Aparna Srivastava

Profession: Dietitian

Registration Number: DT07126

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 08/02/2022 End: 17:00 11/02/2022

Location: This hearing will be held virtually

Panel: Conduct and Competence Committee
Outcome: Adjourned

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Allegation

The allegation:

As a registered Dietitian (DT07126) your fitness to practise is impaired by reason of misconduct and/or lack of competence. In that:

1. While working as a locum Dietitian for City Health Care Partnership (CHCP) between 20 November 2017 and 9 February 2018, you did not:

a. Enter names and/or NHS number on records completed for patients listed in Schedule A
b. Record clinical reasoning and/or evidence base for food and drink recommended to patients in Schedule B.
c. Record clinical reasoning and/or evidence base for recommending chewing food 32 times to patients listed in Schedule C.

2. You recommended using specific shops and/ or brands to the patients listed in Schedule D, without providing clinical reasoning for doing so.

3. You recommended that Patient 69 listen to Classic FM “first thing in the morning and last thing at night” with no explanation or clinical reasoning for doing so.

4. You recommended that Patient 48 listen to Pandit Hariprasad Chaurasia flute music with no explanation or clinical reasoning for doing so.

5. You recommended that Patient 128, who was 91 years old and suffering from Parkinson’s Disease, “try Sahaj Yoga” with no explanation or clinical reasoning for doing so.

6. You sent a Whatsapp message to Colleague A on 3 February 2018 stating words to the effect that:

a. cancer does not spread without sugar and will die on its own without sugar;
b. taking a full lime in warm water is 1000 times more effective than chemotherapy; and
c. taking three spoons of organic or virgin coconut oil in the early morning will keep cancer at bay.

7. The recommendations made at particular 6 (a), (b) and (c) were not clinically justified.

8. The matters set out in particulars 6 and 7 constitute misconduct.

9. The matters set out in particulars 1, 2, 3, 4 and 5 above constitute misconduct and/or a lack of competence.

10. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Schedules

Schedule A

1. Patient 12

2. Patient 14

3. Patient 15

4. Patient 16

5. Patient 19

6. Patient 25

7. Patient 26

8. Patient 43

9. Patient 44

10. Patient 73 a

11. Patient 73 b

12. Patient 77

13. Patient 83

14. Patient 95

15. Patient 101

16. Patient 107

17. Patient 108

18. Patient 112

19. Patient 113

 

Schedule B

1. Patient 1

2. Patient 4

3. Patient 6

4. Patient 7

5. Patient 9

6. Patient 10

7. Patient 17

8. Patient 18

9. Patient 20

10. Patient 25

11. Patient 26

12. Patient 27

13. Patient 29

14. Patient 31

15. Patient 32

16. Patient 33

17. Patient 35

18. Patient 39

19. Patient 41

20. Patient 42

21. Patient 43 a

22. Patient 43 b

23. Patient 48

24. Patient 49

25. Patient 51

26. Patient 52

27. Patient 55

28. Patient 56

29. Patient 57

30. Patient 59

31. Patient 61

32. Patient 63

33. Patient 64

34. Patient 65

35. Patient 68

36. Patient 69

37. Patient 70

38. Patient 71

39. Patient 72

40. Patient 73

41. Patient 74

42. Patient 75

43. Patient 76

44. Patient 77

45. Patient 78

46. Patient 80

47. Patient 81

48. Patient 85

49. Patient 87

50. Patient 88

51. Patient 89

52. Patient 90

53. Patient 91

54. Patient 93

55. Patient 94

56. Patient 95

57. Patient 98

58. Patient 102

59. Patient 103

60. Patient 106

61. Patient 107

62. Patient 109

63. Patient 111

64. Patient 113

65. Patient 116

66. Patient 121

67. Patient 124

68. Patient 125

69. Patient 126

70. Patient 127

71. Patient 128

72. Patient 130

73. Patient 135

74. Patient 138

75. Patient 139

76. Patient 140

77. Patient 141

78. Patient 143

 

Schedule C

1. Patient 17

2. Patient 20

3. Patient 27

4. Patient 39

5. Patient 55

6. Patient 59

7. Patient 63

8. Patient 65

9. Patient 69

10. Patient 72

11. Patient 85

12. Patient 86

13. Patient 87

14. Patient 90

15. Patient 113

16. Patient 124

 

Schedule D

1. Patient 7

2. Patient 18

3. Patient 29

4. Patient 41

5. Patient 60

6. Patient 61

7. Patient 62

8. Patient 81

9. Patient 86

10. Patient 91

11. Patient 94

12. Patient 108

13. Patient 109

14. Patient 110

15. Patient 111

16. Patient 116

17. Patient 121

18. Patient 140

19. Patient 142

Finding

Preliminary Matters

Application to Adjourn by the Registrant

1. The application was heard in private due to the health issues arising. The Panel heard from Ms McCullough for the Registrant who made an application to adjourn the hearing. She referred the Panel to the bundle of 18 pages submitted in support of the application.

2. Ms McCullough referred to the factors in CPS v Picton and accepted that adjournment was an exceptional step. She asked the Panel to consider those factors and agreed that expedition was an important issue. However, she submitted that the Registrant has a medical condition.

3. Ms McCullough submitted that her client will not be able to participate for most of the hearing, if it proceeds. She submitted that this was a document heavy matter and the restricted level of participation by the Registrant would possibly prejudice her position. Even with short hearing days it may not be possible for the Registrant to participate.

4. Ms McCullough told the Panel about the Registrant’s medical conditions and that she was awaiting an appointment with a new Consultant who will provide a detailed prognosis which will deal with the Registrant’s ability to participate in a final hearing.

5. Ms McCullough submitted therefore, that it would be very difficult for the Registrant to effectively participate in this hearing. She sought to adjourn and delay the hearing until after the 28 February 2022. That would hopefully allow a medical report to be obtained. Ms McCullough submitted that even with her support as Counsel, the Registrant would still find it difficult to effectively participate in the hearing. In response to a question from the Panel, Ms McCullough added that she felt that her ability to adequately represent her client was compromised by her client’s medical presentation.

6. The HCPC had no objection to the adjournment and remained neutral. Ms Constantine submitted that more information had been received since the application to adjourn made last week.

7. The Legal Assessor referred the Panel to the important guidance in the HCPTS Practice Note on Postponement and Adjournment of Proceedings. He reminded the Panel to consider the factors in CPS v Picton [2006] EWHC 1108 which include the need to consider and balance the interests of the Registrant with the public interest. A crucial factor in the Panel’s decision is that the Registrant is entitled to a fair hearing.

Decision on Adjournment

8. The Panel considered the documentation before it and the submissions from Ms McCullough. The HCPC remained neutral on the application. The Panel was mindful of the Practice Note, of the need for expedition and the public interest. It was also mindful of the Registrant’s fundamental entitlement to a fair hearing. The Panel has considered all the information before it, which includes details of the Registrant’s health and upcoming medical appointments.

9. The Registrant suffers from a serious medical condition for which she is currently receiving treatment and taking medication. Ms McCullough submitted that, even with some adjustments, such as shorter hearing days, the Registrant will not be able to be effectively participate in the hearing due to her medical condition. Ms McCullough submitted that her ability to represent her client is compromised by her client's significant health problems.

10. The Panel was mindful of the public interest in expedition and the other factors in Picton. The Registrant has serious medical conditions that currently appear to significantly impact on her ability to effectively participate in this hearing. Her Counsel, Ms McCullough submitted that, even with adjustments made, she as Counsel will not be able to fully represent the Registrant given the health issues that arise. The Registrant’s ability to effectively participate in this hearing is crucial to her entitlement to a fair hearing.

11. The Panel concluded that, in these circumstances, the Registrant’s interests outweigh the public interest and the need for expedition. The Panel decided that the Registrant’s health issues significantly undermine on her ability to effectively participate in this hearing, even with the support of her legal representative.

12. The Panel concluded that it would be unfair in these circumstances to proceed with the hearing and it grants the application to adjourn.

Interim Order

13. Mindful of the public interest, the Panel raised of its own volition the issue of a possible interim order. Ms Constantine for the HCPC applied for an interim conditions of practice order for 12 months, primarily for the protection of the public, but also in the public interest and the Registrant’s own interests.

14. Ms Constantine advised that the Registrant is not currently working due to her health. She sought that the Panel impose two interim conditions of practice that would serve to protect the public:-

• For the Registrant to inform the HCPC when she is due to return to work as a Dietitian;
• Keep the HCPC informed of her ongoing medical condition, prognosis and its effect on her ability to work as a Dietitian.

15. Ms McCullough for the Registrant submitted that the interim conditions suggested by the HCPC were sufficient and proportionate in the circumstances. She confirmed that the Registrant was not currently working or employed as a Dietitian.

Decision on interim order

16. The Panel accepted the advice of the Legal Assessor who reminded it to consider the HCPTS Practice Note on interim orders. It must make no findings of fact but consider the overall nature, weight, cogency and source of all the information before it. The Panel should conduct a risk assessment and it may impose an interim order only if it is satisfied that it is necessary to do so for the protection of the public, is otherwise in the public interest, or is in the Registrant’s own interests. The Legal Assessor reminded the Panel of the need to act proportionately.

17. The Panel carefully considered all of the documentation before it and the submissions from both parties. The evidence is largely documentary and it comes from the records of the former employer and from a former colleague. The Panel decided that the information before it was sufficiently detailed, credible and cogent and that there was a prima facie case for an interim order.

18. The allegation is serious. The allegation raises wide-ranging concerns about the Registrant’s professional practice which cover a significant number of service users and had the potential to cause harm. The Panel decided that in the circumstances there was risk of repetition and that an interim order was necessary to protect the public.

19. The Panel also decided in light of the gravity and nature of the allegation, that an interim order was appropriate to maintain public confidence in the profession and uphold proper professional standards. Given the health issues now arising, the Panel further decided that an interim order was in the interests of the Registrant.

20. The Panel was mindful that the current allegation does not concern the Registrant’s health, but that there are now additional, serious health issues that arise, which have resulted in the Registrant being currently unable to effectively participate in the final hearing. That is information that the Panel are now bound to take account of when conducting the required risk assessment and deciding whether to impose an interim order.

21. The Panel first considered interim conditions of practice. The Panel are advised that the Registrant is presently unable to work in her professional role due to her health issues, and she is not working and is not currently employed as a Dietitian. The Panel considered both the allegation and the additional health issues which now arise. It considered whether, in these circumstances, it was able to devise realistic, workable and proportionate interim conditions which would sufficiently deal with the totality of the risks now apparent. It considered the level of restriction that would be required to sufficiently protect the public and what would be in the Registrant’s own interests.

22. The Panel concluded that in order protect the public and deal with the Registrant’s serious health conditions, a significant level of restriction would require to put in place around the Registrant’s professional practice. It concluded that such a level of restriction would be tantamount to a suspension. It decided, given the serious allegation coupled with the health issues now arising, that it was not able to devise realistic, workable and proportionate interim conditions of practice.

23. The Panel concluded that it was appropriate and proportionate in this case to impose a 12 month interim suspension order. That order serves to protect the public and, in light of the Registrant’s serious health conditions, is also in the Registrant’s own interests. 12 months is appropriate given the detailed health information that is still to be obtained as well the rescheduling of the final hearing.

24. The Panel recognises that if the Registrant’s health improves and/or is better understood, she is entitled to seek an early review of this interim order in light of that change in circumstances. The Panel would encourage the Registrant to continue to engage with the HCPC and to keep it informed about her health conditions.

Order

The Registrar is directed to suspend the name of Ms Aparna Srivastava from the Register on an interim basis order for a period of 12 months.

Notes

This hearing has adjourned, with no evidence heard. The date for the rescheduled hearing is to be confirmed.

The Order will be reviewed no later than 8 August 2022.

Hearing History

History of Hearings for Aparna Srivastava

Date Panel Hearing type Outcomes / Status
13/07/2022 Conduct and Competence Committee Interim Order Review Hearing has not yet been held
08/02/2022 Conduct and Competence Committee Final Hearing Adjourned
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