Donna Picton

Preliminary Matters
Service
1.          The Panel noted that the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’) provide at paragraph 3(1)(b) that notice may be served on a registrant by posting it to their address as it appears in the register or sending it to an electronic mail address provided by the registrant for communications. Paragraph 6(2) of the Rules confirms that at least 28 days’ notice of a hearing must be provided to a registrant.

2.          A copy of the Notice of Hearing sent to the Registrant via email on 18 December 2025 was available to the Panel and confirmed:

a.   the date and time of the hearing;

b.   the nature of the hearing, being the substantive hearing of the allegations brought against her by the HCPC; and 

c.    that the hearing was to be conducted virtually.

3.          The Panel was satisfied that the HCPC had discharged its duty to ensure that the Registrant had been afforded an opportunity to appear before it and be heard, as set out at Article 31(15) of the Health Professions Order 2001 (‘the Order’). The Registrant was in attendance and represented at the hearing. 

Proceeding in Private
4.          The Registrant’s Representative requested that the hearing proceed in private when issues relevant to the Registrant’s health were considered. The Presenting Officer did not object to the application. 

5.          The Panel received legal advice, which it applied, and was referred to both the HCPTS Practice Note entitled ‘Conducting Hearings in Private’ and the provisions of Article 6(1) of the European Convention on Human Rights. Whilst mindful that there is a presumption that hearings will be in public, the Panel recognised that individuals are entitled to privacy in relation to their private lives, particularly in relation to health matters. Accordingly, the Panel was content that the majority of the hearing should proceed in public but determined that any references to the health of an individual would be considered in private. 

6.          The Panel noted that there were two observers of the hearing and was informed that they were known to the Registrant and attending to support her. She was therefore content for them to remain in the hearing during any private matters relating to her health.

Reasonable Adjustments

7.          The Registrant’s Representative requested that the Panel apply reasonable adjustments to help the Registrant to engage with the regulatory process. She [redacted] requested that a five minute break be taken from the hearing every 30 minutes or so. The Presenting Officer did not object to the application. 

8.          The Panel received legal advice, which it accepted and applied, in respect of the Panel’s duty to ensure that the hearing is fair to all parties. Medical evidence had been provided to it (dated 11 June 2022) which set out the nature of the adjustments that could be made to assist the Registrant. 

9.          The Panel was mindful that the statutory function of the HCPC is to set and maintain standards for the professions it regulates in support of its overarching objective of protecting the public. The Order provides the statutory fitness to practise framework, supported by Panel Rules. The HCPTS Practice Note entitled ‘Case Management, Directions and Preliminary Hearings’ confirms that the interests of justice are best served by a process which is “simple, accessible and fair” and invites the Panel to make “full use of their case management powers to ensure that cases are heard without undue delay, fairly and justly and in a manner which: 

a.       encourages engagement and co-operation by the parties; 

b.       requires the parties to identify the issues which the Panel needs to decide; 

c.       avoids inflexibility or unnecessary formality in the proceedings; 

d.       makes effective use of the time of the Panel and all those giving evidence; and 

e.       enables the parties to participate fully in the proceedings.”

10.       The Panel also had regard to the HCPTS Practice Note entitled ‘Special Measures’ which provides that panels may make special arrangements to help secure best evidence or engagement at the hearing. 

11.       The Panel determined that taking regular breaks at approximately 30-minute intervals could be accommodated. It was satisfied that whilst more frequent breaks may prolong the proceedings and on occasion be disruptive to the evidence of the HCPC’s witnesses, any such adverse impact was outweighed by the need to ensure that the Registrant is able to participate fully within the proceedings. The Panel was content that applying shorter sessions and regular breaks to assist the Registrant’s full engagement in the regulatory process was a reasonable, proportionate and workable adjustment given the medical information available to it. 

Background
12.       The Registrant is registered with the HCPC as an Operating Department Practitioner (‘ODP’). She qualified in 2015 and was employed as an ODP at the Royal United Hospital until 2019. 

13.       On 7 October 2019 the Registrant commenced employment with The Circle Bath Hospital (‘the Hospital’) as an ODP. On 17 December 2019 she emailed a note to herself regarding her interactions with Colleague G (an anaesthetist), which she forwarded to Colleague C on 7 January 2020. 

14.       The Registrant completed her probation period in February 2020. In April 2020 she volunteered for re-deployment to a Covid Intensive Care Unit where she assisted with airways, intubations and surgery. She returned to the Hospital in July 2020.

15.       A DATIX report was raised on 29 July 2020 in respect of a 5ml syringe with a Fentanyl sticker on it that was discovered in a cupboard. This was investigated by the Theatre and Recovery Lead and closed on 12 August 2020, being attributed to human error with all controlled drugs being accounted for.

16.       In October 2020 it is alleged that the Registrant told Colleague A that Colleague G was a “bitch”. Colleague A also asserts that he heard the Registrant refer to Colleague S as a “cunt” while he was in the coffee room. 

17.       The Registrant states that she raised a DATIX report in respect of a syringe of Fentanyl she found in a cupboard on 9 October 2020. She mentioned it to Colleague A (an anaesthetist) and thought it odd that he did not seem bothered by her discovery. She did not get a response to the raising of this DATIX. 

18.       On 19 October 2020 the Registrant raised a DATIX report regarding a gynaecology patient. Another colleague raised a similar DATIX, from which learning and actions were identified and fed back to staff at a ‘swarm’ meeting on 4 November 2020. 

19.       The Registrant worked an additional shift on Saturday 24 October 2020. It is alleged that the Registrant used repeated foul and abusive language on that date in respect of whether a pizza was vegetarian and referred to individuals variously as a “wanker” and a “shit chef”. It is further alleged that she became involved in an altercation with Colleague A, which concluded with the Registrant telling Colleague A to “fuck off” as she walked out of the department.

20.       By an email dated 26 October 2020 to a manager, the Registrant again raised complaints against Colleague G on a range of issues which included medication and positioning of patients. 

21.       The Registrant met with the Theatre and Recovery Lead and the Senior Anaesthetic Practitioner on 28 October 2020 to discuss the events of 24 October 2020. She was issued with a warning, the details of which were confirmed via an email to the Registrant dated 5 November 2020 by the Theatre and Recovery Lead. The warning stated “we hope to see improved behaviour and outcomes of the SMART objectives we have agreed and set with you[.] This has been issued to due to the incident whereby you left the Hospital at the start of your shift on 24/10/20 after becoming angry and upset with [Colleague A] the anaesthetist where you proceeded to tell him to ‘Fuck Off’ before leaving the Theatre and then department”.

22.       On 4 November 2020 the Registrant attended a swarm meeting – that is a collaborative session designed to quickly analyse and learn from patient safety incidents - in respect of the gynaecology DATIX recorded on 19 October 2020. After this meeting, the Registrant is alleged to have made a number of comments about Colleague G to the effect that she had lied and was useless and dangerous. 

23.       During an anaesthetic team meeting on 11 November 2020, the Registrant is alleged to have raised concerns that she had received no feedback to a DATIX she had raised about a syringe of Fentanyl she had found in a cupboard. She also expressed concern about the behaviour of Colleague A, who was treating her differently and she didn’t know why. Two other ODPs attending the meeting expressed their concerns about Colleague A going to the toilet once surgery started. It was suggested that Colleague A may be using opiates. After the meeting Colleague I (an ODP), who attended the meeting, spoke to Colleague B (an anaesthetist) about her concerns about the meeting. Colleague B then reported Colleague I’s comments to Colleague A.

24.       On 12 November 2020, Colleague B emailed Witness 1, the Clinical Chair of the Hospital and its Director regarding his concerns about the Registrant. He concluded the emails by saying that the Registrant “is the single most disruptive and insubordinate character I have ever had the misfortune of working with. I strongly feel that our otherwise excellent department would benefit from her absence.” On the same date, the Registrant emailed Colleague J to ask about a comment made by Colleague A and whether this was “directed at the datix that I submitted (re the fentanyl).” 

25.       The Registrant met with Witness 1 on 13 November 2020 at the suggestion of Human Resources. A record of the meeting was produced by Witness 1 (but not accepted or signed by the Registrant) and recorded two matters of concern regarding Colleague A and a third to the effect that the Registrant had not received a response to a DATIX she had raised. 

26.       The Registrant was suspended from her employment on 20 November 2020. The suspension was confirmed in a letter dated 29 January 2021 as being necessary pending the conclusion of the disciplinary investigation into the allegations:

a.   that she made unsubstantiated comments to colleagues about a Consultant Anaesthetist which could constitute defamation of character and be libellous; 

b.   regarding her behaviour and attitude at work, including swearing. 

Witness 1 was appointed as the investigating officer.

27.       The Registrant was signed off from work by her General Practitioner between 14 December 2020 and 18 January 2021 and between 28 February and 10 April 2021. She self-certified sick leave between 23 and 27 February 2021. [Redacted].

28.       On 25 March 2021 the Registrant met with a representative from the Human Resources department and agreed to accept a formal disciplinary warning without a hearing to close off the disciplinary issue. It was also agreed that the Registrant would be referred to Occupational Health in anticipation of her returning to work. A phased return to work was agreed with the Registrant, endorsed by Occupational Health and implemented from the week of 10 May 2021. The Occupational Health recommendation advised that the Registrant should not work with certain members of staff who were involved in the disciplinary investigation until either mediation had taken place or a satisfactory working relationship had been established. 

29.       Although the Registrant received positive feedback from some surgeons, concerns were raised as to her behaviour at work in June 2021 – that she had been acting “in a manic way with them”. 

30.       On 19 August 2021 the Registrant was working with Colleague D on a hand surgery, where the patient was conscious. It is alleged that during a discussion with the patient as to where he was from, upon hearing the patient say he had been living in Canada, the Registrant made reference to blaming white male priests for a scandal in Canada. Colleague D raised concerns about the Registrants behaviour with the Theatre and Recovery Lead – Colleague C – on that date and followed the conversation up with an email dated 27 August 2021. The Registrant’s employment with the Hospital ended shortly thereafter. 

31.       The Panel was not informed who referred the Registrant to the HCPC, when the referral was made or the nature of it. 

32.       A panel of the Investigating Committee met on 4 July 2023 to consider an allegation against the Registrant. The Registrant was informed by a letter dated 11 July 2023 of the outcome of that meeting. The allegation was amended at a preliminary hearing on 19 May 2025 and confirmed by letter on 22 May 2025. 

33.       The Registrant was served with a notice to admit or dispute facts and witness statements on 10 September 2025. 

Submissions
34.       The Presenting Officer helpfully ordered his submissions in relation to the facts around the following themes: 

a.  Minimising;

b.  Admissions;

c.  Discrepancies;

d.  Collusion; 

e.  Relationships; 

f.  Chronology;

g.  Motivation;

h.  Reliability.

35.       The Presenting Officer invited the Panel to consider whether, by making partial admissions to some particulars, the Registrant was responding frankly to the concerns or seeking to minimise them. He pointed out that the Registrant accepted she was at the top end of the scale for swearing and admitted calling a colleague a ‘bitch’ but denied referring to another colleague as a ‘cunt’, which he terms a far more serious swear word to use in a professional workplace. He also reminded the Panel that the Registrant admits that she talked about ‘abusive priests’ with a patient but said that was in response to the patient mentioning it. The Presenting Officer also noted that the Registrant accepts stating that a colleague had lied but did not accept that she referred to that colleague as ‘dangerous’. He submitted that it was for the Panel to determine whether there was a pattern of the Registrant “confessing the minimum and avoiding the whole”. 

36.       In respect of the consistency of the Registrant’s evidence the Presenting Officer submitted that this had changed over time. He noted that in response to questions from the Panel, the Registrant accepted the verbal warning issued to her in October 2020 and apologised, but now disputes the basis for this. He submitted that the Registrant’s position as to whether she said she would “fuck off” to Colleague A, or told him to “fuck off” was unclear and that there was a big and fundamental difference between the two. 

37.       The Registrant’s evidence was that it was “beyond a coincidence” that two consultants called her insubordinate within a short space of time, and that it was possible that they colluded. The Presenting Officer invited the Panel to consider the likelihood of this happening given the different narratives before the Panel – either that three consultants and a manager found the Registrant to swear a lot and be difficult, as advanced by the HCPC, or that a consultant singled the Registrant out as she did not like him and he was difficult, while the other two consultants colluded against her as suggested by the Registrant. The Presenting Officer confirmed that the burden of proof is with the regulator and suggested that the Panel may consider this burden discharged given the Registrant alleges that the consultants colluded against her. 

38.       The Presenting Officer reminded the Panel that the Registrant agreed in her evidence in chief and upon cross examination that she could have raised her issues in a more measured and constructive way. 

39.       The Registrant also stated that there was no change from her part in her relationship with Colleague A and she had no idea why the relationship had soured. The Presenting Officer invited the Panel to consider whether the case presented against the Registrant was the reason, given she had arrived to work late, sworn at him and about others. The professional relationship had either soured for no reason, or because the facts alleged are true. 

40.       In respect of the chronology of events, the Presenting Officer reminded the Panel that the Registrant submitted a DATIX report in respect of Fentanyl in July 2020, which was resolved as human error in August 2020. The chronology then shows that Colleague A challenged the Registrant’s behaviour at work in October 2020 and she then raised the issue of his behaviour and opiates in a meeting. The Presenting Officer suggested that upon the Registrant being challenged by Colleague A, she “goes to war” because she can’t accept the challenge in personal or professional terms. 

41.       The narratives before the Panel in respect of the meeting on 11 November 2020 were also very different in the Presenting Officer’s submission. The witnesses suggested the Registrant was raising Colleague A’s behaviour and driving the conversation about him, whereas the Registrant suggests she was silent on the issue and that others raised the concerns. He submitted that the Registrant’s position also appeared to shift in her evidence as it was suggested she was suspicious and added her concerns to those of others. He further suggested that it was not credible that the Registrant remained silent in the meeting and did not contribute frankly to it when she repeatedly asserted that she wanted to raise her concerns due to her regard for patient safety. 

42.       The mechanisms for raising concerns were put to witnesses. The evidence of Witness 1 was that the Registrant’s gossip was unhelpful – the Presenting Officer invited the Panel to consider whether the Registrant was truly responding to the concerns of others or driving her own narrative by talking to small groups of people. 

43.       The Registrant’s account is not reliable, in the Presenting Officer’s submission. He asked the Panel to consider the July 2020 DATIX report, and the fact that opening, dates, changes and closing actions are automatically recorded and can be seen in the document but is not accepted by the Registrant. She also disputes the accuracy of the December 2020 letter to her and the email confirming the verbal warning regarding the incident on 24 October 2020. He invited the Panel to consider the account of the Registrant against the more contemporaneous documents and to prefer the documents as more reliable. 

44.       The Presenting Officer reminded the Panel that the conduct of Colleague A was not the focus of the panel and that Colleague A’s regulator “emphatically supported his account in detail” and provided reasons for that decision [redacted]. He respectfully invited the Panel to focus on the different narratives put forward to it when determining the facts before it. 

45.       The Registrant’s Representative helpfully provided to the Panel her written submissions and addressed the points raised by the Presenting Officer directly. She rejected the suggestion that the Registrant minimised any concerns, submitting she had been “extremely candid” throughout the proceedings and that accepting some particulars and not others did not amount to minimisation, which was not substantiated. 

46.       Regarding the Presenting Officer’s submission on discrepancies the Registrant’s Representative reminded the Panel that the Registrant was to have been issued with a written warning but that this was then reduced to a verbal warning, and there was therefore no discrepancy. She also told the Panel that the Registrant had been “consistent throughout” in respect of the events of 24 October 2020 in that she was ordered out of the theatre and responded “I will fuck off then”. 

47.       It was “right and proper” for the Registrant to raise the prospect of collusion given the chronology and the fact that the anaesthetists worked together. The Registrant’s Representative reminded the Panel that the DATIX report on 9 October 2020 was the starting point and that there was no issue as to what this was, given the email chain provided by the Registrant. She submitted that the Registrant was confused as to the breakdown in the working relationship with Colleague A. The Registrant raised Colleague A’s behaviour in the meeting of 11 November 2020, and the next day Colleague B made general allegations against her because it was clear she was not letting the Fentanyl issue go. The Registrant’s Representative reminded the Panel that Colleague A had access to the DATIX reports and submitted that the Registrant felt that there had been collusion given the chronology and the absence of a reason for the sudden deterioration in her relationship with Colleague A.

48.       The Registrant’s admissions were evidence of insight in the Registrant’s Representative’s submission. The admissions showed that she had reflected on the situation and how she could have handled it differently, but at the time she had handled her concerns practically and as properly as she knew how to. 

49.       Where the Registrant could not remember who had said what, she explained herself to the Panel – other witnesses confirmed that they said the comments that are alleged against the Registrant in respect of the meeting on 11 November 2020. The Registrant is however clear that her concerns related to the system for the controlled drugs and the failure to respond to the DATIX she raised. The Registrant’s Representative reminded the Panel that the Registrant does not face an allegation that she gossiped – the allegation is specific to the meeting, which was not attended by Witness 1. She urged the Panel to focus on the meeting and the evidence it heard from witnesses rather than the investigation, which she said “is littered with issues”.

50.       The Registrant’s Representative submitted that Colleague C was not sure if the DATIX from 29 July 2020 was the DATIX referred to as being created by the Registrant on 9 October 2020 – Colleague C did checks in November 2020 and reported on her findings in December 2020. However, it appeared that the DATIX did trigger an investigation which prompted the change in relationship with Colleague A. Whilst accepting that Colleague A is not on trial, the Registrant’s Representative submitted that his credibility as a witness is. She pointed out that he felt aggrieved for the impact he experienced (i.e. the Fitness to Practise investigation by his regulator) and blamed the Registrant for it, which in turn impacted his ability to give proper evidence to the Panel. 

51.       In respect of the specific allegations, it was accepted that the Registrant referred to Colleague G as a ‘bitch’ due to the ongoing difficulties with her practice, specifically around Colleague G’s positioning of patients for catheterisation (particular 1(a)). The Registrant denied using the word ‘cunt’ and asserted that she had “no reason” to make the statement as alleged about Colleague S, therefore particular 1(b) is denied. Further, the Registrant would not use this word - there was no reason to deny this particular given that the Registrant candidly accepts her use of bad language in the department. The Registrant’s Representative reminded the Panel that the HCPC rely on Colleague A’s evidence, which she said was “inconsistent and overembellished”, starting with a single “fuck off”, then repeatedly saying “fuck off” and finally including that she “gave him the finger” and used this language frequently about everyone. She also pointed out that it was the Registrant’s case that Colleague A overheard her in the coffee room when others were present. Further, if the Registrant had used bad language as frequently as alleged by Colleague A, more complaints should have been generated about the Registrant. The Registrant did accept that she referred to Person C as a “shit chef” but said that this was on a different occasion, when she was discussing the quality of food with another member of staff in the coffee room.

52.       In respect of the suggestion that the Registrant attended work on 24 October 2020 while intoxicated, the Registrant’s Representative referred the Panel to the evidence of Colleague C who also had close contact with the Registrant that morning and raised no concerns about her fitness to work. Further, she pointed out that at least 5 other staff were in close proximity to the Registrant on that date, none of whom have filed a complaint or raised a concern regarding the Registrant being under the influence of alcohol or otherwise unfit for work. The Registrant confirmed that if she had been so intoxicated, it would have been reported and dealt with. Similarly, if the Registrant had allowed a patient to turn blue while she was on her phone as reported by Colleague A, this would have been reported and actioned. The Registrant’s Representative therefore urged the Panel to treat Colleague A’s evidence with caution, there being no contemporaneous evidence backing up his claims, calling Colleague A’s credibility into question. 

53.       In respect of allegation 1(d), the Registrant accepts that she told Colleague A to “fuck off” but in the context that she was ordered to leave the theatre to which she replied “I will fuck off then”. When questioned about the disciplinary warning issued as a result, the Registrant explained that she was unwell at the time and unable to challenge the decision of Colleague C, or that it would make any difference to the outcome. 

54.       The Registrant’s Representative confirmed that the Registrant denies particulars 1(e)(i) and 1(e)(ii), pointing out that the minutes of the meeting in which Colleague B gave his evidence were not provided to him for approval and he was unable to recall the words used in his evidence. He recalled the Registrant “venting” after the swarm meeting but not exactly what was said. His evidence referred to the conversation taking place in the corridor with no-one else present, which the Registrant disputes. Further, Colleague A says that he heard the comments. Colleague B’s email of 12 November 2020 does not set out the words alleged and he confirmed to the Panel that the email related to general views about the Registrant. There were therefore significant issues with the evidence in respect of particular 1(e) in the Registrant’s Representative’s submission, save for the Registrant accepting that she did call Colleague G a liar, therefore the Registrant’s evidence should be preferred. 

55.       In respect of particular 1(f), the Registrant accepted that she made the comments and she should not have done. She put forward the context as relevant to the issue of statutory grounds and impairment – that she was discussing current affairs with the patient. 

56.       The Registrant denies particulars 2(a)(i), 2(a)(ii) and 2(a)(iii). The Registrant admitted the stem of 2(a), but in the context that, while she is now aware of the whistle blowing policy and freedom to speak up guardians, she was unaware of them prior to receiving the information after her suspension and after discussions with her Union representatives. Other colleagues have said there is nothing unusual about raising DATIX issues at these meetings. The Registrant’s Representative submitted that during this meeting, the Registrant raised specific concerns about Colleague A’s behaviour. She noted that other witnesses confirmed they had also raised concerns about Colleague A with management, and that the concerns were consistent in describing Colleague A’s behaviour. The Registrant also raised that she had found a syringe with drugs in it and not received a response. Given the evidence of other witnesses who were at the meeting, it could not be clearer, in the Registrant’s Representative’s submission, that it was not the Registrant who made the comments set out at 2(a)(i), 2(a)(ii) and 2(a)(iii). The HCPC had not met the burden of proof as to what the Registrant had said in the meeting, and anything said outside of the meeting was not relevant to the particulars under consideration. 

57.       In terms of the investigation report prepared by Witness 1, it was material that the notes from the investigation meetings were not signed, nor were they a transcribed or verbatim record of the meetings. Further, the outcome was that there was no issue with the controlled drugs yet signatures were missing from the logs, demonstrating the inconsistency between witnesses and the documentation available to the Panel. The Registrant was clear that the issues identified in the notes of her meeting with Witness 1 on 13 November 2020 did not reflect the conversation as she did not accuse Colleague A of taking opiates at the hospital but was concerned at the change in their working relationship and his aggressive and intimidating attitude towards her. The Registrant’s Representative invited the Panel to carefully consider the evidence and the weight that should be attached to the evidence when making their findings of fact. 

Decision on Facts

Evidence
58.       The Panel was provided with a bundle of documents (totalling 192 pdf pages, some of which were redacted) by the HCPC, which included the witness statements from the HCPC witnesses and their exhibits. The Registrant provided a bundle of documents of 77 pdf pages and gave evidence.

Witness evidence
59.          The Panel heard evidence from eight witnesses called by the HCPC, all of whom adopted their statements as their evidence in chief, were cross examined and answered any questions posed by the Panel. Given that the Allegation refers to anonymised individuals, the Panel maintained the anonymity of witnesses in accordance with the Schedule of Anonymity provided by the HCPC:

a.   Colleague D:

i.  a self-employed consultant anaesthetist with practising privileges at the Hospital who raised a concern about the Registrant in August 2021, particularised at 1(f), and admitted by the Registrant in content but not context. He provided a witness statement dated 16 October 2023 to which he exhibited an email dated 27 August 2021 that he sent to Colleague C, describing the Registrant’s behaviour as “well short of that which we expect in our theatres…at the very least annoying and at worst undermining and unprofessional”. He provided examples to substantiate his concerns and concluded his email by saying “I do not wish this person assigned to my lists and, if this is inevitable, I feel strongly enough about it to cancel my list that day. I consider her detrimental to my practice and a weak, if any, asset in theatre.” 

ii.  The Panel considered Colleague D’s evidence to be consistent, straightforward, forthright and robust. He was balanced in his approach and prepared to consider other perspectives put to him but did not concede his evidence. 

b.   Witness 1: 

i.  a registered nurse who, at the material time, was Deputy Hospital Director, Head of Governance and Infection Prevention Control and the Head of Nursing and Allied Health Professionals at the Hospital. This role meant she was the clinical line manager for clinicians who were not doctors. Witness 1 assisted the Hospital Director to investigate the concern raised by the Registrant in respect of Colleague A and the un-responded to DATIX report. She was then appointed to undertake the disciplinary investigation in respect of the concerns raised about the Registrant. Witness 1 provided a witness statement dated 2 January 2024 to which she exhibited a number of documents.

ii.  The Panel did not consider that Witness 1’s statement was undermined by her live evidence but identified that her live evidence appeared more affected by the passage of time, which it considered unsurprising given the alleged events happened more than five years ago and she investigated the concerns rather than being present when they occurred. The Panel found Witness 1 to be reliable and fair, answering the questions to the best of her ability. She was also open to considering that her recollection may not be correct.

c.    Colleague U

i.  an experienced ODP employed by the Hospital at the material time as an Ophthalmic Specialist Lead who worked part time for two days a week. She provided the Panel with a statement dated 18 November 2023 in which she stated that the Registrant “was very passionate and had an innate sense of justice.” She felt that the Registrant had been treated unfairly, was “inflammatory and loud, but it came from a good place” but her conduct was “not always right”. Colleague U’s evidence related to particular 2.

ii.  The Panel considered that Colleague U gave credible and consistent evidence, being straightforward and forthright. 

d.   Colleague L

i.   a senior ODP employed at the Hospital from 2010, her statement was dated 3 February 2024. It confirmed that she worked with the Registrant often, sometimes once or twice a week. She attended the meeting on 11 November 2020 at the request of the anaesthetic lead to provide him with feedback as he was newly appointed to the role. She stated that the Registrant was “quite disruptive” at the meeting and “wanted to speak about [Colleague A] and was determined that the topic would be raised and made the meeting quite difficult by interrupting the team when other points were being discussed”. She also stated that the Registrant used to be happy to work with Colleague A and she did not know why their relationship had changed but they were both “difficult characters”.

ii.  The Panel noted that Colleague L answered the questions put to her to the best of her ability. Her evidence was consistent with her statement and did not undermine it. 

e.   Colleague I

i.  an ODP who worked at the Hospital from November 2019 until May 2021. She disclosed she had been reported to the HCPC in March 2022 but informed there was no case to answer in November 2023. She provided a witness statement dated 31 January 2024 in which she described the Registrant as “friendly, nice, caring” but that she questioned the actions of colleagues “a bit too much and it came across as overstepping…she would rush into actions and / or decisions without waiting to get the full picture”. Colleague I’s evidence related to Particular 2.

ii.  The Panel considered that Colleague I’s evidence was less direct than other witnesses and reflected her statement. She had strong opinions regarding the Registrant’s actions and was defensive of the department and those involved. In some regards her recollection differed to other witnesses but the Panel found her evidence to be forthright, open and candid. She appeared to have a different approach to DATIX reports and how to raise them and considered the Registrant to be unprofessional on occasion, which made her frustrated.

f.    Colleague A:  

i.  a doctor, surgeon and consultant anaesthetist, Colleague A had practising privileges at the Hospital at the material time. He was reported to his regulator in connection with the concerns raised by the Registrant and investigated. He was informed that there was no case to answer in April 2026 [redacted]. He provided a statement dated 6 June 2024 in which he confirmed that he worked with the Registrant most frequently when she joined the Hospital, and found her to be emotional and “a bit odd”. He said she “tended to say inappropriate things at work, had no filter and used a lot of swear words.” His evidence related to Particular 1(a) to (e).

ii.   The Panel determined that Colleague A had been affected the most, personally and professionally, by the manner and nature of the concerns allegedly raised by the Registrant to the Hospital. It was therefore perhaps understandable that he was more sensitive when giving his evidence, which came across on occasions as a sense of grievance towards the Registrant. This was particularly noticeable when Colleague A told the Panel that he considered that the Registrant attended work on 24 October 2020 either hungover or “half-cut”. the Panel heard that before the altercation with Colleague A the Registrant had attended the team meeting, and immediately after it she spoke to Colleague C. At least five colleagues had therefore had close contact with the Registrant and none of them raised concerns that she was under the influence of alcohol or otherwise unfit to attend work. Further, Colleague A did not at any stage say that the Registrant smelled of drink or was in any other way incapacitated – rather he reported to Witness 1 in a meeting with her on 23 November 2020 that the Registrant looked “angry and tired”. Colleague A also did not raise his concerns regarding drink with HR or management or log a DATIX report about the incident. 

iii.  The Panel considered that Colleague A appeared to have a good recollection of events and his evidence was consistent with his statement, albeit more detailed. The Panel observed that Colleague A was very suspicious during cross-examination, assertive and robustly rejected the Registrant’s version of events being put to him by the Registrant’s Representative. The Panel considered this to be consistent with some of the evidence of the Registrant and other witnesses regarding Colleague A’s behaviour.

f.    Colleague C:

i.   a registered nurse who was employed at the Hospital as the theatre lead between May 2018 and June 2022, therefore responsible for overseeing the running of the theatre department. She provided a statement dated 21 June 2024 which confirmed that she appointed the Registrant and oversaw her successfully completed probation but did not manage her on a “day-to-day basis”. She also frequently worked with the Registrant, got along with her and found her caring towards patients. However, she also found the Registrant “a bit argumentative and at times I felt like a parent who had to explain things in a more simplistic way for her to understand some situation that arose.” Colleague C provided support to the Registrant throughout her employment, including when she was off sick or suspended. She issued a warning to the Registrant in respect of the Registrant’s conduct towards Colleague A on 24 October 2020, which the Registrant did not challenge. 

ii.  The Panel found Colleague C’s oral evidence to be consistent, identifying when she could not remember a matter. She was balanced and gave a fair overview of the department and the Registrant. Her answers were expansive and she was a credible witness who was robust at times, sticking to her evidence in the face of the Registrant’s case being put to her. 

h.   Colleague B:

i.   a consultant anaesthetist employed at the Hospital from May 2019 until June 2021, Colleague B provided a statement prepared in August 2023 and signed in April 2026. He exhibited to his statement an email he sent to Witness 1 on 12 November 2020 in respect of the Registrant, expressing concerns that she was unprofessional, rude and used “spectacularly unsavoury language at great length”. He went on to describe her as “the single most disruptive and insubordinate character I have ever had the misfortune of working with.” concluding that the department would “benefit from her absence”. Colleague B’s evidence was largely confined to Particular 1(e). Colleague B did not recall being sent the notes of his meeting with Witness 1 to approve them, and could not recall the detail of that meeting.

ii.   The Panel found Colleague B to be a balanced, fair and succinct witness who stuck to his statement and did not speculate if he could not remember an event. He was somewhat clearer in his evidence when taken to relevant documents. 

60.          The Panel also had the benefit of receiving evidence from the Registrant in a statement dated 2 May 2026 and orally. She explained that she qualified as an ODP later in life and worked at the Hospital between October 2019 and August 2021. She worked with a number of colleagues in “a high pressure and very busy elective theatre environment” where she was a junior member of staff working alongside significantly more experienced ODPs, many of whom had been employed at the Hospital “for a significant number of years”. The Registrant described being intimidated by the “aggressive manners” of some surgeons, which unnerved her and made her uncomfortable. She struggled with:

a.   the differing communication styles, some of which she described as “aggressive, dismissive, informal, cliquey, intolerant, gossipy, unkind and malicious”; 

b.       junior members of staff getting less preferential treatment and being ostracised and ignored, especially in the coffee room; 

c.       different attitudes between departments; 
and said that the atmosphere was “quite toxic and made me unhappy at work”. 

61.          The Registrant said she was “specifically requested” by Colleague A and “moved off my list…with 0 minutes notice onto his” which she found disruptive to herself and colleagues and she considered could impact upon patient safety. She also asserted that Colleague A would also “run my Colleagues down to me”, particularly Colleague G and Colleague S. The Registrant was incredibly puzzled as to why her relationship with Colleague A had soured by October 2020 and told the Panel that she tried to secure mediation with Colleague A but he was not interested. 

62.          The Panel considered that the Registrant was broadly genuine giving her evidence to it, but that there were issues with her credibility and reliability, particular in relation to timings. It observed that her recollection of events varied quite widely between her statement, examination-in-chief, cross-examination and questioning by the Panel despite the short time frame between them. It found her evidence to be often incompatible with the more contemporaneous documents before it and on occasion neither plausible nor credible. The Panel was mindful this may be due to the passage of time and the Registrant’s health and did not consider that she was dishonest or lying to it, rather she was mistaken and doubling down on her own narrative. It was clear that the Registrant had a strong sense of justice and was passionate about her role, but the Panel struggled to reconcile this characteristic with her apparent lack of challenge, on her own behalf, to the: 

a.   warning and improvement plan she was given in October 2020 by Colleague C in respect of the altercation with Colleague A on 24 October 2020, which she spoke to HR about; 

b.   letter of 14 December 2020 to the Registrant from the Hospital Director which by the Registrant’s account, inaccurately reflected the meeting with Witness 1 on 13 November 2020 and confused the DATIX reports that she said had not been responded to; 

c.    meeting notes of 22 January 2021, which recorded they would be sent to her for review and approval, which the Registrant says are not accurate.

6.          The Panel also observed that the Registrant professed to be concerned solely about patient safety and concern for the health of Colleague A, but did not apparently raise or confirm these in writing other than through the unidentified DATIX she said she submitted on 9 October 2020, despite having emailed both Colleague C and another colleague about her concerns about Colleague G on 7 January 2020 and 26 October 2020. It contrasted this with the email chain she produced between herself and Colleague J (senior anaesthetic lead) which amounted to one sentence about the lack of response, on 12 November 2020, noting that her evidence was that she had followed up the lack of response to the 9 October 2020 DATIX “some days later”. 

64.          The Panel was however also mindful of the Registrant’s personal circumstances in 2020 and that her health deteriorated towards the end of the year. [Redacted].

The Panel’s approach
65.          The Panel is mindful that the burden of proving the Allegation is on the HCPC and that to do so, there must be sufficient evidence to satisfy the civil standard of proof. The Panel considered each of the particulars and sub-particulars of the Allegation separately and reached its own conclusions on the matters referred to. It listened carefully to the submissions of the Presenting Officer and the Registrant’s Representative and had regard to the documentary and oral evidence available to it. 

66.          Legal advice was provided to the Panel by the Legal Assessor, which it accepted and applied. The Panel also had regard to the HCPTS Practice Notes to which it was referred. It was mindful that it was obliged to approach the consideration of an allegation sequentially, determining firstly whether the facts set out in the allegation are proved, then whether those facts amount to the statutory ground set out in the allegation and if so, whether the Registrant’s fitness to practise is impaired. 

67.       In determining whether an allegation is “well founded” or “proved”, the Panel was required to decide firstly whether the HCPC, which has the burden of persuasion in relation to the facts alleged, has discharged that burden. It noted that whilst the Registrant had made a number of admissions to particulars and was ably represented at the hearing, the majority of the admissions were caveated by the context, and the context appeared to evolve with the evidence received by the Panel. The Presenting Officer therefore presented the HCPC’s case as though the admissions had not been made, and the Panel is required to consider and determine each particular accordingly. 

1(a)    Between 2020 and August 2021 you did not communicate professionally with colleagues and / or service users in that; a) On or around October 2020, to Colleague A, you stated that Colleague G was a “bitch” or words to that effect – PROVED
68.       The HCPC relied upon the evidence of Colleague A in respect of this Particular in addition to the Registrant’s admission of it. Colleague A told the Panel via his statement that the Registrant always challenged Colleague G and had taken an “instant dislike” to her. On the day in question, Colleague A was in an anaesthetic room when he heard commotion next door. He went to see what was happening and heard the Registrant make the alleged comment while she was in the corridor.

69.       In his oral evidence the Registrant said that the Registrant swore about Colleague G using “numerous expletives and gesturing with her arms”. He considered it unusual for a colleague to speak about other colleagues in such terms in the hospital in an area that patients accessed. 

70.       The Panel noted that the Registrant admitted the particular, stating to Witness 1 that she had “lots of concerns about [Colleague G’s] clinical practice”. The Panel was content that the particular is proved on the balance of probability by the Registrant’s admission and the evidence of Colleague A.

1(b)    Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; b) On or around October 2020, to Colleague A, you stated that Colleague S was a “cunt” or words to that effect – PROVED
71.       The HCPC relied upon the evidence of Colleague A in respect of this Particular. Colleague A told the Panel that the Registrant “appeared to dislike Colleague S for no reason”. He reported in his statement that, while he was in the coffee room with the Registrant and other staff, he heard the Registrant say that Colleague S was a “cunt” and that this was not the first time she had used inappropriate language about her colleagues, and such incidents happened frequently. 

72.       When cross-examined as to how he could be so clear as to what he had heard, Colleague A said that he was “very sure”.

73.       In her statement, the Registrant denied calling Colleague S a “cunt” and said she did not recall the conversation, incident, time, date or place. Her oral evidence reiterated her written account. In cross examination however the Registrant conceded that if she did call Colleague S a ‘cunt’, this would have been out of frustration.

74.       The Panel noted that in her meeting with Witness 1 on 22 January 2021, the Registrant was not asked specifically about calling Colleague S a ‘cunt’ but did refer to him as “passive aggressive”.

75.       As with particular 1(a), the Panel preferred the evidence of Colleague A to that of the Registrant. It considered that, given her admitted propensity for swearing, and her admission that she found Colleague S hard to work with, it was more likely than not that the Registrant had in fact referred to Colleague S as a ‘cunt’ or words to that effect. It therefore found this particular proved. 

1(c)(i) Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; c) On or around October 2020, to Colleague A you stated that kitchen staff; i. Person A was a “wanker” or words to that effect – PROVED

76.       The HCPC rely upon the evidence of Colleague A again in respect of this particular. His evidence was that this comment was made on 24 October 2020 following the team briefing when the surgeon offered to buy pizza. The Registrant, according to Colleague A, referenced the pizza being vegetarian. In his oral evidence Colleague A elaborated that the surgeon confirmed the Registrant could have a vegetarian pizza and if necessary the chef could prepare one. Colleague A told the Panel that the Registrant’s response was that Person A was a ‘wanker’ and that Person C was a ‘shit chef’. 

77.       The Registrant’s statement states that she did not recall making this statement regarding Person A and could not relate the alleged comment to anything at all. In her oral evidence she told the Panel that the incident did not happen as described and she made this comment about Person C to someone else in the coffee room, echoing what they had said on another occasion. 

78.       The Panel observed that, read in isolation, the allegation was not linked to the incident on 24 October 2020, which perhaps explained the Registrant’s inability to relate the making of the comment to anyone. However, the context provided by Colleague A provided a plausible scenario as to why the Registrant could have made the comment about Person A. The Panel noted that the Registrant had not been in a good mood on 24 October 2020, arriving late to work and having issues with the anaesthetic machine and conflict with Colleague A before the surgeon offered to buy food for the team. The Panel consider that, given the Registrant’s tendency to swear, it was more likely than not that the Registrant had in fact told Colleague A that Person A was a “wanker”, or words to that effect. The Panel therefore found the particular proved on the balance of probability. 

1(c)(ii)  Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; c) On or around October 2020, to Colleague A you stated that kitchen staff and/or ii. Person C was a “shit chef” or words to that effect – PROVED
79.       The Panel considered the information in respect of particular 1(c)(i) above is relevant to this particular and therefore adopts, and does not repeat, it. The Panel notes that the Registrant admits referring to Person C as a ‘shit chef’, but she asserts that the comments was made in an open conversation in the coffee room in response to a colleague commenting on the quality of the food.

80.       Whilst the Panel consider it possible that the Registrant may have referred to Person C as a ‘shit chef’ on more than one occasion, it considers it more probable that in fact the comment was made in the anaesthetic room following the surgeon offering to buy pizza for the team after the briefing of the team before the face lift procedure. Accordingly, the Panel finds this particular proved on the balance of probability and by the Registrant’s admission. 

1(d)    Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; d) On or around October 2020, when Colleague A asked you whether you wanted to be here, you responded with, “I don’t and fuck off” or words to that effect – PROVED
81.       The HCPC rely upon the evidence of Colleague A and Colleague C in respect of this particular. Colleague A says in his statement that having arrived in a bad mood, late for surgery and tired, the Registrant told him to “fuck off” when he asked her if she wanted to be at work. During his live evidence, Colleague A elaborated further on the circumstances, stating that the Registrant told him to fuck off on multiple occasions that day and gave him “the finger”.

82.       Colleague C confirms that she heard the Registrant tell Colleague A to “fuck off” once, and spoke to the Registrant at the time in the changing room to dissuade her from leaving the site given the impact this would have upon the list for the day. She told the Panel that the atmosphere that day was not “banterish” but rather was hostile and seemed completely different. In cross examination she was asked about the Registrant’s state of mind and ability to do her job and responded that “I wasn’t privy to what had happened beforehand. However knowing [the Registrant] and her temperament, she was visibly frazzled, she didn’t want to be there and said she had got to go home”. Colleague C then stated that the Registrant seemed more angry than anything else which is why she asked her to stay to calm down. Colleague C told the Panel that she would not expect someone who wasn’t well enough or in the right frame of mind to keep working, but she believed that the Registrant could have worked in recovery or the other theatre. She was of the view that the Registrant “wasn’t having any of it” and had no thought for the rest of the team or the patients and was already getting changed to go home. Colleague C found the Registrant’s behaviour on 24 October 2020 to be “really unfair” and said the Registrant should have stayed and been professional. Instead, Colleague C had to delay the start of the list to rejig the staffing and proceed safely in the absence of the Registrant. 

83.       When Colleague C was asked by the Panel to expand on what she meant by the Registrant’s temperament, she told it that the Registrant could be “very volatile and high tempered and disruptive”. She thought the Registrant was unaware of the loudness of her voice and its tone, and that she was sometimes “not professional before patients and other colleagues and could be scatty”. Staff complained that she left her workspace in a mess and was negative. She was rude to staff in other departments and would complete a DATIX report rather than raise an issue with someone informally. She also did not use DATIX for anything positive. Colleague C found the Registrant to be very challenging, bringing complaints, negativity and gossip and generally being unprofessional in the workplace. 

84.       The Registrant in her statement said that she admitted telling Colleague A to ‘fuck off’ but not as particularised. She stated “This incident did not occur. Based on my behavioural history and the evidence of colleagues familiar with me. I do not react in this manner when distressed”. In her evidence in chief the Registrant told the Panel that she told Colleague A “I will fuck off then” in response to being told to leave the operating theatre and that she was desperately upset. She also told the Panel that she did not agree with the email confirming the verbal warning issued by Colleague C. She said that she did not accept telling Colleague A to ‘fuck off’, but had said the words ‘fuck off’, however didn’t see the point in challenging it.

85.       The Panel carefully considered the various accounts that had been presented to it in respect of this particular. It found the balanced account of Colleague C persuasive and plausible and determined that it was more likely than not that the Registrant did tell Colleague A to ‘fuck off’ on 24 October 2020 as described by Colleague C. The Panel was satisfied that this particular was proved on the balance of probability and by the Registrant’s own admission.

1(e)(i)   Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; e) On 04 November 2020, following the Gynaecology Swarm, you stated that Colleague G; i) Was “fucking useless” or words to that effect – NOT PROVED 
86.       The HCPC relies on the evidence of Colleague B in respect of particular 1(e). However, his statement does not confirm what the Registrant is alleged to have said and in fact states that he does not recall what was said. In his live evidence to the Panel, Colleague B told it that he did not recall being sent the notes of his meeting with Witness 1 or the content of the same but conceded that it was possible that they accurately reflected what had happened. He vaguely remembered the Registrant saying negative things to him about Colleague G but told the Panel that his strategy for dealing with someone venting like that was to just nod and smile until he could extricate himself from the situation. Colleague B acknowledged that he was aware of the breakdown of the relationship between Colleague A and the Registrant but was not sure what happened with the DATIX. He confirmed that his email of 12 November 2020 raising concerns about the Registrant was a general email and nothing to do with the swarm meeting. 

87.       Colleague A made reference to discussing this incident with colleagues but confirmed that he did not attend the swarm meeting. 

88.       The Registrant denied referring to Colleague G as useless or dangerous but conceded that she had longstanding concerns as to Colleague G’s practice which she did not raise in the swarm meeting even though that is one of the purposes of the meeting. 

89.       The Panel did not consider that the HCPC had provided it with sufficient evidence to discharge its burden of proof in respect of this particular. It therefore found the particular not proved.

1(e)(ii)  Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; e) On 04 November 2020, following the Gynaecology Swarm, you stated that Colleague G ii) Was “dangerous” or words to that effect – NOT PROVED
90.       The Panel considered the information provided to it in respect of particular 1(e)(i) applies equally to this particular and therefore adopts, and does not repeat, it.

91.       For the same reasons as particular 1(e)(i), the Panel did not consider that the HCPC had provided it with sufficient evidence to discharge its burden of proof in respect of this particular. It therefore found the particular not proved.

1(e)(iii)   Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; e) On 04 November 2020, following the Gynaecology Swarm, you stated that Colleague G iii) Had “fucking lied” or words to that effect – PROVED
92.       The Registrant admitted this particular and provided the Panel with detail in her oral evidence as to why she thought Colleague G had lied in the swarm meeting by way of context. 

93.       The Panel was content to accept the Registrant’s admission in respect of this particular and found the allegation proved on the balance of probability.

1(f)     Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; f) On 19 August 2021, in a conversation with Service User B about Canada, you stated, “they’ve had that scandal in Canada. I blame the White, Male Priests” or words to that effect – PROVED

94.       The Panel heard from Colleague D that while he was operating on Service User B on 19 August 2021, he heard the Registrant talking to him about his family in Canada, making no mention of priests. She then “surprisingly and without any sequitur said those words”. When asked how certain Colleague D was about the words used, he said he emailed the theatre manager, Colleague C, to explain that he did not want the Registrant on his team as a result. He said he had been irritated about her behaviour for quite some time, and she disrupted the harmony and efficiency of the theatre. 

95.       When cross-examined Colleague D said that he did not agree that anything said in the lead up to the Registrant’s comment justified it, whatever was said, it came out of the blue. He maintained that he discussed the incident with Colleague C and then followed that conversation up with an email. The purpose of his email to the theatre manager was not to sanction the Registrant, just ensure that she was no longer on his team. He therefore included enough information to “justify the demand” and concluded his email by stating that he would “cancel my list” if she was assigned to him. 

96.       During questions asked by the Panel, Colleague D explained the apparent inconsistency in his evidence as to when the mail sent on 27 August 2021 was written, telling the Panel that it was his practice to write an email in draft and then “have a think about it” before sending it. 

97.       The Registrant’s statement admitted the particular but set out that the patient “initiated the conversation” about Canada when the Registrant commented upon his accent and “ongoing current news stories about historical abuse within religious institutions. My response was part of that conversation.” However, the Registrant told the Panel that she made the response when the patient said that it was not the same as when he moved there. She accepted “wholeheartedly” that she mentioned the priests and should not have done this. [Redacted]. She then reported that she had a difficult relationship with Colleague D and used to dread working with him as he did not make a “hospitable environment”. 

98.       The Panel was satisfied this particular is proved on the balance of probability by virtue of the Registrant’s admission and the evidence provided to it. 

2(a)(i)   On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that; i) You implied that Colleague A was taking Opiates with them to the loo – PROVED
99.       Colleague I’s statement told the Panel that the Registrant started the discussion about Colleague A at the meeting, observing that he goes to the toilet during the first procedure after lunch and querying “whether or not he was taking the drugs for himself” as he did not sign the medication record immediately and placed controlled drugs for a patient in a cupboard. Colleague I said she was uncomfortable at these comments being made and that it felt like the Registrant was “riling up the crowd” and making an “indirect accusation”. 

100.       In her oral evidence, Colleague I said that the Registrant was “heavily implying that Colleague A was messing about with the drugs and going to the loo” but in her opinion Colleague A hardly used opiates in his practice and was very thorough, so she just did not understand the accusation. Her opinion was that the Registrant “had a beef with Colleague A” and made a “very targeted hint to everybody”. Colleague I told the Panel that she did not consider Colleague A to be erratic, and she would want him to anaesthetise her child because he was so thorough. During cross-examination Colleague I told the Panel that the Registrant had a problem with Colleague A and had walked out on him, leaving the site when operating. Colleague I considered that the Registrant was “bitter with him” and it was “all bizarre”.

101.       Colleague L’s statement said that, at the meeting on 11 November 2020 the Registrant was disruptive, wanting to speak about Colleague A and interrupting colleagues when other points were being discussed. When the matter was discussed, the Registrant said she was unhappy with Colleague A and felt he was “untrustworthy” and not to be trusted with controlled drugs as he “had mood swings because he was taking drugs”. She found this confusing as when the Registrant first started at the Hospital, she was always happy to work with him. 

102.       In her oral evidence, Colleague L reiterated that the Registrant told the meeting that she did not find Colleague A trustworthy around controlled drugs and thought he had mood swings due to misusing drugs. Colleague L confirmed she had raised her own concerns with management about Colleague A and been assured that he was being watched and observed. Colleague L did not initially recall the Registrant mentioning the DATIX report of a Fentanyl syringe in the cupboard but did when prompted. She stated that if the Registrant had not had a response to a DATIX, it could be appropriate for the lack of response to be aired in the meeting on 11 November 2020. She confirmed that, although she could be wrong, the Registrant had said that Colleague A takes loo breaks or takes drugs in the toilet. She herself had mentioned Colleague A’s loo breaks to Colleague C and escalated it to Witness 1 when she did not have a response. 

103.       Colleague L did not accept the suggestion from the Registrant’s Representative that the Registrant was raising concerns from a point of concern about the mental health of Colleague A. She told the Panel she had observed the Registrant and Colleague A and they were “extremely close then at each others throats – hot and cold”. She considered both to be “distracted” by whatever the relationship was and angry and retaliatory. She reported discussing Colleague A’s requests to put the Registrant on his list with Colleague A, telling him he should not change staff. Colleague L agreed that the Registrant raised the issue of Colleague A and the Fentanyl due to patient safety, but said that there was “a more personal interaction there”. 

104.       In response to Panel questions, Colleague L said that the Registrant was disruptive during the meeting and kept asking to discuss Colleague A even when other items were being discussed. 

105.       Colleague U’s statement set out that the Registrant raised a concern at the meeting, that Colleague A was “siphoning off controlled drugs”. It was Colleague U’s understanding from what the Registrant said that Colleague A had hidden the fentanyl syringe for his personal use. She did not think the Registrant raised the issue of Colleague A’s erratic behaviour as she raised the initial concern and other colleagues “chipped in”. 

106.       Colleague U was clear in her oral evidence to the Panel that the Registrant raised an “inference or possibility” but not in an accusatory way in respect of Colleague A at the meeting. She said that “almost everyone without exception had something to say” on the issue. She accepted that she raised the issue of Colleague A going to the toilet when in theatre but didn’t think she was the only one that talked about it. She told the Panel that she had already raised concerns about Colleague A with the Medical Chair of the hospital and felt unable to raise it with Colleague C due to her close relationship with Colleague A. She was reluctant to submit a DATIX on the matter as Colleague A had access to those reports. Colleague U stated that everyone contributed to the discussion about Colleague A’s mood swings and erratic behaviour, including the Registrant.

107.       Witness 1 told the Panel that the Registrant raised a concern with the Hospital Director on 13 November 2020 in respect of Colleague A “taking opiates at work” and a syringe believed to contain Fentanyl being found in a cupboard. Witness 1 was appointed to assist the investigation into the allegation regarding the syringe, reporting back to the Director. She interviewed the Registrant on 13 November 2020 and audited the controlled drugs process and records, finding no discrepancies. She also reviewed the DATIX submitted in July 2020 given the similarities with this case. She reported back to the Hospital Director, who then wrote to the Registrant by a letter dated 14 December 2020 to the effect that there was no evidence that an anaesthetist was taking opiates at work or had the alleged mental health condition. 

108.       Witness 1 was then appointed to investigate the concerns about the Registrant’s conduct at the meeting on 11 November 2020. She interviewed the Registrant on 22 January 2021 and recorded the Registrant saying that people expressed concern about Colleagues A’s behaviour in the meeting and that he had upset them. The Registrant could not remember what she said about Colleague A and reported that Colleague U raised Colleague A going to the loo a lot, especially during lockdown. The Registrant is recorded as saying that the meeting did not talk about Colleague A using opiates but she felt that he had been “pretty nonchalant about the fentanyl”. [Redacted]. She went on to say that staff had been “talking about issues but it was wrong for it to be discussed in that setting… the latter part of the meeting was not professional”.

109.       The Panel accepted the Registrant’s partial admission (in respect of the stem of the allegation that she raised issues in the meeting on 11 November 2020 rather than following Hospital procedure) and preferred the evidence of Colleagues I, L and U that the Registrants contributions to the meeting amounted to her implying that Colleague A was taking opiates to the loo. It was content that particular 2(a)(i) was proved on the balance of probability. 

2(a)(ii)  On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that You implied that Colleague A was taking Opiates for their personal use – PROVED
110.       The Panel considered the information in respect of particular 2(a)(i) above applied equally to this particular and adopts it without repeating it. 

111.       The Panel accepted the Registrant’s partial admission (in respect of the stem of the allegation that she raised issues in the meeting on 11 November 2020 rather than following Hospital procedure) and preferred the evidence of Colleagues I, L and U that the Registrants contributions to the meeting amounted to her implying that Colleague A was taking opiates for personal use. It was content that particular 2(a)(ii) was proved on the balance of probability. 

2(a)(iii)   On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that You stated that Colleague A had “mood swings due to taking drugs” or words to that effect – PROVED
112.       The Panel considered the information in respect of particular 2(a)(i) above applied equally to this particular and adopts it without repeating it. 

113.       The Panel accepted the Registrant’s partial admission (in respect of the stem of the allegation that she raised issues in the meeting on 11 November 2020 rather than following Hospital procedure) and preferred the evidence of Colleagues I, L and U that the Registrant raised the issue of Colleague A having mood swings due to taking drugs. It was content that particular 2(a)(iii) was proved on the balance of probability. 

Decision on Statutory Grounds

Submissions

114.       The Presenting Officer submitted that, having found some facts proved, the Panel would now consider whether any of them amount to the statutory ground of misconduct. He reminded the Panel that this is a matter of judgement by the Panel. The HCPC does not therefore provide separate evidence on this point but rather addresses the principles which apply to the determination as to whether a statutory ground of impairment is made out.

115.       It was the HCPC’s case that the Registrant’s behaviour fell seriously short of that expected of a registered professional. The Presenting Officer recognised that the Registrant made partial admissions in respect of her conduct falling short of the standard and referred the Panel to the HCPTS Practice Notes in respect of grounds and impairment. He observed that the allegation relates to the period between 2020 and 2021 and submitted that this amounted to a period of repeated and sustained failure on the Registrant’s part. He invited the Panel to consider the seriousness of the Registrant’s conduct and how this could impact upon the confidence of the public when considering the issue of misconduct.

116.       By way of general overview, the Presenting Officer submitted that:
a.   in the case of Meadow v General Medical Council [2007], the Court of Appeal made clear that “misconduct” should not be viewed as anything less than “serious professional misconduct”;

b.   in Roylance v General Medical Council [1999], the Privy Council identified “the essential elements of the concept” of misconduct and connected them to the rules and standards ordinarily required to be followed by registered professionals. Further, the misconduct must be professional in nature and serious; 

c.    the relevant HCPC Standards of Conduct, Performance and Ethics which apply are dated 2016 and include: 

2.1   You must be polite and considerate;
9.1   You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
a.     the standards specific to the Registrant’s profession are the Standards of Proficiency for Operating Department Practitioners dated 2014 and expect the Registrant to:
1.1   know the limits of their practice and when to seek advice or refer to another professional;
2.1   understand the need to act in the best interests of service users at all times;
2.3   understand the need to respect and uphold the rights, dignity, values, and autonomy of service users including their role in the diagnostic and therapeutic process and in maintaining health and wellbeing;
3.1   understand the need to maintain high standards of personal and professional conduct;
8.1   be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues and others;
9.4   be able to contribute effectively to work undertaken as part of a multi-disciplinary team;
15    understand the need to establish and maintain a safe practice environment.

117.       The Registrant’s Representative rejected the assertion that ODP standard 1.1. was relevant as the Registrant had not exceeded the limits of her practice. She submitted that the core issue was communication. The Registrant had clearly been keen to raise issues on DATIX – there may have been concerns as to how the concerns were raised, but there could be no suggestion that the Registrant did not raise concerns when she identified them. Standard 2.1 was also not breached by the Registrant in the submission of her representative. The Registrant accepted that she should not have used the wording which is set out in Particular 1(f) in discussion with the patient, but noted that the patient had not complained about the Registrant – the complaint came from the surgeon, Colleague D. Every other issue related to conversations with colleagues in corridors, not in front of patients. 

118.       In respect of the incident on 24 October 2020, at the lowest the Registrant responded inappropriately to the altercation with Colleague A and was disciplined by the Hospital accordingly. The Registrant’s Representative reminded the Panel that staff were reallocated to ensure that the procedures planned for that day were completed, albeit later than planned. 

119.       The Registrant had accepted from the outset that the communication style across the department was below the standard of communication expected but her Representative invited the Panel to find that this misconduct was not serious having regard to what was going on at the time. It was clear that there were people swearing and others raising issues in respect of Colleague A at the meeting. Where the Registrant had “stepped outside” the normal phrases used in the department, this had been “candidly accepted”. The Registrant’s Representative invited the Panel to carefully assess the seriousness of the misconduct in accordance with the caselaw set out in the HCPC’s case summary, which she said did not meet the threshold of seriousness as it did not involve dishonesty, patient safety or a direct risk to patient safety. If the conduct factually proved amounted to misconduct, she submitted that it was at the lowest end of the spectrum. 

120.       The Panel received advice from the Legal Assessor, which it accepted and applied, and was referred to relevant HCPTS Practice Notes. 

121.       Having found a number of particulars proved and received submissions in respect of the statutory ground on behalf of both parties, the Panel noted it was required to judge whether a statutory ground of impairment, as advanced by the HCPC, was engaged. It was conscious that deciding the issue of statutory ground was a matter for its own judgement and that it needed to consider the statutory ground of impairment in respect of each of the particulars found proved. 

122.       The Panel took into account the submissions of the advocates in respect of reaching its decision on what, if any, statutory ground was engaged in respect of the proved particulars. It determined that the following Standards were engaged in respect of the proved particulars: 

a.   Standards of Conduct, Performance and Ethics [2016]: 
9.1   You must make sure that your conduct justifies the public’s trust and confidence in you and your profession; 

b.   Standards of Proficiency for Operating Department Practitioners [2014]:
Registrant Operating Department Practitioners must:
3.1   understand the need to maintain high standards of personal and professional conduct;
8.1   be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues and others;
9.1   be able to work where appropriate, in partnership with service users, other professionals, support staff and others 
9.2   understand the need to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team.

123.       The following authorities were considered by the Panel to be relevant to its considerations in respect of whether a statutory ground was made out: 
a.       Roylance v General Medical Council No 2 [2000] 1 AC 311, which advances the premise that:
“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a.... practitioner in the particular circumstances. The misconduct is qualified in two respects. First it is qualified by the word ‘professional’ which links the misconduct to the profession ...Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.” 

b.       R (Remedy UK Ltd) v GMC [2010] EWHC 1245 (Admin), which states that the conduct must be “sufficiently serious that it can properly be described as misconduct going to fitness to practise”. Therefore, not all acts and omissions of a registrant will be regulatory matters; some will fall outside of the scope of the jurisdiction of regulatory law.

c.       Shaw v General Osteopathic Council [2015] EWHC 2721 (Admin), which suggests that in matters which are finely balanced, the issue of moral blameworthiness or opprobrium can be taken into account as a relevant factor of misconduct. 

d.       Calhaem v General Medical Council (2007) – which assessed caselaw and concluded that 5 principles were relevant to the issue of conduct:

i.        Mere negligence does not constitute misconduct, however negligent acts or omissions which are particularly serious may amount to misconduct. 

ii.        A single negligent act or omission is less likely to amount to misconduct than multiple acts or omissions but in some circumstances a single act or omission, if grave, could be misconduct.

 iii.        Deficient professional performance is different to negligence and misconduct. It connotes a standard of professional performance which is unacceptably low and which, save in exceptional circumstances, has been demonstrated by reference to a fair sample of the doctor’s work. 

iv.        A single instance of negligent treatment, unless very serious indeed, would be unlikely to constitute deficient professional performance. 

v.        It is neither necessary nor appropriate to extend the interpretation of deficient professional performance in order to encompass matters which constitute misconduct.

e.       Beckwith v SRA [2020] EWHC 3231 (Admin), which states that it is necessary to focus on the particular statutory and regulatory provisions applicable to a particular profession, rather than attempt some universal statement of principle, and that there is a need to hold members of a profession to a higher standard on some matters, while not falling into the trap of requiring members of that profession to be paragons of virtue in all matters.

124.       The Panel therefore proceeded to consider each particular proved on the facts to determine whether a statutory ground of impairment had been established. It noted that all of the events took place within the work place and were connected with the Registrant’s work. It was therefore content that the conduct related to the Registrant’s profession and was therefore professional in nature.

1(a)    Between 2020 and August 2021 you did not communicate professionally with colleagues and / or service users in that; a) On or around October 2020, to Colleague A, you stated that Colleague G was a “bitch” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT

125.       The Panel carefully considered the context of this particular. It recalled that the Registrant emailed herself about her concerns with Colleague G’s practice on 17 December 2019, then forwarded the email to Colleague C on 7 January 2020. She stated that she also emailed another senior manager about her concerns and did not get any response. The Panel received evidence that the Registrant “always challenged Colleague G on everything” and appeared to have taken an instant dislike to Colleague G. The Panel was not provided with the reason for the Registrant calling Colleague G a ‘bitch’ on this particular date, but noted that the Registrant admitted “expressing frustration to [Colleague A] regarding catheterisation positioning, yet again” and accepted that she “lost patience, hence her language”.

126.       The Panel determined that the Registrant appeared unable to internalise her thoughts and feelings about Colleague G. She appeared unable to accept that her concerns were not shared by her colleagues at the Hospital and considered it appropriate to vent this frustration, in the Hospital, to colleagues who were peers of Colleague G. In doing so, the Registrant did not treat Colleague G with respect, put the colleagues she vented to into a difficult situation and created ‘disharmony’ in the workplace which, by her own admission, could impact patient safety. 

127.       Whilst the Panel considered using the word ‘bitch’ in isolation may be considered to amount to misconduct, it concluded that the context of admitted uncontrolled frustration, repeated complaints to management and challenges to Colleague G’s working practices that were not upheld and regular venting about Colleague G rendered this misconduct into serious professional misconduct, being conduct that fell far short of that expected of a registered ODP.

1(b)    Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; b) On or around October 2020, to Colleague A, you stated that Colleague S was a “cunt” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT
128.       The Panel considered this particular to be something of an outlier as it was provided with little, if any, explanation as to why the Registrant disliked Colleague S. The Panel noted that while the Registrant denied the incident, she accepted that if she had called Colleague S a ‘cunt’, this would be extremely serious and she would expect there to be consequences. She said that if she had used the word, it would have been out of frustration. There was little evidence of the Registrant having a challenging working relationship with Colleague S, other than the account of Colleague A that the Registrant disliked Colleague S for no reason, and no context as to why the comment was made – it was a comment that was overheard by Colleague A when the Registrant was talking to colleagues in the coffee room. 

129.       The Registrant accepted that she was at the top end of the scale for swearing in the Hospital and the Panel considered that she demonstrated a propensity to use inappropriate, foul and or abusive language about colleagues from across the Hospital. The language used on this occasion was particularly serious with no obvious context or provocation. The Panel was therefore satisfied that the Registrant’s conduct by using this word was serious and in a professional location. It therefore amounted to serious professional misconduct and therefore amounted to the statutory ground of misconduct.

1(c)(i) Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; c) On or around October 2020, to Colleague A you stated that kitchen staff; i. Person A was a “wanker” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT
130.       The Registrant’s account in respect of this particular was that she did not recall using the term ‘wanker’. She did not appear to have connected this particular to the events of 24 October 2020. In isolation, the Panel was content that the use of this word may not amount to serious misconduct. However the Panel had established that the language was used by the Registrant when she had already had an altercation with Colleague A and reacted inappropriately to an offer by the operating surgeon to buy the team pizza for lunch. This comment was therefore part of a wider escalation of conduct by the Registrant and was serious and apparently unprovoked, being made as a result of the Registrant’s general mood and demeanour on that date. The Panel therefore considered the use of the word ‘wanker’ about a colleague in these circumstances to be serious professional misconduct and indicative of a registrant with fragile control of her emotions in the workplace and a lack of respect for her colleagues and the professional environment. 

1(c)(ii)  Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; c) On or around October 2020, to Colleague A you stated that kitchen staff and/or ii. Person C was a “shit chef” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT 
131.       The Panel found this comment was also made by the Registrant on 24 October 2020 in the same conversation in which she called Person A a ‘wanker’. It noted that the Registrant’s account was that she made the comment, which she admitted saying, on a different occasion to a different colleague in a different location. This suggested to the Panel that the Registrant regularly used foul language to her colleagues regarding her non-medical colleagues. 

132.       The Panel considered this particular to be further evidence of the Registrant having limited self-control and an inability to regulate her language in the workplace, even while discussing food. The context suggested to the Panel that the Registrant had a pattern of lashing out verbally when displeased or upset. It was content that the making of the comments in the circumstances amounted to serious professional misconduct. 

1(d)    Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; d) On or around October 2020, when Colleague A asked you whether you wanted to be here, you responded with, “I don’t and fuck off” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT.

133.       The Panel adopts and does not repeat its findings in respect of the facts of this particular, especially the evolution it identified in the Registrant’s evidence in relation to this matter. It considered that the Registrant’s conduct in telling Colleague A to ‘fuck off’ when told to leave the theatre on 24 October 2020 amounted to serious professional misconduct. This conduct was compounded by the Registrant refusing to reconsider her course of action when asked to stay and work through the situation by Colleague C. 

134.       The Panel concluded that the Registrant put her own needs before those of her colleagues, patients or the Hospital by leaving the premises having sworn at Colleague A. It considered that her serious professional misconduct was exacerbated when she apologised to Colleague C but challenged the disciplinary warning issued. Even during the course of the hearing, the Registrant refused to accept the basis of the disciplinary sanction issued by Colleague C in respect of the Registrant’s behaviour. It was content that this particular amounted to serious professional misconduct.

1(e)(iii)   Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; e) On 04 November 2020, following the Gynaecology Swarm, you stated that Colleague G iii) Had “fucking lied” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT.
135.       The Panel recalled that the Registrant admitted this particular, against the context of her not challenging Colleague G’s version of events in the swarm meeting and venting to a number of colleagues about what happened in the meeting once it concluded. 

136.       The Panel noted that the purpose of a swarm meeting is to address areas of concern and embed learning relevant to patient safety. It considered that any residual concerns she held about Colleague G should have been raised in the meeting and not to individual colleagues once the meeting ended. In telling colleagues individually after the meeting that Colleague G had lied about what had happened, the Registrant did not act professionally. She undermined Colleague G and questioned her integrity in an indirect manner, having apparently declined to take the appropriate opportunity to air her concerns in the swarm meeting The Registrant’s conduct breached a number of the standards she was expected to comply with in the Panel’s view. 

137.       The Panel considered the Registrant’s conduct in respect of this particular to be very serious. It was unable to identify any development in the Registrant’s understanding of the serious nature of her conduct in the time that elapsed since the incident occurred. 

1(f)     Between 2020 and August 2021 you did not communicate professionally with colleagues and/or service users in that; f) On 19 August 2021, in a conversation with Service User B about Canada, you stated, “they’ve had that scandal in Canada. I blame the White, Male Priests” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT 
138.       The Registrant accepted making an unprofessional comment as set out in this particular, but initially told the Panel that she made the comment in response to conversation made by the patient. By the end of the hearing the Registrant accepted that she had been the person to mention priests, and accepted this was inappropriate. She did not however appear able to appreciate the potential impact of her comment on the patient. She chose not to comment on the fact that, as a result of her behaviour, Colleague D told Colleague C he would rather cancel his list of patients than work with the Registrant in his email of 27 August 2020.

139.       The Panel was content that while the comment set out in this particular was ill-advised, the greater concern for it was that the Registrant considered it appropriate to make the comment, and then to deflect the origin of it onto her patient before finally accepting, in the hearing, that she introduced the topic upon hearing that the patient was from Canada. The Panel consider that the Registrant’s conduct in this regard amounts to serious professional misconduct.

140.       The Panel was unable to identify any development in the Registrant’s understanding of the serious nature of her conduct in the time that elapsed since the incident occurred. 

2(a)(i)   On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that; i) You implied that Colleague A was taking Opiates with them to the loo – SERIOUS PROFESSIONAL MISCONDUCT
141.       The Panel adopts and does not repeat its findings in respect of this particular. It considers the Registrant adopted a subversive and divisive approach to seeking a response she found satisfactory to the concerns she raised regarding the Fentanyl syringe she alleges she found in the cupboard. Further, it appeared to the Panel that the Registrant disguised her desire for a satisfactory answer by attributing it to her concern for Colleague A’s health. 

142.       The Panel could not identify any recognition by the Registrant as to the impact of her comments upon Colleague A, his colleagues and patients. It determined that she wished to pursue satisfaction on the matter for her own purposes. She then repeated her concerns to Witness 1 in a meeting on 13 November 2020. 

143.       The Panel struggled to reconcile the Registrant’s repeated assertion that she raised the concerns due to the impact on patient safety and out of concern for Colleague A with the absence of any documentary evidence such as the DATIX submission receipt, emails to Colleague C or Witness 1 about her concerns or reporting them to her trade union representative. Further, the Registrant appeared to be blind to the impact that her assertions would have upon her colleagues, particularly Colleague A. The Panel was satisfied that the Registrant’s conduct in respect of Particular 2 amounted to serious professional misconduct. 

2(a)(ii)  On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that You implied that Colleague A was taking Opiates for their personal use – SERIOUS PROFESSIONAL MISCONDUCT

144.       The Panel adopts the rationale set out in respect of particular 2(a)(i) above in respect of this particular and does not repeat it. 

2(a)(iii)   On 11 November 2020, during a meeting with other Operating Department Practitioners; a) You raised concerns about Colleague A without following the Trust’s available procedures for raising concerns in that You stated that Colleague A had “mood swings due to taking drugs” or words to that effect – SERIOUS PROFESSIONAL MISCONDUCT

145.       The Panel adopts the rationale set out in respect of particular 2(a)(i) above in respect of this particular and does not repeat it.

Decision on impairment
Submissions
146.       Prior to making submissions on impairment, the Registrant’s Representative recalled the Registrant to give further evidence under oath, and also called two witnesses as to the Registrant’s character. 

147.       The Registrant told the Panel that she had reflected continuously, personally and professionally, on how she communicates with others [redacted]. She told the Panel that her diagnosis had helped her understand a lot about herself and how others perceived her. She had more strategies to utilise now and considered that she had been “very misunderstood all my life which impacted my whole life”. She explained her understanding of how communication impacts patient safety and colleagues. [Redacted].

148.       When asked for her views of the public perception of being allowed to remain in practice, the Registrant could only speak for herself and explained that people would be concerned at any hostility in the team, which may impact the ability of practitioners to practise safely and efficiently.

149.       The Presenting Officer asked the Registrant whether she had minimised her conduct, to which she responded “potentially yes however I would say that I did not use [the word cunt]. I have been found to have used it”. She went on to say that if she heard foul or abusive language, she would explore why it was used and deter future use. 

150.       The Registrant was also asked whether she tried to blame colleagues and suggest they had colluded against her. She said that she had tried to “put the entire scenario into a context” but it was “not as black and white as it may have appeared. And I hope it has been acknowledged, theatres are not as pious as we would like them to be.”

151.       When the Presenting Officer suggested to the Registrant she had “hidden behind colleagues at a similar level” she denied not being frank, saying she had huge patient safety concerns which she raised in accordance with protocol.

152.       The Presenting Officer also invited the Registrant to elaborate on the challenges she faces following her diagnosis. The Registrant told the Panel that her diagnosis has impacted her in lots of ways [redacted]. 

153.       In response to Panel questions the Registrant confirmed that she had moved house [redacted] and had “become anonymous” in terms of social media. She did not want to be misunderstood any more. She had last been employed in a registered role in October 2024 and since then had limited opportunities to undertake training and maintain her practical skills. She wished to return to practice and considered herself a “good reliable ODP” with integrity. She had reflected continuously and believes she still has the skillset to succeed, but recognised that she will have de-skilled in her absence from practice. 

154.       In terms of the support needed to return to the workforce, the Registrant said she would require support to familiarise herself with new equipment and until she felt “sufficiently revised”. She confirmed she would raise any future concerns about colleagues with her line manager in the first instance and take their advice, following her query up with an email to ensure an audit trail. She would not discuss a difference of opinion in the presence of the patient but would question it appropriately later. 

155.       The Panel also heard from the Registrant’s current manager in a hospitality venue, who confirmed that the Registrant worked in a stressful environment which could be fraught and time sensitive. The Registrant was professional and builds good relationships with people – she is well-liked. There had been no issues with the Registrant’s communication, but a member of staff had to be reprimanded for speaking out of turn to her on one occasion. The Registrant had handled the situation professionally. 

156.       The Panel also heard from a former work colleague of the Registrant who said that the Registrant was friendly, bubbly and calm, a very good practitioner who communicated professionally and normally. She observed no issues with any working relationships of the Registrant. 

157.   In respect of impairment, the Registrant’s Representative reminded the Panel of the provisions of the Impairment Practice Note and encouraged it to consider the seriousness of the issues before it. She submitted that the Registrant did not swear in patient areas and invited the panel to find that the conduct was not at the top of the scale of seriousness. 

158.   The Registrant demonstrates “full insight into her [health] status” according to her representative, and a degree of insight into the misconduct which was, in her representative’s submission, at the lower end of the scale of conduct. She has reflected upon her behaviour and understands how to communicate properly. She manages things differently now and is more self-aware as to how she is perceived.

159.   The Registrant’s Representative rejected the suggestion that the Registrant hid behind her colleagues and reminded the Panel of the inconsistencies in the witness evidence. She submitted that the Registrant had remediated her practice and employed strategies to help her remain calm, professional and neutral and invited the Panel to carefully consider the testimonials supplied by the Registrant. There was no evidence of “odd behaviour”, emotional outbursts or uncontrolled emotions and the Registrant is, in her submission, safe to practise. 

160.   The Panel received, accepted and applied the legal advice provided, and had regard to the information provided in the bundle of documents for the hearing. It reminded itself that the test of impairment is expressed in the present tense in relation to the need to protect the public against the acts and omissions of those who are not fit to practise, and that this cannot be achieved without taking account of the way a person has acted or failed to act in the past. It also recognised that the purpose of the regulatory proceedings is not to punish the Registrant. It had regard to the practice note published by the HCPTS entitled “Fitness to Practise Impairment”.

161.   The Panel was mindful that a finding of impairment does not automatically follow a finding that the facts proved amounted to the statutory ground of misconduct – it could properly conclude that the misconduct was an isolated incident and that the chance of repetition in the future is remote. It also noted the guidance in the case of Cohen v General Medical Council [2008] that it must be highly relevant when determining impairment that the conduct leading to the allegation is easily remediable, has been remedied and is highly unlikely to be repeated as well as the “critically important public policy issues” identified in that case. 

162.   In the Panel’s view, the concerns raised against the Registrant were serious but potentially remediable for a registrant who accepted their shortcomings and was prepared to address them. However, the Panel was mindful that the Registrant demonstrated repeated use of inappropriate, undermining, offensive and abusive language over a period of months in her workplace to a variety of colleagues despite being issued with a disciplinary warning and an improvement plan. 

163.   The Panel acknowledged that the Registrant had developed positive strategies to cope with stressful situations, such as breathing techniques and taking time out. She also explained that in the future she would escalate concerns through line managers. The Panel also noted the Registrant’s written statements, in which she reflects on the importance of maintaining professional standards at all times. 

164.   The Panel further acknowledged the extensive positive testimonials and character evidence provided on behalf of the Registrant. It appeared to the Panel that the Registrant had demonstrated appropriate professional practice both before and after her employment at the Hospital. A consultant anaesthetist with whom she had worked between 2015 and 2019 described her practice as “exemplary”, her manner as “lovely” and that she was “very much an advocate for the patients she was looking after”. A Hospital Manager with whom the Registrant worked between 2023 and 2024 stated that she “consistently championed respectful behaviour within the team”.

165.   Notwithstanding these positive testimonials, the Panel had found the particulars proved against the Registrant. It was apparent that there were tensions at the Hospital but this did not justify or excuse the repeated behaviour exhibited by the Registrant.

166.   The Panel considered the Registrant’s conduct to be attitudinal in nature and that by her partial admissions she had sought to minimise her responsibility for her behaviour and deflect blame onto others. It further considered that her insight appears to be under-developed at this point. The Panel observed that the Registrant had not expressed remorse for what had happened and appeared not to recognise or understand the impact of her conduct upon the public, patients and the individual colleagues affected. Further, the Registrant’s witness statement was largely focused on the impact of the events on the Registrant.

167.   As such, the Panel concluded that there was a risk of repetition of similar behaviour.

168.   The Panel was mindful that the case is not a health case but considered the health aspects brought to its attention could be inextricably linked with the conduct found proved against the Registrant. 

169.   In terms of the steps taken by the Registrant to maintain her competence since she last worked in a registered role, the Panel noted that there was no formal reflective piece provided to it. The Registrant included in her statement the details of some articles she had read but did not appear to have produced a critical reflection as to what she had learned from those articles or set out how she would apply the learning to her practice to ensure the conduct is not repeated. The Panel was satisfied that the Registrant is currently impaired on the personal component of impairment. 

170.   In considering the public component of impairment, the Panel had regard to the important public policy issues, particularly the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour. Whilst the Panel had not been informed that the Registrant’s conduct had caused any harm to a patient or their family, such harm had potentially been caused to Colleague A and any colleague drawn into the regulatory investigations.

171.   It was clear to the Panel that the Registrant’s conduct could have adversely impacted patients and their families. It certainly impacted Colleague A, her colleagues and other professionals, causing them distress and frustration. This was particularly impactful in autumn 2020 given the context of the global Covid pandemic and resultant lock downs which exerted a particularly heavy strain on many patients, their care givers and the professionals who treated them. The Panel also noted that the Registrant’s own personal circumstances may have been exacerbated by the Covid lockdown restrictions. 

172.   The Panel was concerned that the Registrant’s inappropriate comments and behaviour would have contributed to a toxic work environment at the Hospital. 

173.   The Panel determined that public and professional trust and confidence in the profession, professional standards, and the regulator would be undermined if a finding of impairment on the public component was not made in these circumstances. 

174.   The Panel was satisfied that the Registrant’s fitness to practise is currently impaired on the public and personal aspect of impairment for the reasons set out above.

Decision on Sanction
175.          The Presenting Officer made no submissions in respect of the appropriate sanction for the Panel to impose.

176.          The Registrant’s Representative reminded the Panel that the HCPC has adopted a Sanctions Policy and directed its attention to paragraph 11 [redacted].

177.          The purpose of a sanction was, in the Registrant’s Representative’s submission, not to punish the Registrant but rather to protect the public and maintain standards of practice in the profession. She invited the Panel to impose an order which was reasonable and proportionate in the circumstances of this case, submitting that the issues of concern identified by the Panel were capable of remediation and centred around communication. She reminded the Panel to start at the lowest available sanction and work up. 

178.          Given the circumstances of this case, the Registrant’s Representative submitted that no order is required to protect the public as the Registrant is not practising. In the event that the Registrant secures employment, she would be subject to a probation period which would be sufficient to reintroduce the Registrant to the working environment and ensure public protection. 

179.          If the Panel was not with the Registrant on making no order, it was submitted that a Caution Order for a period of one year would be a suitable sanction. This would allow the Registrant to return to a healthcare role, prove that there was no ongoing issue regarding her behaviour and attitude, and allow her to develop and demonstrate her insight. Further, the findings against the Registrant were not at the serious end of the spectrum of concerns and related mainly to communications styles. 

180.          The Registrant was also willing to comply with any Conditions of Practice Order that the Panel may see fit to impose such as those addressing training, supervision, reporting and communication. However, the Registrant’s Representative suggested that a conditions of practice order may not be workable, particularly as it would restrict the Registrant’s employability. 

181.          The Panel accepted and applied the advice of the Legal Assessor. It was mindful that the purpose of any sanction is not to punish the Registrant, but to protect the public and promote the wider public interest. The public interest includes maintaining public confidence in the profession and the HCPC as its regulator by upholding proper standards of conduct and behaviour. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity.

182.          The Panel had regard to the Sanctions Policy adopted by HCPC and took into account the submissions made to it. It identified the following aggravating factors in relation to the Registrant’s conduct:
a.   the misconduct largely occurred in the Hospital in areas patients had access to; 
b. the conduct was repeated despite the existence of a disciplinary warning; and
c.   the Registrant prioritised her own interest over those of her patients and her colleagues (e.g. leaving the Hospital on 24 October 2020, using the meeting of 11 November 2020 to air her concerns about Colleague A). 

183.          The mitigating factors identified by the Panel were that the Registrant:
a.   has started to develop insight and demonstrate remediation; 
b.   has been diagnosed with a condition that may impact upon her conduct and how she remediates the concerns; 
c.    is prepared to work to remediate her practice over time and thereby address the concerns identified by the Panel; 
d.   was experiencing personal difficulties at the material time.

184.       The Panel was of the view that the concerns it identified regarding the Registrant’s conduct were not insignificant – a finding of impairment means that there are concerns about a registrant’s current ability to practise safely and effectively. While there may be some instances in which taking no action is the appropriate and proportionate outcome, such as when there is no risk to the public, or to public confidence in the profession, taking no action or imposing a Caution Order in this instance would be inappropriate and insufficient. The Panel had identified some insight and remediation, but this was not, in its view, complete or secure. It also identified a risk of repetition. Further, the Registrant did not appear to have shown any remorse for the impact of her conduct upon her colleagues or the potential impact upon the public and the profession. The Panel was mindful that Caution Orders are appropriate where the allegation means no meaningful practice restriction can be imposed but a suspension of practice order would be disproportionate. This was not such a case in the Panel’s view.

185.       Whilst the misconduct arose from the Registrant’s conduct in the workplace, the Panel did not consider that a conditions of practice order was appropriate or would afford an appropriate level of protection to the public and colleagues of the Registrant. It observed that the Registrant displayed limited awareness of the inappropriate nature of her conduct and told it that she was, [redacted], misunderstood. The Panel was not able to formulate any conditions which would protect the public, remedy the concerns, (which it considered attitudinal in nature), or restore public confidence in the profession and uphold proper standards of conduct and behaviour. Further, it was mindful that the Registrant is not currently working in a healthcare environment. Accordingly, the Panel determined that it would not be appropriate to impose conditions upon the Registrant’s practice.

186.       The Panel then gave careful consideration to the imposition of a Suspension Order, which could send a signal to the Registrant, the profession and the public re-affirming the standards expected of a registered Operating Department Practitioner. The Registrant had engaged in the regulatory process and articulated her desire to return to her profession but accepted she had been unable to maintain her professional skills during her time away from a registered role. It was satisfied that she did want to return to her profession and appeared willing to work towards that goal. It was of the view that a short period of suspension would allow the Registrant the opportunity to further reflect upon her conduct, and also the regulatory process and its outcomes. The Registrant should then be able to address the concerns identified by the Panel through more focused reflection. 

187.       The Panel was mindful that suspending a registrant from practice for any period of time is a serious action and considered it sufficient to mark the seriousness of the concerns identified in this matter. However, it also considered whether removal from the Register could be appropriate and proportionate in the circumstances. It noted the Registrant’s acknowledgement of her conduct and her diagnosis after the events took place. It was satisfied that the conduct it identified, and the Registrant’s response to the same, were not fundamentally incompatible with continued registration. It was content that striking the Registrant from the Register would be disproportionate to the concerns it identified. 

188.       The Panel noted the Registrant’s submissions in respect of her financial challenges but was aware that a suspension would not impact her current employment in the hospitality industry. It was satisfied that the need to protect the public and mark the conduct outweighed any adverse impact upon the Registrant. The Panel determined that a suspension from the Register for a period of four months was appropriate to protect the public and maintain confidence in the profession and the regulator. Any longer suspension would be punitive to the Registrant whilst any shorter period would not afford her the ability to properly demonstrate to a future reviewing Panel that she had remediated all of the Panel’s concerns. 

189.       The Panel considered that a future reviewing panel may be assisted by information from the Registrant demonstrating: 
a.   detailed reflection upon the impact of her behaviour on colleagues, patients, the public and the profession; 
b.   reintegration into a healthcare environment (whether paid or unpaid); 
c.    completion of, and reflection upon, appropriate learning and/or CPD, with particular regard to:
   i.            communication;
   ii.            professional relationships;
   iii.            conflict resolution; and
   iv.            stress management.

ORDER: The Registrar is directed to suspend the name of Ms Donna Picton from the Register for a period of four months.

Right of Appeal
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.
Under Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

Interim Order
Application
1.          Upon the Panel determining the appropriate sanction to be suspension from the Register, the Presenting Officer confirmed he sought an interim suspension order for a period of 18 months to cover the period before the Suspension Order takes effect, and the appeal period.

2.          The Registrant’s Representative acknowledged that the issue as to whether to impose an Interim Order was a matter for the Panel following the making of findings and an order but submitted that no interim order was necessary as the Registrant had not, to date, been subject to any restriction of her practice.

3.          The Panel received advice from the Legal Assessor and was invited to consider the guidance on interim orders following a substantive order as contained within the Sanctions Policy. The Panel also took account of the Practice Note in relation to Interim Orders.

Decision
4.               The Panel was satisfied the Registrant was aware that an Interim Order could be applied for as this was contained within the Notice of Hearing dated 18 December 2025.

5.               Given that the findings of the Panel in relation to the serious misconduct on the part of the Registrant, the aggravating features of the same and the risk posed to the public which led it to conclude that a Suspension Order was appropriate to protect the public, the Panel was content that an Interim Order pursuant to Article 31 of the Order is necessary and proportionate. It determined that such an order is required to protect the public and maintain public confidence in the profession and the regulatory process pending expiry of the appeal period. The Panel was conscious that the imposition of an interim order may have a detrimental impact upon the Registrant but considered the order to be appropriate in the circumstances.

6.               The Panel considered that this order should be imposed for a period of 18 months, noting it will fall away in the event that no appeal is lodged to the substantive order of suspension.

The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. 
This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Donna Picton

Date	Panel	Hearing type	Outcomes / Status
05/05/2026	Conduct and Competence Committee	Final Hearing	Suspended