Ian Simmonds

: Biomedical scientist

: BS62097

: Review Hearing

Date and Time of hearing:13:00 27/11/2015 End: 17:00 27/11/2015

: Hilton Newport, Chepstow Road, Newport, NP18 2LX

: Conduct and Competence Committee
: Conditions of Practice

Allegation

In the course of your employment at Hereford Hospital NHS Trust, whilst on the

HPC register, you:

 

1. Recorded the incorrect blood group on 12 and 18 February 2009;

 

2. Incorrectly recorded a different spin group from the microplate group on 20 February and 20 April 2009;

 

3. Failed to follow sample acceptance procedures on 20 February;

 

4. Failed to label blood and urine samples differently on 11 May 2009;

 

5. Missed four requests for glucose which did not have the appropriate sample on 11 May 2009;

 

6. Underwent a performance review period between 11 May and 09 October 2009, where you continuously demonstrated:

 

a. Poor sample labelling;

c. Poor clinical reasoning skills;

d. Poor observation skills;

e. Poor record-keeping skills;

f. Poor quality control prior to processing manual samples; and

g. An inability to work autonomously.

 

7. The matters set out in 1 – 6 constitute a lack of competence; and

 

8. By reason of your lack of competence, your fitness to practise is impaired.

Finding

Decision:


1. The Panel has been convened today to undertake a review of a Conditions of Practice Order (hereafter “CoPO”).  The current Order, the full terms of which are set out below, is due to expire on 21 July 2016.  It follows that this is an early review.  Although not apparent from the papers sent to the Panel in advance of the hearing, the Panel was informed today that it is an application made jointly by the HCPC and Mr Simmonds.


2. Mr Simmonds has attended this hearing and addressed the Panel.


3. As there is a considerable history of these fitness to practise proceedings it is necessary that the Panel should explain the background:


• On 21 April 2010 a Panel of the Investigating Committee determined that there was a case to answer in relation to an allegation that Mr Simmonds’ fitness to practise was impaired by reason of lack of competence.  The particulars of lack of competence were as set out in paragraphs 1 to 6 inclusive of the allegation as it appears at the head of this document (hereafter “the factual particulars”).


• The final hearing of the allegations took place over four days, commencing on 7 February 2011 and, after a lengthy adjournment, concluding on 24 May 2011.  Mr Simmonds attended the hearing and was represented at it.  Further details of the final hearing findings will be given below, but for present purposes it is sufficient to state that all of the factual particulars save for particular 6(b) were proven, and lack of competence then impairing Mr Simmonds’ fitness to practise was established.  The sanction imposed was a three year CoPO was made.  It is necessary to state part of what the final hearing Panel said when explaining the decision to impose a CoPO:


“Although the Panel has concerns about Mr Simmonds’ ability to remedy his failings it has concluded that a conditions of practice order would be sufficient to protect the public and allow Mr Simmonds the opportunity to address the shortcomings in his practice.  The Panel notes that although his failings relate to basic skills, they mainly occurred in blood transfusion and haematology and therefore considers it appropriate to prevent him practising in these areas.”


As the conditions imposed at the conclusion of the final hearing are no longer the conditions binding on Mr Simmonds, it is not necessary for them to be set out in full.  It should, however, be explained that in addition to prohibiting work in the areas of haematology and blood transfusion, prohibiting out of hours or on-call work, and what might be considered the standard conditions relating to notification to third parties and the HCPC, there was a condition that required Mr Simmonds to confine his professional practice to that of a Trainee Biomedical Scientist post.  It also included a condition that following appointment as a trainee he must satisfactorily complete a period of 18 months supervised practice in an Institute of Biomedical Science approved training laboratory.


• The CoPO imposed at the final hearing was reviewed on 22 May 2012, significantly before that Order was due to expire.  The review was requested by Mr Simmonds who contended that there was an inherent contradiction in the conditions originally imposed because the requirement that he confine his work to that of a trainee meant that he could not commence the period of 18 months supervised practice in an approved training laboratory.  The Panel undertaking this first review considered that the condition requiring work to be restricted to a trainee post amounted to an order of suspension.  Accordingly, it varied that element to requiring Mr Simmons to satisfactorily complete a period of 18 months supervised practice in an Institute of Biomedical Science approved training laboratory.  The length of the CoPO originally imposed was not varied.


• Mr Simmonds made a further application for review of the CoPO which was heard on 20 December 2012.  He contended that the conditions were too restrictive.  In particular, he contended that the obligation to undertake 18 months supervised practice was too long and that there was insufficient flexibility to enable him to work out of hours or on-call if an employer considered him competent to do so.  The Panel undertaking the review again varied the conditions of the CoPO, the term of the Order remaining unchanged.  In particular this Panel removed the requirement that the supervised practice had to be for a period of 18 months, but it underlined the fact that the supervision required by the condition was direct supervision.


• Mr Simmonds made a further application for the CoPO to be reviewed, and this third review was held on 22 July 2013.  Mr Simmonds contended that, despite having made strenuous efforts to obtain work as a Biomedical Scientist, the only time he had come close to securing employment was when the relatively small size of the hospital laboratory concerned meant that it was not approved as an Institute of Biomedical Science training laboratory.  The Panel on that occasion considered that an adequate degree of protection could be provided by varying the condition relating to supervision to one that required direct supervision by a Biomedical Scientist in a laboratory accredited by Clinical Pathology Accreditation UK Limited.  The CoPO as varied was ordered to run for a period of three years from the date of this third review, namely from 22 July 2013.


• A review of the Order was listed to take place on 2 May 2014, but when it was discovered that neither the HCPC nor Mr Simmonds had applied for an early review of the CoPO which then still had over two years to run, the Panel before which the review was listed declined jurisdiction to consider it.  The CoPO imposed on 22 July 2013 therefore continued unvaried.


• The next review was held on 16 July 2014 when Mr Simmonds requested the removal from the conditions that supervision should be “direct”.  The Panel declined to remove that requirement, but it varied the wording of the relevant condition to explain what was meant by “direct supervision”.  Accordingly, the condition was varied by the addition of these words, “Direct supervision does not mean that you must be constantly supervised but is to ensure that your judgements are approved by a registered Biomedical Scientist present in the laboratory.”


• The last review before the present one being undertaken was held on 14 May 2015.  The hearing was requested by the HCPC who contended that Mr Simmonds had breached the terms of the CoPO.  The Panel did not accept that there had been a breach of the Order, and so no further elaboration of that aspect of the application is necessary.  However, Mr Simmonds again contended that the conditions were too onerous and were inhibiting his efforts to secure work as a Biomedical Scientist.  The outcome of the review was that the conditions were again varied, the current form of the Order appearing in paragraph 5 below.  The duration of the Order has not been varied since 22 July 2013, and so it follows that the present CoPO is not due to expire until 21 July 2016.


4. Background.  Mr Simmonds graduated with a degree in Biomedical Sciences in 2008.  As his course of study was an HCPC accredited course, he was admitted to the Biomedical Scientist part of the HCPC register as a consequence of his graduation.  In late September 2008 he commenced work as a trainee Biomedical Scientist at Hereford Hospital NHS Trust with an 18 month fixed term contract.  He started work in the Blood Transfusion Department, moving to the Haematology Department some three months later, returning to Blood Transfusion after about two months.  Concerns reflected in the factual particulars considered by the final hearing Panel were raised.  Initially an informal performance management policy was invoked, but subsequently a formal procedure was instigated.  Mr Simmonds resigned from his post in mid-October 2009 before the formal process was completed.


5. The conditions of practice currently imposed are in the following form, having been amended on 14 May 2015:


(1) You must not work as a qualified Biomedical Scientist until you have completed a period in a training grade and demonstrated your competence to the satisfaction of your employer through the completion of a professional portfolio.


(2) You must send any successfully completed professional portfolio approved by the Institute of Biomedical Science and your employer at the time of completion to the HCPC.


(3) You must notify the HCPC of any change in your role or employer including temporary employment opportunities arranged by an agency.


(4) You must inform the following parties that your registration is subject to these conditions:
a. any organisation or person employing you or contracting with you to undertake professional work as a BMS;
b. any agency you are registered with or apply to be registered with as a BMS (at the time of application); and,
c. any prospective employer (at the time of application for a BMS post).


6. On behalf of the HCPC the Presenting Officer has submitted that the first condition amounts to a suspension order and any restriction intended by the Panel imposing it should not have been expressed in the manner in which it was made.  Beyond that submission, the HCPC did not contend for any particular outcome.  The HCPC submitted that it was a matter for the Panel’s judgement whether a sanction is still needed, and, if it is, what that sanction should be.


7. Mr Simmonds submitted for the Panel’s consideration some additional paperwork which included a reference from his present employment as a university laboratory technician, details of the efforts he has made to obtain employment and a health condition which he described in a private session of the hearing.  In addressing the Panel he drew attention to his objections to present conditions (1) and (2) in particular, and, generally to the difficulty he has encountered in returning to practice despite the many applications he has made.


8. The Panel has accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt in undertaking the review.  In particular:


• The decision on the allegation made by the final hearing Panel is now settled. 


• The matter to be decided by the Panel is whether the present circumstances require a sanction, and if they do, what that sanction should be.  This decision involves the Panel deciding whether Mr Simmonds’ fitness to practise as a Biomedical Scientist remains impaired.


• In making this decision the Panel is required to apply the usual sanction considerations: namely a sanction is not to be applied to punish, but should only be imposed to the extent that it is required to protect the public and to maintain a proper degree of confidence in the registered profession and this regulatory process.


• To ensure that these principles are applied, the first question to be answered is whether any further sanction is required.  If it is, then the available sanctions have to be considered in an ascending order of seriousness until one that sufficiently addresses the proper sanction goals is reached.


• The finding against Mr Simmonds was one of lack of competence.  The consequence of that was that initially the sanction range available ended with the making of a suspension order.  However, as Mr Simmonds has been continuously subject to a CoPO for a period in excess of two years, the effect of Article 29(6) of the Health and Social Work Professions Order 2001 is that at the present time the full sanction range, including the making of a striking-off order, is available.


9. Having considered the matter by reference to the approach described, the Panel has concluded that Mr Simmonds’ fitness to practise remains impaired.  The original findings against him were serious and covered a wide range of activities.  They have not been successfully remediated.  Furthermore, Mr Simmonds’ insight into those shortcomings is not complete, particularly with regard to his accepting responsibility for the standards of his own work.  That said, the Panel acknowledges Mr Simmonds’ consistent engagement with the HCPC in this fitness to practise process and his genuine desire to practise safely as a Biomedical Scientist.


10. The Panel considers that the present position requires the imposition of a sanction, and that any lesser sanction than a conditions of practice order would not offer a sufficient degree of protection to the public.  The Panel considers that as Mr Simmonds wishes to practise as a Biomedical Scientist, and, despite the passage of time since he last worked as such there still remains a prospect that he could do so, at the present time the imposition of a Suspension order would be a disproportionate outcome.  In short, a further conditions of practice order strikes a proper and fair balance between the need to protect the public and Mr Simmonds’ interests.


11. The conditions of the Order made today are set out below and will not be repeated in this narrative explanation.  What the Panel does wish to explain, however, is that it considers that the degree of supervision required by this Order should be no more onerous for a prospective employer to provide than would be needed for any newly qualified practitioner, albeit that the Personal Development Plan should focus on areas of concern identified by the decision of the final hearing Panel.  The Panel envisages that the measures provided for by the new conditions would require about a year in practice to enable a measured judgement on their efficacy to be made.  As Mr Simmonds is not currently working as a Biomedical Scientist and might take some time to obtain a post working as such, the Panel has decided that the appropriate length of the new Order is 2 years from the present time.


12. After the Panel determined that a further CoPO was required, but before it finalised the conditions to be imposed by that Order, the Panel disclosed to both Mr Simmonds and the Presenting Officer the conditions it was minded to impose.  This step was taken not to re-open a discussion about the appropriateness of such a CoPO, but rather to minimise the scope for subsequent objection being taken to the workability of the conditions and also so that any ambiguities might be identified, and if possible, resolved.  The Panel retired to consider the observations of Mr Simmonds and the Presenting Officer on the draft conditions.  The decision of the Panel was to confirm the conditions as disclosed to the parties.


13. The Panel considers that it is necessary to draw Mr Simmonds’ attention to the fact that the HCPC’s Returning to Practice requirements must be met.

Order: With immediate effect (namely, from 27 November 2015), the Registrar is directed to annotate the register to show that for a period of 2 years, you, Ian Simmonds must comply with the following conditions of practice:


(1) You must place yourself and remain under the supervision of a supervisor registered by the HCPC as a Biomedical Scientist working at not lower than AFC Band 7, and supply details of your supervisor to the HCPC within 1 month of obtaining employment as a Biomedical Scientist. You must attend upon that supervisor as required and follow their advice and recommendations.

(2) You must work with the supervisor to formulate a Personal Development Plan which will include satisfactory completion of the standard laboratory training programme applicable to trainees, and must address the deficiencies in following and adhering to the laboratory Standard Operating Procedures in the following areas:


i. Sample acceptance criteria;
ii. Sample labeling and correct analysis;
iii. Quality assurance procedures;
iv. Reporting and record keeping.


(3) Within three months of securing employment for which your HCPC registration is required you must forward a copy of your Personal Development Plan to the HCPC.

(4) For the purpose of considering your progress towards achieving the aims set out in your Personal Development Plan, you must meet with your supervisor not less frequently than:

a. weekly for the first 3 months of your employment; and,
b. monthly for the following 9 months;
c. thereafter, as your supervisor requires.

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

(6) You must arrange for your supervisor to provide a report on your progress towards achieving the aims set out in your Personal Development Plan for the purposes of the review of this Order.

(7) You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

(8) You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work;

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application).


[NOTE: the supervision required by these conditions is not constant supervision.  Furthermore, the supervision does not require your workplace judgements to be approved by your supervisor save to the extent that the ordinary requirements of the laboratory in which you work demand such approval.]

 

 

Order

No information currently available

Notes

An Early Substantive Review hearing took place at  Hilton Newport, Wales on Friday 27 November 2015. Conditions of Practise were imposed.

Hearing history

History of Hearings for Ian Simmonds

Date Panel Hearing type Outcomes / Status
24/11/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
27/11/2015 Conduct and Competence Committee Review Hearing Conditions of Practice