Nursing and Midwifery Council: Fitness to Practise Committee. Substantive Order Review Hearing. 26 January 2018

Transcription

1 Nursing and Midwifery Council Fitness to Practise Committee Substantive Order Review Hearing 26 January 2018 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of registrant: NMC PIN: Part(s) of the register: Area of Registered Address: Type of Case: Panel Members: Legal Assessor: Panel Secretary: Nursing and Midwifery Council: Mrs Olorunleye: Victoria Yetunde Olorunleye 05F0268O Registered Midwife Midwifery (June 2005) England Lack of Competence Clive Chalk (Chair, lay member) Bernadette Nipper (Registrant member) Mark Gibson (Registrant member) Adrienne Morgan Jodie Harrison Sappho Dias, Case Presenter Not present and not represented in absence Order being reviewed: Outcome: Conditions of Practice Order (12 months) Conditions of Practice (2 years) to come into effect on 3 March 2018 in accordance with Article 30 (1) Page 1 of 14

2 Service of Notice of Hearing The panel was informed at the start of this hearing that Mrs Olorunleye was not in attendance, nor was she represented in her absence. The panel was informed that the notice of this hearing was sent to Mrs Olorunleye on 20 December 2017 by recorded delivery and first class post to her address on the register. The panel noted that notice of this hearing was delivered to Mrs Olorunleye s address on 21 December The panel accepted the advice of the legal assessor. In the light of the information available the panel was satisfied that notice had been served in accordance with Rules 11 and 34 of The Nursing and Midwifery Council (Fitness to Practise) Rules Order of Council 2004 (as amended February 2012) (the Rules). Proceeding in absence The panel then considered proceeding in the absence of Mrs Olorunleye. The panel was mindful that the discretion to proceed in absence is one which must be exercised with the utmost care and caution. The panel considered all of the information before it, together with the submissions made by Ms Dias, on behalf of the Nursing and Midwifery Council (NMC). The panel accepted the advice of the legal assessor. Ms Dias drew the panels attention to the written submissions from Mrs Olorunleye dated 25 January 2018 and submitted that Mrs Olorunleye is aware of today s hearing and has voluntarily absented herself. The panel noted the contents of a telephone note written by the NMC case officer dated 25 January Mrs Olorunleye confirmed that she had received the notice of today s Page 2 of 14

3 hearing but informed the case officer that she was unable to attend due to work commitments. Mrs Olorunleye had been sent notice of today s hearing and the panel was satisfied that she was aware of today s hearing and it is of the view that she had chosen not to attend. The panel, therefore, concluded that she had chosen voluntarily to absent herself. The panel had no reason to believe that an adjournment would result in Mrs Olorunleye s attendance and noted that in her written submissions Mrs Olorunleye had not requested an adjournment. Having weighed the interests of Mrs Olorunleye with those of the NMC and the public interest in an expeditious disposal of this hearing the panel determined to proceed in Mrs Olorunleye s absence. Decision and reasons on review of the current order: The panel decided to impose a new conditions of practice order for a period of two years. This order will come into effect on the expiry of the existing order at the end of 3 March 2018 in accordance with Article 30 (1) of the Nursing and Midwifery Order 2001 (as amended) (the Order). This is the second review of a substantive order imposed on Mrs Olorunleye s registration on 4 March Mrs Olorunleye initially received a suspension order for a period of 12 months by a panel of the Conduct and Competence Committee at the substantive hearing on 2 February On 26 January 2017 the reviewing panel made a conditions of practice order for a period of 12 months from the expiry of the existing order. The current order is due to expire on 3 March The panel is reviewing the order pursuant to Article 30(1) of the Order. The charges found proved which resulted in the imposition of the substantive order were as follows: That you, whilst employed as a registered midwife by the Princess Alexandra Hospital NHS Trust (the Trust), failed to demonstrate the standard of knowledge, skill and judgement required for practice as a registered midwife in that you: Page 3 of 14

4 1. On 12 December 2012 failed to follow best practice when administering medication to Patient A in that you: a. Did not prepare, or witness the drawing up of the drug into the syringe; b. Injected a substance unknown to you, into Patient A; c. Failed to gain consent from Patient A before administering the injection. 2. On 18 January 2013 failed to work within your scope of practice when performing a speculum examination on Patient B in that you : a. Failed to check Patient B s medical notes before completing the examination; b. Performed a speculum examination on Patient B who was only 31 weeks pregnant at the time. 3. Failed to satisfactorily complete a LSA practice programme between July 2013 and December 2013 as set out in schedule 1. Schedule 1: 1. On 13 November 2013 during an observed medication round you required prompting to check patient identities 2. On 13 November 2013 during an observed medication round you needed prompting to use the MAR chart to identify timings and doses of medication 3. On 13 November 2013 during an observed medication round you were unable to competently measure a dose of liquid medication 4. On 13 November 2013 during an observed medication round you left the drugs trolley unlocked and unattended 5. On 13 November 2013 during an observed medication round you took approximately one hour to administer medication to five women 6. On 14 November 2013 during an observed medication round you attempted to administer a medication to Patient C at the incorrect time Page 4 of 14

5 7. Between July 2013 and December 2013 you failed to satisfactorily complete a reflective essay to the required standard. 8. Between July 2013 and December 2013 you did not produce an individual learning plan 9. Between July 2013 and December 2013 you did not participate in the review existing guidelines against national standards. 10. Between July 2013 and December 2013 you did not demonstrate sufficient knowledge of legislation Between July 2013 and December 2013 you did not demonstrate sufficient ability to be able to communicate in a professional manner at all times. The first reviewing panel determined the following with regard to impairment: The panel considered whether your fitness to practise remains currently impaired. The panel considered that you have demonstrated significant insight into your previous failings and have made efforts to remediate them. It also considered that you have made some efforts to maintain your clinical knowledge and keep your skills up to date. However, due to the current suspension order you have not had the opportunity to demonstrate that you are ready to return to safe and effective practice as a registered midwife. The panel therefore concluded that there remains a risk of repetition of your errors should you be permitted to return to midwifery practice without restrictions. The panel therefore decided that a finding of current impairment was necessary on the grounds of public protection. The panel has borne in mind that its primary function was to protect patients and the wider public interest, which includes maintaining confidence in the nursing profession and upholding proper professional standards and behaviour. The panel decided that, in this case, a finding of impairment on public interest grounds was also required. Page 5 of 14

6 For these reasons, the panel finds that your fitness to practise remains impaired. The first reviewing panel determined the following with regard to sanction: The panel first considered whether to take no action but concluded that this would be inappropriate in view of the seriousness of the case and the ongoing public protection concerns. The panel decided that it would be neither proportionate nor in the public interest to take no further action. The panel then considered whether to impose a caution order but concluded that this would be inappropriate for the same reasons. The panel considered substituting the current suspension order with a conditions of practice order. The charges found proved in this case were serious, however there has been evidence produced to show that you have developed significant insight and that you wish to remediate the deficiencies in your practice and return to midwifery. The panel was mindful that you would be willing to cooperate with a conditions of practice order and have investigated a return to practice course. Further the panel considered that it would be possible to formulate practicable and workable conditions, which, if complied with, may lead to your unrestricted return to practice and would serve to protect the public and the reputation of the profession in the meantime. The panel considered a further period of suspension, but concluded that this would be disproportionate and serve no further useful purpose. The panel decided that the public would be suitably protected, as would the reputation of the profession, by the implementation of the following conditions of practice: 1. Before you return to practice you must successfully complete and pass an NMC-approved return to practice programme complying with its Page 6 of 14

7 requirements in both theory and midwifery practice. 2. You must provide to the reviewing panel a report from your line manager, who must be aware of these conditions, specifically commenting on your competence in medicines administration, communication and professional behaviour, at least 14 days prior to any NMC review hearing. 3. You must notify the NMC within 14 days of any midwifery appointment (whether paid or unpaid) you accept within the UK or elsewhere, and provide the NMC with contact details of your employer. 4. You must inform the NMC of any professional investigation started against you and/or any professional disciplinary proceedings taken against you within 14 days of you receiving notice of them; 5. You must within 14 days of accepting any post or employment requiring registration with the NMC, or any course of study connected with nursing or midwifery, provide the NMC with the name/contact details of the individual or organisation offering the post, employment or course of study; 6. You must immediately inform the following parties that you are subject to a conditions of practice order under the NMC s fitness to practise procedures, and disclose the conditions listed at (1) to (5) above, to them: a. Any organisation or person employing, contracting with, or using you to undertake midwifery work; b. Any agency you are registered with or apply to be registered with (at the time of application); c. Any prospective employer (at the time of application); and d. Any educational establishment at which you are undertaking a course of study connected with nursing or midwifery, or any such establishment to which you apply to take such a course (at the time of application). Page 7 of 14

8 This order will be reviewed shortly before expiry. At any review the panel may revoke the order or any condition of it, it may confirm the order, or vary any condition of it, or it may replace the order with any other order open to it. A reviewing panel would be assisted by: Your continued engagement and attendance; Evidence that you have complied with conditions 1 and 2; If you have not complied with the conditions, evidence of why not; Testimonials or references for any paid or voluntary work undertaken; Decision on current fitness to practise The panel has considered carefully whether Mrs Olorunleye s fitness to practise remains impaired. Whilst there is no statutory definition of fitness to practise, the NMC has defined fitness to practise as a registrant s suitability to remain on the register without restriction. In considering this case, the panel has carried out a comprehensive review of the order in light of the current circumstances. It has noted the decision of the last panel. However, it has exercised its own judgment as to current impairment. The panel has had regard to all of the documentation before it, including the NMC hearing bundle, and written submissions from Mrs Olorunleye dated 25 January It has taken account of the submissions made by Ms Dias on behalf of the NMC. Ms Dias outlined the background of the case and drew the panel s attention to the previous reviewing panel s decision dated 26 January The reviewing panel concluded that Mrs Olorunleye had shown significant insight into her failings and had made an effort to keep her clinical knowledge up to date during her period of suspension. That panel noted that the next reviewing panel would be assisted by the following from Mrs Olorunleye: Your continued engagement and attendance; Evidence that you have complied with conditions 1 and 2; Page 8 of 14

9 If you have not complied with the conditions, evidence of why not; Testimonials or references for any paid or voluntary work undertaken; Ms Dias referred to Mrs Olorunleye s written submissions. Mrs Olorunleye is still working as a Care Support Worker at North Middlesex NHS Trust Hospital. She has been unable to secure a place on a return to practice programme so has been unable to fully remediate her practise. Ms Dias submitted there has been no material change of circumstances since the review hearing on 26 January 2017 therefore Mrs Olorunleye remains impaired. Ms Dias submitted the findings of the previous panel remain on the grounds of public protection and wider public interest. The panel considered Mrs Olorunley s written submissions dated 25 January 2018 where she states I wish the panel could extend my condition of order while I continue to look out for opportunity of sponsorship or where to do the program. Am [sic] ready to abide with other positive steps the panel could recommend for me to put things right. The panel heard and accepted the advice of the legal assessor. In reaching its decision, the panel was mindful of the need to protect the public, maintain public confidence in the profession and to declare and uphold proper standards of conduct and performance. The panel considered whether Mrs Olorunleye s fitness to practise remains impaired. At the substantive hearing, that panel found that Mrs Olorunleye s failings were sufficiently serious so as to amount to lack of competence. The reviewing panel found that Mrs Olorunleye had demonstrated significant insight into these failings and had made efforts to remediate her practise. This panel is aware that despite many attempts by Mrs Olorunleye to return to practice she has been unsuccessful in obtaining employment as a midwife or in securing a place on a return to practice course. Accordingly the panel determined that since the review hearing on 26 January 2017 when the conditions of practice order was imposed there Page 9 of 14

10 has been no change in material circumstances and there is no evidence before the panel to suggest otherwise. The panel had borne in mind that its primary function was to protect patients and the wider public interest which includes maintaining confidence in the nursing profession and upholding proper standards of conduct and performance. The panel determined that, in this case, since the deficiencies which had been identified have not been remedied, a finding of continuing impairment is required in order to protect the public and to maintain confidence in the nursing profession and to uphold proper standards and behaviour. For these reasons, the panel finds that Mrs Olorunley s fitness to practise remains impaired. Determination on sanction Having found Mrs Olorunleye s fitness to practise currently impaired, the panel then considered what, if any, sanction it should impose in this case. The panel noted that its powers are set out in Article 30 (1) and 29 (5) of the Order. The panel has also taken into account the NMC s Sanctions Guidance (SG) and has borne in mind that the purpose of a sanction is not to be punitive, though any sanction imposed may have a punitive effect. The panel noted that a striking-off order was not available to it in this case since Mrs Olorunley had not been subject to a suspension order or a conditions of practice order for two years immediately prior to today s date. The panel first considered to allow the existing order to expire but concluded that this would be inappropriate in view of the risk of repetition identified and seriousness of the case. The panel decided that it would be neither proportionate nor in the public interest to take no further action. The panel then considered whether to impose a caution but concluded that this would be inappropriate in view of the risk of repetition identified and seriousness of the case. Page 10 of 14

11 The panel decided that it would be neither proportionate nor in the public interest to impose a caution order. The panel next considered the imposition of a conditions of practice order. Mrs Olorunleye is currently working as a Care Support Worker and despite her efforts has found it difficult to find a placement for the return to practice programme or a Trust willing to sponsor her. However, she has engaged with the process thus far and the panel is of the view that once Mrs Olorunleye successfully finds a place on a return to practice programme she will have the opportunity to remediate her shortcomings. The panel is mindful that any conditions imposed must be proportionate, measurable and workable. The panel was of the view that a conditions of practice order is sufficient to protect patients and the wider public interest, and that conditions could be formulated which would protect patients during the period they are in force. Accordingly, the panel determined, pursuant to Article 30(1) (c) of the Nursing and Midwifery Order 2001, to make a conditions of practice order for a period of two years, which will come into effect on the expiry of the current order. The panel recognise the difficulty Mrs Olorunleye has faced in securing a place on a return to practice programme or a Trust willing to sponsor her and considered that 2 years is a realistic time for Mrs Olorunleye to concentrate on securing a place and subsequently return to safe practice. The panel noted that although Mrs Olorunleye has tried to comply with the conditions of practice order it did not have before it a report from her line manager as set out in condition 2. It noted that the condition requires a report specifically commenting on Mrs Olorunleye s competence in medicines administration, communication and professional behaviour. The panel bore in mind that Mrs Olorunleye is working as a Care Support Worker and is not administering medication. She therefore may have considered she was not able to comply with this condition at this time. However the panel determined that a reference from Mrs Olorunleye s line manager commenting on her communication and professional behaviour would have been beneficial regardless of whether Mrs Olorunleye is currently practising or not. For these reasons the panel decided to amend condition 2 to reflect this. The panel also decided to include a number of further conditions to assist Mrs Olorunleye s remediation once she has successfully returned to Page 11 of 14

12 practise. It decided to impose the following conditions which it considered are appropriate and proportionate in this case: 1. Before you return to practice you must successfully complete and pass an NMCapproved return to practice programme complying with its requirements in both theory and midwifery practice. 2. You must provide to the reviewing panel a report from your line manager, who must be aware of these conditions, specifically commenting on your communication and professional behaviour, at least 14 days prior to any NMC review hearing. 3. Once you have successfully completed a return to practice course and returned to practice: a. you must work with your line manager, mentor or supervisor (or their nominated deputy) to create a personal development plan designed to address the concerns about the following areas of your practice: 1) Administering of medication 2) Effective communication with patients b. You must meet with your line manager, mentor or supervisor (or their nominated deputy) at least every 2 weeks to discuss the standard of your performance and your progress towards achieving the aims set out in your written personal development plan. c. You must forward to the NMC a copy of your personal development plan within 28 days of the date on which these conditions become effective or the date on which you take up an appointment, whichever is sooner. d. You must provide to the reviewing panel a report from your line manager, who must be aware of these conditions, specifically commenting on your successful completion of set learning objectives and assessments related Page 12 of 14

13 to medicine administration, at least 14 days prior to any NMC review hearing. 4. You must notify the NMC within 14 days of any midwifery appointment (whether paid or unpaid) you accept within the UK or elsewhere, and provide the NMC with contact details of your employer. 5. You must inform the NMC of any professional investigation started against you and/or any professional disciplinary proceedings taken against you within 14 days of you receiving notice of them; 6. You must within 14 days of accepting any post or employment requiring registration with the NMC, or any course of study connected with nursing or midwifery, provide the NMC with the name/contact details of the individual or organisation offering the post, employment or course of study; 7. You must immediately inform the following parties that you are subject to a conditions of practice order under the NMC s fitness to practise procedures, and disclose the conditions listed at (1) to (6) above, to them: a. Any organisation or person employing, contracting with, or using you to undertake midwifery work; b. Any agency you are registered with or apply to be registered with (at the time of application); c. Any prospective employer (at the time of application); and d. Any educational establishment at which you are undertaking a course of study connected with nursing or midwifery, or any such establishment to which you apply to take such a course (at the time of application). This order will be reviewed shortly before expiry. At any review the panel may revoke the order or any condition of it, it may confirm the order, or vary any condition of it, or it may replace the order with any other order open to it. Page 13 of 14

14 The panel considered imposing a suspension order, but determined that it would be disproportionate at this time. In accordance with Article 30 (1) of the Nursing and Midwifery Order 2001 this conditions of practice order will come into effect upon the expiry of the existing conditions of practice order, namely 3 March A reviewing panel will be assisted by: Mrs Olorunleye s continued engagement and attendance; Evidence that Mrs Olorunleye has complied with conditions; If Mrs Olorunleye has not complied with the conditions, evidence of why not; Testimonials or references for any paid or voluntary work undertaken; At any time, Mrs Olorunleye or the NMC may ask for the order to be reviewed by a panel if any relevant new information becomes available. This decision will be confirmed to Mrs Olorunleye in writing. That concludes this determination. Page 14 of 14