Conduct and Competence Committee Substantive Order Review Hearing Tuesday 11 October 2016 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of Registrant Nurse: NMC PIN: Sylwia Szopa 06F0110C Part(s) of the register: Registered Nurse Sub Part 1 Adult (30 June 2006) Area of Registered Address: Panel Members: Legal Assessor: Panel Secretary: Nursing & Midwifery Council: Registrant: Order being reviewed: Outcome: England Louise Rose (Chair, Lay member) Michael Marlo Duque (Registrant member) Kay Grindell (Lay member) Neil Mercer Manisha Hirani Represented by Maria Henty, counsel, instructed by the NMC Regulatory Legal Team Not present and not represented in absence Suspension Order (4 months) Strike-Off, to take effect upon expiry of the current order 1
Service of Notice of Hearing: The panel was informed at the start of this hearing that Miss Szopa was not in attendance, nor was she represented in her absence. The panel was informed that the notice of this hearing was sent to Miss Szopa on 8 September 2016 by recorded delivery and first class post to her address on the NMC register. 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 Miss Szopa. 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 Henty, on behalf of the NMC. The panel accepted the advice of the legal assessor. The panel noted that there had been no response from Miss Szopa in relation to the notice of hearing. The panel was mindful that Miss Szopa has neither engaged for some time, nor did she attend the last hearing. Miss Szopa had been sent notice of today s hearing and the panel was therefore satisfied that she was or should be aware of today s hearing and it is of the view that she had chosen to disengage. The panel, therefore, concluded that she had chosen voluntarily to absent herself. The panel had no reason to believe that an adjournment 2
would result in Miss Szopa s attendance at a future hearing. Having weighed the interests of Miss Szopa with those of the NMC and the public interest in an expeditious disposal of this hearing the panel determined to proceed in her absence. Decision and reasons on review of the current order: The panel decided to impose a striking-off order. This is the second review of a suspension order, originally imposed by a panel of the Conduct and Competence Committee on 12 June 2015 for a period of 12 months. This order was subsequently reviewed on 2 June 2016 and that panel extended the suspension order for a further 4 months. The current order is due to expire on 13 November 2016. The panel is reviewing the order pursuant to Article 30(1) of the Nursing and Midwifery Order 2001(the Order). The sanctions available to the panel that made the substantive order, and accordingly that are available to this panel, are contained within Article 29 of the Order. This panel may allow the present order to lapse upon expiry, revoke the present order with immediate effect, extend the present order, make a caution order, make a conditions of practice order, or impose a striking-off order. The charges found proved which resulted in the imposition of the substantive order were as follows: That you; 1. On 2 November 2013, worked as a Registered Nurse at Cooper House Care Home whilst your NMC registration had lapsed 2. Your action in charge 1 above was dishonest in that you were misrepresenting that you were a Registered Nurse when you knew you were not. 3. On 3 November 2013, worked as a Registered Nurse at Cooper House Care Home whilst your NMC registration had lapsed 3
4. Your action in charge 3 above was dishonest in that you were misrepresenting that you were a Registered Nurse when you knew you were not. 5. On 3 November 2013, worked as a Registered Nurse at Earls Lodge Care Home whilst your NMC registration had lapsed 6. Your action in charge 5 above was dishonest in that you were misrepresenting that you were a Registered Nurse when you knew you were not. 7. On 6 November 2013, worked as a Registered Nurse at Atkinson Court Care Home whilst your NMC registration had lapsed 8. Your action in charge 7 above was dishonest in that you were misrepresenting that you were a Registered Nurse when you knew you were not. And for reasons set out above your fitness to practise is impaired by reason of your misconduct. The substantive reviewing panel on 2 June 2016 determined the following with regard to impairment: The panel considered whether Miss Szopa s fitness to practise remains impaired. The panel considered that it had received no new information which would allow it to depart from the previous panel s decision for a finding of current impairment of Miss Szopa s fitness to practise. Miss Szopa has not adhered to the recommendations of the previous panel in preparing a reflective piece and producing written testimonials on her behalf. The panel considered that it had no evidence that Miss Szopa has developed insight into the impact of her misconduct nor that she has taken any steps to address this. As such the panel concluded that Miss Szopa was still liable in the future to put patients at unwarranted risk of harm and bring the profession into disrepute. 4
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, a finding of continuing impairment is both for the protection of the public and is otherwise in the public interest. For these reasons, the panel finds that Miss Szopa s fitness to practise remains impaired. The substantive reviewing panel on 2 June 2016 determined the following with regard to sanction: The panel considered the imposition of a further period of suspension. It was of the view that a suspension order would allow Miss Szopa further time to fully reflect on her previous dishonesty and misconduct. It considered that Miss Szopa needs to gain a full understanding of how the dishonesty of one nurse can impact upon the nursing profession as a whole and not just the organisation that the individual nurse is working for. The panel concluded that a further 4 month suspension order would be the appropriate and proportionate response and would afford Miss Szopa adequate time to complete her reflective piece and demonstrate remediation of her actions At the end of the period of suspension another panel will review the order. At the review hearing the panel may revoke the order, or it may extend the order, or it may replace the order with another order including a striking off order. Any future panel may be assisted by Miss Szopa s attendance at the hearing and by receiving written evidence from her, including: A reflective statement, written by her, following a recognised nursing model. This will include Miss Szopa s thoughts on, and insight into, how her dishonest actions have impacted upon patients and colleagues as well as the public s view of the nursing profession. 5
Any up-to-date references or testimonials which can comment on Miss Szopa s honesty and integrity. These references may come from paid or unpaid work in a healthcare or non-healthcare setting. Evidence of how Miss Szopa has maintained her nursing knowledge and skills up to date. Decision on current fitness to practise: The panel has considered carefully whether Miss Szopa 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 the light of the current circumstances. It has noted the decision of the previous substantive panel. However, it has exercised its own judgment as to current impairment. Ms Henty explained the background to the case and guided the panel to the relevant sections of the previous panel s decision. She submitted that nothing has changed since the order was last reviewed on 2 June 2016. There has been no correspondence from Miss Szopa, and she has not submitted a reflective piece to demonstrate her insight and understanding of the impact of her actions on patients, any testimonials or any indication of any current employment. Ms Henty submitted that there has been a lack of engagement from Miss Szopa and a lack of willingness to address her failings. Ms Henty submitted that Miss Szopa s fitness to practise is still impaired and invited the panel to impose, at least, a suspension order, given that there has been no information provided to suggest otherwise. The panel heard and accepted the advice of the legal assessor. The panel has had regard to all of the documentation before it. It has taken account of the submissions made by Ms Henty, on behalf of the NMC. 6
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 considered whether Miss Szopa s fitness to practise remains currently impaired. The panel considered that it had received no new information which would allow it to depart from the previous panel s decision for a finding of current impairment of Miss Szopa s fitness to practise. The panel took into account that Miss Szopa has not fully engaged with these proceedings since the original substantive hearing in June 2015. The panel wished to echo the previous panel s decision, in particular, that Miss Szopa has not adhered to the recommendations of the previous panel in preparing a reflective piece and producing written testimonials on her behalf. The panel considered that it had no evidence that Miss Szopa has developed insight into the impact of her misconduct or that she has taken any steps to address this. As such the panel concluded that Miss Szopa was still liable in the future to put patients at unwarranted risk of harm and bring the profession into disrepute. 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, a finding of continuing impairment is both for the protection of the public and is otherwise in the public interest. For these reasons, the panel finds that Miss Szopa s fitness to practise remains impaired. Determination on sanction: Having found Miss Szopa 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 7
powers in relation to sanction are set out in Article 29 of the Order. The panel has also taken into account the NMC s Indicative Sanctions Guidance (ISG) 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 the 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 order but concluded that this would be inappropriate in view of the fact that the case was not at the lower end of the spectrum of impaired fitness to practise and would not restrict Miss Szopa s right to practise. 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 a conditions of practice order is insufficient to protect patients and the wider public interest. It agreed with the previous panel s decision for excluding such a course of action in that: The panel took the view that a conditions of practice order would not be workable given your dishonesty, as your misconduct related to a character issue rather than clinical failures. Although conditions might be formulated, for example to require you to attend courses to develop your insight, the panel was not satisfied that the public interest would be satisfied by allowing you to return to practice, albeit restricted. The panel determined therefore that the placing of conditions on your registration would not adequately address the seriousness of this case and would not protect the public interest. The panel next considered whether to extend the current suspension order. The panel took into account that the previous panel, on 2 June 2016, had provided Miss Szopa with a further 4 month period of suspension to allow her time to fully reflect on her failings and provide a reviewing panel with a detailed reflective piece; testimonials attesting to her character; and evidence of how Miss Szopa has kept her nursing skills 8
up-to-date. Miss Szopa has failed to provide any of these to this reviewing panel. Further, the previous panel had suggested to Miss Szopa that her attendance at a future hearing would be beneficial. The panel was mindful that these were recommendations made by a previous panel which would assist a reviewing panel to determine Miss Szopa s current ability to practice safely as a nurse. In the absence of such evidence, the panel was of the view that Miss Szopa has shown a persistent lack of insight into her misconduct and has not appreciated the seriousness of her lack of engagement with these proceedings. The panel took into account that Miss Szopa has been suspended for a total of 16 months, and therefore has been provided with ample opportunities to demonstrate her willingness to return to safe practice, and address her failings; however, Miss Szopa has failed to take them. The panel was of the view that considerable evidence would be required to show that Miss Szopa no longer posed a risk to the public. 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 Miss Szopa 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 strike-off order will take effect upon expiry of the current order. This decision will be confirmed to Miss Szopa in writing. That concludes this determination. 9