Mr Justin Williams

: Operating department practitioner

: ODP23141

Interim Order: Imposed on 05 Aug 2015

: Review Hearing

Date and Time of hearing:12:30 14/08/2017 End: 17:00 14/08/2017

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

: Conduct and Competence Committee
: Suspended

Allegation

During the course of your employment as an Operating Department
Practitioner with BMI Bath Clinic, between March 2008 and April 2015, you:
1. On or around 24 May 2014, when closing down theatre 2:
a) Did not shut and/or lock the anaesthetic drug cupboards and/or fridge.
b) Left a Propofol-filled syringe with intravenous infusion and warming coil in the theatre connected to the infusion pump.
c) Did not ensure that the intubation trolley was adequately tidied and/or stocked.
d) Left drugs on the anaesthetic machine and/or trolley.

2. On 19 December 2014, you:
a) Did not adequately check and/or prepare the anaesthetic machine prior to a patient being anaesthetised.
b) Did not recognise that the reservoir bag had been incorrectly connected to the common gas outlet.
c) Responded inappropriately to a problem with the anaesthetic machine, in that you prepared to swap the anaesthetic machine with another without carrying out the prerequisite checks.

3. The matters set out in paragraphs 1 - 2 constitute misconduct and/or lack of competence.

4. 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 notice of today’s hearing had been served on the Registrant at his registered address.


Proceeding in absence


2. The Registrant did not appear nor was he represented. He had not attended the final hearing in February 2016 or the first review hearing in February 2017, although he had made written submissions to the first review panel.


3. On behalf of the HCPC, Ms Willmann applied for the hearing to be conducted in the absence of the Registrant on the basis that he had been notified of the date, time and location of the hearing at his registered address. Ms Willmann therefore submitted that it was in the public interest for the hearing to proceed expeditiously.


4. Having considered the revised HCPC Practice Note on proceeding in absence and the advice of the Legal Assessor on the case of GMC v Adeogba [2016] EWCA Civ 162 (“the fair, economical, expeditious and efficient disposal of allegations against medical practitioners is of real importance”), the Panel was satisfied that the Registrant had received reasonable notice of today’s hearing.  The Registrant had not applied for an adjournment.  There was no indication that he would attend at a later date if today’s hearing were to be adjourned.  The Panel noted the overriding public interest in dealing with matters in a timely manner and that this was a mandatory review. In balancing the Registrant’s interest and the public interest, the Panel decided that the matter should be heard in the absence of the Registrant.


Background


5. The Registrant commenced employment as an Operating Department Practitioner (ODP) with the BMI Bath Clinic as a Theatre Practitioner in Anaesthetics in September 2004.  He was responsible for ‘closing down’ the theatre on Saturday 24 May 2014.  It was discovered on the next working day that the theatre had not been correctly closed as set out in particular 1 of the allegation. 


6. The incident in particular 2 of the allegation on 19 December 2014 arose when the Registrant planned to switch a patient from one anaesthetic machine to another, but he failed to identify that the machine in use had an incorrectly fitted reservoir bag and erroneously chose to replace the machine rather than identify and rectify the error.   The Registrant’s employer referred him to the HCPC on 10 April 2015 as a result of this incident.


7. The Registrant did not appear and nor was he represented before the Conduct and Competence Committee of the HCPC at a final hearing on 18 February 2016.  The particulars of allegation were proved and his failings were found to amount to misconduct.


8. The Panel at the final hearing found that the Registrant’s fitness to practise was impaired by reason of the potential for harm to colleagues and patients and his limited insight, including past failures to respond to issues about his practice.  In his favour, the Registrant had admitted and apologised for his actions and there was no indication of any history of similar incidents.


9. The Panel at the final hearing imposed a Suspension Order of 12 months.  The case was too serious for any lesser order and a period of suspension would allow the Registrant to reflect, take remedial action and provide evidence for the review.  The Registrant was advised that a reviewing Panel might be assisted by the following:

a) a reflective statement covering both incidents and the responses he made at the time the incidents were raised with him;
b) if health issues were relevant to both incidents, evidence from him and/or his GP about his health and treatment both at the time of the incidents and currently;
c) information about his thoughts and plans for his future career;
d) any remedial or rehabilitative steps taken by him;
e) evidence that he has maintained his CPD;
f) if he has been working in the healthcare field, a reference or testimonial from his employer.
10. The first review hearing was held on 15 February 2017. The Registrant did not attend, but he made written submissions in an email dated 1 February 2017 in which he acknowledged his shortcomings and expressed remorse and regret.  He also provided evidence that he had reflected on his actions. He produced mitigation in relation to past health, family and personal issues.   However, there was no evidence as to his current state of health or any substantive evidence as to his continuing professional development or any testimonial as to his recent work.


11. The first review Panel therefore concluded that a further period of suspension of six months was necessary to protect the public and to enable the Registrant to gather the further evidence to persuade the next Panel that he could return to his profession.  He was strongly urged to assist his own case by attending the next review hearing.


Second Review


12. There has been no further response from the Registrant.  Ms Willmann for the HCPC reminded the Panel of the history of the case and of its powers as to extending, continuing, varying or revoking the order or imposing another order.  She submitted that this was a serious matter and there were continuing concerns about the Registrant’s fitness to practise in the absence of any further information as to his circumstances.  Accordingly, it was submitted that his fitness to practise remains impaired.  Ms Willmann for the HCPC made no specific submission as to the appropriate sanction.


Decision

13. A substantive review is a two stage process.  The first task of the Panel is to decide whether the Registrant’s fitness to practise is currently impaired and if so, to then consider what, if any, sanction should be imposed upon his registration. In reaching its decision, the Panel has considered all the relevant material and had regard to the HCPC Practice Notes on Impairment and Indicative Sanctions Policy and the necessity for proportionality.  The Panel accepted the advice of the Legal Assessor as to the principles to be applied on the issues of impairment and sanction.

14. The Panel had firmly in mind that the purpose of this hearing was to conduct a thorough appraisal of the Registrant’s current fitness to practise, including an assessment of insight and future risk, and that this was not a rehearing of the facts of the original case.  

15. The Panel accepted the submissions made on behalf of the HCPC that the Registrant had failed to engage with the regulatory process or to submit any further evidence of insight or remediation.  The original allegation was a serious matter of misconduct that had placed service users at risk.  The Panel therefore concluded that the Registrant’s fitness to practise remained impaired.  In making this finding, the Panel had in mind the absence of further information about the Registrant’s current circumstances since the first review.  The Panel also considered that a finding of impairment was necessary to protect the public and maintain public confidence in the profession.


Sanction


16. The nature of the misconduct was too serious to make no order.  The case concerned clinical failings, so there was a continuing risk to the public in the absence of further information.  An order was also necessary to maintain public confidence in the profession. The Panel considered whether to impose a Caution Order, but decided that it was inappropriate, because there was no further evidence of insight or remediation and it would not provide sufficient public protection.

17. The Panel might have been receptive to a submission that the Registrant should be permitted to return to work under supervision under a Conditions of Practice Order had there been some engagement from the registrant. In the absence of any engagement, the Panel was concerned that the issues highlighted by the original panel remained unaddressed. In particular, the Panel noted the finding that the Registrant has not always responded positively or constructively to issues raised with him about his practice in the past.  A Conditions of Practice Order was not therefore appropriate or workable in the absence of information about the Registrant’s current circumstances, further evidence as to his level of insight, and some indication that he was willing to engage with his regulator.  

18. The Panel then moved to consider whether to extend the current Suspension Order.  The original findings of fact related to a serious matter of misconduct.  There is no further indication of improved insight or remediation.  The Panel therefore decided that a further Suspension Order of four months was necessary and proportionate for the purpose of public protection at this stage.  An order of shorter duration is intended to concentrate the Registrant’s mind on the need to engage with his regulator and demonstrate his fitness to practise if he is to return to his profession.

19. The Panel considered the sanction of striking-off, in view of the original finding of misconduct, the limited insight and the absence of engagement, but determined that the Registrant should have one more opportunity to engage with the HCPC and demonstrate his fitness to practise at a further review hearing.  This Panel strongly urges the Registrant to assist his own case by responding and engaging with the HCPC at the next review if he wishes to return to practice.   The Registrant should understand that the next review panel might be left with little option but to impose the sanction of striking off if he fails to engage with the HCPC

Order

ORDER: That the Registrar is directed to suspend the registration of Justin Williams for a period of 4 months from the date this order comes into effect.

Notes

No notes available

Hearing history

History of Hearings for Mr Justin Williams

Date Panel Hearing type Outcomes / Status
07/12/2017 Conduct and Competence Committee Review Hearing Struck off
14/08/2017 Conduct and Competence Committee Review Hearing Suspended
15/02/2017 Conduct and Competence Committee Final Hearing Hearing has not yet been held
15/02/2017 Conduct and Competence Committee Review Hearing Suspended
16/02/2016 Conduct and Competence Committee Final Hearing Suspended
28/01/2016 Conduct and Competence Committee Interim Order Review Interim Suspension
05/08/2015 Conduct and Competence Committee Interim Order Application Interim Suspension