Nursing and Midwifery Council Fitness to Practise Committee. Substantive Order Review Meeting

Transcription

1 Nursing and Midwifery Council Fitness to Practise Committee Substantive Order Review Meeting 23 August 2018 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of registrant: NMC PIN: Part(s) of the register: Area of Registered Address: Ms Amina Mannan 07J0132S Sub part 1 RNA: Adult Nurse 9 December 2010 Scotland Panel Members: Legal Assessor: Panel Secretary: Anthony Griffin (Chair, lay member) Jade Rankine (Registrant member) Anita Underwood (Registrant member) Nigel Mitchell Kelly O Brien Order being reviewed: Outcome: Suspension Order (4 months) Striking-off order to come into effect on in accordance with Article 30 (1) 1

2 Service of Notice of Meeting The panel was informed at the start of this meeting that the notice of this meeting was sent to Ms Mannan on 19 July 2018 by recorded delivery and first class post to her registered address, informing her that the NMC planned to review the order at a meeting on or after 20 August The letter states that if she wished for the matter to be heard at a hearing she should contact the NMC by the 3 August The NMC received no response from Ms Mannan. The panel noted that notice of this meeting was delivered to Ms Mannan s registered address on 20 July 2018 and signed for in the printed name of MANNAN. The panel accepted the advice of the legal assessor. The panel considered whether notice of this meeting has been served in accordance with the rules. Rules 11A and 34 of the Nursing and Midwifery Council (Fitness to Practise) Rules 2004, as amended state: 11A.(1) Where a meeting is to be held in accordance with rule 10(3), the Conduct and Competence Committee or the Health Committee shall send notice of the meeting to the registrant no later than 28 days before the date the meeting is to be held. 34.(3) Any other notice or document to be served on a person under these Rules may be sent by (a) ordinary post Bearing in mind the information above, the panel was satisfied, that the service has been effected in accordance with the Rules. 2

3 Decision and reasons on review of the current order: The panel decided to impose a striking-off order. This order will come into effect at the end of 2 October 2018 in accordance with Article 30 (1) of the Nursing and Midwifery Order 2001 (as amended) (the Order). This is the third review of a substantive order. A conditions of practice order was, originally imposed by a Conduct and Competence Committee on 2 November 2016 for six months. That order was extended for a further period of 6 months at a review on 4 May The second reviewing panel imposed a suspension order on 1 June 2018 for four months. The current order is due to expire on 2 October The panel is reviewing the order pursuant to Article 30(1) of the Order. The charges found proved by way of admission which resulted in the imposition of the substantive order were as follows: That you, a registered nurse: 1. On 10 May 2015, in relation to Resident A: a) Did not administer the prescribed medications set out in Schedule 1. b) Incorrectly signed the medication administration record (MAR) to indicate that you had administered one or more of the prescribed medications set out in Schedule On 10 May 2015, did not administer one or more of the prescribed medications set out in Schedule 2 to Resident B or, in the alternative, did not contemporaneously record that you had administered one or more of those medications to Resident B. 3. On or after 11 May 2015 retrospectively recorded that you had administered one or more of the medications set out in Schedule 2 to Resident B on 10 May and did not mark this as retrospective. 4. On 12 June 2015, did not administer one or more prescribed medications set out in Schedule 3 or, in the alternative, did not contemporaneously record that you had administered one or more of those medications. 3

4 5. On 13 June 2015, retrospectively recorded that you had administered one or more of the medications set out in Schedule 3 on 12 June 2015 and did not mark this as retrospective. 6. On 13 June 2015, retrospectively recorded that you had administered one or more of the medications set out in Schedule 3 on 12 June 2015 when you were not sure whether the medication(s) had been administered. AND, in light of the above, your fitness to practise is impaired by reason of your misconduct. SCHEDULE 1 Adcal-D3 750mg Atenolol 50mg Bendroflumethiazide 2.5mg Folic Acid 5mg Mebeverine 135mg Ramipril 1.25mg SCHEDULE 2 Neoral Oral solution 100mg/ml 50ml 100mg (1mls) Paracetamol suspension 250mg/5ml Vancomycin Inf Vial 500mg 125 mg in 30 mls water SCHEDULE 3 In respect of Resident C Glipizide 5mg Metaformin 500mg Simvastatin 20mg In respect of Resident D Aclidinum brom inhaler 375mcg Omeprazole 20mg Nystatin suspension U/ml 30ml 4

5 In respect of Resident E Digoxin 62.5mcg Loratadine 10mg Paracetamol 500mg Simvastatin 40mg Trazadone 50mg In respect of Resident F Adcal D3 Citalopram 20mg In respect of Resident G Quetiapine 100mg Quetiapine 25mg In respect of Resident H Paracetamol 500mg In respect of Resident I Co-beneldopa 25mg/100mg The second reviewing panel determined the following with regard to impairment: The panel has had regard to all of the documentation before it and has taken account of the submissions made by Ms Comiskey. 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 behaviour. The panel has considered carefully whether Miss Mannan 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 5

6 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 was concerned that Miss Mannan has not engaged with the NMC process since the substantive hearing where she expressed remorse, had taken full responsibility for her actions and provided a full and candid account of why the incidents arose. It remained unclear to this panel whether Miss Mannan is currently employed and in what capacity. The panel has received no evidence of compliance with the conditions of practice order or evidence of any steps Miss Mannan has taken to remediate her misconduct or keep her nursing skills and knowledge up to date such as undertaking any relevant training. In the absence of any evidence to the contrary, the panel cannot be satisfied that Miss Mannan has addressed the concerns of the previous panel in relation to remediation such that she is safe to return to practise as a registered nurse without restriction. The panel therefore concluded that there is an ongoing risk of harm to patients and the risk of repetition remains. For these reasons, the panel found that Miss Mannan s fitness to practise remains impaired on public protection and public interest grounds. The second 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 risk of repetition identified and seriousness of the case. The panel decided that it would be neither proportionate nor adequately protect the public or satisfy the wider public interest to take no further action. The panel then considered whether to impose a caution order 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 6

7 nor adequately protect the public or satisfy the wider public interest to impose a caution order. It would leave Miss Mannan in unrestricted practice. The panel next considered a continuation of the current conditions of practice order. The panel was mindful that Miss Mannan has not communicated with the NMC since the original substantive panel in November It remains unclear whether she is practising as a registered nurse or has complied with the current conditions of practice order. The panel considered this to be significant as it could not determine Miss Mannan s level of remediation and willingness to comply with conditions of practice. It took into account that the previous panel afforded Miss Mannan a further opportunity to secure employment as a registered nurse and to produce evidence of her compliance with the conditions of practice order. In all the circumstances the panel considered that a conditions of practice order is no longer the appropriate order in this case. The panel concluded that continuing a conditions of practice order further, where there has been a prolonged period of non-communication from Miss Mannan, would undermine public confidence in the nursing profession and in the regulatory process. The panel next went on to consider a suspension order. In the panel s judgment, a suspension order for a period of four months would afford Miss Mannan a further opportunity to engage with her regulator and allow a future panel to assess her current circumstances and to determine if she wishes to remain in the nursing profession. Miss Mannan should be reminded that the next reviewing panel would have all sanctions available to including importantly a striking-off order. The panel determined that a suspension order is the only appropriate sanction which would both protect the public and satisfy the wider public interest. It considered this to be the most appropriate and proportionate sanction available at this time. 7

8 This suspension order will take effect upon the expiry of the current conditions of practice order, namely at the end of 2 June 2018 in accordance with Article 30 (1) of the Nursing and Midwifery Order Decision on current fitness to practise The panel has considered carefully whether Ms Mannan 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 the NMC Bundle and it 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. This panel had regard to the findings of the previous panel and noted that it had not been provided with any new information since this date. This panel was concerned that Miss Mannan has not engaged with the NMC process since the substantive hearing. It noted that there is no evidence of compliance with the conditions of practice order, or any engagement since the imposition of the suspension order. The panel considered that it had no information about Ms Mannan s current employment. Accordingly, this panel could not be satisfied that Ms Mannan had taken any steps to remediate her misconduct or keep her nursing skills up to date such that she is safe to return to practice without restriction. The panel therefore concluded that there is an ongoing risk of harm to patients and the risk of repetition remains. 8

9 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. A registrant has a duty to engage with the NMC as its regulator, and Ms Mannon had failed to engage. Accordingly, the panel determined that, in this case, a finding of continuing impairment on public interest grounds is required. For these reasons, the panel found that Miss Mannan s fitness to practise remains impaired on public protection and public interest grounds. Determination on sanction Having found Ms Mannan 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 29 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 first considered whether to take no action 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 decided that a caution order would not be appropriate for the same reasons. The panel next considered the imposition of a conditions of practice order. The panel was mindful that Miss Mannan has not engaged with the NMC since November The panel considered that it had no evidence that Ms Mannan had complied with the previous conditions of practice order, furthermore she has not engaged with the NMC following a further opportunity to engage and remediate afforded to her by the previous panel. The panel concluded that a conditions of practice order would not be workable given Ms Mannan s long period of non-engagement and in all the circumstances of this case. 9

10 The panel next considered imposing a further suspension order. The panel noted that Ms Mannan has not engaged with the NMC since the substantive hearing. It considered that the previous panel imposed a period of suspension to afford Miss Mannan a further opportunity to engage with her regulator and allow a future panel to assess her current circumstances and to determine if she wishes to remain in the nursing profession. This panel has not received any information from Ms Mannan despite this opportunity. It noted that there was no evidence that Ms Mannan intended to engage with NMC proceedings in the future. Accordingly, the panel determined that a further period of suspension would not serve any useful purpose in all of the circumstances. The panel determined that it was necessary to take action to prevent Ms Mannan from practising in the future and concluded that the only sanction that would adequately protect the public and serve the public interest was a striking-off order. The panel therefore directs the registrar to strike Ms Mannan s name from the register. In accordance with Article 30 (1) of the Nursing and Midwifery Order 2001 this strikingoff will come into effect upon the expiry of the existing suspension order, namely 2 October This decision will be confirmed to Ms Mannan in writing. That concludes this determination. 10