Mr Ian Simmonds

: Biomedical scientist

: BS62097

: Review Hearing

Date and Time of hearing:10:00 24/11/2017 End: 12:30 24/11/2017

: Hotel Novotel Cardiff Centre, Schooner Way, Cardiff CF10 4RT

: Conduct and Competence Committee
: Conditions of Practice

Allegation

In the course of your employment at Hereford Hospital NHS Trust, whilst on the

HPC register, you:

 

1. Recorded the incorrect blood group on 12 and 18 February 2009;

 

2. Incorrectly recorded a different spin group from the microplate group on 20 February and 20 April 2009;

 

3. Failed to follow sample acceptance procedures on 20 February;

 

4. Failed to label blood and urine samples differently on 11 May 2009;

 

5. Missed four requests for glucose which did not have the appropriate sample on 11 May 2009;

 

6. Underwent a performance review period between 11 May and 09 October 2009, where you continuously demonstrated:

 

a. Poor sample labelling;

c. Poor clinical reasoning skills;

d. Poor observation skills;

e. Poor record-keeping skills;

f. Poor quality control prior to processing manual samples; and

g. An inability to work autonomously.

 

7. The matters set out in 1 – 6 constitute a lack of competence; and

 

8. By reason of your lack of competence, your fitness to practise is impaired.

Finding

Preliminary Matters

Introduction

1.     Mr Ian Simmonds (the Registrant) is registered with the HCPC as a Biomedical Scientist.  On 24 May 2011 a Panel of the Conduct and Competence Committee found that the fitness to practise of Mr Simmonds was impaired by reason of lack of competence. The Panel made a Conditions of Practice Order (COPO) to run for 3 years.  That initial COPO has been replaced on two previous occasions such that Mr Simmonds has been subject to a COPO in various forms since May 2011.

2.     This hearing is a mandatory review of the last COPO which was imposed on 27 November 2015 to run for 2 years.

Service of notice of hearing

3.     The notice of hearing was sent to the Registrant by post on 1 November 2017 to the address provided by him for HCPC registration purposes.  The Panel was satisfied that the hearing notice had been properly served.

Background

4.     The Registrant graduated with a degree in Biomedical Sciences in 2008.  His course of study was an HCPC accredited course and, on that basis, he was admitted to the Biomedical Scientist part of the HCPC register. In late September 2008 he commenced work as a trainee Biomedical Scientist at Hereford Hospital NHS Trust with an 18 month fixed term contract. He started work in the Blood Transfusion Department, moving to the Haematology Department some three months later, returning to Blood Transfusion after about two months. Concerns arose relating to the Registrant’s practice and, at first, an informal performance management policy was invoked.  Later, a formal procedure was instigated. The Registrant resigned from his employment in mid-October 2009 before the formal process was completed.

5.     It is relevant to set out the history of the various hearings since the original COPO was imposed in May 2011.

6.     On 22 May 2012, the order made in May 2011 was reviewed on the application of the Registrant. The Panel then sitting found that there still was a lack of competence on the part of the Registrant and decided that the Conditions of Practice Order should continue but on varied conditions.

7.     On 20 December 2012, the Order was again reviewed on the application of the Registrant.  The Panel then sitting found that there still was a lack of competence on the part of the Registrant and decided that the Conditions of Practice Order should continue but made further variation to the conditions.

8.     On 22 July 2013 the Order was again reviewed on the application of the Registrant. Again, the Panel then sitting found that there was still a lack of competence such that the Conditions of Practice Order should be maintained and, indeed, should be extended so that the duration of the Order ran for a further 3 years from 22 July 2013.  The Panel then sitting made amendments to the Conditions.

9.     On 2 May 2014, a Panel further considered the Order at a hearing at which the Registrant was present.  The Panel took the view that there was no jurisdiction to review the Order at that point in time. That was because neither the Registrant nor the HCPC had applied for the Order to be reviewed.   It appears that the Panel took the view that there was no basis upon which a mandatory review under Article 30 could then be considered given that the current Conditions of Practice Order was not nearing expiry. The hearing was taking place less than one year after the imposition of a three year Conditions of Practice Order on 22 July 2013.

10.   On 16 July 2014 the Order was again reviewed on the application of the Registrant. The Panel then sitting found that there was still a lack of competence such that the Conditions of Practice Order should be maintained but with varied Conditions.

11.   On 14 May 2015 the Order was again reviewed, this time on the application of the HCPC.  The Panel then sitting determined that there was still a lack of competence on the part of the Registrant such that the Conditions of Practice Order should continue but with varied Conditions.

12.   On 27 November 2015 the Order was reviewed on the joint application of the Registrant and the HCPC. The Panel then sitting determined that the fitness to practise of the Registrant remained impaired and the Panel made a new Conditions of Practice Order to run for 2 years.

13.   The Conditions of Practice currently imposed are as follows:

The Registrant is currently subject to the following Conditions of Practice Order:

 

(1)     You must place yourself and remain under the supervision of a supervisor registered by the HCPC as a Biomedical Scientist working at not lower than AFC Band 7, and supply details of your supervisor to the HCPC within 1 month of obtaining employment as a Biomedical Scientist. You must attend upon that supervisor as required and follow their advice and recommendations.

 

(2)     You must work with the supervisor to formulate a Personal Development Plan which will include satisfactory completion of the standard laboratory training programme applicable to trainees, and must address the deficiencies in following and adhering to the laboratory Standard Operating Procedures in the following areas:

 

i. Sample acceptance criteria;

ii. Sample labelling and correct analysis;

iii. Quality assurance procedures;

iv. Reporting and record keeping.

 

(3)     Within three months of securing employment for which your HCPC registration is required you must forward a copy of your Personal Development Plan to the HCPC.

 

           (4) For the purpose of considering your progress towards achieving    the aims set out in your Personal Development Plan, you must meet with your supervisor not less frequently than:

 

a. weekly for the first 3 months of your employment; and,

b. monthly for the following 9 months;

c. thereafter, as your supervisor requires.

 

(5)  You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

 

(6)     You must arrange for your supervisor to provide a report on your progress towards achieving the aims set out in your Personal Development Plan for the purposes of the review of this Order.

 

(7) You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

 

(8)     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;

 

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).

 

Submissions

14.   Ms Bass submitted that the HCPC considered that the Registrant’s fitness to practise remained impaired. The least restrictive sanction would be a continuation of the current Conditions of Practice Order.  The Panel was asked to bear in mind, however, that a striking off order would be available given the period during which there had been Conditions of Practice and the Panel was asked to give that option serious consideration.

15.   The Panel was also asked to take into account that at the hearing in 2011 the Panel then sitting found that the Registrant had shown a lack of attention to detail, a lack of accuracy, and frequent lapses in concentration which were not isolated incidents.

16.   It was accepted that the Registrant had attended each of the previous review hearings and had made applications for early reviews of previous Orders.  It was also accepted that the Registrant was genuinely seeking work but it appeared he had not provided evidence that he had remedied past failings and therefore he should be considered as being still impaired.

17.   The Registrant asked the Panel to take into account that during the period in which he had been subject to Conditions of Practice he had made numerous applications for employment within the NHS.  He genuinely wanted to gain employment so that he could return to work as a BMS.  However, the prospect of obtaining employment in either a BMS or Medical Laboratory Assistant capacity was becoming increasingly difficult as time progressed.  The Registrant also commented on his health issues and even though benefiting from the relevant interview guarantee scheme he had not obtained employment.

18.   The Registrant asked the Panel to consider making a combination of a Caution and a Conditions of Practice Order.  If the Conditions of Practice Order part could be constructed on the basis that no definite conditions would apply until he notified the HCPC that he had gained some type of employment that would at least increase the prospect of him reaching an interview stage. That was because the current condition requiring him to notify prospective employers (of any type - whether or not he was applying for a BMS position) served as a deterrent to those prospective employers.

19.   The Registrant suggested as an option that the Panel could consider a condition that he should not in future work in the areas of blood transfusion and haematology.  That would allow him to apply for posts working in other areas of Biomedical Science in which he felt he had competence and experience.

20.   The Registrant said that he had been continuing his professional education by reading the Institute of Biomedical Science Gazette and other professional journals and he would answer the questions that were set in that Gazette.  He asked the Panel to take into account that since the hearing in 2011 he had been in the employment of the University of South Wales as a Senior Science Technician. He believed that that role required him to use many of the skills relevant to Biomedical Scientist duties.  He had attended courses in his capacity as a Radioactive Protection Supervisor within the University.  He was also seeking to become a Registered Science Technician with the Association of Science Education.

21.   In response to questions from the Panel the Registrant said that he had been invited for about 20 interviews over the last year in connection with BMS posts or associated practitioner posts. In his current role as a senior technician he would set up practical experiments to be conducted by professors and lecturers. The Registrant described a number of scientific techniques that he has employed which range from the simple to the advanced in terms of the level of competence required. He would demonstrate to students how to carry out practical experiments and would help students with their assignments.  He was involved in quality control functions but not at the same level as would apply in NHS employment.  One of his tasks was to be familiar with the regulations relating to the safe use of radioactive materials.

22.   The Registrant said that it would be about every 3 months that he would try to answer the questions in the back of the BMS Journal. He accepted he had not carried out BMS Continuing Professional Development but he said he had carried out continuing self-learning, including the use of new techniques.

23.   In making closing comments Ms Bass said that she would support the request made by the Registrant for variation to the condition that required the Registrant to disclose the conditions even when applying for non-BMS posts.

24.   The Registrant had no further comments he wished to make.

25.   The Panel received and accepted the advice of the Legal Assessor.

Decision

26.   The task of the Panel is to determine whether the fitness to practise of the Registrant remains impaired.  The Panel has taken into account all of the findings of the Panel sitting on the original hearing in 2011. The Panel also takes into account the HCPC Indicative Sanctions Policy.

27.   In deciding what, if any, sanction to impose, panels should apply the principle of proportionality, considering whether the chosen sanction:

·          is an appropriate exercise of the Panel's powers;

·          is a suitable means of attaining the degree of public protection identified by the Panel;

·          takes account of the wider public interest, such as maintaining public confidence in the profession;

·          is the least restrictive means of attaining that degree of public protection;

·          is proportionate in the strict sense and strikes a proper balance between the protection of the public and the rights of the Registrant.

28.   A key factor in many cases will be the extent to which a registrant recognises his or her failings and is willing to address them.

 

29.   The Panel has taken into account all that the Registrant has said, in particular the steps he believes he has taken to remediate his past failings. However, the Panel takes the view that the Registrant has not fully remedied those past failings and feel that the Registrant still needs to build on the work he has carried out in that respect.  Any insight the Registrant has regarding those past failings is still developing. The Panel believes the Registrant needs to have in the forefront of his mind the potential serious consequences of his past failings.  There could have been serious consequences caused to members of the public. The primary purpose of this regulatory process is to protect members of the public and the Panel would have liked to have seen from the Registrant greater recognition of the degree of potential harm which he created for members of the public by his past failings.

 

30.   The Panel has concluded, against the background of incomplete insight and insufficient remediation, that the Registrant’s fitness to practise remains impaired.

 

31.   It is not appropriate to make no Order.  That would create an unacceptable risk to members of the public. A Caution Order is not appropriate because the Registrant does not yet have full insight into the potential consequences of his past failings. Despite the fact that these proceedings have run for 6 years the Panel takes into account that the Registrant has participated in all the previous hearings and has an active wish to return to work in the BMS profession.  There remains a possibility that the Registrant will gain full insight into his past failings and will achieve appropriate remediation. That is most likely to be achieved by the imposition of appropriate Conditions of Practice and the Panel is satisfied that some amendment is required to the Conditions which are currently in force.

 

32.   In the circumstances, therefore, to consider a Suspension Order or a Striking-off Order would not be proportionate.

 

33.   The Conditions of Practice that will apply in future are set out below.  With regard to Condition 9, which requires the Registrant to bring particular pieces of evidence to any future hearing, the Panel has made that condition to make clear to the Registrant that he has a responsibility to demonstrate he has gained proper insight and has remediated his past failings. The Panel holds the view that the Registrant did not attend this hearing with the type of information and material that is to be reasonably expected from a person who seeks to show they are capable of unrestricted practice. The Registrant had not thought to provide, for example, any references from the employer for whom he has been working for the past 6 years. In the Registrant’s current position as a Senior Science Technician at the University of South Wales his role requires him to perform tasks which are similar in terms of some of the competencies to those required of a Biomedical Scientist. In the Panel’s view, the Registrant should be able to demonstrate these transferrable skills to a future reviewing panel. He had not provided a clear account of his current duties with an explanation as to the extent to which those duties may demonstrate skills relevant to the work of a Biomedical Scientist.  He had not provided any written reflective material.  Condition 9 below is intended to assist both the Registrant and any Panel sitting on a future review.

 

34.   The Registrant will note in Condition 1 below that the Panel has amended the grade of the supervisor from AFC Band 7 to AFC Band 6 as an AFC Band 6 should possess the requisite skills and experience to supervise the Registrant effectively.

Order

Order: The Registrar is directed to vary the Conditions of Practice Order against the registration of Mr Ian Simmonds for a further period of 12 Months on the expiry of the existing order. The Conditions are:

 

(1)     You must place yourself and remain under the supervision of a supervisor registered by the HCPC as a Biomedical Scientist working at not lower than AFC Band 6, and supply details of your supervisor to the HCPC within 1 month of obtaining employment as a Biomedical Scientist. You must attend upon that supervisor as required and follow their advice and recommendations.

 

(2)     You must work with the supervisor to formulate a Personal Development Plan which will include satisfactory completion of the standard laboratory training programme applicable to trainees, and must address the deficiencies in following and adhering to the laboratory Standard Operating Procedures in the following areas:

 

A.     Sample acceptance criteria;

 

B.     Sample labelling and correct analysis;

 

C.     Quality assurance procedures;

 

D.     Reporting and record keeping.

 

(3)     Within three months of securing employment for which your HCPC registration is required you must forward a copy of your Personal Development Plan to the HCPC.

 

(4)  For the purpose of considering your progress towards achieving the

aims set out in your Personal Development Plan, you must meet with

your supervisor not less frequently than:

 

A.     weekly for the first 3 months of your employment; and,

 

B.     monthly for the following 9 months;

 

C.     thereafter, as your supervisor requires.

 

(5)  You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

 

(6)     You must arrange for your supervisor to provide a report on your progress towards achieving the aims set out in your Personal Development Plan for the purposes of the review of this Order.

 

(7)  You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

 

(8)     You must inform the following parties when you apply for a role as a Biomedical Scientist that your registration is subject to these conditions.

 

A.     any organisation or person employing or contracting with you to undertake professional work;

 

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).    

(9)     You must bring to any future review hearing the following:

A.      a reference in respect of your current or most recent employment which makes specific comment on your current performance in  that role and which gives an opinion as to the extent to which you have demonstrated the required competences of that role.

B.      a copy of the job description relevant to your current or most recent role.

C.      a written piece from you setting out the transferable skills you believe you have acquired and/or demonstrated in your current or most recent employment and which are relevant to a role as a Biomedical Scientist.

D.      a Continuing Professional Development log detailing all learning and development you have undertaken to maintain and/or enhance your skills and knowledge relevant to work as a Biomedical Scientist. This could include courses, seminars, or webinars attended as well as learning gleaned from books, journals, articles or similar sources.

E.      A reflective piece setting out your insight into the potential impact from the shortcomings on your part identified at your final hearing in February and May 2011 on members of the public and on the Biomedical Scientist profession.

Note:

1.     The supervision required by these conditions is not constant supervision.

2.     The supervision does not require your workplace judgements to be approved by your supervisor save to the extent that the ordinary requirements of any laboratory in which you work demand such approval.

3.       Conditions 1 – 6 above apply only when you are employed as a Biomedical Scientist.

Notes

The order imposed today will apply from 27 November 2017.

This order will be reviewed again before its expiry on 27 November 2018.

Hearing history

History of Hearings for Mr Ian Simmonds

Date Panel Hearing type Outcomes / Status
24/11/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
27/11/2015 Conduct and Competence Committee Review Hearing Conditions of Practice