Emma Jones

Preliminary Matters

Application for part of the hearing in private

1. Ms Paterson made an application for parts of the hearing to be heard in private as there would be reference to the Registrant’s health. She submitted that these parts of the hearing should be in private, with the remainder of the hearing conducted in public. Mr Tobias on behalf of the HCPC supported the application.

2. The Panel accepted the Legal Assessor’s advice and was aware that there is a public interest in hearings being held in public as ‘open justice’ is the means by which confidence in the regulatory process is maintained. However, it was aware that it has a discretion to conduct hearings, or parts of hearings in private where the interests of an individual outweigh the public interest in a public hearing. The Panel considered that the Registrant has a right to privacy in respect of her health and that outweighed the public interest in those matters being heard in public. The application for parts of the hearing, where there was reference to the Registrant’s health, was granted.

Background

3. The HCPC received a referral from the Registrant’s former employer, Bradford Teaching Hospitals NHS Trust on 28 October 2020. The referral indicated that the Registrant had been subject to an investigation in April 2018 following allegations that she had inhaled anaesthetic gases whilst at work.

4. A further set of similar allegations were made in June 2019, and the Registrant was subject to a disciplinary process as a result.

5. The allegations investigated by the Trust arose after colleagues of the Registrant reported suspicions that the Registrant had been inhaling anaesthetic gases used for patients.

6. At a final hearing, which was three times adjourned, and took place over the course of 12 days between 20 November 2023 and 9 April 2024, the panel found the Allegation proved. It imposed a 12-month Suspension Order.

7. At the impairment stage, the panel determined that the conduct was remediable; it arose from serious errors of judgment. However, the panel considered that the conduct had not been remedied. The Registrant, having admitted the Allegation after the panel had found the facts proved had only just started to develop insight. [Redacted]. The panel therefore found that there was a risk of repetition.

8. In imposing the 12-month Suspension Order the panel took into account the Registrant’s dishonesty in her accounts of events both when questioned by her employer and the panel at the hearing. It found impairment in the public interest. However, the Registrant had indicated she was willing to work to remedy her past wrongdoing.

9. That panel considered that a future reviewing panel would be assisted by:

• Evidence of further reflection and more fully developed insight into the implications of the misconduct on patients, colleagues and the public perception of the ODP profession;
• Evidence of CPD with a focus on professionalism, and also to maintain clinical skills during the period of absence from practice.
Registrant’s evidence.

10. The Registrant gave evidence under affirmation. She confirmed her detailed reflective statement dated 8 April 2025. She had also provided the Panel with evidence of comprehensive CPD which she hoped was sufficient to get her back into practice. She confirmed that the testimonials were written in the last two months.

11. When asked about the previous panel’s finding that her evidence had been dishonest, the Registrant said that at the time of the incidents with nitrous oxide she was “stupid, young and naïve”. She did not understand the full consequences of her actions. She lied at the beginning and a web of lies developed, meaning she continued to lie. If she were confronted about something embarrassing now, she would apologise and acknowledge that she was in the wrong. The understanding of drugs that she had developed through the CPD she had undertaken had been prompted by her dishonesty around her use of nitrous oxide.

12. The Registrant confirmed that she would comply with any conditions of practice that the Panel was minded to impose.

13. [Redacted].

Submissions

14. Mr Tobias on behalf of the HCPC submitted that should the panel be so minded, the HCPC would propose that the current Suspension Order be reduced to a conditions of practice order. He referred the Panel to the Sanctions Policy with regard to the purpose of a review and its powers. The Panel’s task, he submitted, was to consider all the information available and determine what if any sanction continues to be required to protect the public and meet the wider public interest. He suggested some specific conditions of practice which he invited the Panel to consider.

15. Ms Paterson invited the Panel to find that the Registrant is no longer impaired, and that the Suspension Order should be revoked on its expiry. She submitted that all the concerns of the original panel had been sufficiently addressed. The Registrant had demonstrated insight in her evidence, so the risk of repetition was very low, both in relation to misuse of anaesthetic gases, and not being transparent when things go wrong. Ms Paterson submitted that the Registrant understands the seriousness of her actions and as such it is highly unlikely that there would be a further lapse of judgment of a similar kind. The Registrant had taken action to ensure that her failures will not recur. She had kept her knowledge up to date via her CPD and her testimonials spoke of positive developments in insight. The Registrant, it was submitted, was no longer a risk to patients, nor did the public interest require an ongoing finding of impairment.

Legal advice

16. The Panel accepted the advice of the legal assessor. It was aware that the purpose of review is to consider:

• whether the Registrant’s fitness to practise remains impaired; and
• if so, whether the existing order or another order needs to be in place to protect the public.

17. If the Panel finds that the Registrant remains impaired, its powers, in accordance with Article 30 are to:

• Extend the Order;
• Replace the Order with any other order that could have been made at the substantive hearing;
• With effect from the expiry of the Suspension Order make a conditions of practice order.

18. There is a persuasive burden on the Registrant as set out in Abrahaem v General Medical Council [2008] EWHC 183 (Admin).

19. The Panel’s role was to determine whether the Registrant remains impaired and if so, whether the existing Order should be continued or another sanction imposed to protect the public. It must assess the Registrant’s insight and remediation and hence whether there remains a risk of repetition. Before the Registrant is permitted to return to unrestricted practice the Panel need to be satisfied that she is fit to do so.

Decision

20. The Panel began by noting the basis upon which the previous panel found impairment, namely a lack of insight and the Panel was not satisfied that the Registrant had coping strategies in place [redacted]. She had also brought the profession into disrepute and a finding of impairment was required in the public interest to send a message that the conduct was unacceptable and would not be tolerated.

21. The Panel evaluated the Registrant’s comprehensive reflective statement. The Panel accepted that the Registrant now understands the risks associated with her actions, risks to patients, her colleagues and herself. She also acknowledges the significant impact such conduct had on the public’s trust in her and the profession more broadly. She set out in detail the importance of honesty going forwards and the impact of her dishonesty on herself, her colleagues and the public.

22. The Panel began by considering whether there remains current impairment on the public interest limb. It was satisfied that the Registrant had sufficiently reflected on the impact of her actions on trust and confidence in the profession. She had articulated the negative impact of both her actions in misuse of nitrous oxide and her dishonesty on both the public and the profession. In her oral evidence she had explained the embarrassment she felt at the time and that this led her to lie. She said she had learnt the hard way. The Panel accepted her evidence that as a result of this process she is likely to be transparent about issues affecting her in the future. It found that the risk of repeated dishonesty was extremely low.

23. The Panel determined that the regulatory process and the sanction imposed by the substantive panel, combined with the significantly developed insight the Registrant has now demonstrated would satisfy a member of the public that matters have been appropriately dealt with. The efforts the Registrant had gone to with regard to CPD demonstrated a genuine commitment to put things right and included drug and alcohol awareness. The Panel determined that the public interest no longer requires a finding of impairment.

24. The Panel then considered whether there remains a risk of repetition of self-medicating and hence a public protection risk. Whilst it acknowledged the Registrant’s evidence that this would not be the case, and did not disbelieve her intentions here, it had a lack of supporting evidence. For example, the Registrant had said that she remains under the care of a consultant for pain management, but there were no clinic letters before the Panel. Further, whilst the Registrant, to her credit, has undertaken a significant volume of CPD with a view to maintaining her skills and knowledge whilst she has not been permitted to practise, equally she has not been exposed to workplace pressures [redacted]. Whilst the Registrant gave cogent evidence of [redacted] management using exercise, and said that she is able to seek help from others as needed, again there was no corroborating evidence from professionals.

25. [Redacted]. The Panel was not sufficiently reassured that she will be able to manage her health [redacted] safely in the work environment. Hence there remained a risk of repetition, and the Panel found that the Registrant remains impaired on the public protection limb.

26. The Panel went on to consider what sanction is now necessary to mitigate against this risk. Having regard to the submissions made, and reviewed the Sanctions Policy with regard to when a conditions of practice order may be appropriate, the Panel was of the view that support at work will be necessary to ensure that the Registrant is able to continue to use her current [redacted] management strategies effectively [redacted]. The Panel considered that this measure is only likely to be necessary short term, because [redacted] health deterioration linked to a return to practice are likely to become apparent fairly quickly.

27. The Panel therefore determined that upon expiry of the current Suspension Order a Conditions of Practice Order for a period of 6 months would proportionately manage the risks identified. The Panel having had regard to the submissions of the parties in this respect, and noting that the Registrant may wish to undertake agency work, anticipates that the following conditions will be workable and proportionate whilst at the same time protecting the public:

1. You must identify a workplace supervisor/mentor who must be registered with a statutory health regulator. You must meet with this supervisor/mentor on a monthly basis to:

a. Discuss any impact of your health on your return to practice and how you are managing that;

b. Keep them up to date on how you are managing [redacted] the effectiveness of the coping strategies and mechanisms that you have in place;

c. Discuss any support you may need in order to manage your health [redacted] in the work environment, and follow their advice.

2. You must inform the HCPC as to the identity and registration details of your supervisor/mentor within 14 days of commencing work and consent to the HCPC contacting them;

3. You must provide the HCPC with a report from your supervisor/mentor two weeks prior to the review of this Order. The report must include how you have managed your health [redacted] since your return to work;

4. You must inform the HCPC within 7 days of becoming aware of any patient safety incident you have been involved in, or of any disciplinary investigation or proceedings against you being commenced.

28. The Panel has not specified whether the supervisor/mentor referred to above is to be an employee of any agency, or healthcare setting where the Registrant may be placed if she is given a medium or longer term placement. This is with a view to ensuring the necessary flexibility for the conditions to be workable, whilst enabling the necessary support and oversight.

29. The Panel in addition considered that a future reviewing panel may be assisted by:

• [Redacted];
• [Redacted];
• A reflection from you on your return to work [redacted].

ORDER: The Registrar is directed to impose a Conditions of Practice Order for a period of 6 months from the expiry of the current Suspension Order in the following terms:

1. You must identify a workplace supervisor/mentor who must be registered with a statutory health regulator. You must meet with this supervisor/mentor on a monthly basis to:

a. Discuss any impact of your health on your return to practice and how you are managing that;

b. Keep them up to date on how you are managing [redacted] the effectiveness of the coping strategies and mechanisms that you have in place;

c. Discuss any support you may need in order to manage your health [redacted] in the work environment, and follow their advice.

2. You must inform the HCPC as to the identity and registration details of your supervisor/mentor within 14 days of commencing work and consent to the HCPC contacting them;

3. You must provide the HCPC with a report from your supervisor/mentor two weeks prior to the review of this Order. The report must include how you have managed your health [redacted] since your return to work;

4. You must inform the HCPC within 7 days of becoming aware of any patient safety incident you have been involved in, or of any disciplinary investigation or proceedings against you being commenced.

The Order imposed today will apply from 7 May 2025.

This Order will be reviewed again before its expiry on 7 November 2025.

History of Hearings for Emma Jones