Mrs Amy L Mawson

: Occupational therapist

: OT26164

: Review Hearing

Date and Time of hearing:10:00 04/01/2018 End: 12:30 04/01/2018

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

: Conduct and Competence Committee
: Struck off

Allegation

Whilst employed as an Occupational Therapist for Avon and Wiltshire Mental Health

Partnership NHS Trust:

1. Between 28 June 2013 and 3 March 2014, regarding Service User 1, you:

a. Did not complete an assessment until 9 January 2014.

b. Did not record the 9 January 2014 assessment until 5 February 2014.

c. Did not complete and/or record an adequate assessment in that the assessment recorded on 5 February 2014 was incomplete.

d. Not proved.

e. Not proved.

 

2. Between 3 July 2013 and 14 April 2014, regarding Service User 2, you:

a. Did not complete an assessment until 27 January 2014

b. Did not record the 27 January 2014 assessment until 5 February 2014

c. Did not complete and/or record an adequate assessment in that the assessment recorded on 5 February 2014 was incomplete

d. Not proved.

e. Not proved.

f.  Not proved.

 

3. Between 27 September 2013 and 18 February 2014, regarding Service User 3, you:

a. Did not complete an assessment until 30 January 2014

b. Did not record the 30 January 2014 assessment until 6 February 2014

c. Did not complete and/or record an adequate assessment in that the assessment recorded on 6 February 2014 was incomplete

d.  Not proved.

e.  Not proved.

 

4. Between 6 January 2014 and 14 April 2014, regarding Service User 4, you:

a. Did not complete an assessment until 29 January 2014

b. Did not record the 29 January 2014 assessment until 5 February 2014

c. Did not complete and/or record any contact between 5 February 2014 and 14 April 2014

d.  Not proved.

 

5. Between 30 January 2014 and 14 April 2014, regarding Service User 5, you:

a. Did not complete and/or record an adequate assessment in that the assessment recorded on 6 February 2014 was incomplete

b.  Not proved.

c.  Not proved.

 

6. Between 5 February 2014 and 14 April 2014, regarding Service User 6, you:

a. Did not complete and/or record an adequate assessment in that the assessment recorded on 6 February 2014 was incomplete

b.  Not proved.

c.  Not proved.

 

7. Between 16 January 2014 and 11 April 2014, regarding Service User 7, you:

a. Did not complete and/or record an assessment

b. Did not complete and/or record any contact

c. Did not facilitate progress towards recovery in that:

(i) You did not complete and/or record sufficient occupational therapy interventions to achieve care plan goals;

(ii) Your interventions were not personalised and/or not linked to care plan goals.

 

8. Between 22 January 2014 and 14 April 2014, regarding Service User 8, you:

a. Did not complete and/or record an adequate assessment in that the assessment recorded on 6 February 2014 was incomplete

b.  Not proved.

c.  Not proved.

d.  Not proved.

 

9. Between 12 February 2014 and 14 April 2014, regarding Service User 9, you:

a. Did not complete and/or record an assessment

b.  Not proved.

c.  Not proved.

 

10. Between 9 March 2014 and 14 April 2014, regarding Service User 10, you:

a. Did not complete and/or record an assessment

b. Did not complete and/or record any contact or interventions

 

11. Between 11 March 2014 and 7 April 2014, regarding Service User 11, you:

a. Did not complete and/or record an assessment

b. Did not complete and/or record a care plan

c. Did not complete and/or record any contact or interventions

 

12. On 5 February 2014 you indicated that you finished work at 18:29 but you recorded assessments at:

a. 19:31

b. 19:40

c. 19:46

d. 19:52

e. 19:57

 

13. On 6 February 2014 you indicated that you finished work at 18:32 but you recorded assessments at:

a. 18:47

b. 18:54

c. 19:26

d. 19:31

 

14.  Not proved.

 

15. In or around April 2010 you did not act in Service User A’s best interests and/or failed to maintain professional boundaries in that you arranged for a friend of yours to purchase a horse from Service User A

 

16. In or around November 2013, you failed to maintain professional boundaries in that you lent money to, and/or received money from, Service User B

 

17. Your actions at paragraphs 1-11 constitute misconduct and/or a lack of

Competence

 

18. Your actions at paragraphs 12-16 constitute misconduct

 

19. By reason of your misconduct and/or lack of competence, your fitness to practise is Impaired.

Finding

Preliminary Matters

Service of Notice

1. The notice of this hearing was sent to the Registrant at her address as it appeared in the register on 29 November 2017. The notice contained the date, time and venue of today’s hearing.

2. The Panel accepted the advice of the Legal Assessor, and is satisfied that notice of today’s hearing has been served in accordance with Rule 6(1) of the Conduct and Competence Committee Rules 2003 (the “Rules”).

Proceeding in the absence of the Registrant

3. The Panel then went on to consider whether to proceed in the absence of the Registrant pursuant to Rule 11 of the Rules. In doing so, it considered the submissions of Mr Mason on behalf of the HCPC.

4. Mr Mason submitted that the HCPC has taken all reasonable steps to serve the notice on the Registrant. He further submitted that the Registrant has not engaged with the HCPC, and that an adjournment would serve no useful purpose. The Registrant’s last contact to the HCPC was on 18 August 2015 at a scheduled teleconference. Mr Mason reminded the Panel that there was a public interest in this matter being dealt with expeditiously.

5. The Panel accepted the advice of the Legal Assessor. He advised that, if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the hearing, then the Panel had the discretion to proceed in the absence of the Registrant.

6. The Legal Assessor also referred the Panel to the case of GMC v Adeogba and Visvardis [2016] EWCA Civ 162 and advised that the Adeogba case reminded the Panel that its primary objective is the protection of the public and of the public interest. In that regard, the case of Adeogba was clear that “where there is good reason not to proceed, the case should be adjourned; where there is not, however, it is only right that it should proceed”.

7. It was clear, from the principles derived from case law, that the Panel was required to ensure that fairness and justice were maintained when deciding whether or not to proceed in a Registrant’s absence.

8. The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of the hearing. It was also satisfied that the Registrant would be of the hearing.

9. In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPTS practice note entitled ‘Proceeding in the Absence of a Registrant’. The Panel weighed its responsibility for public protection and the expeditious disposal of the case with the Registrant’s right to a fair hearing.

10. In reaching its decision the Panel took into account the following:

• The Registrant has not engaged with the process since 2015;

• There is a public interest that this substantive order is reviewed before it expires on 11 February 2018.

11. The Panel was satisfied that the Registrant had voluntarily absented herself from the hearing. It determined that it was unlikely that an adjournment would result in the Registrant’s attendance at a later date, in the light of the non-engagement of the Registrant since 2015. Having weighed the public interest for expedition in cases against the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.

Background

12. The Registrant was employed by the Avon and Wiltshire Mental Health Partnership NHS Trust (the Trust) from about 1998 and was a Band 6 Occupational Therapist in the Applewood Unit, which had 18 adult in-patient service users. These were vulnerable service users because they had mental health problems; some were detained under the Mental Health Act. The Registrant was the subject of a Trust investigation in 2010 with regard to her dealings with the rehoming of a service user’s horse.

13. From January 2013 the Registrant had management responsibility for one Band 4 Occupational Therapy Technician and one Band 5 part-time Occupational Therapist, who joined the Unit, although these responsibilities were removed within about a month. From April 2013  the  Registrant  was  provided  with  support  under  the  Trust’s  “Improving Performance” Policy which continued into 2014. The Registrant’s last day at work was 14 April 2014. Her employment with the Trust ceased when she was dismissed with effect from 12 September 2014. The Trust’s concerns were referred to the HCPC. A final hearing of the Conduct and Competence Committee (CCC) was held between the dates of 17 November 2015 and 13 April 2016. That panel found a number of facts proved and determined that the facts found proved amounted to misconduct but not a lack of competence. It found the Registrant’s fitness to practise to be impaired.

14. In considering the question of sanction, that panel found a number of aggravating features. The failure to respect professional boundaries occurred twice, (the second time occurred despite retraining after the first occasion). The repeated failures in completing and recording of assessments gave rise to the risk of harm to this group of service users. Service users were deprived of engagement with relevant services and as a consequence there were potential delays in their discharge. All the service users involved were particularly vulnerable. There was actual emotional harm to Service User A. The Registrant’s failures affected the reputations of the Trust and the profession. The panel found several mitigating factors. The Registrant had shown some insight by admitting her shortcomings whilst still at the Trust and initially engaging in this regulatory process. The Registrant, although misguided, had clearly been motivated by good intentions in her actions regarding the rehoming of Service User A’s horse. The Registrant had had to cope with health issues. The panel reviewed all of the available sanctions and imposed a Suspension Order for 12 months.

15. The Registrant did not attend nor engage with the review of the Order. That reviewing panel determined that the Registrant’s fitness to practise remained impaired. It also determined that a Striking Off Order could have been justified at that point in time but determined that it was appropriate to give the Registrant a further opportunity to demonstrate insight and begin the process of remediation. To that end, the reviewing panel extended the period of suspension for a further nine months.

Decision

Submissions

16. Mr Mason reminded the Panel that the period of suspension had been extended by the reviewing panel specifically to provide Mrs Mawson with the opportunity to re-engage with the process. He submitted that a further extension would serve no useful purpose and would not further the public interest, in the light of the lack of engagement on the part of the Registrant.

Legal advice

17. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if she is fit to return to unrestricted practice. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment.

18. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel must go on to consider what sanction, if any, should be imposed. The Legal Assessor advised the Panel that, if it determined that the Registrant’s fitness to practise remained impaired, all the options under Article 30 of the 2001 Order could be exercised by the Panel. He also advised the Panel that it should bear in mind the principle of fairness and proportionality and to have regard to the Indicative Sanctions Policy document issued by the HCPC.

Panel’s considerations and decision

19. The Panel accepted the advice of the Legal Assessor. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Mr Mason. In particular it noted the following factors:

(a) This is a case of misconduct and there is no suggestion that the Registrant lacked the requisite competence to carry out the role of an Occupational Therapist. Hence this is a case where the Registrant’s insight is of greater importance.

(b) The lack of engagement of the Registrant with the process.

20. There is no evidence before the Panel today that could satisfy it that the Registrant’s fitness to practice was no longer impaired. She did not engage with the final hearing, nor did she engage in the last review of the substantive order.

21. In the light of all the above, the Panel determined that the Registrant’s fitness to practise remains impaired in that there remains a real risk of repetition of the Registrant’s misconduct, and the public interest would also require a finding that the Registrant’s fitness to practise remained impaired in these circumstances.

22. The Panel then went on to consider what the appropriate and proportionate sanction should be. It had regard to the Indicative Sanctions Policy issued by the HCPC and considered the available sanctions in order of severity, starting with the least restrictive. In the light of the lack of engagement and commitment to the profession on the part of the Registrant, the Panel determined that it was not appropriate to take no further action, nor was it appropriate to substitute a Caution for the Suspension Order.

23. The Panel considered whether a Conditions of Practice Order would be appropriate in this case. However, the Registrant’s lack of engagement in the process demonstrated that she is no longer committed to the profession and therefore conditions of practice would serve no useful purpose.

24. In the light of all the above, the Panel also considered that a further period of suspension was also not appropriate. It took into account that the Registrant has been suspended since 20 November 2015, and she has not engaged with the process since 2015 nor has she demonstrated any insight into her misconduct. The Panel determined that this was unlikely to change in the future as she has not seized the opportunity afforded to her by the previous panel. A further period of suspension would serve no useful purpose and would not further the public interest.

25. The Panel determined that the appropriate and proportionate sanction now is to strike the Registrant’s name off the Register.

Order

That the Registrar is directed to strike the name of Mrs Amy Mawson from the Register on the date this order comes into effect. The Order imposed today will apply from 11 February 2018.

Notes

No notes available

Hearing history

History of Hearings for Mrs Amy L Mawson

Date Panel Hearing type Outcomes / Status
04/01/2018 Conduct and Competence Committee Review Hearing Struck off
31/03/2017 Conduct and Competence Committee Review Hearing Suspended
13/04/2016 Conduct and Competence Committee Final Hearing Suspended