Nursing and Midwifery Council Fitness to Practise Committee

Transcription

1 Nursing and Midwifery Council Fitness to Practise Committee Substantive Meeting 5 September 2017 Nursing and Midwifery Council, George Street, Edinburgh, EH2 4LH Name of registrant: Muhammad Ilyas NMC PIN: 01K1694O Part(s) of the register: Registered Nurse Sub Part 1 RN1 Adult November 2001 Area of Registered Address: England Type of Case: Misconduct Panel Members: Richard Davies (Chair, Lay member) Claire Blackwood (Registrant member) Jacinta Mackie (Lay member) Legal Assessor: Panel Secretary: Michael Bell Lucy Eames Facts proved by admission: Fitness to practise: Sanction: Interim Order: All Impaired Striking-off order Interim suspension order, 18 months 1

2 Details of charge: That you, a registered nurse: 1. On or around 16 July 2014, during a telephone interview with BUPA, stated that you had left Newham University Hospital due to family issues and spending too much time travelling, or words to that effect when, in fact, you had been dismissed. 2. On or around 13 October 2014 submitted an application form to Bupa stating that your reason for leaving Newham Health Care was because you were leaving to abroad when, in fact, you had been dismissed. 3. Your actions at charge 1 and/or 2, above, were dishonest in that you intended to conceal that you were dismissed from Newham University Hospital. 4. On or around 13 October 2014 submitted an application form to Bupa in which you failed to disclose that you had previously been employed by East London NHS Foundation Trust ( the Trust ). 5. Your actions at charge 4, above, were dishonest in that you intended to conceal that you had been employed by the Trust. 6. Between 31 October 2014 and 21 June 2016 failed to inform Bupa that you were the subject of an NMC investigation. 7. Your actions in charge 6, above, were dishonest in that you intended to conceal that you were under investigation by the NMC. 8. On or around 11 May 2015 asked and/or permitted your legal representatives to inform the NMC that you were still not working when, in fact, you were employed by Bupa. 9. Your actions at charge 8, above, were dishonest in that you intended to conceal your employment from the NMC. And in light of the above, your fitness to practise is impaired by reason of your misconduct. 2

3 Decision on Service of Notice of Meeting The panel was informed that the notice of this meeting was sent to Mr Ilyas on 4 August 2017 by recorded delivery and first class post to his registered address. 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 11A and 34 of The Nursing and Midwifery Council (Fitness to Practise) Rules Order of Council 2004 (as amended February 2012) (the Rules). Background Mr Ilyas was referred to the NMC on 28 August 2016 by BUPA Care Homes, Hornchurch Care Home (the Home). It is alleged that he had not disclosed to them at the application or interview stages accurate reasons for leaving his post at Newham University Hospital and had omitted from his application form previous employment details and reasons for his dismissal from East London NHS Foundation Trust. It is also alleged that whilst employed by the Home Mr Ilyas failed to inform them that he had been currently the subject of an NMC investigation. At the time of application via a telephone screening interview Mr Ilyas allegedly said his reasons for leaving previous employment at Newham University Hospital were because he had family issues and he was spending too much time travelling and not that he had been dismissed. However, the reasons listed in his written application form, signed on 13 October 2014 were that he was leaving to abroad. Decision on the findings on facts and reasons In his response to charges form, dated 12 July 2017, Mr Ilyas admitted the following charges; 3

4 That you, a registered nurse: 1. On or around 16 July 2014, during a telephone interview with BUPA, stated that you had left Newham University Hospital due to family issues and spending too much time travelling, or words to that effect when, in fact, you had been dismissed. 2. On or around 13 October 2014 submitted an application form to Bupa stating that your reason for leaving Newham Health Care was because you were leaving to abroad when, in fact, you had been dismissed. 3. Your actions at charge 1 and/or 2, above, were dishonest in that you intended to conceal that you were dismissed from Newham University Hospital. 4. On or around 13 October 2014 submitted an application form to Bupa in which you failed to disclose that you had previously been employed by East London NHS Foundation Trust ( the Trust ). 5. Your actions at charge 4, above, were dishonest in that you intended to conceal that you had been employed by the Trust. 6. Between 31 October 2014 and 21 June 2016 failed to inform Bupa that you were the subject of an NMC investigation. 7. Your actions in charge 6, above, were dishonest in that you intended to conceal that you were under investigation by the NMC. 8. On or around 11 May 2015 asked and/or permitted your legal representatives to inform the NMC that you were still not working when, in fact, you were employed by Bupa. 4

5 9. Your actions at charge 8, above, were dishonest in that you intended to conceal your employment from the NMC. These were therefore announced as proved. In terms of charges 3, 5, 7 and 9 involving dishonesty, the panel considered that an ordinary and reasonable member of the nursing profession would have considered that Mr Ilyas actions were dishonest and that he would have been aware that his actions were dishonest by this standard. The panel therefore determined that he acted dishonestly in trying to conceal employment related information. Decision on misconduct When determining whether the facts found proved amount to misconduct the panel had regard to the terms of The code: Standards of conduct, performance and ethics for nurses and midwives 2008 (the 2008 Code) and The Code: Professional standards of practice and behaviour for nurses and midwives (the 2015 Code). The panel, when reaching its decision, had regard to the public interest and accepted that there was no burden or standard of proof at this stage and exercised its own professional judgement. The panel was of the view that Mr Ilyas actions did fall significantly short of the standards expected of a registered nurse, and that they amounted to breaches of the Codes. Specifically from the 2008 Code: be open and honest, act with integrity and uphold the reputation of your profession. 61 You must uphold the reputation of your profession at all times. From the 2015 Code: 5

6 20.1 keep to and uphold the standards and values set out in the Code 20.2 act with honesty and integrity at all times, treating people fairly and without discrimination, bullying or harassment The panel appreciated that breaches of the Code did not automatically result in a finding of misconduct. However, the panel considered that Mr Ilyas conduct featured several acts of dishonesty. It acknowledged that honesty and integrity are expected of all registered nurses. The panel determined that in acting as he had done Mr Ilyas had put his own interests before the interests of others. His behaviour represented a clear departure from the standards expected of a registered nurse. The panel found that Mr Ilyas actions had fallen seriously short of the conduct and standards expected of a nurse and amounted to misconduct. Decision on impairment The panel next went on to decide whether as a result of this misconduct Mr Ilyas fitness to practise is currently impaired. Nurses occupy a position of privilege and trust in society and are expected at all times to be professional and to maintain proper professional standards. Patients and their families must be able to trust nurses with their lives and the lives of their loved ones. To justify that trust, nurses must be honest and open and act with integrity. They must make sure that their conduct at all times justifies both their patients and the public s trust in the profession. In this regard the panel considered the judgement of Mrs Justice Cox in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) in reaching its decision, in paragraph 74 she said: In determining whether a practitioner s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not 6

7 only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances. Mrs Justice Cox went on to say in Paragraph 76: I would also add the following observations in this case having heard submissions, principally from Ms McDonald, as to the helpful and comprehensive approach to determining this issue formulated by Dame Janet Smith in her Fifth Report from Shipman, referred to above. At paragraph she identified the following as an appropriate test for panels considering impairment of a doctor s fitness to practise, but in my view the test would be equally applicable to other practitioners governed by different regulatory schemes. Do our findings of fact in respect of the doctor s misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he: a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or 7

8 d. has in the past acted dishonestly and/or is liable to act dishonestly in the future. The panel found that all limbs of the test were engaged. It was now evident that Mr Ilyas had been dishonest on several occasions over a prolonged period of time. The panel noted that he had submitted a reflective piece to the NMC in November In this statement he accepted that he acted dishonestly and that his behaviour had been wrong as regards allegations pertinent to his conduct between October 2013 and January These matters had been subject to previous regulatory proceedings. They were dealt with by Consensual Panel Determination in May The separate allegations found proved today showed that, despite his purported reflection, Mr Ilyas had conducted himself dishonestly even in June The panel acknowledged that taken overall his behaviour could not be regarded as representing an isolated incident, but was rather an established course of conduct. The panel noted that there was no evidence of insight, remorse or remediation from Mr Ilyas. It accepted that dishonesty was difficult to remediate, but Mr Ilyas had not shown that he had made any effort to rehabilitate himself or to remediate his conduct. Owing to Mr Ilyas sustained dishonesty the panel could not be satisfied that the reflective piece put before the NMC in November 2015 could be relied upon. The panel was of the view that there was nothing to suggest that Mr Ilyas would not repeat his dishonesty in the future. The panel therefore decided that a finding of impairment was necessary on the grounds of public protection. The panel bore in mind that the overarching objectives of the NMC are to protect, promote and maintain the health safety and well-being of the public and patients, and to uphold/protect the wider public interest, which includes promoting and maintaining public confidence in the nursing and midwifery professions and upholding the proper professional standards for members of those professions. The panel determined that, in 8

9 this case, a finding of impairment on public interest grounds was required to maintain confidence in the profession and the NMC as regulator, Having regard to all of the above, the panel was satisfied that Mr Ilyas fitness to practise is currently impaired. Determination on sanction: The panel has considered this case very carefully and has decided to make a strikingoff order. It directs the registrar to strike Mr Ilyas name from the register. The effect of this order is that the NMC register will show that Mr Ilyas has been struck-off the register. In reaching this decision, the panel has had regard to all the evidence that has been adduced in this case. The panel accepted the advice of the legal assessor. The panel has borne in mind that any sanction imposed must be appropriate and proportionate and, although not intended to be punitive in its effect, may have such consequences. The panel had careful regard to the Sanctions Guidance (SG) published by the NMC. It recognised that the decision on sanction is a matter for the panel, exercising its own independent judgement and attending to the principle of proportionality. The panel took into account the following aggravating factors: repeated dishonesty over a prolonged of time no insight no evidence of remorse lack of engagement The panel first considered whether to take no action or to impose a caution order but concluded that these would be inappropriate in view of the seriousness of the case. The panel decided that it would be neither proportionate nor in the public interest to take no 9

10 further action or to impose a caution order as these sanctions would not restrict or otherwise regulate Mr Ilyas practice. The panel next considered whether placing conditions of practice on Mr Ilyas registration would be a sufficient and appropriate response. It took into account that the issues in this case were not clinical and therefore could not be readily addressed by conditions. Indeed the panel could not identify any practicable, measurable or monitorable conditions that would be proportionate and appropriate in this case. Moreover, the panel determined that a conditions of practice order would not be sufficient to address the gravity of Mr Ilyas dishonesty. The panel then went on to consider whether a suspension order would represent an appropriate sanction. The panel recalled that Mr Ilyas misconduct involved a pattern of behaviour. It considered that this conduct had itself demonstrated an attitudinal problem. Mr Ilyas had breached a fundamental tenet of the nursing profession repeatedly and appeared not to have learnt from the experience of undergoing proceedings before his regulator. There was no evidence before the panel that his insight was anything other than seriously deficient. Indeed it appeared to be wholly lacking. The conduct, as highlighted by the facts found proved, represented a significant departure from the standards expected of a registered nurse. The panel noted that the breach of the fundamental tenets of the profession evidenced by Mr Ilyas actions was so serious as to be fundamentally incompatible with his remaining on the register. The panel determined that there was nothing before it to suggest that a suspension order could be regarded as an appropriate sanction. The panel concluded that suspension would not be sufficient or proportionate in the circumstances of this case. Balancing all of these factors and after taking into account all the evidence before it, the panel determined that the appropriate and proportionate sanction is that of a striking-off 10

11 order. Having regard to the matters it identified, in particular the degree to which Mr Ilyas misconduct was bound to have adverse implications to the reputation of the profession, the panel has concluded that nothing short of this would be sufficient in this case. The panel considered that this order was necessary to mark the importance of maintaining public confidence in the profession, and to send to the public and the profession a clear message about the standard of behaviour required of a registered nurse. Determination on Interim Order The panel accepted the advice of the legal assessor. The panel was satisfied that an interim suspension order is necessary for the protection of the public and is otherwise in the public interest. The panel had regard to the seriousness of the facts found proved and the reasons set out in its decision for the substantive order in reaching the decision to impose an interim order. To do otherwise would be incompatible with its earlier findings. The period of this order is for 18 months to allow for the possibility of an appeal to be made and determined. If no appeal is made, then the interim order will be replaced by the striking-off order 28 days after Mr Ilyas is sent the decision of this hearing in writing. That concludes this determination. 11