Mr Andrew J MacFarlane
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Whilst registered with the Health and Care Professions Council as a Chiropodist and during the course of your employment with Central London Community Healthcare NHS Trust, you:
- Subsequent to your 26 October 2016 operation on Patient C, promised to send Patient C and her husband photographs of the affected joints, and you:
- a) Sent them photographs of another patient’s foot;
- b) Did not Datix this data breach.
- You undertook 9 supervised assessments, and:
- a) On 18 October 2017, you:
- i) Did not spot that the first patient treated was incorrectly listed on CERNER;
- ii) Did not follow procedure in that you brought equipment to the theatre yourself;
iii) Allowed the anaesthetic block to proceed without column 1 of the WHO checklist having been completed;
- iv) Did not obtain an MRSA result prior to surgery.
- b) On 1 November 2017, you:
- i) Did not provide staff with safety advice in relation to the use of phenol;
- ii) Were inconsistent when directing the 2nd column of the WHO checklist.
- c) On 10 January 2018, you:
- i) Did not record intra-operative observations for the duration of the procedure carried out on your first patient;
- ii) Did not observe a potential break in the sterility of the surgical trolley;
iii) Allowed the scrub nurse and her circulator to disperse before the WHO checklist had been finalised for your second patient.
- d) On 17 January 2018, in relation to your second patient, you:
- i) Did not recognise that their blood pressure was at an unacceptable level for surgery to take place;
- ii) Began the WHO checklist before all theatre staff were present;
iii) Did not direct nursing staff to take sufficiently regular blood pressure readings;
- iv) Did not follow the supervisor’s instructions.
- e) On 31 January 2018, you:
- i) Did not adequately control theatre staff;
- ii) Allowed nurses to remove the drapes too early before the patient’s toe had reperfused.
- f) On 7 February 2018, you:
- i) Did not ensure that a patient’s blood pressure and SPO2 and pulse was recorded on the observation chart.
- g) On 28 February 2018, you:
- i) Dispensed oral antibiotic prophylaxis to a patient less than one hour prior to incision;
- ii) Did not ensure that the antibiotic was written on the ‘once only drug chart’.
- The matters set out at particulars 1 and 2 amount to misconduct and/or lack of competence.
- By reason of your misconduct and/or lack of competence, your fitness to practice is impaired.
Application to adjourn:
1. At the outset of the hearing, Ms Constantine for the HCPC applied to adjourn the hearing on grounds that the HCPC needed further time to consider:
(i) whether it needed to take supplementary statements on (a) an expert report (11 pages) and (b) the Registrant’s statement and his exhibits (around 100 pages) which were served on his behalf at about 11.30 am on 8 January 2021,
(ii) whether it needed to re-instruct an expert of its own, and
(iii) to obtain the clinical notes requested by the Registrant relating to one patient, which show blood pressure readings taken during a surgical procedure.
2. Ms Constantine explained that its witness, EBK would need to be seen and that he had only limited availability this week. Further the case lawyer was unavailable to take any supplementary statements that might be needed from EBK today. She also indicated that until the case lawyer had seen EBK, it would not be known if the HCPC needed to reinstruct its expert. Ms Constantine outlined the attempts made by the HCPC to obtain the clinical notes requested by the Registrant and indicated that it hoped these would be available in due course.
3. Mr Partridge for the Registrant opposed the application to adjourn. He apologised for the late service of the Registrant’s bundle of documents. He explained that part of the delay was due to the Registrant being unavoidably unavailable for a short period at the end of November and after the HCPC papers had been served. Mr Partridge explained that the Registrant’s main exhibit consisted of EBK’s original supervision notes. Mr Partridge stated that these were, in some respects, different to the supervision notes produced by EBK in his witness statement. Mr Partridge also submitted that the time estimate for the hearing was a generous one and that it should be possible to obtain the necessary further supplementary statements and still conclude the case within the allotted time.
4. The Panel has considered the application to adjourn with care and has had in mind the HCPTS Practice Note on Postponement and Adjournment of Proceedings. It has received and accepted legal advice.
5. The Panel notes the late service of documents by the Registrant. Whilst it considers this to be regrettable, it accepts that the Registrant had good reasons for not being available for a short period at the end of November 2020. The Panel is satisfied that HCPC has clearly not had sufficient time to fully prepare its case in light of the new documentation, which includes an expert’s report. The Panel has considered the general need for expedition in the conduct of proceedings and has balanced the interests of the Registrant to have his case heard at the appointed time with the public interest. This case involves allegations relating to the Registrant’s clinical competence and the Panel is satisfied that it would be prejudicial to the public interest if it did not adjourn the case today. The Panel has had in mind that the over-arching objective of these proceedings is the protection of the public, as well as maintaining public confidence in the Chiropodist profession and in its regulatory process. It is satisfied that a reasonable and informed member of the public would be concerned in a case which raises issues of clinical competence, if one of the parties to the proceedings, through no fault of its own, did not have sufficient time to fully prepare its case.
6. Accordingly, the Panel has decided to grant the HCPC’s application to adjourn this case.
Virtual hearing of the conduct and competence committee due to take place from 11-15 January 2021 at 10:00am on day 1 and 09.30 am between days 2-5.
History of Hearings for Mr Andrew J MacFarlane
|Date||Panel||Hearing type||Outcomes / Status|
|11/01/2021||Conduct and Competence Committee||Final Hearing||Adjourned|