Mr John F Skelton

: Prosthetist / orthotist

: PO00623

: Review Hearing

Date and Time of hearing:10:00 07/11/2017 End: 12:00 07/11/2017

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

: Conduct and Competence Committee
: Suspended

Allegation

During the course of your employment as an Orthotist at University Hospitals Bristol NHS Foundation Trust from around March 2014 until around March 2015 you:
1. In relation to Service User A:
a) On or around 8 August 2014 you:
i. Did not consistently use professional communication
ii. You did not appropriately accommodate Service User A’s wishes
2. In relation to Service User B, who has cerebal palsy:
a) On or around 8 August 2014 you:
i. Said ‘‘you don’t have a disability,’’ or words to that effect
ii. Said Colleague A ‘‘was talking a load nonsense,’’ or words to that effect
iii. [Not proved]
iv. [Not proved]
3. In relation to Service User C:
a) Used unprofessional and or/inappropriate language including:
i. ‘‘if you were my private patient, I would not be treating you’’, or words to that effect
ii. ‘‘you don’t need splints’’ or words to that effect
iii. ‘‘she will want to wear high heels and by fitting her with splints you are not allowing her to do that,’’ or words to that effect
b) Did not appear to accommodate the wishes of Service User D, Service User C’s mother, in providing treatment to Service User C
4. In relation to Service User E:
a) On an unknown date before 26 February 2015 you:
i. Spoke to Service User E in an inappropriate manner
ii. Attempted to put Service User E’s foot into a splint that was not appropriate on more than one occasion
iii. Said her pain ‘‘was psychosomatic,’’ or words to that effect
iv. Said ‘‘why don’t you cut your leg off,’’ or words to that effect
b) On or around 26 February 2015 you:
i. Repeatedly called her by her last name
ii. Said ‘‘I am calling you by your last name, as you refused to be seen by me,’’ or words to that effect.
5. [Not proved]
6. On an unknown date you called Colleague B ‘‘petunia’’
a) The comment referred to in 6 was said in front of Service Users.
7. On an unknown date in the workplace, without reasonable excuse, you used racist and/or inappropriate terminology including:
a) ‘Paki’
b) ‘Chocolate Tart’
c) ‘Nigger’
d) [Not proved]
8. The matters described in paragraphs 1-7 constitute misconduct.
9. By reason of that misconduct your fitness to practise is impaired.

Finding

Preliminary matters
Service
1. The Panel was aware that written notice of these proceedings was posted to the Registrant at his registered address by first class post on 4 October 2017. It was also emailed to his registered email address on the same date. The Panel determined that notice of this hearing had been properly served in accordance with the relevant rules.

Proceeding in absence
2. The Panel heard the submission of Ms Willmann to proceed in the absence of the Registrant. It heard and accepted the Legal Assessor’s advice and paid due regard to the HCPTS Practice Note on ‘Proceeding in the Absence of the Registrant.’

3. The Panel, in the knowledge that this is a mandatory review, was told that on 3 November 2017, the Registrant sent an email to the HCPC stating as follows: ‘‘it is with regret I cannot attend the review. I cannot take up the offer of communicating by telephone.’’ This was followed by another email, dated 4 November 2017, from the Registrant in which he apologised for not being present at these proceedings.

4. It is clear to the Panel that the Registrant has voluntarily absented himself from this hearing, there would be no point in directing an adjournment and that the public interest demands that this case should proceed in the absence of the Registrant.

Background
5. The Registrant, a Prosthetist/Orthotist of many years experience, began employment as an Orthotist at the University Hospitals Bristol NHS Foundation Trust (the Trust) on around September 2013. He left the Trust, having tendered his resignation, before the end of March 2015. During this period of work a number of criticisms were made about him by patients. Four specific patients complained that the Registrant used entirely inappropriate language towards them. These remarks caused them, each in turn, considerable offence. Additionally, the Registrant was responsible for using racist terminology to colleagues.

Decision
6. The Panel heard the submission of Ms Willmann that the fitness to practise of the Registrant remained impaired and that the appropriate course for the Panel to adopt today would be to extend the current order of suspension. It seemed to the Panel that the recent email from the Registrant of 3 November 2017 could be said to amount to an application to lift the suspension. This interpretation is based upon the words of the Registrant to this effect ‘‘I will undergo supervision and ensure skills are current if the Suspension Order is lifted.’’

7. The Panel was aware that the process under Article 30 of the Health and Social Work Professions Order 2001 was one of review and not one of appeal, and that its function was to determine whether the Registrant’s fitness to practise was still impaired and, if so, what the appropriate and proportionate sanction, if any, should be, so as to protect the public and safeguard the public interest.

8. In considering the material in this case, the Panel took the view that some of the contents of the Registrant’s email of 3 November were disrespectful of his profession and the regulatory process. The original sanction of a Suspension Order of 9 months was not designed as a punishment, but, rather, was to provide the Registrant with an opportunity to address the concerns about his practice that had been identified within paragraphs 40 and 41 of the original determination. His engagement since with the review procedure has been, in the view of the Panel, at most, superficial. Although he claims that he has truly reflected on his approach to ‘‘care and communicate with people’’ he added his opinion that the Panel also ‘‘should reflect on its own motivations, agendas and dare I say reporting the facts.’’ He further opined that ‘‘there appeared to be an agenda beyond judging my case independently.’’

9. The Registrant has not assisted today’s Panel by providing it with information about his employment, any indication as to his future professional plans or has submitted any evidence that he has been keeping his practice up to date and remediating his misconduct by undertaking relevant courses. Nor has the Panel been given any character and/or employment references. Paragraph 70 of the previous panel’s determination makes reference to these as steps he might take to remediate his impairment.

10. In the judgment of the Panel, the Registrant continues to fail to take responsibility for his own practice and conduct. He seems not to be aware of his ongoing responsibility to keep up to date with current training and evidence based practice. He is reminded that once a finding of impairment is made the onus is then upon the Registrant to address those concerns and satisfy the regulator that he is no longer impaired.

11. In the above circumstances, the Panel has determined that the Registrant’s practice remains impaired. His lack of insight means that the Panel is not assured that, if permitted to return to unrestricted practice, the Registrant would not repeat his past failures. To conclude otherwise would also be to ignore proper consideration of the public interest.

12.  In deciding what sanction, if any, to impose, the Panel referred to the HCPTS Indicative Sanctions Policy.

13. The Panel first considered taking no further action, mediation, or the imposition of a Caution Order, but concluded that these were inappropriate due to the serious nature of the findings. In view of the lack of any compelling evidence of remediation, the Panel takes the view that a Conditions of Practice Order would not be appropriate either, because it would not adequately protect the public. In any event, since the Panel has no idea what employment, if any, the Registrant is now undertaking, appropriate Conditions could not be formulated.

14. On the other hand, an extension of the current Suspension Order, would be appropriate and proportionate in protecting the public and in addressing the wider public interest. To extend the order by a further six months would provide the Registrant with a final opportunity to demonstrate commitment to his profession and the standards that underpin it.

15. The Panel would like to echo the recommendations of the previous panel and invite the Registrant, as a minimum, to provide at the next review hearing the documents and evidence referred to at paragraph 70 of the determination of the 26 January 2017.

 

Order

The Registrar is directed to suspend the registration of Mr John F Skelton for a further period of 6 months on the expiry of the existing order.

Notes

The order imposed today will apply from 23 November 2017.

This order will be reviewed again before its expiry on 23 May 2018.

Hearing history

History of Hearings for Mr John F Skelton

Date Panel Hearing type Outcomes / Status
07/11/2017 Conduct and Competence Committee Review Hearing Suspended
23/01/2017 Conduct and Competence Committee Final Hearing Suspended