drug. She submitted it was more likely than not that the Registrant knew it was a controlled drug given her senior role in the hospital.
91. Ms Sheridan referred the Panel to the proper test for dishonesty as explained in Ivey v Genting Casino  UKSC 67. She submitted that the Registrant had acted dishonestly in seeking and obtaining the Tramadol. Ms Sheridan submitted that HCPC Standards of conduct, performance and ethics 2 and 9 were breached and that the facts amounted to misconduct. She referred the Panel to the guidance in Roylance v. General Medical Council (No 2)  1 AC 311.
92. On the issue of impairment, Ms Sheridan referred the Panel to the HCPTS Practice Note on Finding Fitness to Practise Impaired and to the guidance in Council for Healthcare Regulatory Excellence v Nursing and Midwifery Council, Paula Grant  EWHC 927 (Admin). She urged the Panel to consider the Registrant’s insight and to carefully consider the public interest. She submitted that the Panel should find the Registrant currently impaired on both the private and public aspect of impairment.
93. The Panel received and carefully considered the written submissions from Mr Calder who did not make verbal submissions. In summary, he submitted that the case arose because “a senior drugs nurse made an error in her advice” to the Registrant. He submitted that Tramadol was not a controlled drug and that the Registrant had been open and honest when seeking the drug from Colleague A. The Registrant did not know it was to be treated as a controlled drug and that she had been open and honest in her dealings with Colleague A, JR and SG. He submitted there had been miscommunication but that JR and SG were credible.
94. Mr Calder accepted that the Registrant had said she had not been explicit in telling SG and JR that the Tramadol was for personal use, but that did not make the Registrant a liar. In summary he submitted that the Registrant was the only non-medical person involved and she should not be held to a higher standard than the other professional staff. He submitted particular 1(b) was not proved.
95. Mr Calder said in respect of particulars 2 (a) and 2(b) that Colleague A’s evidence was inconsistent and it could not be known why she signed out the remaining Tramadol, what she did with it or why she claims in her evidence to have passed it to the Registrant. He submitted it was more likely than not that Colleague A had denatured the drugs outside hospital policy and then changed her story in her evidence. He submitted that particular 2 was not proved. Mr Calder did not specifically address particular 3 or 4 of the allegation.
96. On impairment, Mr Calder submitted that the Registrant was regretful and offered sincere apologies. She accepted she had fallen well short of the standards expected by the public and understood that her behaviour could undermine public confidence.
97. The Panel heard and accepted the advice of the Legal Assessor as to facts, misconduct and impairment. He reminded the Panel of the fact finding exercise applying the balance of probabilities to the evidence and that the onus rests on the HCPC. The Registrant need prove nothing. He referred the Panel to the guidance in Roylance as to misconduct. On finding impairment, the Legal Assessor referred to HCPTS Practice Note on Finding Fitness to Practice Impaired and to the guidance in CHRE v Grant  EWHC 927 (Admin). He stressed the importance of the public interest. On dishonesty the Legal Assessor referred the Panel to the case of Ivey and to the appropriate, objective test for dishonesty.
Decision on Facts:
98. The Panel carefully considered all the evidence and the oral and written Submissions from both parties. It assessed all the witnesses it had heard from.
99. JW was a consistent, credible and honest witness who sought to assist the Panel.
100. Colleague A was a vulnerable witness. She was at times confused and inconsistent. She was tearful on numerous occasions and her memory was clearly affected by the passage of time. She remained ashamed and remorseful about her actions and the lies she told on Friday 6 January 2017 before confessing to AB on 7 January 2017. However, on key parts of her evidence she was consistent and credible.
101. SG gave clear and coherent evidence. She was calm, honest, reliable, and balanced. She gave credit to the Registrant as a respected Social Worker. She did not seek to blame anyone and took responsibility. The Panel found her evidence compelling.
102. JR relied on her written interview notes and her statement and she appeared conscious of her junior role. She corroborated the main points in the evidence of SG.
103. AB was the Registrant and the Colleague A’s Line manager and a registered nurse. She was credible, consistent, reliable and honest. She said when she could not recall events.
104. The Panel found the Registrant’s evidence to be inconsistent and at times lacked coherency or cogency. She was not consistent about the events of 3, 6 and 9 January 2017, and her oral evidence was often inconsistent with the written account of her earlier interviews during the hospital investigation. The Panel found that her responses to questions did not reflect the seniority of her position and her senior role in the hospital. At times she appeared confused, such as regarding the reasons for not collecting her prescription for Tramadol. Her recollection was at times poor. The Panel found that the Registrant’s evidence was lacking in both reliability and credibility.
Particular 1 (a) - Proved
105. This is admitted. Colleague A accepted that on 3 January 2017 the Registrant had asked her for some Tramadol whilst on Meadows ward. This accorded with the Registrant’s evidence. She said the Registrant had been in pain and she, Colleague A, had said the Registrant could “go down to the emergency drugs cupboard on Maple and sign some out.” Colleague A said that she told the Registrant to take one dose - two 50mg tablets, which she knew from the Registrant was her prescribed dose, but she had not seen any prescription. It was corroborated by Colleague A.
106. Colleague A also explained that she had felt coerced by the Registrant to supply the Tramadol as she seemed to be in such pain and it seemed urgent. She said that the Registrant had approached her several times in the past for medication. The Panel find this particular proved.
Particular 1 (b) – Proved
107. SG and JR were consistent and clear that the Registrant told them that the drug was for Meadows ward. Both were clear that they did not know it was for the Registrant’s personal use and she did not tell them. The entry in the controlled drug book also states that the drug was for Meadows ward, and is signed by both SG and JR.
108. SG told the Panel that she was clear that she would not have given a Controlled Drug for personal use and twice asked what the Tramadol was for. The Registrant repeated that it was for Colleague A, on Meadows ward. The Panel preferred the evidence of SG and JR to that of the Registrant.
Particular 2 (a) and 2 (b) – Proved
109. These particulars are closely linked. The evidence of Colleague A is that she got a call from the Registrant early on 6 January 2017 asking for Tramadol, as she could not pick up her prescription. The Registrant claims she did not ask or receive Tramadol and that this is untrue and a fabrication. She accepts that she met Colleague A twice on Friday 6 January 2017, but not that she was given 32 Tramadol tablets.
110. Colleague A told the Panel that she had signed out the remaining 32 Tramadol tablets. She then realised that 20 tablets had been signed out to Meadows ward not 2 tablets, on 3 January 2017. Colleague A said she took the 32 tablets to the Registrant, gave them to her and told her that they would be in trouble if found out. She asked the Registrant to say that the Tramadol had been denatured. Colleague A met with AB on 6 January 2017 and told her that the Tramadol had been denatured.
111. Colleague A said she had a sleepless night on 6 January 2017 and called AB on the Saturday morning, 7 January 2017. She told AB she had not in fact denatured the 32 tablets and had lied to her on Friday. AB’s evidence confirmed that conversation. If Colleague A had continued with her deceit about the denaturing of the tablets it may not have been discovered. The Panel found that she did not have any apparent motive to confess that she had lied to AB on 6 January 2017, as it placed her in a very serious position.
112. The Registrant sent an email on Friday 6 January 2017 at 13.04 to AB mentioning her prescription and expressing concerns about the paperwork, but she did not mention Tramadol or the quantities. The Registrant accepted in her evidence that she did not tell AB the whole story in her email of 6 January 2017, or at the meeting with AB on Monday 9 January 2017, making no mention of the 32 tablets.
113. The Registrant told the Panel that she thought Colleague A would take responsibility, and in oral evidence said she did not understand what “denatured” meant. This was only raised in her evidence at this hearing. The Panel took account of her interview on 3 February 2017 when the Registrant said repeatedly that Colleague A said she had “got rid of” the 32 tablets.
114. The Registrant told the Panel about her use of Tramadol at that time but claimed she did not need the additional tablets on 6 January 2017 as she had collected her prescription on Thursday. The Panel have not seen that prescription. The Panel considered that the Registrant’s various explanations about why she had not collected her prescription for Tramadol were not credible. Those given by her in oral evidence were varied and they were different from what she had said at the investigatory interview. She was not able to explain those inconsistencies to the Panel.
115. The Panel does not accept the Registrant’s version of events. Her version lacks credibility. The Panel had no evidence of the Registrant’s prescription had been fulfilled and it was more likely that the Registrant had asked Colleague A for the Tramadol. It took account of the evidence from Colleague A and the Registrant and that the Registrant had made prior requests of Colleague A, and others, for pain relieving medication.
116. The Panel recognised that Colleagues A’s evidence was at times confused and, at times, lacked credibility. However, on balance, the Panel considered that Colleague A’s explanation in respect of these particulars of the allegation was coherent, consistent and was credible. The Panel prefers the explanation of Colleague A to that of the Registrant. It found these particulars proved.
Particular 3 (a) - Proved
117. The Registrant was a senior member of staff responsible for safeguarding across the region. She also chaired twice weekly safeguarding meetings at the hospital which included medication errors as a standing item. The Registrant was prescribed Tramadol and had taken it as part of her treatment plan over a number of years. AB, her manager, told the Panel that she would be “very surprised” if the Registrant did not know that Tramadol was a controlled drug.
118. SG and JR explained in their evidence that when a CD is taken from the drug cupboard it is signed for and dated by two authorised nurses in the CD book. If CDs are moved between wards there is a reconciliation process between the CD books for each ward. The Panel took account of the differences in the CD drug book and the Emergency drug book, and the procedures involved in dispensing. The Registrant interrupted SG at the start of her ward round to ask her for Tramadol. SG had to locate the nominated nurse for the CD cupboard keys, JR. The two nurses and the Registrant entered the medication room where the CD cupboard was located. The CD book was in that cupboard marked “controlled drugs cupboard”. SG and JR both said that the Registrant was leaning on the counter next to the CD book when the Tramadol was counted out and signed for by SG and JR.
119. JW said in his evidence that whilst the Registrant may not have known that Tramadol was a CD when she asked for it from Colleague A, he was clear that when she witnessed the security process for accessing and dispensing Tramadol she must have known it was a CD.
120. The Panel might expect a senior Social Worker responsible for safeguarding to know the status of Tramadol at that time. Further she was taking it as part of medication regime, amongst other medications.
121. The Registrant denied any knowledge of Tramadol being a CD and said she little knowledge of controlled drugs or medicines management. The Panel did not accept the Registrant’s evidence in this regard. It is not credible.
122. On balance, the Panel therefore find that it was more likely than not that the Registrant did know that Tramadol was a controlled drug and finds the particular proved.
Particular 3 (b) – Proved
123. The Panel considered that the Registrant was not credible in her denial of knowledge of the Trust policy. JW explained how the policy was communicated to staff and that the Registrant sat on the hospital governance committee. She was a senior member of hospital management. It is not credible that in such a role she did not have knowledge that it would be against Trust policy to take CDs from a ward for personal use. AB said that she would not expect any colleague to access medication from hospital stock that is prescribed for patients. The Panel agree. The Panel found this particular proved.
Particular 4 – Dishonesty
124. The Panel considered the guidance in the Ivey case and applied the test set out therein to the facts found proved.
125. In respect of particular 1(a) the Panel considers this was a patient’s medicine and that is clear from the CD book. The Registrant took medication prescribed to a patient on Maple ward for the Registrant’s personal use. She did not pay for or return the drug. The Panel determined that viewed objectively taking that drug was dishonest.
126. In respect of particular 1(b) the evidence of SG and JR is preferred to that of the Registrant. It was consistent and credible. They both said that the Registrant told them the medicine was for Meadows ward and both said that at no point did the Registrant tell them or indicate that Tramadol drug was for her personal use. The Panel determined that allowing those dispensing nurses to believe Tramadol was for another ward and not for her personal use was dishonest.
127. In respect of 2(a) and 2(b) the Registrant maintained a deception with regard to AB to whom she did not disclose the full picture on 9 January 2017. The Panel accepted Colleague A’s version of events that she gave Tramadol to the Registrant and told her to say it had been disposed of. It takes the view that the Registrant knowingly received a controlled drug from Colleague A and knew that Colleague A had obtained that on the pretence of disposing of it. Those actions, judged objectively, would be considered dishonest by an ordinary, decent person.
128. In respect of particular 3 (a) and 3 (b) the Panel did not find the Registrant credible or believable in respect of her knowledge of Trust policy. She was a senior member of the hospital staff with governance responsibility. The Panel does not accept that the Registrant did not know Tramadol was not a CD, or that obtaining Tramadol, or any drugs, for personal use was against Trust policy. Moreover, any drugs held by the hospital for patients are the property of the hospital and not for the personal use of staff. The Panel consider that viewed objectively by an ordinary, decent person the Registrant’s behaviour in knowingly obtaining a CD, and requesting and using it for personal use was dishonest.
Decision on Grounds:
129. The Panel having found all the facts proved next considered the ground of misconduct. It followed the advice in the Roylance case and applied that guidance to its factual findings.
130. The Registrant put her interests before those of patients and other service users; she placed her colleagues in a difficult position and on two separate occasions obtained a controlled drug under false pretences for her personal use in breach of the hospital policy.
131. The Registrant was also dishonest. She breached the HCPC Standards of conduct, performance and ethics Standard 9. She breached fundamental tenets of the profession in acting dishonestly and fell far short of the proper standards to be expected of a Social Worker and her actions were so serious as to amount to misconduct.
Decision on Impairment:
132. The Panel accepted the Legal Assessor’s advice and considered the relevant HCPTS Practice Note and the guidance in the Grant case.
133. The Registrant has apologised and reflected on the wrongdoing that she has admitted to. However evidence of insight is limited. In her evidence she sought repeatedly to deflect responsibility and to place blame and responsibility on others. However, the Registrant did say that she now recognised that taking medication intended for a patient is wrong.
134. There is little evidence of any remediation of her practice. The Panel does accept that dishonesty can be difficult to remediate but the Registrant has not addressed her dishonesty to any extent and she has continued to deny it.
135. The Panel noted that she is presently working in a social work role. The Panel heard limited evidence of the role. There are no testimonials or references before the Panel from any employer, although it noted the three character references dated 2 and 3 March 2017. The Panel noted this was most likely before the current allegations were before the HCPC. It concluded that in light of the lack of evidence of meaningful insight and remediation that the Registrant is at risk of repeating her behaviour.
136. The Panel considered that a member of the public would be appalled that a senior Social Worker had committed such acts of dishonesty. Due to the lack of remediation and lack of insight, the Panel found that the Registrant is likely in the future to bring the profession into disrepute and is liable to act dishonestly in the future. It found that in light of its findings on facts and misconduct that public confidence in the profession would be undermined if a finding of impairment were not made. The Panel accordingly found that the Registrant’s fitness to practise is impaired on both the private and public grounds.
137. The Panel finds that the Registrant’s fitness to practise was at the time, and remains, impaired.
Registrant’s Evidence Sanction Stage:
142. The Registrant was sworn and gave further evidence at the sanction stage. She told the Panel about her current full time employment in a safeguarding lead role which she commenced in January 2019. She said her present job was in community work regarding improving access to health care in the community. She said she was also working on a project in a prison setting. She said the risk levels and responsibility were far less than previously. She was enjoying the role, giving safeguarding advice in a less stressful environment with better working hours.
143. As regards her current health, the Registrant said that she was not on any medication and had not taken medication for 18 months. She had stopped playing sport and was more thoughtful about her health.
144. Ms Sheridan asked the Registrant about the references submitted at this stage. She referred to the Reference from her current employer dated 26 February 2019 which explained “they were fully aware of the ongoing issue regarding her professional registration”. The Registrant explained that she had shown the HCPC allegations to her employer’s HR department. She said that information from the HCPC website about the case had also been considered by the Board of her employer. They had then offered her the job.
Submissions on Sanction:
145. Ms Sheridan submitted to the Panel that sanction was a matter for it. The Panel should act proportionately and have regard to the HCPC Indicative Sanctions Policy. She outlined the sanctions available and the advice in that policy. She referred to Igboaka v GMC  EWHC 2728 (Admin) which indicated that in cases of proven dishonesty that a severe sanction should be expected.
146. She submitted that the aggravating features were the Registrant’s limited insight, her lack of remediation, and that she placed colleagues in a difficult position. Further, the dishonesty was not isolated. In mitigation she submitted that there was the lack of any previous regulatory concerns.
147. Mr Calder referred to the Registrant’s previous good character and said that this was an isolated incident. He told the Panel that the Registrant had not been subject to any restrictions on her practice and she has worked without incident since 2017. He said the Registrant has learned her lesson and knew that she had placed her career and her family at risk. He referred the Panel to the references provided. Mr Calder asked that the Panel be as lenient as possible and submitted that anything beyond conditions of practice would prevent the Registrant making a contribution to the profession and serving the community. He said she would fully comply with any sanction imposed.
148. The Panel accepted the advice of the Legal Assessor. He referred the Panel to the HCPC Indicative Sanctions Policy. The Panel is required to act fairly and proportionately and to apply the least restrictive sanction necessary to protect the public and the wider public interest. He reminded the panel that the Registrant was previously of good character. The Panel must also at all times be mindful of the public interest, which included the need to maintain confidence in the profession and the regulator.
Decision on Sanction:
149. In considering the appropriate sanction the Panel has had regard to the HCPC Indicative Sanctions Policy, to its earlier findings and to the submissions. It was mindful that the primary purpose of sanction is to protect the public and the wider public interest. It balanced the Registrant’s interests with that over-arching purpose.
150. The Panel first considered the aggravating and mitigating features. The Panel considered that the aggravating features are: -
a. The seriousness of the dishonesty
b. The Registrant’s deflection of blame and responsibility on to others and she placed colleagues in a difficult position on two occasions
c. The seniority of her role at the hospital
d. The lack of meaningful or developed insight
e. The Registrant potentially deprived a patient of medicine and put her own interests ahead of those of patients
151. The Panel considered that the mitigating factors are:-
a. The Registrant had health issues and was in pain at the time
b. The early admission of particular 1 (a) of the allegation for which she has apologised and shown remorse
c. The evidence of a permissive culture in the handling of medicines in the hospital
d. A positive reference from her current employer and previous good character
152. In view of the seriousness of the misconduct, to take no further action or to impose a Caution Order would not be appropriate as such orders fail to address the seriousness of the misconduct found and the risk of repetition. The Registrant’s misconduct is serious and neither of these would be sufficient to protect the public, or to maintain confidence in the profession and the regulatory process.
153. The Panel next considered a Conditions of Practice Order. There is limited evidence of insight or remediation and the misconduct and repeated dishonesty found is serious. The Panel has identified there is a risk of repetition of the behaviour which led to Panel’s findings. In these circumstances the Panel was not able to devise proportionate, appropriate, workable, verifiable or realistic conditions of practice. The dishonesty found proved and breach of trust were behaviours that could not be appropriately addressed by conditions of practice.
154. Further, given the nature and gravity of the misconduct found by the Panel, conditions of practice would not serve to protect the public interest, maintain public confidence in the profession or the regulator, deter other professionals, or uphold proper standards.
155. The Panel next considered a Suspension Order. The Panel has found that the Registrant was dishonest and twice obtained a controlled drug from the hospital for her personal use, misleading colleagues in order to do so. She was a senior Social Worker who chaired safeguarding meetings and sat on the hospital Governance committee. The Panel found that her version of events was not true. The misconduct found is grave and the dishonesty was repeated. Further, the Panel found that there is risk of repetition given the Registrant’s insufficient insight and the lack of evidence of remediation.
156. The Panel was mindful of the positive reference from the Registrant’s current employer. Whilst it is positive, crucially, it fails to deal with the Registrant’s integrity and honesty. In that important aspect the reference is silent and of limited value.
157. With regard to the public interest, the Panel determined that given its findings as to misconduct and impairment, that a Suspension Order would for its duration protect the public, but would fail to uphold proper standards and maintain confidence in the profession. It would not be an appropriate or proportionate sanction.
158. The Panel then considered a Striking Off Order. It considered paragraphs 47, 48 and 49 of the Indicative Sanctions Policy. Paragraph 47 states that Striking Off “is a sanction of last resort for serious, deliberate, or reckless acts involving abuse of trust such as …dishonesty.” The Registrant’s acts were serious, deliberate, and involved abuse of trust, and were dishonest. She lied to and misled colleagues.
159. Paragraph 48 states that “Striking Off should be used where there is no other way to protect the public, for example where there is a lack of insight…or denial” The Panel has identified a lack of insight and continued denial of her dishonesty.
160. Paragraph 49 states that “Striking Off may also be appropriate where the nature and gravity of the allegation are such that any lesser sanction would lack deterrent effect or undermine confidence in the profession concerned or the regulatory process”. The Panel determined that in all the circumstances, and given the nature and gravity of its findings, nothing less than a Striking Off Order would provide the necessary deterrent to other professionals and maintain public confidence in Social Workers.
161. The Panel concluded after careful consideration of the Indicative Sanctions Policy, all the information before it and its finding of misconduct, that a Striking Off Order is the appropriate and proportionate sanction.
Decision on Interim Order:
162. The Panel heard from Ms Sheridan who sought an interim suspension order for 18 months. She submitted that an order was necessary to protect the public, and was otherwise in the public interest. She referred to the Panel’s decision and the risk of repetition it had identified. She referred to the HCPC Practice Note on Interim Orders and submitted that the Notice of Hearing sent to the Registrant indicated that an interim order may be sought at this stage.
163. Mr Calder said his client was seeking to appeal and he sought that no interim order be imposed. He reminded the Panel that the Registrant had worked on an unrestricted basis for two years. She was not an immediate risk to service users. He said that the Registrant may lose her employment, her home. He submitted that the Registrant is the main bread winner in her family. He asked that the Registrant be given the opportunity to work with the HCPC. Mr Calder said he understood that an interim conditions of practice order may not be not appropriate.
164. The Panel took account of all the information before it and the submissions. The Panel accepted the advice of the Legal Assessor. He referred it to the HCPTS Practice Note on Interim Orders and reminded the Panel that the primary purpose of an interim order is protection of the public and that it is needs to balance the interests of the Registrant with the need to protect the public and the wider public interest. The Panel checked the Notice of Hearing sent to the Registrant dated the 19 December 2018 which had given her notice of the final hearing. It does provide notice to her that an interim order may be sought at the conclusion of a final hearing.
165. The Panel considered the Registrant’s interests and the submissions about the potential implications for her family and employment. It was mindful of the need to balance her interests with the need to protect the public and the public interest.
166. The Panel determined that it would be wholly incompatible with its earlier findings and the Striking Off Order it has imposed, to conclude that an interim order is not necessary for protection of the public or otherwise in the public interest. The Panel accordingly find that an interim order is necessary on both grounds.
167. The Panel has found that the Registrant is dishonest. The Panel did not accept the Registrant’s evidence under oath. There is a lack of insight and remediation and there is a risk of repetition. There is a potential risk to patients. There is a clear and immediate need to protect the public and the public interest.
168. The Panel carefully considered an interim conditions of practice order. Any conditions of practice must be realistic, verifiable and workable. They must also be capable of addressing the concerns and risks identified by the Panel. Given the Panel’s decision on misconduct and dishonesty it is not possible to devise interim conditions of practice that appropriately and proportionately manage dishonesty and the risk of repetition. Interim Conditions of Practice would not maintain public confidence in the profession or the regulator in light of the nature and gravity of the Panel’s findings.
169. The Panel considers that a member of the public would be shocked and troubled were it to impose no interim order, or an Interim Conditions of Practice Order, in the circumstances of this case.
170. The Panel determined that it is appropriate to impose an Interim Suspension Order for a period of 18 months to cover any appeal period. When the 28 day period for lodging an appeal expires this interim order will come to an end, unless there has been an application to appeal. The Panel noted that Mr Calder mentioned the Registrant intended to appeal. If there is no appeal the Striking Off Order will apply.
ORDER: That the Registrar is directed to strike the name of Miss Nicola Ann McColm from the Register on the date this order comes into effect.
A reconvened final hearing of the Conduct and Competence Committee was concluded at the Holiday Inn Bolton Centre between Monday 4th March and Friday 8th March.
History of Hearings for Miss Nicola Ann McColm
|Date||Panel||Hearing type||Outcomes / Status|
|04/03/2019||Conduct and Competence Committee||Final Hearing||Struck off|
|05/11/2018||Conduct and Competence Committee||Final Hearing||Adjourned part heard|