HCPTS |

Profession: Dietitian

Registration Number: DT09173

Hearing Type: Voluntary Removal Agreement

Date and Time of hearing: 10:00 29/05/2020 End: 17:00 29/05/2020

Location: Hearing took place virtually

Panel: Conduct and Competence Committee

Outcome: Voluntary Removal agreed

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Allegation

Whilst employed by East Lancashire Hospitals NHS Trust, and registered
with the Health and Care Profession Council (HCPC) as a Dietician,
between in or around February 2016 and in or around May 2017, you;

1. In relation to Service User A;
a. Did not review Service User A as required and/or expected
b. Inappropriately discharged Service User A
c. Did not notify Service A appropriately and/or at all of his
discharge

2. You inappropriately carried out telephone assessments and/or
reviews in relation to;
a. Service User B
b. Service User D
c. Service User F

3. In relation to Service User C;
a. Recorded that you had seen Service User C when that was
not the case
b. Inappropriately discharged Service User C

4. In relation to Service User D;
a. Did not arrange a review for Service User D as required
b. Sent a copy of the original treatment plan to the referrer

5. In relation to Service User E you failed to carry out an urgent
home visit as requested by the integrated neighbourhood
co-ordinator

6. In relation to Service User G;
a. Failed to appropriately acknowledge and/or respond to the
Service Users report that she was drinking soya milk
b. Inappropriately offered Service User G;
i. a pint of full cream milk
ii. milk based supplements
c. failed to ask Service User G if she had an allergy

7. Incorrectly calculated feedings requirements in relation to;
a. Service User H;
b. Service User I
c. Service User J

8. In relation to Service User K, you assessed a patient for an
enteral feed and;
a. Failed to notice and/or ascertain that Service User K was
prescribed Phenytoin
b. Failed to notice that the Service User required a feeding
break to prevent drug nutrient interaction

9. In relation to Service user L, a diabetic patient;
a. Failed to identify and/or document that Service User L;
i. had raised blood glucose
ii. had been commenced on insulin
b. Failed to take into account the factors above when devising
the dietetic plan

10. In relation to Service User M, a diabetic patient;
a. Incorrectly advised the Service User that she should not be
eating cheese as a snack
b. Did not provide appropriate advice regarding suitable drinks

11. Inappropriately advised Service User N, who was on
palliative treatment, that the objective for dietetic involvement was
weight and strength gain

12. In respect of Service User O, offered her scrambled egg
and/or custard despite;
a. Service User O’s medical notes making clear she had an
egg allergy
b. Discussing Service User O’s egg allergy with your manager
prior to the assessment

13. Your actions at paragraphs 1 to 12 above amount to lack of
competence and/or misconduct

14. As a result of that lack of competence and/or misconduct
your fitness to practise is impaired.

Finding

Preliminary Matters

Notice of Hearing

1. Due to the current Covid-19 crisis and the Government’s advice in response to it, the Committee met to consider this matter via remote conferencing facilities.

2. The Registrant was sent a Notice of Hearing by post on 28 February 2020. Due to the Covid-19 situation, she was subsequently sent an Amended Notice of Hearing by email on 24 April 2020. The Panel was satisfied that the date of the Amended Notice of Hearing falls within the statutory time limit of 28 days under Rule 6(2) of the HCPC Conduct and Competence Committee (Procedure) Rules 2003, (“the Rules”), and also provides the day, time and venue, as required by Rule 6(1) of the Rules. The Panel noted that Rule 3 (2) ordinarily requires that the Notice of Hearing should be sent by post but the Panel was satisfied that email communication is an appropriate and necessary method of communication due to the current Covid-19 situation. The Panel also noted that the Registrant has replied to the email containing the Amended Notice of Hearing on 24 April 2020 and had therefore clearly received it.

3. For the above reasons, the Panel has determined that there is good service of the Notice of Hearing.

Proceeding in Absence

4. The Panel heard and accepted the advice of the Legal Assessor.

5. Whilst the Panel is aware that a decision to proceed in the absence of the Registrant is one to be taken with great care and caution, the Panel has decided to exercise its discretion to proceed in the absence of the Registrant in accordance with Rule 11 of the Rules.

6. In reaching its decision, the Panel had regard to the following matters:

• Service of the appropriate notice of this hearing has been properly effected.

• The Registrant has not applied for an adjournment or sought to object to this hearing proceeding in her absence. In her email to the HCPC dated 24 April 2020 she stated “I do not wish to participate in any way as stated previously... I have wanted to be removed from the HCPC register for over 2 years as I did not wish to ever practise as a dietitian again.” The Panel noted that the Registrant had replied in similar terms to the Notice of Hearing sent to her by email and post in February 2020.

• The Registrant was fully aware of this hearing and had made an informed decision not to attend.

• The Registrant has engaged with the HCPC in relation to this matter and this is a hearing of the Registrant’s own application for Voluntary Removal from the Register.

• The HCPC consents to the Registrant’s Voluntary Removal from the Register.

• There would be no prejudice or unfairness to the Registrant if the hearing proceeds today.

• There is a public interest with the matter proceeding expeditiously.

Hearing in Private

7. The Panel noted that the content of the Registrant’s email dated 24 April 2020 and other parts of the material in the hearing bundle touched upon her health and private life.

8. Ms Simpson for the HCPC submitted that those parts of the hearing should be held in private.

9. The Panel accepted the advice of the Legal Assessor who referred it to Rule 10(1)(a) of the Rules.

10. The Panel decided that those parts of the hearing that concern the Registrant's health and private life should be private and reflected as such in the published determination.

Background (Taken From HCPC Skeleton Argument)

11. The Registrant is a registered Dietitian. She was employed as Band 7 Dietitian with East Lancashire NHS Trust.

12. In 2016, performance concerns in respect of the Registrant were raised by staff at the Trust and complaints were also received from patients. In August 2016, before these concerns could be investigated, the Registrant went on leave. She returned to work in January 2017. However, despite having her banding reduced and moving to a different team within the department and having a phased return to work, she was unable to manage her caseload independently. A formal performance management process was commenced in April 2017.

13. Upon the Registrant’s return, a capability hearing was convened and she was dismissed from her role. Tracey Hugill, Head of Dietetics and Orthotics for the Trust, subsequently submitted a fitness to practise concern to the HCPC.

14. On 16 January 2019, a Panel of the Investigating Committee determined that there was a case to answer against the Registrant.

15. Prior to the Case to Answer Decision of 16 January 2019, the Registrant emailed on two occasions, advising:

i. 24 August 2018: “I am not practicing as a Dietitian and have not done so since leaving my job with the NHS in April 2018… I did not submit the application to register with the HCPC in June 2018 and ceased to pay registration fees. Therefore, my name should not be on the register and I do not understand why it is”.

ii. 12 October 2018: “Can you please tell me why I have been registered with the HCPC when I did not complete the form to re-register and I have not paid any subscriptions and cancelled my direct debit for subscriptions in May 2018. I have not practiced as a dietitian since leaving the NHS and do not wish to do so…I have worked as a care worker since leaving the NHS at the end of April 2018”.

16. The Health Professions Order 2001 precludes a Registrant from removing themselves from the Register, or for their registration to lapse (by way of non-payment, for example) whilst they are the subject of a Fitness to Practise investigation. It is, however, possible for a Registrant to apply to a Panel of the Conduct and Competence or Health Committees for Voluntary Removal, on agreement with the HCPC. This can only be done once the Investigating Committee has concluded there is a case to answer.

17. Following the Investigating Committee Panel decision, the Registrant emailed again, on 06 May 2019, requesting “please take my name off the HCPC register and leave me alone”.

18. On receipt of this email, the HCPC reviewed the case and considered the circumstances suitable for disposal by way of a Voluntary Removal Agreement. The Registrant was therefore sent an email on 22 May 2019. This email explained the process by which a voluntary removal application can be made. It explained that the Registrant would have to admit the Allegation against her, and that her fitness to practise is currently impaired.

19. The Registrant responded the following day, advising “I will agree to all of the attached allegations if it means that I will be taken off the register and there will be an end to this continuous harassment. I did not want to register as I had no intention of practicing as a dietitian. I am no longer fit to practise after almost two years of not working as a dietitian… Please take me off the HCPC register and allow me to get on with my life”.

20. On 23 October 2019, the Registrant was advised that the HCPC cannot guarantee, if the Registrant admits the allegations, that the HCPC will approve the VRA. It was explained to her that the decision will ultimately be one for an independent Panel to decide, whether or not to approve the application for voluntary removal. She was provided with further information as to the process of VRA and sent the Practice Note which explains this means of disposal in detail. She was also told that a VRA has a similar effect to a striking off order. The Registrant asked to confirm her position in respect of disposing of her case by means of voluntary removal.

21. The Registrant emailed further, on 23 October 2019, stating “Please consider my application for VRA as I have asked to be removed from the HCPC Register for over 18 morths [sic], I did not apply to renew my registration and do not intend to practise as a Dietitian ever again, I am unfit to practise and will agree to all of the allegations made about me…”.

22. The HCPC agreed that this case was suitable for disposal by way of Voluntary Removal from the Register, and the Registrant was advised that this hearing would be listed in order to determine the application. The Registrant confirmed again by email on 20 January 2020 that she wished to be voluntarily removed from the HCPC Register; has not practiced as a Dietitian since being dismissed in April 2018; did not apply to be registered as she is unfit to practise; and does not intend to practise as a Dietitian again.

23. The Registrant was sent the Voluntary Removal Agreement to sign. A signed copy has now been provided. Having signed it, the Registrant thereby again admits the Allegation, accepts that her fitness to practise is impaired, and confirms that she has no intention of returning to practice.

HCPC Submissions (Taken From HCPC Skeleton Argument)

24. The HCPC submits that, in all the circumstances, voluntary removal from the Register would be an appropriate means of resolving the current matter.

25. Given voluntary removal is equivalent in effect to a strike-off, the HCPC submits that the necessary public protection would be ensured by this course of action.

26. The HCPC also submits that it would not be detrimental to the wider public interest to dispose of this matter by way of voluntary removal. It is submitted that this case does not raise concerns in regards to the wider public interest to such an extent that the matter must be disposed of at a final hearing. The HCPC reiterates that the Registrant has admitted the substance of the allegations and that voluntary removal from the register will have the same effect as a strike-off. It is submitted that these factors are sufficient to maintain public confidence in the profession and to declare and uphold proper standards of behaviour.

27. It is therefore submitted that the Voluntary Removal Agreement is an appropriate and expeditious way of dealing with this matter and the HCPC respectfully invites the Panel to approve the proposed agreement.

Decision

28. The Panel considered the all of the material before it including the main evidence bundle, the HCPC Skeleton Argument in support of the Voluntary Removal Agreement (“the VRA”), the email exchange between the Registrant and the HCPC and the signed copy of the VRA.

29. The Panel also had regard to Ms Simpson’s oral submission to the Panel today in which she adopted the content of her skeleton argument. She confirmed that the HCPC was satisfied that the Registrant fully understood the effect of the Voluntary Removal Agreement and that granting the application would not compromise the protection of the public or have any detrimental effect on the wider public interest.

30. The Panel accepted the advice of the Legal Assessor and had careful regard to the content of the HCPTS Practice Note on Disposal of Cases by Consent. The Panel had particular regard to the following part of the Practice Note:

“In cases where the HCPC is satisfied that it would be adequately protecting the public if the Registrant was permitted to resign from the Register it may enter into a Voluntary Removal Agreement allowing the registrant to do so, but on similar terms to those which would apply if the registrant had been struck off.”

31. The Panel noted the content of the Registrant’s written and email correspondence with the HCPC over the last 2 years in which she repeatedly stated that she no longer wanted to practise as a Dietitian and wanted to be removed from the Register. The Panel was therefore satisfied that this was a considered and informed decision on the part of the Registrant.

32. The Panel noted from the documents that the Investigating Committee had concluded that there was a case to answer, and that the Registrant has admitted the Allegation as part of the VRA. The Registrant has also signed a Declaration that there was no other matter of which the Registrant was aware which might give rise to any other allegation.

33. The Panel was mindful of its overarching objective of protection of the public and the public interest.

34. The Panel therefore considered whether there were any factors that would make it undesirable to allow the allegation to be concluded on the consensual basis set out in the VRA. The Panel was satisfied that the public would be adequately protected if this Allegation were withdrawn and the Registrant permitted to have her name removed from the Register and leave the Dietetic profession in accordance with the terms of the VRA. The Panel was also satisfied that there are no overriding public interest factors that would require this matter to go to a full substantive hearing.

35. The Panel is aware that if the Registrant seeks to return to the HCPC Register at any time in the future, her application would be treated as if she had been struck off as a result of the Allegation.

36. The Panel is satisfied that this means of disposal of this case is appropriate and proportionate, and is jointly in the interests of the public, the HCPC and the Registrant.

37. Accordingly, the Panel approves the Voluntary Removal Agreement and the withdrawal of the allegation and discontinuance of those proceedings.

Order

ORDER: The Registrar is directed to remove the name of Suzann J Connah from the Dietetic part of the HCPC Register with immediate effect.

Notes

No notes available

Hearing History

History of Hearings for Ms Suzann J Connah

Date	Panel	Hearing type	Outcomes / Status
29/05/2020	Conduct and Competence Committee	Voluntary Removal Agreement	Voluntary Removal agreed