Fitness to Practise Committee Substantive Order Review Hearing 09 August 2018 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of Registrant Nurse: NMC PIN: Elena Cristina Sacuiu 13F0142C Part(s) of the register: RN1, Registered Nurse Sub part 1 Adult (24 June 2013) Area of Registered Address: Panel Members: Legal Assessor: Panel Secretary: Nursing and Midwifery Council: Registrant: Order being reviewed: Outcome: England Najrul Khasru (Chair/Lay Member) Denise Price (Registrant Member) Gill Madden (Lay Member) Jonathan Whitfield Richard Webb Represented by Francis O Toole, Case Presenter Present and represented by Nicole O Reily, Royal College of Nursing Conditions of Practice Order 12 months 12 months Conditions of Practice order to take immediate effect. Page 1 of 7
Decision and Reasons: This is the second review of a conditions of practice order imposed on your registration at a hearing of the Conduct and Competence Committee on 30 September 2016 for 12 months. The order was extended for a further 12 months at a review hearing on 31 October 2017. This is an early review of the order requested by you. At the original hearing the substantive panel found the following charges proved: That you, a registered nurse: 1. Do not have the necessary knowledge of English to practise safely and effectively. AND in light of the above, your fitness to practise is impaired by reason of your lack of knowledge of English. The order is due to expire at the end of 01 November 2018. The reviewing panel today had regard to the submissions of Mr O Toole on behalf of the Nursing and Midwifery Council (NMC) and from Ms O Reily on your behalf. The panel accepted the advice of the legal assessor. At the previous hearing the panel stated as follows: The panel considered that this case was not at the lower end of the spectrum and that a caution order would allow practice without restriction and would be inappropriate in view of the public protection concerns identified in this case. 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. The panel was of the view that the continuation of the current conditions of practice order is Page 2 of 7
sufficient to protect patients and the wider public interest, noting as the original panel did that there was no evidence of general incompetence or deep seated attitudinal problems and that conditions could be formulated which would protect patients during the period they are in force. The panel recognised that you understand the seriousness of satisfying the NMC s requirements for application of the English language when working as a Registered Nurse and determined that you deserved further time to prove that you are able to achieve this. It noted that there were mitigating circumstances that led to your progress being somewhat curtailed this year and also took account of the support that has been provided to you at your current place of employment. The panel considered that your reflective piece confirms that you are motivated to reach the appropriate standard with regard to the English language and considered that you showed humility when giving evidence before it. Further, it considered that the references and testimonials provided by you attest to your excellent clinical practice. The review panel today first considered the issue of whether or not your fitness to practise continues to be impaired. In determining this, the reviewing panel had careful regard to what, if anything, had changed since the last review which might enable it to conclude that your fitness to practise is no longer impaired. The panel considered matters afresh in light of all the information before it today, including the reasoning of the previous panels, however it has exercised its own professional judgement in reaching its decision. The panel was mindful of the need to protect the public, maintain public confidence in the profession, and the need to declare and uphold proper standards of conduct and behaviour. The panel was provided with a bundle of documents which included a reference from the Bournemouth School of English dated 31 July 2018 which confirmed the good progress you are making in your English language studies. The reference also commented on the areas where you need to focus with regard to your studies. The panel was provided with a further reference from your former manager dated 05 August 2018 which commented positively on your practice as a registered nurse. Page 3 of 7
The panel was informed that you are no longer employed at Wellington Grange Residential and Nursing Care Home. The first condition of your conditions of practice order stated that you must restrict your practice to this employer. This conditions is no longer workable and that is the reason an early review has been requested. Accordingly the panel today was invited to vary the conditions to restrict your employer to a sole employer. You have applied for a position as a registered nurse with an NHS Trust. The panel was informed that staffing circumstances at the care home where you were previously employed had changed which meant that you became concerned that you may not be able to comply with your condition regarding indirect supervision. As a result you decided to resign from your employment there and the panel considered this demonstrated your professionalism and insight. Although you continue to study and are making good progress, you are yet to complete your IELTS test to the requisite NMC standard and in light of this the panel was of the view that the public would remain at risk of harm if you were to practise without restriction. The panel also considered that allowing a nurse to practise without the requisite level of English would undermine public confidence in the profession and bring the profession and the regulatory body into disrepute. It therefore concluded that the public interest is also engaged in this case. In all the circumstances, the panel decided that a finding of current impairment is necessary on the public protection and public interest grounds. The panel therefore determined that your fitness to practise remains impaired. In relation to sanction, the panel noted that the powers available to it today are set out in Article 30(2) of the Order. The panel has also taken into account the NMC s Sanctions Guidance 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. Page 4 of 7
The panel first considered whether to take no action but concluded that this would be inappropriate. To take no further action would not place restrictions on your practice and so would not protect the public. For the same reasons the panel also considered that a caution order would not be appropriate. The panel next considered the extension and/or variation of the conditions of practice order. The panel was of the view that a conditions of practice order remains sufficient to protect patients, noting that this case relates solely to your competence in the English language. The panel took into account your engagement with the NMC. You are willing to comply with a conditions of practice order and recognise the need to achieve the required level of competence. The panel considered a further 12 months conditions of practice order in varied terms would allow you the opportunity to address the concerns regarding your language skills. The panel decided that the period of 12 months would allow you time to achieve the requisite knowledge of English. The panel considered a suspension order before finalising its decision and concluded, given your engagement, that a suspension order would be disproportionate at this time. Accordingly, the panel determined, pursuant to article 30(2), to impose a conditions of practice order for a period of 12 months with immediate effect. The conditions are as follows: 1. Whilst consolidating your English language skills to enable you to practise safely and effectively and until you have passed the IELTS to the requisite standard, you must restrict your nursing practice to one employer. 2. At any time that you are employed or otherwise providing nursing services, you must place yourself and remain under the indirect supervision of a workplace line manager, mentor or supervisor nominated by your employer. Such supervision is to consist of working at all times on the same shift as another registered nurse Page 5 of 7
who is physically present in or on the same ward, unit, floor or home that you are working in or on. 3. You must continue to work to improve your proficiency in the English Language towards achieving the NMC standard required for registration. You must retake the International English Language Test (IELTS) prior to any NMC review of this Order and you must send the results of the IELTS assessment to the NMC at least 7 days before the review of this order 4. You must forward a report to the NMC from the home manager or deputy manager setting out the standard of your clinical performance generally, and specifically in relation to your English language proficiency, prior to any NMC review of this order. 5. You must inform the NMC of any professional investigation started against you and/or any professional disciplinary proceedings taken against you within 7 days of you receiving notice of them. 6. You must within 14 days of accepting any employment or 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 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). b) Any organisation or person employing, contracting with, or using you to undertake nursing work. Page 6 of 7
You or the NMC can call for an early review at any stage. That concludes this determination. Page 7 of 7