Josephine M Noble

: Physiotherapist

: PH34576

: Review Hearing

Date and Time of hearing:10:00 15/01/2016 End: 12:30 15/01/2016

: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

: Health Committee
: Conditions of Practice

Allegation

The below allegation was considered by the Health Committee at a Consent Hearing on 28 April 2015:

 

1. By reason of your health, your fitness to practise as a Physiotherapist is impaired.

 

The Panel imposed a Conditions of Practice Order by way of Consent for a period of 3 years.

 

Finding

Preliminary Matters:

1. The Panel considered whether this hearing should be held in private or not.  Ms Carson on behalf of the HCPC submitted that this was not necessary as her presentation to the Panel would not include any details relating to the Registrant’s health. The Panel therefore decided that the hearing should be heard in public, unless matters pertaining to the Registrant’s private life is mentioned. The Panel received advice from the Legal Assessor and decided that the hearing would be held in public, with a private determination provided, as necessary.

2. The Panel found that there had been correct service of the proceedings.

3. The Panel next considered whether to proceed with the hearing in the absence of the Registrant. The Panel was advised by the Legal Assessor and followed that advice.

4. Ms Carson submitted that the hearing should proceed in the absence of the Registrant. She referred to e-mail and postal correspondence with the Registrant. This correspondence deals with a proposal for a Consent Order. The last e-mail dated 15 January 2015 confirms that the Registrant will neither attend the hearing today, nor be available to be contacted by telephone. Ms Carson submitted that her correspondence gave rise to an implicit assumption that the hearing will proceed in her absence and that she has not objected to that.

5. The Panel exercised their discretion to proceed in the absence of the Registrant on the following basis:

i) there had been no request for an adjournment;
ii) the Registrant had indicated by a full statement the representations she would have made herself had she been able to attend, physically, or virtually;
iii) that this was an early review being held on the basis of an alleged breach of conditions and that it was important that it went ahead in a timely fashion;
iv) that no purpose would be served by adjourning;
v) that is was fair and just to proceed.

Background:

6. The Registrant was employed by North Tees and Hartlepool NHS Foundation Trust (the Trust) from 1992 until October 2012. The Registrant is a Band 6 Physiotherapist working in the speciality of musculoskeletal physiotherapy. In May 2012 a colleague of the Registrant raised concerns regarding the lack of content in a set of patient notes because the notes did not contain sufficient or appropriate information. A review of the Registrant’s notes was completed and identified 19 sets of notes which gave cause for concern.

7. A disciplinary investigation was requested by senior management. During the investigation the Registrant admitted that the allegation was accurate, apologised for her actions, and prepared a statement which made connections between her poor record keeping and her health. A disciplinary hearing was held on 3 October 2012 and the Registrant was dismissed from her employment.

8. The Trust referred the Registrant to the HCPC on 2 November 2012. An Investigating Committee of the HCPC referred the case to a Conduct and Competence Committee of the HCPC on 7 February 2013.  On 30 January, on the application of the Registrant, the case was transferred from the Conduct and Competence Committee to a Health Committee, pursuant to Rule 4(1) of the HCPC (Conduct and Competence Committee)(Procedure) Rules 2003.

9. The Registrant recognised that there needed to be long term monitoring of her health and agreed to a three year Conditions of Practice Order.  The Panel on 28 April 2015 approved the Consent Order. This is the first review of that Order.  It is an early review given an alleged breach of the Conditions of Practice imposed. 

Decision

10. The Panel heard submissions and saw evidence that the HCPC had written to the Registrant on 27 November 2015 to indicate that information had been received that the Registrant appeared to have breached condition 4 (a), in that recent employers of the Registrant had not been made aware of the conditions on her practice.  At the time the Order was made the Registrant was working for the Northumbria Healthcare Trust.  Further, that there had been a breach of conditions 5 and 6.

11. The Registrant wrote on 29 November 2015 and again on 5 January 2016. The latter correspondence contains statements from GP, the Employment Agency under which she is registered, and from the Registrant herself. She gave two explanations for failing to comply with condition 4 (a):

I. she had misunderstood the requirement with regards to her current place of work but had told the employment agency on whose books she remained;

II. that she had expected the employment agency to convey this to those contracting for her services but accepted that this was in part her own responsibility.

12. The Panel was concerned to see the material that the Registrant has provided. 

13. The following had been provided:

I. a statement from the Registrant indicating that her work was going well;
II. a statement from her GP to say that she was well at present;
III. an open reference addressed to “whom it may concern” from the employment agency with whom the Registrant was registered, attesting to her honesty, “recommending Jo to you”, but not specifically mentioning that the Registrant’s practice was subject to conditions.

14. The Panel has given the Registrant the benefit of the doubt that some of the conditions could have been misunderstood but in light of the original findings and the updated information are of the view that it is as important for public protection as it is for the Registrant in her own interest that her practice be subject to restrictions. The Registrant’s health condition is one that has been in remission for only a year following upheavals and there is no independent evidence from the places where she has worked which comments on her professional ability and conduct.  Were there to be a relapse, this would be a significant issue in relation to her practice.

15. The Panel considered that conditions could continue to address the risk identified, without suspension being required.  The current Conditions of Practice Order is for a period of two years.  The Panel considered that a period of two years was sufficient, given the relapsing nature of the Registrant’s health condition, to evidence whether she can practise safely.  

16. The conditions will be as follows:

1.  You must place yourself under the care of your GP, attend upon them as required by them, and follow their advice and recommendations.
 
2.  You must inform your GP that you are subject to a conditions of practice order under the HCPC's fitness to practice procedures, and disclose these conditions to them.
 
3.  You must allow your GP to exchange information about your health, treatment and compliance with this conditions of practice order with the HCPC.

4. 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 work as a HCPC registered physiotherapist, and this includes any placement you are given;

b) Any agency you are registered with, either currently, or in the next 12 months that could supply you with work as a physiotherapist;

c) Any prospective employer (at the time of application).

5. You must provide the HCPC with a medical report every 6 months (from the date of the hearing).  This report should attest to your ability to practise as a physiotherapist safely and effectively.

6. You must provide the HCPC with a report every 3 months (from the date of this hearing) from your workplace.  This report must be completed by a HCPC registered physiotherapist and attest to your ability to keep patient records to the required standard.

7. You must provide to the HCPC as soon as possible but no later than the end of February 2016, written confirmation from Orchard Medical Employment Agency and any other agency that you are registered with, that they are aware of the current order of conditions restricting your ability to practise.

 

Order

The Registrar is directed to vary the current Conditions of Practice Order against the registration of Mrs Josephine M Noble with immediate effect with the following Conditions of Practice for a period of 2 years:

1.  You must place yourself under the care of your GP, attend upon them as required by them, and follow their advice and recommendations.
 
2.  You must inform your GP that you are subject to a conditions of practice order under the HCPC's fitness to practice procedures, and disclose these conditions to them.
 
3.  You must allow your GP to exchange information about your health, treatment and compliance with this conditions of practice order with the HCPC.

4. 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 work as a HCPC registered physiotherapist, and this includes any placement you are given;

b) Any agency you are registered with, either currently, or in the next 12 months that could supply you with work as a physiotherapist;

c) Any prospective employer (at the time of application).

5. You must provide the HCPC with a medical report every 6 months (from the date of the hearing).  This report should attest to your ability to practise as a physiotherapist safely and effectively.

6. You must provide the HCPC with a report every 3 months (from the date of this hearing) from your workplace.  This report must be completed by a HCPC registered physiotherapist and attest to your ability to keep patient records to the required standard.

7. You must provide to the HCPC as soon as possible but no later than the end of February 2016, written confirmation from Orchard Medical Employment Agency and any other agency that you are registered with, that they are aware of the current order of conditions restricting your ability to practise.

Notes

The Order takes immediate effect and will be reviewed before its expiry on 15 January 2018.

 

This was an Early Review hearing that took place on Monday 15 January 2016 at the Health and Care Professions Council.

Hearing history

History of Hearings for Josephine M Noble

Date Panel Hearing type Outcomes / Status
05/01/2018 Health Committee Review Hearing Hearing has not yet been held
01/12/2017 Health Committee Review Hearing Adjourned
15/01/2016 Health Committee Review Hearing Conditions of Practice
28/04/2015 Health Committee Final Hearing Conditions of Practice