Mr Christopher Losinski
1. Your fitness to practise is impaired by reason of your physical and/or mental health.
1. Mr Losinski (“the Registrant”) is registered with the HCPC as an Occupational Therapist. Notice of this hearing was posted to the Registrant’s registered address by first class post on 9 May 2017. A copy was also sent to him by email on the same date. The Panel was satisfied that notice had been served in accordance with the Health and Care Professions Council (Health Committee) (Procedure) Rules.
The Absence of the Registrant
2. The Panel took into account the HCPC Practice Note “Proceeding in the absence of the Registrant”. The Panel has to strike a balance between fairness to the Registrant and fairness to the wider public interest in ensuring that matters such as these are dealt with in an effective and expeditious manner. In an email dated 9 May 2017 the Registrant said he would not be attending. The Panel decided it was fair to proceed in the absence of the Registrant.
Amendment to the Allegation
3. Ms Turner applied for an amendment to the wording of the Allegation. The Registrant had been notified of the proposed amendment on 17 March 2017. He had raised no query or objection on the point. The Panel was satisfied that the amendment did not substantially change the nature of the Allegation and that it was fair to allow the amendment.
Hearing in Private
4. Ms Turner applied for the hearing to be conducted in private given that this is a Health Allegation and the HCPC case rested to a considerable extent on references to the Registrant’s health condition. The Panel took into account the Health and Care Professions Tribunal Service (HCPTS) Practice Note: “Conducting Hearings in Private”. In general, HCPTS cases should be heard in public. But the Procedure Rules permit hearings to be conducted in private where it is necessary to protect the private life of a registrant. The Panel is satisfied that this is such a case. Given the way in which the health condition of the Registrant is central to this case it is not practicable to try to separate the hearing into private and public portions. The Panel decided the proper course was to hold the whole hearing in private.
5. Two versions of this Decision have been prepared. One is a “Private” version and the other is a “Public” version. The Public version does not give details of the medical condition of the Registrant.
6. The Registrant’s first qualified role as an Occupational Therapist ran from 10 August 2015 to 1 February 2016 during which time he was employed by an NHS Trust (“the Trust”). During that employment there were concerns that the Registrant’s medical condition impacted on his ability to retain and process information which, in turn, led to poor clinical reasoning. The employment ended upon the Registrant’s resignation.
7. In preparing this case the HCPC has commissioned a report from Dr M, a Consultant in his field. By an earlier order the Chair of this Panel consented to the HCPC relying upon Dr M as an Expert Witness.
Decision on Facts
8. On 1 February 2016, the HCPC received a referral from the Trust concerning the Registrant. The Registrant had been employed by the Trust as an Occupational Therapist from 10 August 2015 to 1 February 2016. The referral made reference to the Registrant being absent from work because of a medical condition. He had returned to work on a rehabilitation programme but was not managing to function.
9. On 19 November 2015 a Occupational Health Consultant (“OHC”) provided a written assessment to the Trust.
10. Dr M interviewed the Registrant by telephone on 6 December 2016.
11. During the interview the Registrant told Dr M that for the 6 month period prior to the interview he had been employed as a support worker for a private company. He had not been off sick from work during that period. He said he “currently has no plan to return to work as an OT or renew his license but this was not definite in terms of his future/later employment”.
12. Dr M was of the opinion, in effect, that the Registrant would not be well enough to return to work as an Occupational Therapist until he had undergone a period of medical treatment.
13. The Panel has noted the reported difficulties from the Trust concerning the manner in which the Registrant was carrying out his role. There is nothing to show those accounts are unreliable. The Panel accepts that the Registrant’s medical condition impacted on his ability to retain and process information which, in turn, led to poor clinical reasoning. The Registrant was unable to deal with a full caseload and towards the end of his employment he had a caseload of 2 patients. He was requiring daily supervision but continued to make mistakes.
14. The Panel accepts the diagnosis given by Dr M.
15. The Panel is satisfied that the Registrant accepts he has a medical condition. But the Panel cannot be satisfied that the Registrant acknowledges there are steps in the form of treatment that he would need to take before any return to work.
16. The Panel has to make a judgment as to whether fitness to practise is impaired as at today’s date. The Panel has taken into account the HCPTS Practice Note: “Finding that Fitness to Practise is Impaired”.
17. The Panel has considered the Personal Component and has concluded on the basis of the evidence from Dr M that the Registrant is not, and will not be, competent or well enough to return to work as an Occupational Therapist until he has received the medical treatment as advised by Dr M.
18. In respect of the Public Component the Panel has concluded that if the Registrant were to practise there would be a risk of harm to patients because of his inability to provide adequate clinical reasoning.
19. The Panel has decided that the Registrant’s fitness to practise is impaired. He does not currently have sufficient competence and there would be a risk to public safety and damage to public confidence in the Occupational Therapist profession if the Panel were to find otherwise.
20. The Panel has considered the appropriate sanction and has taken into account the HCPTS “Indicative Sanctions Policy”. It has received submissions from the HCPC and accepted the advice of the Legal Assessor. The purpose of sanctions is not to be punitive. The primary purpose is to protect members of the public. Relevant other objectives are to maintain the reputation of the Occupational Therapy profession and confidence in this regulatory process.
21. It is not appropriate to make no order, refer for Mediation or impose a Caution as these sanctions do not sufficiently protect the public.
22. The Panel has considered a Conditions of Practice Order. Such an order will be appropriate where a Panel is confident a registrant will adhere to the conditions, is genuinely committed to resolving the issues they seek to address and can be trusted to make a determined effort to do so. Conditions of practice are unlikely to be suitable in cases where a registrant has failed to engage with the fitness to practise process.
23. There is no evidence that the Registrant will adhere to Conditions of Practice. He has failed to engage with this regulatory process and he has indicated that he does not intend to return to practice. The Panel has concluded that a Conditions of Practice Order is therefore not appropriate.
24. The Panel has concluded that a Suspension Order for twelve months is the only effective and proportionate order. It is necessary to provide adequate protection for the public and to maintain the reputation of Occupational Therapists and confidence in this regulatory process.
25. The Order of Suspension now imposed will be reviewed before its expiry. It is not open to this Panel to bind a future Reviewing Panel but this Panel believes it will be helpful for any future Reviewing Panel if:
(i) The Registrant personally attends any future review;
(ii) The Registrant provides the Reviewing Panel with evidence or a report from a suitably qualified therapist confirming that the Registrant has undertaken all, or a significant part of the therapies (including the CBT model) as suggested by Dr M in the report now before the Panel;
(iii)The therapist referred to above must be someone who is appropriately qualified to carry out an assessment of as discussed on page 13 of Dr M’s report.
26. The Panel has imposed a Suspension for twelve months to allow sufficient time for the Registrant to provide the information set out above.
27. The Registrant has previously indicated he has no wish to return to the Occupational Therapist profession. The Panel recommends in those circumstances that the HCPC explore with the Registrant a voluntary removal from the Register.
A Final Hearing of the Health Committee took place at 405 Kennington road London from Tuesday 25 July 2017to Wednesday 26 July 2017.