Mrs Karen S Collister

: Biomedical scientist

: BS52833

: Review Hearing

Date and Time of hearing:12:30 15/08/2017 End: 17:00 15/08/2017

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

: Conduct and Competence Committee
: Voluntary Removal agreed

Allegation

During the course of your practice as a Biomedical Scientist with the Countess of Chester Hospital NHS Foundation Trust, you:

 

1. Repeatedly failed bench competency tests, including:

a) a blood culture bench test over the period 4-13 January 2011, in which you made major errors in 18.8 per cent of total specimens and minor errors in 25 per cent, including:

i) you wrongly recorded Gram films;

ii) you failed to preserve isolates with regard to sample number 150163A;

iii) you left slopes at the back of the bench and/or you failed to label them properly;

iv) on 5 January 2011 and/or 6 January 2011 you did not report amoxicillin sensitivity results for sample numbers 150052A, 150052N, 156130A, 150076A and 150076N;

v) you reported CNSI from anaerobic bottle and CNS2 with the same sensitivity pattern from the aerobic bottle, in reference to sample number 156091N;

vi) you incorrectly read the sensitivity plates for the aerobic bottle numbered 150183J;

vii) you did not repeat the Oxacillin test for sample number 150008A.

 

b) a respiratory bench test over the period 4-13 January 2011, in which you demonstrated poor understanding of respiratory bacteriology, including:

i) In respect of number of sample number 170079P, you reported a Moraxella catarrhalis (MCAT) as sensitive to AMO because zone size was 31mm and larger than the zone on the template although the Beta lactamose (BLAC) was positive;

ii) In respect of sample number 170079P, you reported counts from the selective plates rather than the non-selective plates.

 

c) a blood culture bench test over the period 21 February - 4 March 2011, in which you made major errors in 17.8 per cent of total specimens and minor errors in 16 percent, including:

i) occasions where organisms were recorded as saved on beads but were not, for example, Samples 150863XB and 15075XN;

ii) you did not use the sensitivity templates in respect of sample 150894XN.

 

d) a respiratory bench test over the period 21 February - 4 March 2011, in which you demonstrated that your knowledge and/or understanding were insufficient to avoid interpretive errors, in particular:

i) In respect of sample 17001, you carried out sensitivity testing on MCAT bacterium although it was not actually MCAT bacterium;

ii) In respect of sample numbers 171095 and 121203, you failed to realize that you had mixed up the BLAC results despite the sensitivity profiles indicating otherwise;

iii) In respect of sample number 171100, you failed to record the results at 48 hours;

iv) In respect of sample number 170981, you incorrectly reported the sample as Trimethoprim when it was Trimethoprim resistant.

 

2. In March 2011 you plagiarised a colleague's work in written evidence you submitted for your specialist portfolio.

 

3. The matters set out in paragraph 1 amount to lack of competence.

 

4. The matters set out in paragraph 2 amounts to misconduct.

 

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

Finding

Preliminary matters

Service

1. The Panel was satisfied that the Registrant had been properly served with the Notice of the Hearing by a letter sent to her registered address dated 14 July 2017.

2. The Notice of Hearing informed the Registrant that the hearing would be to consider a review of the current Suspension Order. The Registrant indicated in an e-mail dated 21 July 2017 that she wished to be removed from the Register. The HCPC responded to that request with a proposal for a Voluntary Removal Agreement. The Notice of Hearing does not refer the proposed Voluntary Removal Agreement, but the position was clearly explained to the Registrant in a letter dated 31 July 2017. She was advised that at the hearing today the Panel would consider whether to deal with the case via the consent arrangements. If the Panel did not feel that was appropriate, they would continue to hear the review in full.

3. Ms Carson made an application for the hearing to proceed in the absence of the Registrant. She referred the Panel to an e-mail from the Registrant dated 21 July 2017. The Registrant states that due to financial constraints she is unable to attend the hearing “now and for the foreseeable future”. Ms Carson also referred the Panel to correspondence from the HCPC relating to the proposed Voluntary Removal Agreement and the VRA documentation signed by the Registrant.

4. The Panel took into account the HCPTS Practice Note “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel was satisfied from the Registrant’s e-mail dated 21 July 2017 that she is aware of today’s hearing and has waived her right to attend the hearing. No useful purpose would be served by an adjournment, because there was no likelihood that the Registrant would attend at a later date. It was in the public interest that the consideration of the proposed Voluntary Removal Agreement and, if appropriate, the review hearing, should take place without delay.

Background

5. The Registrant was a Band 5 Trainee Biomedical Scientist (TBMS) employed by the Countess of Chester Hospital NHS Foundation Trust (the Trust), now known as the Wirral University Teaching Hospital NHS Foundation Trust. As a TBMS, the Registrant completed her HCPC registration by 2006 and would have been expected to commence her specialist portfolio in order to progress to a Band 6 Biomedical Scientist. She did not start her specialist portfolio until 2008.

6. By 2009 the Registrant’s mentor had concerns that she had not completed her specialist portfolio within the allocated timeframe. The Registrant was given a one-year extension of time, but still had not completed her specialist portfolio by December 2010. Performance management procedures were initiated on 13 December 2010 and further assistance was provided to the Registrant to assist her to complete the portfolio. The Trust was concerned that, without completing the portfolio and associated competencies, the Registrant was unable to undertake the full range of the duties required.

7. The Registrant failed blood culture and respiratory bench tests between 4 and 13 January 2011 and between 21 and 4 March 2011. In May 2011 the Registrant initiated a grievance against the Chief Biomedical Scientist, which was not upheld by the Trust. However, it became apparent to the Trust that the Registrant had been plagiarising another colleague’s work.

8. On 22 March 2012 the Trust terminated the Registrant’s employment and made a referral to the HCPC about her lack of competence.

9. At a Substantive Hearing in 2013, the Registrant admitted the act of plagiarism, although she invited the Panel to accept that she had good reason for so doing. She did not admit that this amounted to misconduct. She denied the other particulars of the allegation.

10. The Substantive Hearing Panel found all particulars proved except for particular 1(a)(iii) which was partially proved. The Panel found that the repeated failure of bench competence tests amounted to the statutory ground of lack of competence, and that the admitted plagiarism was sufficiently serious to constitute misconduct.

11. The Substantive Hearing Panel was concerned about the Registrant’s lack of insight into her failings and the potential for harm, if she had not been closely supervised. There was an absence of remediation through undertaking relevant training courses or otherwise. The Panel was unable to discount the possibility of repetition of the Registrant’s deficiencies. Impairment of her fitness to practise was, therefore, found on the ground of lack of competence. The Panel did not accept that there was a justifiable reason for the Registrant’s misconduct, nor that she had expressed any particular remorse about her actions. On the basis of the wider public interest and in order to maintain public confidence in the Biomedical Science Profession, the Panel determined that the Registrant’s fitness to practise was impaired as a result of her misconduct and her lack of competence.

12. The Substantive Hearing Panel decided that the appropriate and proportionate sanction was a Conditions of Practice Order for a period of 2 years.

13. The Conditions of Practice Order was reviewed on 12 August 2015. The Registrant attended the hearing and represented herself. The reviewing Panel was not presented with evidence to demonstrate remediation of the failings identified. She had not worked within a BMS or related environment and her skills had not been tested. The Panel was also concerned that her evidence demonstrated a continued lack of insight into the failings identified in her practice. The Panel on 12 August 2015 found that the Registrant’s fitness to practise remained impaired in relation to the Registrant’s lack of competence.

14. The Panel decided that the suitable and proportionate disposal of the case was to extend conditions of practice for 12 months. The Panel varied the conditions to widen the scope for the identification of a person to supervise the Registrant. The purpose of the amendment was to reduce the impact of the condition on the Registrant’s obtaining employment as a Biomedical Scientist. The amendment involved no appreciable decrease in the protection afforded to the public.

15. The Conditions of Practice Order was further reviewed on 12 August 2016. The Registrant did not attend the hearing and there was no evidence of any remedial action, training or CPD. The Panel on 12 August 2016 decided that the Registrant’s fitness to practise remained impaired. The Panel considered that there remained some prospect that the Registrant could be rehabilitated and decided that the appropriate sanction was a Suspension Order for a period of 12 months.

Decision

16. Ms Carson submitted that the proposed Voluntary Removal Agreement secured the appropriate level of public protection and would not be detrimental to the wider public interest.

17. The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPTS Practice Note “Disposal of Cases by Consent”.

18. The Panel was satisfied that the proposed Voluntary Removal Agreement provides the appropriate level of public protection. It protects the public because the Registrant will be removed from the Register and will be unable to practise as a Biomedical Scientist. There are also safeguards in place if the Registrant applied to be readmitted to the Register which are similar to those that would apply if the Registrant had been struck off the Register. An application for readmission would be subject to close scrutiny.

19. The Panel carefully considered whether the approval of the Voluntary Removal Agreement would be detrimental to the wider public interest. In this case there has been a full public hearing in which evidence was presented, the Registrant attended, factual findings were made, findings of lack of competence, misconduct and current impairment were made and a sanction was imposed. There have been two review hearings, both of which were heard in public.

20. The circumstances are that the Registrant has been unable to secure work as a Biomedical Scientist and unable to demonstrate that she has remedied her lack of competence.

21. In this context the Panel decided that the proposed VRA does not damage the wider public interest. The previous public hearings have
demonstrated the importance of compliance with standards of competence and behaviour and the Panel’s approval of the VRA would not undermine those standards. The steps taken by the Regulator as set out above are sufficient to maintain confidence in the profession and the regulatory process.

22. The Panel therefore agreed to the matter being concluded by means of a VRA and approved the proposed Notice of Withdrawal.

23. In its deliberations the Panel noted that the Allegation in Schedule A of the VRA includes particular 1(a)(iii) which was found by the Substantive Hearing Panel to be partially proved. It was not proved that the Registrant failed to label the slopes properly. This point does not invalidate the VRA or require it to be redrafted, but the Panel considered that this point should be noted in its determination.

Order

The Panel directs that the Suspension Order be revoked on the basis that the Registrar will remove the name of Mrs Karen Collister from the Register with immediate effect.

Notes

The Registrant will not be able to reapply to be on the Register for 5 years from the date that this order comes into effect.

Hearing history

History of Hearings for Mrs Karen S Collister

Date Panel Hearing type Outcomes / Status
15/08/2017 Conduct and Competence Committee Review Hearing Voluntary Removal agreed
12/08/2016 Conduct and Competence Committee Review Hearing Suspended