Mr Andrew S Woodall

: Occupational therapist

: OT33880

: Review Hearing

Date and Time of hearing:10:00 29/09/2017 End: 12:30 29/09/2017

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

: Conduct and Competence Committee
: Conditions of Practice

Allegation

During your employment as an Occupational Therapist for Chesterfield Royal Hospital NHS Foundation Trust between September 2003 and May 2013, you:

1. Failed to maintain adequate records in that:


a) You did not make entries on the clinical case notes for significant periods of times in that in relation to:

i. Child 19, you did not make any entries after 20 June 2007;
ii. Child 16, you did not make any entries after 27 July 2007;
iii. Child 17 you did not make any entries between 12 September 2009 and 11 September 2012;
iv. Child 23, you did not make any entries;
  a) not proved 

 
  b) not proved

  and/or
  c) after 10 November 2011;
v. Child15, you did not make any entries between;
  a) 24 April 2010 and 22 December 2010;

  and/or
  b) between 24 December 2010 and 9 October

  2012;
vi. Child 14, you did not make any entries;
  a) between 12 June 2010 and 26 January

  2011 ; and/or
  b) between 10 February 2011 and 30

  November 2011; and/or
  c) after 23 December 2011;
vii. not proved
viii. Child 20, you did not make any entries after 3 December 2009;
ix. Child 3, you did not make any entries after 29 June 2006;
x. Child 4, you did not make any entries after 10 September 2007
xi. Child 9, you did not make any entries after 18 February 2009;
  b) You did not record visits that you had

  undertaken in relation to the following cases:
xii. Child 12 ;
xiii. Child 11 ;
xiv. Child 14 ;
xv. Child 13 .
c) Your notes for the following cases contained incomplete entries:
i. Child 22
ii. Child 10
iii. Child 21

2. Did not undertake and/or record visits in relation to the following cases:
a. Child 8 ;
b. Child 7 ;
c. Child 6 ;
d. Child 5 .

3. Did not complete statement reports in relation to the following cases:
a. Child 18 due on or around 11 October 2012;
b. Child 15 due on or around 10 April 2012.

4. Failed to complete requested and/or required actions in that:
a. In relation to Child 1 :
i. Between on or around 24 March 2011 and September 2012, you did not arrange for an improved head support to be provided for her class chair;
ii. Between on or around November 2011 and September 2012 did not complete a sling assessment.
b. In relation to Child 2, you did not provide the school and/or Child 2’s parents with any exercise programmes following your assessment of the child in around June or July 2012.

5. Failed to discharge service users in the following cases:
a. Child 3
b. Child 4
c. Child 9
d. Child 19

6. Stored confidential information in an inappropriate manner in that you had approximately 56 patient case files at home.

7. The matters described in paragraphs 1 –5 constitute misconduct and/or lack of competence.

8. The matters described in paragraph 6 constitute misconduct.

9. By reason of that 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 home address.

Proceeding in absence

2. The Registrant did not appear nor was he represented. He telephoned the HCPC on the day before the hearing to say that he had missed the notice of hearing and only just picked up the bundle from his local post office.  He said he could not attend either personally or by telephone due to his work commitments, but that he did not want to apply for an adjournment. He sent an email to the HCPC on the morning of this hearing, explaining again that he had only recently received notification of the hearing, but acknowledging that this was due to an administrative error on his part. Whilst he could not attend the hearing, he said that he would have done so but for his work commitments. He gave details of his positive progress to date in his current position and attached a reference from his line manager. He had not attended the original final hearing in August 2014, but he did attend the first review hearing on 23 October 2015 and the second review hearing on 29 October 2016. 

3. On behalf of the HCPC, Mr Newman applied for the hearing to be conducted in the absence of the Registrant on the basis that the Registrant had been notified of the date, time and location of the hearing at his registered address. Mr Newman 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 and had voluntarily absented himself.  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 was employed as an Occupational Therapist at Chesterfield Royal Hospital NHS Foundation Trust.  He was based in the Children’s Community Occupational Therapy Department where he was responsible for children with learning and physical impairment.  Concerns arose in 2012 concerning his failure to maintain adequate records, to make visits and to complete required actions in relation to numerous children under his supervision between 2007 and 2012.

6. The Registrant did not appear and nor was he represented before the Conduct and Competence Committee of the HCPC at a final hearing on 28-29 October 2014.  He had indicated in writing that he admitted the facts as set out in the amended allegation. He was also found to have kept approximately 56 files at home, some of which had been at his home for several years.  The proven allegations included his failure to maintain adequate records for 14 service users and his failure to undertake or record visits to four service users.  His conduct was found to have fallen well short of that which would be regarded as proper in the circumstances.  The misconduct had persisted over an extended period of time with a large number of cases involving particularly vulnerable patients. 

7. The Panel at the final hearing found that the Registrant’s fitness to practise was impaired by reason of his misconduct. The Panel considered the personal component in relation to the Registrant’s own practice and any evidence of insight, remorse or remediation and the public component in relation to protection of service users and the need to declare and uphold proper professional standards.  The Registrant was found to pose a risk of harm to those in his care.  There was no evidence of insight or remediation, so there was a consequent risk of repetition.  

8. The Panel at the final hearing imposed a Suspension Order of 12 months.  The case was too serious for any lesser order.  The Panel at the final hearing considered that the misconduct was remediable and that a period of suspension would give the Registrant an opportunity to re-engage with the process and demonstrate insight.  The Registrant was advised that the following may assist his case on review:-


• The Registrant’s attendance at the review hearing
• Independent evidence of his current health
• Evidence of his adherence to HCPC CPD standards
• References from any paid or voluntary employment addressing issues of case management and record keeping
• Evidence of any training he has undertaken to address the misconduct identified, and
• Evidence of the coping strategies he has developed to deal with stressful situations.
The first review

9. The Registrant attended the first review hearing on 23 October 2015 and gave evidence of his remorse at his failings and his intention to remediate his failings.  He asked for his suspension to be extended so that he could undertake and complete a plan to take the appropriate courses on time management and record keeping.  He was working full time as a support worker for young people with additional needs or disabilities and provided a reference from his manager.  The Panel commended the Registrant’s positive response, but noted his admission that his fitness to practise remained impaired.  On that basis, the Suspension Order was extended for a further 12 months.
The second review

10. The Registrant attended the second review hearing on 29 October 2016 and gave evidence of his training and his continued work with children and young people with challenging behaviour.  He produced evidence of his work and a good reference from his current employer.  The Panel at the second review was satisfied that the Registrant had taken substantial steps to address the concerns about his failings. He was found to have shown good insight into his shortcomings and to have significantly reduced the risk of repetition.  However, the Panel remained concerned that his progress was not yet tested in a clinical setting in which he would be required to treat patients and to maintain records. His conduct therefore remained impaired on personal grounds, but no finding of impairment was required on public interest grounds in view of his progress towards remedying his previous misconduct.

11. The Panel at the second review therefore imposed a Conditions of Practice Order in the terms set out below on the basis that such an order would enable a supervised return to practice whilst mitigating and controlling the risks.

1. When undertaking work as an Occupational Therapist, you must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC for a period of 6 months starting from the date that you take up a clinical role.

2. You must supply details of your workplace supervisor to the HCPC within 14 days of taking up a clinical role. You must attend upon that workplace supervisor as required and follow their advice and recommendations.

3. You should submit records of your supervision notes agreed with your workplace supervisor to the HCPC on a monthly basis during the 6 month period of supervision.

4. You must promptly inform the HCPC in writing within 14 days if you take up any employment as an Occupational Therapist.

5. You must promptly inform the HCPC in writing of any disciplinary
proceedings taken against you by your employer.

6. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work as an Occupational Therapist;

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application).

This review hearing

12. This is the third review. Mr Newman for the HCPC reminded the Panel of the history of the case and of their powers as to extending, continuing, varying or revoking the order or imposing another order.  He submitted that there were continuing concerns about the Registrant’s fitness to practise as an Occupational Therapist because the Registrant was not yet doing work of equivalent difficulty and responsibility and that he had not worked as an Occupational Therapist since 2013.  Accordingly, it was submitted that the Registrant posed a continuing risk to service users if he were to return to unrestricted practice, therefore his fitness to practise remains impaired.

13. In relation to sanction, Mr Newman for the HCPC submitted that a further Conditions of Practice Order of short duration in the same terms was the appropriate and proportionate sanction in order to protect the public and to give the Registrant a further opportunity to demonstrate engagement and remediation.

14. In the absence of the Registrant, the Panel had regard to the content of the Registrant’s email dated 29 September 2017 in which he described how he had heeded comments made at the last review hearing and taken on more responsibility by finding and supporting placements for young service users at Aspire Disability Support Service where he has worked as a support worker for more than four years.  The Panel noted that the Registrant has become team leader for service provision of 24/7 supported living.   The Panel also took into account the positive reference from the Registrant’s line manager in considering issues of impairment and/or sanction.

Decision

15. 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. The Panel accepted the advice of the Legal Assessor.


16. 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 future risk, and that this was not a rehearing of the original case or previous reviews. 

17. The Panel accepted the force of the submissions made on behalf of the HCPC that the Registrant had worked hard in his current role, but that he had achieved insufficient progress to permit him to return to unrestricted practice. There was no evidence of the Registrant returning to clinical or therapeutic work as an Occupational Therapist.  In considering the personal component in relation to impairment, the Panel accepted that the Registrant had improved his administrative and organisational skills in his current position, but he had not returned to professional practice under supervision, so there remained a risk to service users.  

18. The nature of the misconduct was too serious to make no order or to consider mediation.  The Panel considered whether to impose a Caution Order, but decided that it was inappropriate, because it would not provide sufficient public protection.

19. The Panel considered that a short extension of the current Conditions of Practice Order was the proportionate and appropriate sanction at this stage.  The terms of the order were necessary to provide protection to service users.  The Panel has extended the current order by only 4 months so that the Registrant can now concentrate his mind on what is achievable or workable and demonstrate what practical steps he is taking towards an eventual return to practice as an Occupational Therapist.   He would greatly assist his case by attending the next review hearing.

20. The Panel considered the alternative sanctions of suspension and striking-off, but considered that both were disproportionate at this stage.  However, the Registrant should be aware that the Panel felt a degree of frustration that the Registrant had failed to arrange his commitments so that he could attend the hearing and give evidence of his progress and his future plans.  The Registrant should also be aware that there will come a stage when these review proceedings will inevitably conclude either with his successful return to unrestricted practice or with his removal from the register, whether voluntary or otherwise.

Order

The Registrar is directed to extend the Conditions of Practice Order against the registration of Mr Andrew S Woodall for a further period of 4 months on the expiry of the existing order.

1. When undertaking work as an Occupational Therapist, you must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC for a period of 6 months starting from the date that you take up a clinical role.

2. You must supply details of your workplace supervisor to the HCPC within 14 days of taking up a clinical role. You must attend upon that workplace supervisor as required and follow their advice and recommendations.

3. You should submit records of your supervision notes agreed with your workplace supervisor to the HCPC on a monthly basis during the 6 month period of supervision.

4. You must promptly inform the HCPC in writing within 14 days if you take up any employment as an Occupational Therapist.

5. You must promptly inform the HCPC in writing of any disciplinary
proceedings taken against you by your employer.

6. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work as an Occupational Therapist;

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application).

Notes

The order imposed today will apply from 25 October 2017. This order will be reviewed aain before its expiry on 25 February 2018.

Hearing history

History of Hearings for Mr Andrew S Woodall

Date Panel Hearing type Outcomes / Status
29/09/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
26/10/2016 Conduct and Competence Committee Review Hearing Conditions of Practice
23/10/2015 Conduct and Competence Committee Review Hearing Suspended
28/10/2014 Conduct and Competence Committee Final Hearing Suspended