Mrs Cavel Callender
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Allegation
While employed as an Operating Department Practitioner by the Heart of England NHS Foundation NHS Trust:
1. Between 16 June 2014 and 4 July 2014 you:
a) Did not check the anaesthetic machine correctly during a simulation exercise with Colleague A.
b) Did not demonstrate to Colleague C general knowledge about anaesthetic machines and how to check them.
2. On or around 4 July 2014, whilst recovering post-theatre patients, you copied observations and/or documentation from a previous recovery phase instead of taking and recording new observations and/or documentation of the patient.
3. On or around 28 July 2014, whilst being supervised by Colleague A:
a) you were unable to distinguish between safe and unsafe thoracic suctioning.
b) you incorrectly measured a patient’s respiration rates.
c) regarding at least one of your patients that day, you:
i) did not regularly measure the patient's respiration rate;
ii) did not regularly measure the patient's temperature ;
iii) did not accurately record the patient's respiration rate;
iv) did not accurately record the patient's temperature.
4. On or around 31 July 2014, while recovering a patient who had undergone surgery, you did not conduct a complete handover to the medical team.
5. Not proved.
6. On or around 27 October 2014, whilst observed by Colleague C, you:
a) suggested an inappropriate and/or unsafe treatment plan for a patient with high blood pressure.
b) gave an incorrect handover to a medical team.
c) were unable to state the side effects of and/or appropriate dosages for cyclizine.
d) did not identify that the wrong pressure had been set and/or implement the correct chest drain pressure for a patient.
7. On or around 4 November 2014, while working with Colleague A, you:
a) did not regularly measure the respiratory rate for at least one patient.
b) did not accurately record the respiratory rate for at least one patient.
8. On or around 21 November 2014, while being observed by Colleague C and/or Colleague D, you:
a) did not set up the theatre correctly.
b) did not complete the required paperwork as requested.
9. On or around 27 November 2014, while working with Colleague C, you did not load the echelon gun correctly.
10. On or around 3 December 2014, while working with Colleague D, you did not recall that a large swab was in the chest of a patient when performing a swab check.
11. The matters described in paragraphs 1-11 constitute misconduct and/or lack of competence.
12. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Finding
Preliminary matters
Application to proceed in private
1.The Registrant participated in the hearing by telephone. At the outset of the case, Ms Ktisti, on behalf of the HCPC, applied for those parts of the hearing which related to the Registrant’s health to be heard in private, in order to protect the confidentiality relating to the Registrant’s private life.
2.Having heard and accepted the advice of the Legal Assessor, the Panel was satisfied that it was justified to hear those parts of the case in private, in order to protect the confidentiality relating to the Registrant’s private life.
Background
1.The Registrant is registered with the HCPC as an Operating Department Practitioner (ODP). The Registrant started her employment as an ODP at the Heart of England NHS Foundation Trust on 16 June 2014. She was a Band 5 Practitioner.
2.During the course of the Registrant’s employment with the Trust she was exposed to all the areas in which she would be expected to work, ie Scrubs (surgery), Anaesthetics and Recovery. Her probationary period was meant to last for a period of 12 weeks but this was extended for a further 3 months due to both the Registrant’s lack of progress and her sick leave. This additional time was to give her the best chance to improve her performance. Notwithstanding the additional support, the Registrant did not pass her probation.
3.The substantive hearing took place between 20 and 22 March 2017. In relation to the facts found proved, the substantive panel was satisfied that they amounted to multiple examples of a serious and wide ranging lack of competence on the part of the Registrant. The substantive panel imposed a Suspension Order of 12 months. In reaching this conclusion, it found that the Registrant had breached fundamental standards of the profession and had failed to acknowledge her failings or to show any insight, remorse or remediation. The substantive panel considered that a less restrictive sanction would fail to protect the public and would undermine public confidence in the profession and the Regulator.
4.On 12 March 2018, the Order was reviewed (the first review). The first review panel found that the Registrant’s fitness to practise remained impaired on the grounds of both public protection and the wider public interest. It had no evidence before it to demonstrate remediation, insight or any acknowledgement of her failings and how they may pose a risk to service users. The first review panel extended the Suspension Order by a period of 12 months and made recommendations to the Registrant about information which might assist a future reviewing panel.
5.On 14 March 2019, the Order was reviewed (the second review). The second review panel considered that there had been no material change of circumstances, and that the Registrant had disengaged with her regulatory body. In the absence of any evidence that the Registrant had made any attempts to remedy her serious and wide ranging deficiencies, the second review panel found that the Registrant’s fitness remained impaired on the basis of public protection and the wider public interest. It extended the Registrant’s Suspension Order by a further 6 months.
Decision
6.Ms Ksitsi, on behalf of the HCPC, explained that there were two file notes before the Panel of contact between the Registrant and the HCPC on 12 September 2019, and that the Registrant was participating in this review by telephone. She said that the communications between the Registrant and the HCPC indicated that the Registrant would like to voluntarily remove herself from the Register. Ms Ksitsi said that the HCPC was prepared to explore voluntary removal with the Registrant, but that it would require continued engagement with the Registrant. She submitted that the Registrant’s fitness to practise remained impaired, and invited the Panel to extend the Suspension Order for a period up to six months to allow voluntary removal to be explored with the Registrant.
7.The Registrant explained to the Panel that she wished to draw a line and ideally to remove herself from the Register. She said that she would like to apologise for not engaging with the HCPC for a considerable length of time. She accepted that the onus was entirely on her to have engaged, but the proceedings had been stressful and her health had been a factor.
8.The Panel heard and accepted the advice of the Legal Assessor. The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired, and if it was, what action to take in respect of sanction.
9.This reviewing Panel, like the previous substantive and reviewing panels, had no evidence of remediation or insight in respect of the Registrant’s lack of competence. Accordingly, the Panel is of the view that the risks identified by the previous panels remain. Consequently, it was of the view that the Registrant’s fitness to practise remains impaired on the grounds of both public protection and the wider public interest in maintaining public confidence in the profession and upholding standards.
10.The Panel acknowledged that what had changed since the last review was that the Registrant had re-engaged with the HCPC and had apologised and taken responsibility for her lack of previous engagement. She had taken initial steps to explore with the HCPC an alternative route for being removed from the Register.
11.In relation to sanction, the Panel considered that the options of taking no action or imposing a Caution Order were not appropriate. Neither would address the risks identified in respect of public protection, and the case was too serious to be addressed in that way.
12.The Panel considered a Conditions of Practice Order. It was of the view that it was not possible to formulate workable conditions which would address the wide ranging issues of public protection or meet the wider public interest. It noted that the Registrant had indicated that she did not intend to practise again.
13.The Panel went on to consider whether a further period of suspension would be the appropriate sanction in this case. It was satisfied that such an order would continue to protect the public. The Panel went on to ask itself whether such an order would satisfy the need to maintain public confidence in the profession and to uphold professional standards. The Panel was mindful that until yesterday (12 September 2019), there had been no engagement from the Registrant since March 2018.
14.The Panel was encouraged that the Registrant had re-engaged, and that she wanted to explore with the HCPC whether the case would be suitable for voluntary removal from the Register. The Panel acknowledged that this was a process which would require continued engagement by the Registrant, and an assessment by the HCPC as to whether it considered the case to be suitable for voluntary removal. If the case was deemed suitable, then that assessment would be scrutinised by an independent panel of the HCPTS who would make the final decision.
15.The Panel was satisfied that a further period of suspension would meet the wider public interest, in light of the Registrant’s recent re-engagement, as the public protection issues in this case. It considered that it was appropriate and proportionate to extend the Suspension Order by a further six months in order to allow the process of exploring voluntary removal to be carried out. It noted that in the event that voluntary removal was not deemed suitable, this Order would be reviewed prior to its expiry, when all options would be available to the reviewing panel.
Order
The Panel decided to extend the order for a further 6 months.
Notes
No notes available
Hearing History
History of Hearings for Mrs Cavel Callender
Date | Panel | Hearing type | Outcomes / Status |
---|---|---|---|
16/01/2020 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |
13/09/2019 | Conduct and Competence Committee | Review Hearing | Suspended |