Mr Dylan W Williams

: Chiropodist / podiatrist

: CH10769

: Final Hearing

Date and Time of hearing:10:00 07/03/2017 End: 17:00 07/03/2017

: Park Plaza Cardiff Greyfriars Road Cardiff South Glamorgan CF10 3AL

: Conduct and Competence Committee
: Voluntary Removal agreed

Allegation

During the course of your employment as a Podiatrist at Abertawe Bro Morgannwg University Health Board, you failed to maintain adequate records, in that:

1. A clinical audit was carried out between 28 March 2011 and 8 April 2011, and it was found that:

a) Between October 2010 and March 2011, you did not maintain electronic records of the patients you attended to at the walk in clinic in Port Talbot Resource Centre;

b) As a result of your actions as set out in paragraph 1a, a total of 15 sets of electronic notes were missing for this period.

2. On or around 18 July 2011 you did not maintain adequate records, in that you did not complete clinical notes for the diabetic patients that you attended

to at Neath Port Talbot Hospital.

3. The matters set out in paragraphs 1 a, 1 b and 2 constitute lack of competence.

4. By reason of that lack of competence your fitness to practise is impaired.

This is to advise you that the Health and Care Professions Council intends to apply to the Panel of the Conduct and Competence Committee at a Preliminary hearing to formally amend the allegation. This is in view of

information which has been provided during the process of further information.

The allegation that will be put before the Panel is as follows During the course of your employment as a Podiatrist at Abertawe Bro Morgannwg University Health Board, you failed to maintain adequate records,

in that:

1. A clinical audit was carried out to cover appointments between 28 March 2011 and 8 April 2011, where you were the assessing/treating Podiatrist, and

it was found that out of 16 electronic patient records, 15 were missing.

2) An ongoing clinical audit was carried out to cover appointments between 18 May 2011 and 3 October 2011 where you were the assessing/treating Podiatrist, and:

a. notes were missing;

b. notes were located but entries were missing or incomplete;

c. notes were not competed contemporaneously, or

d. notes had been taken home for completion

3. A clinical audit was carried out to cover appointments on 08 February

21012 where you were the assessing/treating Podiatrist , and it was found that:

a. out of 10 patient records, 5 were missing:

b. of the remaining 5 records, previous entries were missing

4. A clinical audit was carried out to cover appointments between 25 and 28 June 2012 where you were assessing/treating Podiatrist, and it was found

that out of 43 patient records, no up to date electronic or paper records were available.

5. The matters set out in paragraphs 1- 4 constitute lack of competence and or misconduct.

6. By reason of that lack of competence and or misconduct your fitness to practise is impaired.

 

1. In February 2014 a clinical audit was carried out to cover appointments at Neath Port Talbot Hospital and it was found that:

(a) On 4 February 2014 – no notes were completed out of 6 patient appointments

(b) 0n 5 February 2014 – no notes were completed out of 11 patient appointments

(c) 0n 6 February 2014 – no notes were completed out of 4 patient appointments

(d) 0n 11 February 2014 – only four sets of notes were completed and 3 notes missing

(e) 0n 12 February 2014 – no notes were completed out of 14 patient appointments

(f) 0n 13 February 2014 – no notes were completed out of 5 patient appointments

(g) 0n 17 February 2014 – no notes were completed out of 9 patient appointments

(h) 0n 18 February 2014 – no notes were completed out of 4 patient appointments

(i) 0n 19 February 2014 – only two sets of notes were completed and 9 notes missing

(j) 0n 20 February 2014 – no notes were completed out of 4 patient appointments

(k) 0n 25 February 2014 – no notes were completed out of 14 patient appointments

(l) 0n 26 February 2014 – only 11 notes present and 6 notes missing (m) 0n 27 February

2014 – no notes were completed out of 5 patient appointments

2. On a date prior to 2 June 2014, you removed approximately 737 patient identifiable paper

records from Neath Port Talbot Hospital and stored them outside of NHS Wales premises.

3. Between February 2014 and April 2014 you did not complete case notes and/or

completed case notes retrospectively, and

a. You altered the date stamp on records that you completed retrospectively by unplugging

the network cable and amending the date on the documents.

4. Your actions as described at paragraph 3a are dishonest.

5. The matters as described in paragraphs 3a-4 constitute misconduct.

6. The matters as described at paragraphs 1 - 4 amount to misconduct and/or a lack of

competence.

7. By reason of your misconduct and/or lack of competence your fitness to practise is

impaired.

 

Finding

Preliminary Matters

Service


1. The Panel was satisfied that the Registrant was served at his registered address with the Notice of this Hearing dated 24 February 2017. In it, the correct venue, date and time was set out. The notice was sent after an initial notice of an early Review Hearing dated 7 February 2017. This was followed by correspondence with the Registrant resulting in the hearing being listed as a Voluntary Removal Agreement. In these particular circumstances that amounts to notice in a reasonable time in the view of the Panel. Therefore, the Panel has determined that there has been effective service of the Notice of Hearing.


Proceeding in the Absence of the Registrant


2. Mr Chan submitted on behalf of the HCPC, that the hearing should proceed in the Registrant's absence. The Registrant had indicated in an email of 9 February 2017 that ‘I no longer wish to participate in any further HCPC proceedings against me’.

3.  He has since then signed a Voluntary Removal Agreement on 3 March 2017 and a further clarification of it today. The Panel took those actions to mean, that neither the Registrant nor a Legal Representative would be attending this hearing. The Panel accepted the Legal Assessor's advice. It also took into consideration the HCPC's Practice Note on Proceeding in Absence of a Registrant.

4. The Panel considered that the Registrant, who had been served with the Notice of Hearing, had the choice to engage with this process, as he has knowledge of today's hearing and has chosen not to attend either personally or by telephone. In the Panel's judgement he has absented himself of his own free will. The Panel concluded that it was in the public interest to continue with the hearing in his absence to ensure an expeditious and efficient disposal of the hearing in relation to this serious matter. It also considered that it was in the Registrant’s interests to have his application for Voluntary Removal heard today. Neither the Registrant nor a Legal Representative has requested an adjournment and the Panel concluded that, if the hearing was to be adjourned today, he would be unlikely to attend on the next occasion. Furthermore, the Panel determined that the protection of the public and the wider public interest outweighed the interests of the Registrant.

Background


5. The Panel today is dealing with 2 matters, FTP04720 where the hearing was concluded on 28 January 2015 and FTP36423 where the hearing was concluded on 11 January 2017. The first hearing dealt with issues of record keeping in 2011 and 2012 where the Registrant had been the treating Podiatrist. The facts found proved had amounted to lack of competence, the Registrant’s Fitness to Practise  had been found to be impaired and a Conditions of practice order for 12 months had been imposed. That order was extended for a period of 18 months on 21 October 2016.

6. The second hearing in January 2017 dealt with issues of removal from NHS premises of some 737 patient records by the Registrant in 2014. They were stored outside NHS premises. Records were not completed and some were altered. The alterations were found to be dishonest. The facts found proved had amounted to misconduct, the Registrant’s Fitness to Practise had been found impaired and an order of 12 months suspension had been imposed.

7. The Panel notes that in neither hearing have any complaints been made about the Registrant’s clinical abilities. The complaints relate to concerns over record keeping and subsequent dishonesty.

8. The Registrant has now asked for and signed a Voluntary Removal Agreement. He has admitted all of the facts of both hearings. The HCPC have today asked for the revocation of the orders and the removal of the Registrant from the Register.


Decision


9. The Panel is asked to consider whether it should agree to resolve this case by consent and agree to the Voluntary Removal Agreement. It accepts the advice given in the practice note on ‘Disposal by Consent’:   ‘However, as the Health and Social Work Professions Order 2001 (the Order) imposes broad public protection obligations upon the Health and Care Professions Council, neither the HCPC nor a Panel should agree to resolve a case by consent unless they are satisfied that:


       • the appropriate level of public protection is being secured; and


       • doing so would not be detrimental to the wider public interest.’


10. The Panel first considered whether it would be appropriate to revoke the current orders affecting the Registrant’s registration. If both orders are revoked the Panel has to consider whether the public would be properly protected and would those actions be in the public interest. In the Panel’s view the current orders have adequately protected the public and were in the public interest until now. Those concerns would not be affected by the revocation of the orders as that revocation would be followed immediately by removal of the Registrant from the Register which removes his ability to practice.

11. The Panel then concentrated on the question of whether a Voluntary Removal Agreement would be adequate to protect the public or have the capability of maintaining confidence in the profession or the regulatory process. The nature of the Agreement is such that it is equivalent to a striking off order.

12. The Panel considers that the nature of the Agreement is fair and proportionate in these circumstances. Since the findings made against the Registrant in the two substantive hearings, the public has been adequately protected by the sanctions imposed. It will be adequately protected by the voluntary removal of the Registrant from the register. There is nothing in these circumstances which would undermine the confidence of the public in the profession, or the regulatory process if a Voluntary Removal Agreement is approved. The Panel cannot see any benefit in refusing the application and then reviewing the current sanctions.

13.  In all of the circumstances before it the Panel has concluded that it will allow the Voluntary Removal Agreement to be actioned forthwith. The effect of that Agreement is that the Registrant will no longer be registered as a Chiropodist/Podiatrist.

Order

Order: The Registrar is directed to revoke the Conditions of Practice Order imposed on 26 January 2015 with immediate effect.  The Registrar is further directed to revoke the Suspension Order imposed on 11 January 2017 with immediate effect.

Notes

A voluntary removal agreement hearing of the Conduct and Competence committee panel took place in Cardiff on Tuesday 7 March 2017. If the Registrant seeks to return to the HCPC Register at any time the application would be treated as if the Registrant had been struck off as a result of that allegation.

Hearing history

History of Hearings for Mr Dylan W Williams

Date Panel Hearing type Outcomes / Status
07/03/2017 Conduct and Competence Committee Final Hearing Voluntary Removal agreed
09/01/2017 Conduct and Competence Committee Final Hearing Suspended
21/01/2016 Conduct and Competence Committee Review Hearing Conditions of Practice