Ms Amy Jackson

: Operating department practitioner

: ODP33349

: Review Hearing

Date and Time of hearing:13:30 17/03/2017 End: 17:00 17/03/2017

: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Struck off

Allegation

As amended

During the course of your employment as an Operating Department Practitioner at BMI the Lincoln Hospital, you:

1. Not proved.

2. Not proved.

3. On 20 August 2013, did not wear a lead apron when walking into a theatre case which required one.

4. On or around 29 August 2013, did not:

a. Follow the theatre checklist for a patient;

b. Not proved.

c. Wear gloves when shaving a patient and did not wash your hands before and after the procedure.

5. On 29 August 2013 during a clinical process:

a. Were unable to locate a Magills forcep and handed a Consultant a straight artery clip.

b. Not proved.

c. Did not apply cricoid pressure to a patient when requested to by Colleague A.

6. On 29 August 2013, did not:

a. Ascertain the allergy status of a patient; and

b. Ask the patient whether they had drunk any liquid or time food was last eaten.

7. On or around 9 September 2013, did not:

a. Notice that a patient's saturations were dropping and the patient was not breathing;

b. Notice that there was a leak in a patient's ventilator.

8. The matters described at paragraphs 1- 7 constitute misconduct and/or lack of competence.

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

Finding

Background:

1.       The Registrant had been employed by the BMI, the Lincoln Hospital (the former employer) as a registered Operating Department Practitioner (ODP) in theatres from 2011 until her dismissal in December 2013. The former employer appeared to have lost the Registrant’s personnel file. In any event, the Panel had no evidence of it or the Registrant’s accurate past employment and professional history before it. Thus, the dates and some information herein may not be completely accurate. They are gathered from the various documents in the bundles including information from the Registrant, as well as from the evidence given by the HCPC witnesses.

2.       The Registrant had undergone a significant career break, possibly having qualified earlier as an ODP. She commenced healthcare work in 1992, first working as an Enrolled Nurse (EN). In 1997 she went into agency work for 2 years and stated from 1997 until 1999 worked as an ODP, when she broke her career to raise a family. She then worked at BMI Lincoln (the former employer) as a Healthcare Assistant in theatres from approximately 2010 until approximately 2011. The Registrant stated that her former employer picked up that she had prior ODP experience and asked her to come back in a clinical role and that the hospital would train her. She said that she had completed the required written competencies, that she had sent those to the HCPC as required and that she also kept a reflective diary. From the time of her re-registration in July 2011 as an ODP, the Registrant was working part time at the former employer, for approximately 27 hours a week.

3.       On 1 June 2013, following surgery, a patient required post-operative analgesia in the recovery room in the prescribed form of 10mg Morphine. The Registrant was to administer it. It is alleged that she failed to dilute the Morphine as was the required technique, and that she incorrectly gave it in concentrated form, also without titrating the dose and giving it gradually.

4.       Senior staff were informed, an Incident Report was completed and an investigation process headed by AM, the Director of Clinical Services was commenced.

5.       As a consequence, AM instigated a Performance Improvement Plan (PIP) for the Registrant. This commenced on 2 July 2013 and included weekly meetings and reports over a 12-week period, the requirement to keep a reflective diary and the maintenance of a patient log. The PIP was implemented and maintained by DB, a theatre manager and the Registrant’s line manager from 27 May 2013, and it was supervised by MH, a lead ODP and the Registrant’s supervisor. When MH was on leave, the PIP supervision was undertaken by either BM or CB.

6.       In addition, at around this time, AP, a National Theatre Clinical Skills and Education Trainer for BMI’s Education and Training group and a registered nurse, was also asked to conduct an on-going assessment of the Registrant in practice. She first met the Registrant on 14th June 2013 with DB and prepared a report on the Registrant after this meeting. AP then undertook two assessments of the Registrant on 2 July and 29 August 2013 and prepared reports after each of those assessments.

7.       Also in June 2013, the HR Department of the former employer appointed another practitioner, A O’B, a Quality and Risk Manager at BMI Thornbury, Sheffield, who specialised in theatres, and who was also a registered nurse to investigate concerns about the Registrant’s performance as a result of the morphine incident on 1 June 2013.

8.       During the course of the PIP, a number of further failings were identified by the former employer and these formed the basis of the allegations before this Panel.

9.       The Registrant’s performance was reviewed on 12 September 2013, after which a meeting took place on 17 September 2013, at which the Registrant was suspended from practice.

10.    The Registrant was reported to the HCPC and these matters were heard on 16 – 20 March 2015. The final hearing Panel found the above matters proved. It determined that Particulars 3 and 4c amounted to misconduct. The Panel also determined that Particulars 4a, 5a, 5c, 6a, 6b, 7a and 7b amounted to lack of competence on the part of the Registrant. The Panel determined that the Registrant’s fitness to practise was impaired by reason of misconduct and lack of competence.

11.    That Panel determined that the proportionate and appropriate sanction was one of a Suspension Order for 12 months.

 
Preliminary matters:

Service of Notice

12.    The notice of today’s hearing was sent to the Registrant at her address as it appeared in the register on 19 December 2016. The notice contained the date, time and venue of today’s hearing.

13.    The Panel accepted the advice of the Legal Assessor, and is satisfied that notice of today’s hearing has been served in accordance with the rules.

Proceeding in the absence of the Registrant

14.    The Panel then went on to consider whether to proceed in the absence of the Registrant pursuant to Rule 11 of the Conduct and Competent Committee Rules. In doing so, it considered the submissions of Ms Hamilton on behalf of the HCPC.

15.    Ms Hamilton submitted that the HCPC has taken all reasonable steps to serve the notice on the Registrant. Ms Hamilton stated that the Registrant has not engaged with the HCPC, and that an adjournment would serve no useful purpose. Her last contact to the HCPC was in March 2016 by way of letter wherein she stated, “… I am now following a different career path and have no wish to return to working as an Operating Department Practitioner… Therefore even at the end of this year’s suspension the situation will not change”. Ms Hamilton reminded the Panel that there was a public interest in this matter being dealt with expeditiously.

16.    The Panel accepted the advice of the Legal Assessor. He advised that, if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the hearing, then the Panel had the discretion to proceed in the absence of the Registrant.

17.    The Legal Assessor referred the Panel to the case of GMC v Adeogba and Visvardis [2016] EWCA Civ 162 and advised that the Adeogba case reminded the Panel that its primary objective is the protection of the public and of the public interest.

18.    The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of the hearing. It was also satisfied that the Registrant should be aware of the hearing.

19.    In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPC practice note entitled ‘Proceeding in the Absence of a Registrant’. The Panel weighed its responsibilities for public protection and the expeditious disposal of the case with the Registrant’s right to a fair hearing.

20.    The Panel was satisfied that the Registrant had voluntarily absented herself from the hearing. It determined that it was unlikely that an adjournment would result in the Registrant’s attendance at a later date in the light of the non-engagement from the Registrant. Having weighed the public interest in the expeditious review of the Interim Order against the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.

Submissions

1.       Ms Hamilton, on behalf of the HCPC submitted that in the light of the lack of engagement on the part of the Registrant and the fact that the period of suspension has already been extended, a further extension would serve no useful purpose and would not satisfy the public interest and therefore the HCPC recommends that the Registrant’s name be struck off the register.

Legal advice

2.       The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if she is fit to return to unrestricted practice. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment.

a)    The Legal Assessor advised that the Panel might find the questions formulated in the case of CHRE v NMC and Grant (2011) EWHC 927 (Admin) of some assistance, albeit slightly modified for these proceedings:

‘Does the evidence before the Panel today show that the Registrant’s fitness to practice remains impaired by reason of her misconduct in the sense that she:

a)            is liable in the future to act so as to put a service user at unwarranted risk of harm; and/or

b)            is liable in the future to bring the Operating Department Practitioner profession into disrepute; and/or

c)            is liable in the future to breach one of the fundamental tenets of the profession?’

3.       The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel must go on to consider what sanction, if any, should be imposed. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired all the options under Article 30 of the 2001 Order could be exercised by the Panel. He also advised the Panel that it should bear in mind the principle of fairness and proportionality and have regard to the Indicative Sanctions Policy document issued by the HCPC. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.

Decision

1.       The Panel accepted the advice of the Legal Assessor. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Ms Hamilton. In particular it noted the lack of engagement of the Registrant with the process.

2.       There is no evidence before the Panel today that could satisfy it that the Registrant’s fitness to practise was no longer impaired. She did not engage with the final hearing nor has she engaged in the subsequent reviews of the substantive order. There is therefore no evidence before the Panel that the Registrant has insight into her failings, or has remediated them. Her lack of engagement in the process demonstrates that she is no longer committed to the profession.

3.       In light of all the above, the Panel determines that the Registrant’s fitness to practise remains impaired.

4.       The Panel then went on to consider what the appropriate and proportionate sanction should be. It had regard to the Indicative Sanctions Guide issued by the HCPC and considered the available sanctions in order of severity, starting with the least restrictive. In the light of the lack of engagement and commitment to the profession on the part of the Registrant, the Panel determined that it was not appropriate to take no further action, nor was it appropriate to impose conditions of practice which would in the circumstance be wholly impracticable.

5.       In the light of all the above, the Panel also considered that a further period of suspension was also not appropriate. It took into account that the Registrant has been suspended since 20 March 2015, and she has not engaged nor demonstrated any insight into her misconduct. The Registrant has not practised as an ODP since December 2013. In the circumstances the Panel considers that the risk of repetition of her misconduct and lack of competence remains The Panel considered that this was unlikely to change in future in the light of the Registrant’s letter of 24 March 2016. A further period of suspension would therefore serve no useful purpose and would not further the public interest.

6.       Panel determined that the appropriate and proportionate sanction now is to strike the Registrant’s name off the Register.


 

Order

Order: That the Registrar is directed to strike the name of Ms Amy Jackson from the Register upon the expiry of the current order.

Notes

No notes available

Hearing history

History of Hearings for Ms Amy Jackson

Date Panel Hearing type Outcomes / Status
17/03/2017 Conduct and Competence Committee Review Hearing Struck off
16/03/2015 Conduct and Competence Committee Final Hearing Suspended