George A P Dunn

Background

1. The Registrant is registered as a Chiropodist/Podiatrist, and he was employed in this capacity by the Cheshire East NHS Trust when concerns arose regarding his practice.

2. An anonymous referral was made to the HCPC on 28 June 2023, advising that:

“I regret to report that he (the Registrant) has inserted antibiotic beads into the feet of a number of patients at Waters Green surgery. This occurred around 2 weeks ago. The beads were only prescribed for 1 patient - and yet he used them for a further 2 others. They were therefore not prescribed for use on the other patients, and the batch had become contaminated by the 1st patient’s blood (it is only to be used for 1 patient)”

3. A further email from the Referrer was received on 7 November 2023 which suggested that the Cheshire East NHS Trust (“The Trust”) had not adequately investigated the concerns. Subsequently the HCPC engaged directly with the Registrant’s line manager to request further information and documentation.

4. Following an internal investigation, by the Trust it was determined that there were concerns pertaining to the administration and prescription of Stimulan Antibiotic Beads by the Registrant. A patient safety incident report was concluded on 9 October 2023. This resulted in the creating and implementing of a Standard Operating Procedure for the use of the beads, so that the prescriber of the beads should be the person administering the beads or the administration is made under direct supervision.

5. The matter was subsequently investigated by the HCPC, who then determined that there may have been concerns pertaining to the Registrant’s fitness to practice.

6. The Registrant provided his written responses to the HCPC on 1 February 2024 and 16 April 2024 and admitted the substance of the allegation and set out some contextual and mitigating factors.

7. On 7 June 2024 the HCPC’s solicitors raised the question of disposal of the case by way of a consent order for Conditions of Practice. The Registrant agreed with this course of action and provided a signed pro-forma dated 14 August 2024 which was received by the HCPC on 2 September 2024.

8. Within the pro-forma the Registrant admitted the substance of the allegation, that it amounts to misconduct and or a lack of competence and that his fitness to practise is impaired.

9. The Registrant has undertaken an Aseptic Non-Touch technique training course and is noted as a cascade trainer. He has fully engaged with the Trust investigation and the HCPC process. He remains working for the Trust and has not been the subject of an interim order and there have been no further concerns or complaints.

Submissions on behalf of the HCPC

10. The HCPC set out its submissions in a skeleton argument dated 26 March 2025. Mr Anderson on behalf of the HCPC adopted those in oral submissions and set out that the HCPC considered that a Conditions of Practice Order was the appropriate disposal in these circumstances. In summary he submitted that the Registrant admits the substance of the allegation and that his fitness to practice is impaired. He submitted that the evidence before the Panel demonstrated that the Registrant had developed insight and had undertaken training. He submitted that the proposed conditions would adequately protect the public and provide the appropriate degree of supervision to adequately monitor the Registrant’s practice and alleviate the concerns raised in the allegation.
Submissions on behalf of the Registrant

11. Mr Olphert on behalf of the Registrant confirmed that the Registrant agreed to the imposition of a Conditions of Practice Order and confirmed that the Registrant accepted the allegation and that his fitness to practise was impaired. Mr Olphert confirmed that the Registrant had discussed the proposed conditions with his employer who was happy to support him. He submitted that given the delay in between agreeing the Conditions and bringing the matter before a Panel, the Panel should consider imposing a shorter period for the proposed conditions.

12. Following submissions, the Panel asked the Registrant about his current working arrangements and his use of Stimulan Antibiotic beads in his practice. The Registrant confirmed that the current Standard Operating Procedure for the use of this medication is that it is to be administered by the person who has prescribed it. The Registrant confirmed he is not a prescriber. He told the Panel that he had reviewed patients on two occasions who had been prescribed the beads and had them applied by others.

13. In these circumstances the Panel invited submissions regarding the wording of proposed Condition 3 and whether two-monthly audits of the Registrant’s use of this medication was workable.

14. Mr Olphert submitted that a condition notifying the HCPC if the Registrant was involved in treating a patient with this medication would perhaps be more appropriate.

15. Mr Anderson on behalf of the HCPC conceded that this was pragmatic in the circumstances.

16. Following deliberations the Panel invited further submissions from the parties regarding the proposed length of the order. In particular, the Panel noted that Mr Olphert had suggested a shorter period than the six months that had been agreed. He submitted that given the delay and the nature of the conditions four months would be sufficient.

17. Mr Anderson on behalf of the HCPC sought instructions and confirmed that there was no objection to a shorter period given that the supervision was stipulated to begin in two weeks and there was now no longer a need for the two-monthly audits.

Decision

18. The Panel has considered the submissions of the HCPC as set out in the Skeleton Argument and adopted by Mr Anderson. The Panel has taken account of the position of the Registrant as set out by Mr Olphert in the documents identified above. The Panel has further considered all the other documents that have been submitted.

19. In making its decision, the Panel accepted the advice of the Legal Assessor who referred it to the Practice Note (Disposal of Cases by Consent) and reminded the Panel of the HCPC’s overarching statutory objective to protect the public. The Panel has considered carefully whether the proposed agreement would afford the appropriate level of public protection and further whether approval of the agreement would not be detrimental to the wider public interest.

20. The Panel was satisfied that the allegations had been thoroughly investigated by the HCPC. It was satisfied that it had been provided with sufficient information to assess the case against the Registrant and determine whether the proposed consent order was a likely outcome at a final hearing.

21. The Panel has concluded that the agreement for a Consensual Disposal by the imposition of a Conditions of Practice Order should be approved and that an order should be made in the modified terms as agreed with the parties as set out below for the following reasons.

22. The Registrant has admitted the substance of the Allegation. He has also admitted that his fitness to practise is thereby impaired. The Panel noted that the Registrant was professionally represented and had been given an opportunity to fully consider the allegations. The Panel noted that the Registrant had engaged with the investigation by the Trust and the HCPC and his admissions were consistent with his earlier responses.

23. The Panel considered that the public will be adequately protected by the imposition of a Conditions of Practice Order for a period of X months. Moreover, it addresses and safeguards the public interest.

24. In coming to its conclusions, the Panel has accepted the submissions of the HCPC that the proposed Conditions directly address the specific concerns and ensure the public are protected. The Panel considered that the allegations were serious and placed patients at direct risk of infection. The Panel considered that although this was an isolated event and there has been no repetition of these concerns, a period of conditional registration would ensure that the Registrant has put into practice his learning and ensure that there was no residual risk of repetition.

25. The Panel noted that the use of Stimulan Antibiotic Beads was not common and the Registrant was not routinely using this medication. The Panel considered that the proposed conditions which provide for supervision by a workplace supervisor and subsequent reporting of any time that the Registrant used Stimulan medication would provide reassurance that the Registrant had implemented his learning. The provision of a reflective piece would, in the view of the Panel, further enhance the Registrant’s insight and demonstrate his understanding to reduce and risk of repetition.

26. The Panel considered that under the proposed conditions the Registrant would be subject to fornightly supervision sessions and that the HCPC would be notified each time the Registrant was involved with treating a patient with Stimulan medication. The Panel considered that a period of four months would be sufficient for the Registrant to demonstrate he had addressed the concerns which led to the allegation. The Panel noted the delay of over six months in bringing the consent application to a panel and it considered that a period of four months was the appropriate and proportionate period for the order.

27. The Panel has noted that the proposed Order would be subject to review. In the opinion of the Panel, the proposed Conditions are similar in kind to the Order that would be likely to be imposed at a substantive Fitness to Practise hearing.

28. The panel considered that there are no reasons of a public interest kind to require a substantive fitness to practise hearing. Also, the Panel has concluded that a well-informed member of the public would conclude that this matter is properly disposed of by the consensual outcome sought by the both the Registrant and the HCPC.

29. For all the reasons that are set out above, the Panel has determined to approve, with immediate effect, the outcome sought by both the HCPC and the Registrant in the agreement for consensual disposal, namely the imposition of the following Conditions of Practice Order for a period of four months.

ORDER: The Registrar is directed to annotate the HCPC Register to show that, for four months from the date that this Order takes effect (“the Operative Date”), you, George Dunn must comply with the following conditions of practice:

1. You must place yourself and remain under the indirect supervision of a workplace supervisor, who must be a registered health care professional and supply details of your supervisor to the HCPC within two weeks of the date of this Order.

2. You must attend upon that supervisor ideally on a fortnightly basis or two supervisions within each monthly period and follow their advice and recommendations.

3. You must inform the HCPC and your supervisor if you use or administer Stimulan Antibiotic Beads on patients during the period in which this order is in force and arrange for your supervisor to forward to the HCPC the outcome of supervision on this matter.

4. You must work with your supervisor to formulate a Personal Development Plan designed to address the deficiencies in cross-contamination and the use of sterile gloves.

5. You must meet with your supervisor on a fortnightly basis or two times in each monthly period to consider your progress towards achieving the aims set out in your Personal Development Plan.

6. You must write a reflective piece to evidence what you have learnt and how you have applied the learning to your practice, and you must provide a copy of that reflective piece to your supervisor and the HCPC two weeks before the end of the term of this Order.

7. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

8. Within two months of this Order, you must forward a copy of your Personal Development Plan to the HCPC.

9. You must inform the HCPC within seven days if you cease to be employed by your current employer.

10. You must inform the HCPC within seven days if you take up any other or further professional work.

11. You must inform the HCPC within seven days of becoming aware of:

a) Any patient safety incident you are involved in
b) Any investigation started against you
c) Any disciplinary proceedings taken against you

12. You must inform the following parties that your registration is subject to these conditions:

a) Any organisation or person employing or contracting with you to undertake professional work.
b) Any agency you are registered with or apply to be registered with to undertake professional work (at the time of application).
c) Any prospective employer for professional work (at the time of your application).
d) Any organisation through which you are undertaking professional training.

13. You must allow the HCPC to share, as necessary, details about your performance, compliance with, and/or progress under these conditions with:

a) Any organisation or person employing or contracting with you to undertake professional work.
b) any agency you are registered with or apply to be registered with to undertake professional work (at the time of application)
c) Any prospective employer for professional work (at the time of your application);
d) Any organisation through which you are undertaking professional training.

Right of Appeal
An appeal may be made to the High Court in England and Wales against the Panel’s decision and the order it has made.

History of Hearings for George A P Dunn