Investigating Committee Substantive Hearing Fraudulent/Incorrect Entry 14 November 2016 Nursing and Midwifery Council, 61 Aldwych, London WC2B 4AE Name of Registrant Nurse: NMC PIN: Mrs Phedra Kibi Louise Wright 89Y1800E Part(s) of the register: RN1, Registered Nurse (Sub Part 1) Adult (14 July 1992) Area of Registered Address: Panel Members: Legal Assessor: Panel Secretary: Registrant: Nursing and Midwifery Council: Facts proved: England Mandy Renton (Chair, Registrant member) Janet Mountford (Registrant member) Judy Allfrey (Lay member) Gerard Coll Rajinder Jagdev Present and represented by Kathryn Pitters of Charter Chambers, attending on behalf of Emma Davies of Royal College of Nursing Represented by Jeremy Loran, instructed by NMC Regulatory Legal Team All, in the second alternative Outcome: The panel directed that the entry on the NMC s Register had been incorrectly made. It directed that there be an order that the Registrar remove the entry from the Register. Interim Order: No interim order imposed. Page 1 of 9
Charges: 1. During the process for readmission to the NMC register, you provided incorrect information in that you: 1.1. On 5 October 2015 on your application form for readmission, declared that you had not worked as a registered nurse since your NMC registration had lapsed, when this was not the case 1.2. On 5 October 2015 in a letter to the NMC, stated that you had not worked as a registered nurse since your NMC registration had lapsed, which was not the case 1.3. On 12 October 2015 in an email to the NMC stated that you had not worked as a registered nurse since your NMC registration had lapsed, which was not the case AND thereby, an entry made on sub part 1 of the register of the Nursing and Midwifery Council, in the name of Phedra Kibi Louise Wright, PIN: 89Y1800E, was fraudulently procured/incorrectly made. Page 2 of 9
Background The charges arose following an anonymous referral where it is alleged that whilst your registration had lapsed, you continued to work at Clifton College as a school nurse and also at Bristol Urology Associates ( BUA ) as a practice manager. Your entry onto the NMC register was either incorrectly entered or fraudulently procured. As a result of failing to complete your Notification of Practice ( NoP ) form, your registration lapsed on 28 February 2014. In a letter to the Registrations Team on 5 October 2015, you stated I have categorically not been working as a registered nurse but I have been overseeing nurses s work within the BUA and I wish to go back onto the register to resume my previous job as a school nurse at Clifton College. I held this post from 2010-2012. This was further reiterated in the readmission application form dated 5 October 2015 which indicated that you had not worked as registered nurse since your registration had lapsed. You wrote an email to the Registrations Team on 12 October 2015 stating that I would like to confirm that I misunderstood the re-registration form when I filled it out originally and I can categorically confirm I have not been working as a registered nurse since my registration lapsed. You were accepted onto the register on 28 October 2015. You called the Screening Team on 4 January 2016 stating that you had not practised whilst your registration had lapsed and that you could provide evidence to that effect. You then called the Screening Team on 6 January 2016 stating that you may have worked on six occasions whilst your registration had lapsed. Page 3 of 9
The Screening Team contacted BUA who stated that you had been employed with them since May 2004 as a practice manager on a job share basis and nurse when required. BUA explained that the practice manager role does not require an NMC PIN and that you did not practise regularly as a nurse but provided nursing when their regular nurse was unavailable. The Investigations Team has made further enquiries into the fact that you may have worked as a nurse whilst your registration had lapsed. As a result of those enquiries, it has been confirmed by email that you did not in fact work as a registered nurse, but as a healthcare assistant. You responded to the allegations by email on 4 January 2016 stating that your role at BUA did not require you to be registered as a nurse and that you occasionally assisted at the patient bedside during procedures when the healthcare assistant was not available. In a further response to the NMC, you stated that you worked six shifts between February 2015 and May 2015 as a registered nurse, whilst your registration had lapsed, at Clifton College in the capacity of a School Nurse. Clifton College confirmed that when you became aware that your registration had lapsed, you resigned from your post with immediate effect. However, enquiries made by the Investigations Team suggest that since lapsing on 28 February 2014, you worked on numerous occasions as a registered nurse at Clifton College. Admissions At the outset of the hearing you accepted that the entry on the register was incorrectly made based on the inaccurate information you had provided. You denied that the entry was fraudulently procured. Application under Rule 19 Ms Pitters made an application on your behalf to hear part of the hearing in private under Rule 19 (3) in relation to matters relating to health. Page 4 of 9
The panel heard and accepted the advice of the legal assessor. The panel was satisfied that there was good reason to hear this part of the evidence in private, and accordingly allowed your application. Outcome and reasons The panel heard submissions from Mr Loran on behalf of the NMC, and those made by Ms Pitters on your behalf. The panel also heard live oral evidence from you whilst under oath. The panel accepted the advice of the legal assessor who referred the panel to Article 22 (1) (b) of the Nursing and Midwifery Order 2001 ( the Order ) which provides for the allegations that a nurse s or midwife s entry on the register has been fraudulently procured or incorrectly made. The panel determined that your entry on the NMC s register had been incorrectly made. You gave evidence that you accepted that both applications were made by you and that you intended to give full and accurate information as you understood it at that time. You explained that a number of very difficult circumstances existed at the time of both applications. [PRIVATE] You gave evidence explaining how your thought processes had become focused on your primary work which was as a practice manager at BUA which did not require registration as a registered nurse. Page 5 of 9
Mr Loran submitted that both of your applications seemed fluent and comprehensive, and showed evidence of being well-thought through. For that reason, Mr Loran urged the panel to infer that fraud was evident. In the panel s view, both of the applications made, dated 1 December 2015 and 5 October 2015, were in close proximity in time but are plainly inconsistent. Neither makes reference to your secondary occupation as a school nurse at Clifton College Bristol, which requires registration with the NMC. The reference which you submitted in your first application did not meet the Registrar s requirements. The panel was prepared to accept this as evidence of confusion rather than purposely misleading the Registrar. The panel was satisfied that there is as much evidence of confusion as there is of the clearly directed intention to mislead the Registrar. On that basis, looking at the evidence on the whole, the panel was unable to say that on the balance of probabilities, this was a fraudulent application by you. [PRIVATE] Accordingly, the panel found the allegations proved in the second alternative. The panel then decided what direction, if any, to make under Article 26(7) of the Order. Article 26(7) of the Order states:..if the Investigating Committee is satisfied that an entry in the register has been fraudulently procured or incorrectly made, it may make an order that the Registrar remove or amend the entry and shall notify the person concerned of his right of appeal under article 38. Mr Loran submitted that following the panel s findings, the panel had the power to take no action, order the Registrar to amend the entry or remove the entry from the Register. He referred the panel to the NMC s Incorrect and Fraudulent Entry Guidance (The Guidance) in particular paragraph 29 and 30: Page 6 of 9
The appropriate outcome will depend on the circumstances of the case. However, in general, where the IC has found an allegation of fraudulent or incorrect entry proved, the suitable response in both cases will normally be for the entry to be removed and, if the nurse or midwife wishes to return to the register, a new application to be made to the Registrar. This is because the IC is not deciding whether or not the individual now meets the relevant entry requirements and therefore can be allowed to remain on the register. Instead, the IC s role is to assess whether there is reason to question the validity of the original registration or renewal decision. It is for the Registrar to decide whether an individual should be allowed to practise as a nurse or midwife. Mr Loran also referred the panel to paragraphs 29-36 of the Guidance. Mr Loran submitted that in light of the panel s findings, the panel should direct the removal of your entry from the Register. He reminded the panel that you could subsequently apply to the NMC to be re-admitted onto the register. Ms Pitters invited the panel to take no action. She referred to the many supportive testimonials already introduced into evidence and that you had practised without incident during the period of non-registration and since 28 October 2015. She submitted that the Registrar would have little difficulty in finding that you would be a suitable person for readmission, and that you meet all of the criteria. On that basis, it would be disproportionate and unnecessary to order that you be removed from the Register, requiring you to reapply. Further, she submitted that you are currently practising without restriction and given that you are an experienced and good nurse, it would not be in the public interest to remove you from the Register. The panel accepted the advice of the legal assessor. The panel bore in mind that you have been a registered nurse for some time and that there is nothing before it to suggest that there ever have been concerns raised with Page 7 of 9
your clinical practice. However, that was not the focus of this decision making process which is centred on the public interest in the integrity of the Register. The panel considered that having found that your entry on the NMC register was incorrectly made, it would be inappropriate to take no action. This could not be described as a trivial error such as a mis-dating of an entry or accidental slip. The integrity of a register is an imperative and is in the public interest, which has been emphasised by the introduction of the revalidation procedure. The panel was of the view that notwithstanding your confusion and errors on both application forms, your entry on the register was incorrectly made, and that therefore it was necessary to take action. The information which the Registrar did not have was substantial and material to your readmission to the Register. The panel bore in mind that the Registrar had not been given the correct information in order to scrutinise the application and reach an informed decision as to whether you are a fit and proper person to remain on the NMC s register. The panel concluded that the only appropriate course is to direct that your entry be removed from the register. This will allow any renewed application for re-entry in the register to be properly considered by the Registrar in the light of a correctly completed application form containing all the relevant information. The panel therefore directs that the Registrar removes your entry from the register. You will be notified of the panel s decision in writing. You have the right to appeal the decision under Article 38 of the Order. This order cannot take effect until the end of the appeal period (28 days from the date of the notice of the decision) or if an appeal is made, before the appeal has been concluded. Determination on Interim Order: Pursuant to Article 26 (10) of the Nursing and Midwifery Order 2001, the panel s decision to remove your name from the register will not come into effect until 28 days Page 8 of 9
after you have been notified of it in writing, in acknowledgement of your right of appeal. Article 31 of the Nursing and Midwifery Order 2001 outlines the criteria for the imposition of an interim order. The panel may only make an interim order if it is satisfied that it is necessary for the protection of the public, or is otherwise in the public interest or in your own interests. Mr Loran, on behalf of the NMC, made an application for an interim suspension order of 18 months to cover the period of any appeal. He submitted that the strong public interest in maintaining the integrity of the Register made an order necessary only on public interest grounds. Ms Pitters, on your behalf, opposed the application reminding the panel that no interim order had been imposed to date, and there was a high bar to reach for an interim order to be imposed on public interest grounds. The panel accepted the advice of the legal assessor. The panel went on to consider whether an interim order was in the public interest. The panel was mindful that the threshold for making an interim order solely on the grounds of the public interest is high. It determined that in the particular circumstances of this case, that high threshold had not been met. The panel therefore concluded that an interim order is not necessary or proportionate in this case. That concluded this determination. This decision will be confirmed to you in writing. Page 9 of 9