Aparna Srivastava
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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 |
|---|---|---|---|
| 22/08/2023 | Conduct and Competence Committee | Final Hearing | Conditions of Practice |
| 10/01/2023 | Conduct and Competence Committee | Final Hearing | Adjourned part heard |
| 08/02/2022 | Conduct and Competence Committee | Final Hearing | Adjourned |