Conduct and Competence Committee Substantive Hearing Held at Nursing and Midwifery Council, 13a Cathedral Road, Cardiff, CF11 9HA On 30 January 2017

Transcription

1 Conduct and Competence Committee Substantive Hearing Held at Nursing and Midwifery Council, 13a Cathedral Road, Cardiff, CF11 9HA On 30 January 2017 Registrant: NMC PIN: Peter Greaves 99I0868E Part(s) of the register: Registered Nurse Sub part 1 Mental Health Nursing September 2002 Area of registered address: Type of case: Panel Members: Legal Assessor: Panel Secretary: Nursing and Midwifery Council: Wales Conviction Richard Davies (Chair, lay member) Jennifer Frost (Registrant member) Tracey Jary (Registrant member) Graeme Henderson Kim Nyawira Represented by Ayanna Nelson on behalf of the NMC Registrant: Present and represented by Chris Green instructed by the Royal College of Nursing Facts found proved: 1 and 2 Fitness to practise: Sanction: Impaired Caution order (5 years) Page 1 of 12

2 Charge as read: That you: 1. On 01 December 2015, were convicted of driving with alcohol level above limit at Ceredigion Magistrates Court. 2. On 01 December 2015, were convicted of dangerous driving x2 at Ceredigion Magistrates Court. AND, in light of the above, your fitness to practise is impaired by reason of your conviction. Decision on the facts: On 01 December 2015 you were convicted of driving a motor vehicle with excess alcohol at Ceredigion Magistrates Court, contrary to the Road Traffic Act 1988 s.5(1)(a). You were also convicted of two counts of dangerous driving at Ceredigion Magistrates Court, contrary to the Road Traffic Act 1988 s.2. You were sentenced on 23 December 2015 at Swansea Crown Court to: 8 months imprisonment, suspended for 12 months; Rehabilitation Activity Requirement for a maximum of 10 days; Unpaid work of 150 hours before 22/12/ 16 Disqualified until an extended driving test had been passed Extended test to be taken after a period of 4 years driving disqualification has finished (interim from 1/12/15 at Magistrates Court) At the commencement of this hearing, the panel heard you admitted the charges against you. Accordingly, the panel found the charges proved by way of your admission. It also took account of the Certificate of Conviction before it. Page 2 of 12

3 Decision on Impairment: The panel then went on to consider whether, on the basis of your convictions, your fitness to practise is currently impaired. The NMC defines fitness to practise as a registrant s suitability to remain on the register without restriction. In her submissions, Ms Nelson submitted that, notwithstanding your admission that your fitness to practise is currently impaired, impairment was a matter for the panel s own judgement. She submitted that the panel may find that the public confidence in the profession and in the NMC as its regulator would be severely undermined if no finding of impairment were made in this case. She invited the panel to find that your fitness to practise is currently impaired. Mr Green, on your behalf, informed the panel that you admitted that your fitness to practise is currently impaired. He told the panel that you accepted that you had brought the nursing profession into disrepute by reason of your convictions. He submitted that the risk of repetition in this case was low, given that you are currently banned from driving for four years. He informed the panel that you would be required to undertake an extended driving test after your driving disqualification was complete. He also informed the panel that you had undertaken Rehabilitation Activity in line with your sentence which you had now completed together with your unpaid community work. However, he submitted that it was nevertheless accepted that your fitness to practise is currently impaired. The panel heard and accepted the advice of the legal assessor. In reaching its decision, the panel took into account the submissions made by Ms Nelson on behalf of the NMC and Mr Green on your behalf, as well as all of the information before it. The panel has exercised its own judgment in determining whether your fitness to practise is currently impaired by reason of your convictions. It took account of the public interest, that is to say not only the need to protect patients but also the maintenance of Page 3 of 12

4 public confidence in the profession and its regulation, and the upholding and declaring of proper standards. In reaching its decision, the panel noted that you had been convicted of driving with an alcohol level some two to three times above the prescribed limit. You had also been convicted of two counts of dangerous driving. The panel also reflected on the fact that you had a previous conviction for driving a motor vehicle with excess alcohol in However, the panel considered that this was some 7 years ago and there was no evidence before it of any repetition in the interim period to suggest that you had displayed an adverse pattern of behaviour. The panel took account of the Judge s sentencing remarks in your case. He had indicated that you had put other road users at risk of serious injury or worse. You had driven at some 80 miles per hour in a zone limited to 30 miles per hour. The panel noted that you had pleaded guilty prior to the convictions. You also admitted the facts and accepted that your fitness to practise is currently impaired at these proceedings. You did not seek to deflect blame from yourself or diminish your responsibility as a registered nurse. You accepted that you were driving dangerously and that you had put members of the public at risk. It was undisputed that the incidents that led to your convictions occurred during a significant break in your practice and not immediately before or after you had been on duty. Taking all these factors into account, and in all the circumstances of this case, the panel considered that it was unlikely that you would act in a similar manner in the immediate future. It noted that you were banned from driving for 4 years. The panel noted that there was no suggestion that your conduct had impacted on your clinical practice or had placed patients at an unwarranted risk of harm. Accordingly, the panel determined that the risk of repetition in this case was low. The panel went on to consider whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment of fitness to practise were not made in the circumstances of this case. The panel considered that the incidents which gave rise to your convictions were serious Page 4 of 12

5 and unacceptable. At the very least, they were in breach of paragraph 20.4 of the Code: Professional Standards of practice and behaviour for nurses and midwives (2015): 20.4 keep to the laws of the country in which you are practising. Other members of the profession and members of the public would regard your actions as likely to have adverse implications for trust and confidence in the profession itself. The panel was in no doubt that the convictions had brought the reputation of the profession into disrepute. Taking all these factors together, the panel concluded that the need to uphold proper professional standards and public confidence in the profession and the regulatory process would be undermined if a finding of impairment was not made in the particular circumstances of this case. For all of these reasons, the panel concluded that your fitness to practise is currently impaired by reason of your conviction on public interest grounds alone. Determination on Sanction: Having determined that your fitness to practise is currently impaired, the panel considered what sanction, if any, it should impose in relation to your registration. The panel has decided to impose a caution order for a period of 5 years. In reaching its decision on sanction, the panel considered the submissions made by Ms Nelson on behalf of the NMC, and Mr Green on your behalf. It also considered all of the evidence that had been adduced during these proceedings including the remarks of the sentencing judge. It also had regard to your bundle of evidence which included: 8 references and testimonials; Report from your Probation Service Officer; Your reflective statement. Page 5 of 12

6 The panel heard oral evidence from you and Ms 1, your current manager. You told the panel that you deeply regretted your actions. You accepted that your actions had the potential to cause serious harm to other road users and members of the public. You apologised for your behaviour and said there was no justification for what you did. You said that also understood the serious consequences of your actions on the reputation of the profession. You told the panel that in your view your levels of alcohol pertinent to two convictions within ten years made you high risk. You explained that you had accepted this and now wished to ensure that there was no repetition on your part. You explained to the panel the remedial actions you had undertaken as part of your sentence, in particular the Rehabilitation Activities. You told the panel that you had tested yourself as regards dependency issues. However, you said that the recurrence of a drink-driving conviction in 2015 had been a wake-up call which caused you to re-examine and reflect deeply on your social drinking to ensure that you did not allow such unacceptable behaviour to occur again. You told the panel that you now considered that, as a nurse, you could not drink and drive again. You explained to the panel the strategies that you have adopted to ensure no repetition. You told the panel that you were currently working as a nurse at Bridell Manor Nursing Home ( the Home ). You explained your duties to the panel. You stressed that you felt that you had let your colleagues and employer down. You told the panel that you were a passionate and committed nurse with a strong desire to make a difference. You implored the panel not to remove you from the register. Ms 1, your current manager at the Home, spoke highly of your practice as a nurse. She told the panel that the behaviour that led to the convictions was not intrinsic to your character. She said that she had never had cause to question your conduct or behaviour. She told the panel that you had been extremely remorseful about your conduct from the outset. She said you understood the impact of your conduct on the Home, the service users and your colleagues. She told the panel that you were currently the only registered mental health nurse at the Page 6 of 12

7 Home and you were an integral part of the team. She said that losing you would greatly affect the service and have adverse impacts upon service users. She explained that she would only be able to keep your job open for you for a period of three months at most were you to be removed from the register temporarily. The panel heard and accepted the advice of the legal assessor. In her submissions, Ms Nelson invited the panel to consider all the sanctions available. She referred the panel to the NMC s Indicative Sanctions Guidance ( ISG ) and submitted that sanction was a matter for the panel s own judgement. She invited the panel to consider the aggravating and mitigating factors in this case, some of which she detailed. She invited the panel to apply the principle of proportionality when considering sanction. In his submissions, Mr Green also outlined the mitigating factors which he submitted might be considered relevant. He reminded the panel that you had been banned for four years and would be required to undertake an extended driving test once your disqualification period ends. He submitted that the public were sufficiently protected in these circumstances. Nevertheless, he invited the panel to give your evidence and the remorse and insight you had demonstrated due weight. He submitted that you had shown a strong awareness that this was not your first offence of drink-driving, and a firm resolve to avoid repetition. Mr Green also invited the panel to consider the notably positive references and testimonials highlighting your usual high standards of clinical practice. He submitted that you accepted that you had acted on impulse without considering the consequences. However, he invited the panel to find that the consequences that followed - namely your conviction, the threat of a custodial sentence and these regulatory proceedings had had a significant deterrent effect on you. He submitted that the panel could accept your assurances that you would not repeat your conduct. Page 7 of 12

8 Although he accepted that the facts leading up to the conviction were serious, Mr Green submitted that to impose a striking off order would be disproportionate in all the circumstances of this case. He reminded the panel that you had already received a sentence from the Crown Court. He submitted that the appropriate sanction would be a caution as it would mark that your actions as serious and unacceptable. In addition, Mr Green submitted that, given the evidence before the panel regarding your clinical practice, the public interest would be best served by allowing an experienced and capable nurse to continue to practice. However, if the panel was minded to impose a suspension order, he submitted that a short suspension order would be allow you to return to your role at the Home, given the evidence of Ms 1. The panel exercised its own judgement and accepted the advice of the legal assessor. It took account of the ISG and the need to protect the public as well as the wider public interest. This includes maintaining public confidence in the profession and the regulatory process, and declaring and upholding proper standards of conduct and behaviour. The panel applied the principle of proportionality, weighing the interests of the public with your interests. The panel also bore in mind that the purpose of a sanction is not to be punitive, although it may have that effect. The panel carefully considered the mitigating and aggravating factors in this case. In doing so, the panel took into account the sentencing judge s remarks in respect of the aggravating and mitigating factors. The aggravating factors which the panel found to be present were as follows. This was not a one-off offence, you had a previous conviction for drink driving; You had previously undergone a Rehabilitation Programme in respect of your first drink-driving conviction but nevertheless repeated your conduct some 7 years later; You had a high level of alcohol - some two to three times over the prescribed limit; Page 8 of 12

9 You failed to stop for the police despite being signalled to do so and continued to drive for some 24 miles; You were driving at 80 mph in a 30 mph zone. The mitigating factors which the panel found to be present were as follows. You admitted the offences and pleaded guilty at the first opportunity; You attended a Drink-Drive Rehabilitation Course and had completed all aspects of your sentence to the complete satisfaction of your probation officer; You had fully engaged with the NMC and made early admissions in relation to facts and impairment; You had demonstrated a significant level of insight both in your reflective account and your oral evidence. You had shown a substantial level of remorse; You had accepted full responsibility and demonstrated an awareness of the implications of your convictions on the public, your colleagues and the profession; There were no clinical concerns and the panel was provided with 8 positive references and testimonials attesting to your character and clinical practice; The panel heard from your current manager who spoke highly of your character and clinical practice; There was no evidence of an attitudinal or ongoing health concern in relation to alcohol; There was no evidence of repetition since December The panel then went on to consider what, if any, sanction was appropriate in this case. It considered all of the sanctions available to it in ascending order of seriousness. The panel first considered whether to take no action but concluded that it would not be in the public interest to do so. The nature of the behaviour which led to your conviction and the sentence of imprisonment, albeit suspended, was serious. The panel considered that the public would expect your conduct to be marked by the imposition of an appropriate sanction. In the panel s judgment, a finding of impairment alone together with no further action being taken would not be sufficient. Accordingly, the panel determined that a conviction of this nature required an appropriate sanction in order to Page 9 of 12

10 uphold proper standards of conduct and behaviour and to maintain confidence in the profession and in the NMC as a regulator. To take no action would fail to send out a clear signal to both the nursing profession and the public that your behaviour was unacceptable. The panel next considered whether to impose a caution order. It had regard to the ISG, which states that a caution order may be appropriate where: the panel wishes to mark that the behaviour was unacceptable and must not happen again, and where the nurse or midwife s history is such that the panel is confident that there is no risk to the public or to patients which requires the nurse or midwife s practice rights to be restricted. The panel considered that your offences could not be described as wholly isolated. You had previously been convicted of drink-driving in Although you had previously undergone a Rehabilitation Programme in respect of your first drink-driving conviction you nevertheless repeated your conduct in You have now been convicted of driving with an alcohol level some two to three times above the prescribed limit and two counts of dangerous driving. The panel took account of the Judge s sentencing remarks in your case. He had indicated that you had put other road users at risk of serious injury or worse. You had failed to stop for the police despite being signalled to do so and continued to drive for some 24 miles. Further, you had driven at 80 miles per hour in a zone limited to 30 miles per hour. The panel was in no doubt that the facts pertinent to your convictions were serious. However, the panel heard oral evidence from you. You demonstrated a high level of insight and remorse into your conduct. You had fully engaged with the criminal justice system, pleading guilty to your convictions at an early stage. Similarly, you had fully engaged with these regulatory proceedings, made early admissions to the facts and accepted that your fitness to practise is currently impaired. In your evidence, you appeared to understand the serious implications of the conduct which led to your convictions not only on those you worked with but also on the public and the profession. You accepted full responsibility for your actions and there was no evidence of repetition before this panel. Indeed, the panel had regard to a letter from your probation officer confirming that you had undertaken Rehabilitation Activities and completed all aspects Page 10 of 12

11 of the 12 month Suspended Sentence order successfully on 22 December The panel considered its findings on impairment in relation to your previous conviction that there was no evidence before it of any repetition in the interim period to suggest that you had displayed an adverse pattern of behaviour. There was also no evidence of any ongoing health concern in relation to alcohol. Further, the panel also heard oral evidence from your current manager, Ms 1, who spoke very highly of you as a nurse. She told the panel that you were an integral member of staff and in a testimonial dated 26 June 2016, she spoke of you as an excellent nurse. He shows true dedication to our residents, always striving to give them the best possible care and quality of life. The panel also had regard to a number of professional references and testimonials which also spoke highly of your character and clinical practice. Taking all these factors into account, the panel determined that in the exceptional circumstances of this case, a caution order would be the most appropriate and proportionate sanction. In the particular circumstances of this case, it was the panel s judgement that the mitigating factors outweighed the aggravating factors. It bore in mind that the seriousness of your conduct had also been marked by the Criminal Justice system. In the panel s view, the impact of the legal proceedings against you and these regulatory proceedings will have had a significant and salutary effect on you which make it unlikely that you would act in a similar manner in future. The panel determined that a caution order would mark the matter as serious and unacceptable. It would satisfy the wider public interest in that it would send a clear message to the public and the profession that such behaviour cannot be tolerated, thereby upholding public confidence in the NMC as a regulator. In order to satisfy itself that a caution order was the appropriate sanction, the panel considered the possibility of imposing a conditions of practice order. However, the panel did not consider that there was any evidence of general incompetence or specific areas of your practice in need of assessment or retraining. The panel therefore found that there would be no useful purpose served in imposing a conditions of practice order, nor would it be appropriate in these circumstances. The panel went on to consider the next available sanction of suspension. The panel was mindful that a period of suspension would also sufficiently serve the public interest Page 11 of 12

12 considerations in this case. However, given the significant mitigating factors in your case, the panel determined that in all the circumstances a suspension order would be unduly punitive and serve no useful purpose. It would also deprive the public of the services of a highly valued and experienced nurse. The panel determined the appropriate length of time for the caution order. The panel concluded that a period of 5 years would be adequate, proportionate and would protect the wider public interest. This would keep in the forefront of your mind the standards of professional conduct expected of a nurse. The panel was satisfied that a caution order for a period of 5 years was both appropriate and proportionate sanction. You are required to disclose to any current employer, or to any prospective employer at the time of application that you are subject to this order. This decision will be confirmed to you in writing. That concludes this determination. Page 12 of 12