Mr Gomahan Chelliah

: Physiotherapist

: PH46512

: Review Hearing

Date and Time of hearing:10:00 04/12/2017 End: 12:30 04/12/2017

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

: Conduct and Competence Committee
: Conditions of Practice

Allegation

(The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 07 – 09 June 2016)

Between January 2015 and 7 April 2015, during your employment as a physiotherapist for United Lincolnshire Hospitals NHS Trust you:
1) Did not demonstrate an adequate understanding of:
(a) the Active Cycle of Breathing Technique (ACBT) on or around 23 January 2015;
(b) oxygen therapy on or around 10 March 2015.
2) Failed a Respiratory Competency Framework written test on the following occasions:
(a) on or around 16 March 2015;
(b) on or around 1 April 2015.
3) On or around 29 January 2015, saw a ventilated patient, Patient A, despite being told not to see ventilated patients unless asked to do so.
4) In relation to Patient B:
(a) completed chest vibrations on her when she had fractured ribs;
(b) - Not found proved
(c) did not provide physiotherapy intervention in relation to the patient’s diagnosis of atelectasis;
(d) on or round 13 February 2015, did not conduct a chest assessment;
(e) on or around 16 February 2015, did not adequately document what concerns you had identified.
5) In relation to Patient C:
(a) did not adequately document what her baseline was;
(b) discharged her without first conducting a transfer assessment.
6) In relation to Patient D:
(a) did not adequately document her baseline transfers;
(b) did not fully and/or accurately document her optiflow settings;
(c) did not adequately document and/or gather sufficient medical and/or social history in your initial assessment.
7) In relation to Patient E, produced a treatment plan that did not adequately address the concerns identified in your assessment.
8) In relation to Patient F:
(a) did not clearly document what exercises had been completed;
(b) did not produce an adequate treatment plan(s) in that you did not document:
i. sufficient detail in relation to the aims of the physiotherapy sessions;
ii. sufficient detail in relation to the concerns identified;
iii. sufficient detail in relation to the proposed treatment.
9) In relation to Patient G:
(a) did not document sufficient information about the patient’s abilities;
(b) did not document sufficient detail in relation to the concerns identified;
(c) produced a treatment plan that did not include sufficient detail in relation to the proposed treatment.
10) On or around 9 February 2015, in relation to Patient H:
(a) did not document sufficient detail in relation to your assessment of the patient;
(b) did not identify and/or document any concerns;
(c) did not document a clear treatment plan and/or treatment goals;
(d) did not document and/or complete a discharge plan.
11) In relation to Patient I:
(a) did not document and/or gather sufficient medical and/or social history in your initial assessment;
(b) did not complete adequate treatment plans in that you did not document;
i. sufficient detail in relation to the concerns identified;
ii. sufficient detail in relation to the proposed treatment;
(c) did not conduct and/or document a transfer assessment;
(d) did not conduct and/or document a sufficient number and/or type of strengthening exercises;
(e) did not try using and/or document that you had tried using incentive spirometry to address the patient’s reduced air entry.
12) The matters as described in paragraphs 1 – 11 constitute misconduct and/or lack of competence.
13) By reason of your misconduct and/or lack of competence, your fitness to practise is impaired.

At the substantive hearing on 07 – 09 June 2016 the Panel of the Conduct and Competence Committee found all of the particulars bar 4(b) proved. The Panel determined that all the proved particulars amounted to a lack of competence bar particular 3 which they found amounted to misconduct. The Panel found the Registrant’s fitness to practise to be impaired and imposed an 18 month conditions of practice order as a sanction.

 

Finding

Background:
1. The Registrant commenced employment at Lincoln County Hospital (LCH) physiotherapy department as a Band 5 physiotherapist on the Intensive Care and Surgical Ward (“the Ward”) in January 2015.
2. In January 2015 concerns were raised by the Registrant’s Team Lead regarding his competencies, in particular those relating to patients suffering from respiratory conditions, for example in relation to the use of oxygen therapy and the treatment of ventilated patients. It was alleged that despite supervision sessions and training his performance did not improve significantly. He failed his respiratory competency written test on two occasions.
3. The Registrant resigned from his employment at Lincoln County Hospital on 7 April 2015.
4. The Allegation (above) was considered by a Panel of the Conduct and Competence Committee at the HCPC’s substantive hearing on 07 – 09 June 2016.  The Panel found all of the particulars bar 4(b) proved. The Panel determined that all the proved particulars amounted to a lack of competence bar particular 3 which they found amounted to misconduct. The Panel found the Registrant’s fitness to practise to be impaired and imposed an 18 month conditions of practice order as a sanction.
5. The conditions imposed were as follows:
The Registrar is directed to annotate the Register to show that, for a period of eighteen months from the date that this Order comes into effect (“the Operative Date”), you, Mr Gomahan Chelliah, must comply with the following conditions of practice:
1) You must not undertake work in an Intensive Therapy / High Dependency Unit nor undertake work in the respiratory component of treatment for patients in other clinical settings.
2) You may only take employment as a Physiotherapist at a Band 5 level.
3) You must promptly inform the HCPC if you take up employment as a Physiotherapist.
4) You must promptly inform the HCPC of any disciplinary proceedings taken against you in your role as a Physiotherapist by your employer.
5) When employed as a Physiotherapist, you must place yourself and remain under the supervision of a Physiotherapist of at least Band 6 level, and supply details of your supervisor to the HCPC within 6 weeks of the operative date when such person becomes your supervisor. You must attend upon that supervisor as required and follow their advice and recommendations.
6) When employed as a Physiotherapist, you must meet with your supervisor and formulate a Personal Development Plan (“PDP”) designed to address the following areas:
(a) Your ability to work independently on your cases;
(b) Assessment and treatment planning;
(c) Accurate and appropriate clinical record keeping;
(d) Your ability to undertake clinical reviews of:
i. Physiotherapeutic treatment goals and
ii. Physiotherapeutic treatment plans
7) Within 3 months of obtaining employment as a Physiotherapist you must forward a copy of your PDP to the HCPC.
8) When employed as a Physiotherapist you must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan
9) If employed as a Physiotherapist, you must provide a report from your supervisor about your progress towards achieving the aims set out in your PDP not later than 28 days and not earlier than 56 days before this Order is reviewed. This should include testimonials where possible.
10) 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 work as a Physiotherapist;
b) any agency you are registered with or apply to be registered with as a Physiotherapist (at the time of application);
c) any prospective employer seeking to employ you as a Physiotherapist (at the time of application).
11) You will be responsible for meeting any and all costs associated with complying with these conditions.
6. The conditions imposed did not apply until 7 July 2016 to allow for the 28 day appeal period. The order is therefore due to expire on 7 January 2018.
Decision: 
7. The Panel was presented with an HCPC bundle consisting of 40 pages. The Panel was also provided with a Registrant’s bundle consisting of 40 pages and additional documents from the Registrant comprising reference forms from the agency through whom the Registrant works, care4health, for the periods April-May 2016 (3 weeks), 12 September 2016 – 30 May 2017 and 5 June 2017 – 30 June 2017 and a letter from care4health, dated 4 December 2017.

8. The Panel heard oral evidence by telephone from Allison Jones, Band 6 (Lead) Physiotherapist at Louth Hospital. Ms Jones acted as the Registrant’s Clinical Supervisor between October 2016 and March 2017.

9. The Panel carefully considered the submissions made by Ms Hamilton on behalf of the HCPC, the oral evidence of Allison Jones, and the submissions made on the Registrant’s behalf by Mr Toms. The Panel also had regard to the documentary evidence contained within the Registrant’s bundle and the further documents.

10. The Panel received and accepted the advice of the Legal Assessor and had regard to its powers on reviewing an Order as set out under Article 30(1) of the Health and Social Work Professions Order 2001.

11. The Panel noted that Mr Chelliah had continued in employment as a locum Physiotherapist since the imposition of the Conditions of Practice Order. The Panel considered that Mr Chelliah is well-regarded as a Physiotherapist. His references whilst employed through care4health have been good and very good. The Panel noted the evidence of Ms Jones who had supervised the Registrant for six continuous months, in that she had no concerns at all about the Registrant’s work including his record keeping. The Panel also accepted the evidence of that Mr Chelliah’s current manager at Lincoln Community Health Services NHS Trust is satisfied with his performance and there are no concerns about his practice.

12. The Panel was satisfied that Mr Chelliah had demonstrated sufficient remediation and compliance with the Conditions of Practice Order in respect of the matters found proved in respect of his inadequate understanding of various aspects of practice and in respect of deficiencies in his record keeping. However, the Panel was also mindful that by Condition 1, Mr Chelliah has been unable to undertake any work in the respiratory component of treatment for patients. Taking into account that Mr Chelliah had failed the Respiratory Competency Framework written test on two separate occasions, the Panel regarded it as essential that Mr Chelliah was able to demonstrate sufficient competency in this regard.

13. The only evidence as to Mr Chelliah’s competence in the respiratory component of treatment was from Allison Jones who told that Panel that they had “practised on each other”. When asked about her reference dated 5 December 2016, Ms Jones was unable to remember whether Mr Chelliah’s performance of the Active Cycle Breathing Exercise Techniques were applied directly to a patient or not.

14. In all the circumstances, whilst the Panel was satisfied that Mr Chelliah has substantially remedied his lack of competences and misconduct, it was unable to say whether his lack of knowledge and skill regarding respiratory competence remained. For this reason, the Panel concluded that Mr Chelliah’s fitness to practise is still impaired.

15. The Panel was satisfied that it was appropriate and proportionate to vary the Conditions of Practice Order and extend its duration for a further 6 months period as follows:

Order

The Registrar is directed to annotate the Register to show that, for a period of six months from the date that this Order comes into effect (“the Operative Date”), that you, Mr Gomahan Chelliah, must comply with the following conditions of practice:
1) You may only take employment as a Physiotherapist at a Band 5 level.
2) You must promptly inform the HCPC if you take up employment as a Physiotherapist.
3) You must promptly inform the HCPC of any disciplinary proceedings taken against you in your role as a Physiotherapist by your employer.
4) When employed as a Physiotherapist and undertaking any work in the respiratory components of patient treatment, you must place yourself and remain under the supervision of a Physiotherapist of at least Band 6 level, and supply details of your supervisor to the HCPC within 6 weeks of the operative date when such person becomes your supervisor. You must attend upon that supervisor as required and follow their advice and recommendations.
5) You must only work under supervision when undertaking any work in the respiratory component of patient treatment.
6) You must provide a report from your supervisor about your competence in relation to the respiratory component of patient treatment at least 14 days prior to any review of this order.
7) 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 work as a Physiotherapist;
b) any agency you are registered with or apply to be registered with as a Physiotherapist (at the time of application);
c) any prospective employer seeking to employ you as a Physiotherapist (at the time of application).
8) You will be responsible for meeting any and all costs associated with complying with these conditions.


 

Notes

The order imposed today will apply with immediate effect.


This order will be reviewed again before its expiry on 04 June 2018.

Hearing history

History of Hearings for Mr Gomahan Chelliah

Date Panel Hearing type Outcomes / Status
04/12/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
07/06/2016 Conduct and Competence Committee Final Hearing Conditions of Practice
02/06/2016 Conduct and Competence Committee Interim Order Review Interim Conditions of Practice