Holly Tetlow
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Allegation
As a registered Occupational Therapist (OT76472) your fitness to practise is impaired by reason of your misconduct and/or lack of competence. In that;
1. Between 12 July 2018 and 26 October 2018, in relation to Patient A, you;
a) Did not fully assess and/or document your assessment of Patient A’s toileting requirements
b) Did not provide Patient A with the appropriate equipment for discharge home
2. Between 14 June 2018 and 27 July 2018, in relation to Patient B, you;
a) Did not complete follow up actions until prompted in supervision
b) Did not maintain adequate records
c) Did not demonstrate adequate clinical reasoning
3. Between 20 July 2018 and 3 October 2018, in relation to Patient C, you;
a) Did not maintain adequate records
b) Did not demonstrate adequate clinical reasoning
c) Did not complete follow up actions until prompted in supervision
4. Between 20 July 2018 and 3 October 2018, in relation to Patient D, you;
a) Did not maintain adequate records
b) Did not demonstrate adequate clinical reasoning
c) Did not complete follow up actions until prompted in supervision
5. Between 9 October 2018 and 7 November 2018, in relation to Patient E, you;
a) Did not maintain adequate records
b) Did not effectively communicate with others involved in Patient E’s care and/or Patient E
c) Did not complete follow up actions until prompted in supervision
d) Were unable to carry out therapeutic interventions without prompting
e) Demonstrated a lack of knowledge in the area of moving and handling
6. Between 19 October 18 to 14 November 2018, in relation to Patient F, you;
a) Did not demonstrate adequate clinical reasoning
b) Did not maintain adequate records
c) Were unable to carry out therapeutic interventions
d) Did not effectively communicate with others involved in Patient F’s care and/or Patient F
7. Between 10 November 2018 to 23 November 2018, in relation to Patient G, you
a) Did not effectively communicate with others involved in Patient G’s care and/ or Patient G
b) Were unable to carry out therapeutic interventions and/or assessments without prompting
c) Were unable to complete appropriate discharge planning
d) Did not demonstrate adequate clinical reasoning
e) Did not maintain adequate records
8. Between 24 January 2019 to 18 February 2019, in relation to Patient H, you
a) Were unable to carry out therapeutic interventions and/or assessments without prompting
b) Did not maintain adequate records
c) Did not effectively communicate with others involved in Patient H’s care and/ or Patient H
d) Did not demonstrate adequate clinical reasoning
9. Between 31 January 2019 to 6 March 2019, in relation to Patient I, you
a) Were unable to carry out therapeutic interventions and/or assessments without prompting
b) Did not demonstrate adequate clinical reasoning
c) Did not request assistance when practising outside of knowledge area
d) Did not effectively communicate with Patient I
e) Did not maintain adequate records
f) Demonstrated a lack of knowledge in the areas of posture and positioning during use of rotunda
10. Between 5 February 2019 and 1 March 2019, in relation to Patient J, you
a) Were unable to carry out therapeutic interventions and/or assessments without prompting
b) Did not request assistance when practising outside of knowledge area
c) Did not maintain adequate records
11. Between 6 February 2019 and 22 February 2019, in relation to Patient K, you
a) Were unable to carry out therapeutic interventions and/or assessments without prompting
b) Did not demonstrate adequate clinical reasoning
12. Your actions in paragraphs 1-11 constitute misconduct and/or a lack of competence
13. By reason of your lack of competence your fitness to practice is impaired.
Finding
Preliminary Matters
Service
1.The Panel was satisfied that the notice of hearing dated 30 January 2024 was sent to the Registrant’s registered email address, that it contained sufficient information as to the purpose of today’s hearing, with guidance as to how to attend the virtual hearing and that in all the circumstances the notice had been sent sufficiently in advance of the hearing. Therefore, there had been adequate service.
Proceeding in Absence
2. Ms Sampson applied for the hearing to proceed in the absence of the Registrant. She referred to the Registrant’s email dated 2 February 2024 in which the Registrant stated that she would not be attending the hearing because she would be at work. Ms Sampson submitted that it would be fair in all the circumstances for the hearing to proceed in the absence of the Registrant. The Panel received advice from the Legal Assessor, which it accepted.
3. The Panel decided that it would be fair to proceed in the absence of the Registrant. The Registrant supported the HCPC’s application for her voluntary removal from the Register, was aware of today’s hearing, had made no application to postpone it and decided not to attend.
Decision on Application
4. A bundle of documents was placed before the Panel on behalf of the HCPC. The Panel received written and oral submissions from Ms Sampson on behalf of the HCPC and there were no further written representations from the Registrant in support of the application. The Panel received advice from the Legal Assessor, which it accepted.
5. There is no dispute as to the facts and circumstances relevant to this application.
6. The Registrant is a registered Occupational Therapist. At the material time, the Registrant was employed as a Band 5 Occupational Therapist for the Solent NHS Trust (“the Trust”). She had been employed in that capacity as a Rotational Occupational Therapist from 1 December 2017, that being her first employment after qualification.
7. The Registrant initially worked in the Community Team, but on 14 May 2018 she moved to work on the Spinnaker Ward. Concerns about the Registrant’s performance arose following that move and formed the basis of a referral to the HCPC. The Registrant’s employment with the Trust ended in early April 2019.
8. The Spinnaker Ward was an inpatient rehabilitation ward for older people. At the time that the Registrant worked on the ward, there were sixteen beds, and the average length of stay was three weeks. An Occupational Therapist working on the ward would have had a caseload of approximately six patients, and the Occupational Therapists were responsible for a variety of assessments and interventions to support patients. They were expected to work alongside a full multi-disciplinary team (“MDT”) to develop an onward plan for the patients included in their caseload.
9. The concerns about the Registrant arose from shortcomings in her performance with relation to eleven patients who were on the Spinnaker Ward during the time that the Registrant worked there.
10. Following the referral to the HCPC, a final hearing of the case took place between 10-16 February 2022, before a panel of the Conduct and Competence Committee. The Allegation considered by that panel was that set out above.
11. The concerns raised by the Allegation included:
⦁ not fully assessing and/or documenting assessments of patient requirements;
⦁ not providing appropriate equipment for patient discharge home;
⦁ not maintaining adequate records;
⦁ not demonstrating adequate clinical reasoning;
⦁ not effectively communicating with others involved in patient care and/or patients;
⦁ not completing follow up actions until prompted in supervision;
⦁ inability to carry out therapeutic interventions without prompting;
⦁ inability to complete appropriate discharge planning.
12. The final hearing panel found all the factual particulars of the Allegation proved, except 2(a); 3(c); 4(c); 5(e); 9(c), (e) & (f), 10(b). That panel found that the Registrant’s conduct amounted to a lack of competence and that her fitness to practise was impaired in relation to both the personal and public components of impairment. It imposed a 12-month Suspension Order.
13. At paragraph 77 of its decision, the Panel expressed the hope that the HCPC would “consider the appropriateness of offering the voluntary removal process to the Registrant, so that (if the HCPC considers it appropriate) the Registrant can consider applying for voluntary removal from the HCPC Register if she has decided that she wishes to put Occupational Therapy behind her”.
14. Following the conclusion of the final hearing, the HCPC explored the option of a voluntary disposal of the case.
15. On 30 January 2023, prior to the first Substantive Review Hearing, the HCPC Presenting Officer (PO) contacted the Registrant to ascertain whether she was interested in the option of Voluntary Removal (VR). The PO attached the Voluntary Removal Response Pro-forma and the HCPTS Practice Note on Disposal of Cases by Consent.
16. On 12 February 2023, the Registrant returned a completed and electronic VR Application Pro-Forma to the HCPC. However, there was insufficient time to conclude the VR process before the substantive review hearing.
17. On 14 February 2023, the Suspension Order was reviewed for the first time. The reviewing panel extended it for a 12-month period. At paragraph 33 of its decision, that panel noted the suggestion made by the final hearing panel that the possibility of VR should be explored with the Registrant; and noted that, from the correspondence before the panel, it appeared that the Registrant was interested in pursuing this possibility. In extending the Suspension Order in view of the Registrant’s continued impaired fitness to practise, the Panel noted that the extension would allow the Registrant “time to continue to engage with the HCPC and for a VRA to be fully explored by both the Registrant and the HCPC.”
18. Following the review hearing, through no fault on the part of the Registrant, there was a delay in the HCPC progressing her Voluntary Removal Application (VRA).
19. On 29 January 2024, a new HCPC Case Manager (CM) emailed the Registrant to enquire whether she still wished to pursue Voluntary Removal. On 30 January 2024, the Registrant confirmed by email that she did.
20. The Panel has before it a completed and electronically signed Voluntary Removal Application Pro-forma, dated 12 February 2023 in which the Registrant accepted the Allegation and that her fitness to practise is impaired. At pages 1 and 2 of the Pro-forma, the Registrant stated that she had applied for Voluntary Removal as her “career has diverged from that of occupational therapy and [she feels] it would ease proceedings to do this”.
21. On 30 January 2024, the CM wrote to the Registrant confirming that her application had been approved by the HCPC and attaching the Voluntary Removal Agreement for the Registrant’s signature and that of her witness.
22. On 2 February 2024, the Registrant returned the signed Voluntary Removal Agreement. It was subsequently signed on behalf of the HCPC, on the same date, by Laura Coffey, Executive Director of Fitness to Practise and Tribunal Service.
23. The Voluntary Removal Agreement is an agreement between the HCPC and the Registrant. The principal terms of the agreement are that the HCPC will apply to have the Suspension Order imposed on the Registrant revoked following:
⦁ a signed request by the Registrant to be removed from the Register and,
⦁ a commitment that the Registrant will cease and desist from practising as an Occupational Therapist and will not attempt to re-join the register.
24. The terms and effect of the agreement are that should the Registrant apply to come back on to the Register, her application would be treated in the same way as someone who had been struck off, following a hearing before the Conduct and Competence Committee.
25. The Health Professions Order 2001 as amended does not explicitly provide for consent arrangements. However, there is a Practice Note “Disposal of Cases by Consent” that the HCPC has approved as a means of allowing matters, where suitable, to be disposed of by consent.
26. The Practice Note states that a Panel should not agree to resolve a case in this way unless it is satisfied that the appropriate level of public protection is being secured and doing so would not be detrimental to the wider public interest.
27. It is clear from the correspondence received that the Registrant has no desire to practise as an Occupational Therapist in the future.
28. Additionally, that in signing the Voluntary Removal Agreement, the Registrant has accepted and acknowledged that her fitness to practise is impaired by reason of the Allegation.
29. The Registrant has been provided with detailed information about the consent process and the effect of voluntary removal from the Register, should the application be granted.
30. The Registrant has had a significant amount of time to review this information and has consistently maintained her position since she first submitted the completed Pro-Forma on 12 February 2023.
31. Therefore, the Panel has concluded that the Registrant’s consent to voluntary removal is informed, the Registrant having maintained her position in this regard for at least a year.
32. The public would be protected by the arrangements proposed under the Voluntary Removal Agreement. That agreement is equivalent, in effect, to a Striking off Order, which would be the most likely outcome of the case in circumstances where the Registrant is no longer working as an Occupational Therapist and demonstrating no desire to return to the profession.
33. As the Registrant would no longer be registered as an Occupational Therapist and has confirmed that she does not wish to practise in the future, the public would be adequately protected from any potential risk posed by the Registrant’s practice.
34. As to the wider public interest, confidence in the profession and the regulatory process has been maintained by way of the findings of fact and sanction imposed at the final hearing, and by the continuing Suspension Order. The wider public interest would not be undermined should this matter be disposed of by way of consent.
35. The arrangements for the Registrant’s voluntary removal from the Register also constitute a fair, cost-effective and expeditious disposal of the case.
36. In the circumstances, the Panel has decided that it is appropriate to dispose of this matter as proposed by the parties and to give effect to the Voluntary Removal Agreement. Therefore, the Panel has decided to permit the HCPC to withdraw the proceedings. The Panel’s permission to withdraw the proceedings is to be given effect by the Chair’s signature of the Pro Forma Notice of Withdrawal. The Panel has also decided that the Suspension Order be revoked.
Order
The Panel decided to grant the application for voluntary removal.
Notes
No notes available
Hearing History
History of Hearings for Holly Tetlow
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 09/02/2024 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |