PUBLIC RECORD. Record of Determinations Medical Practitioners Tribunal. Date: 05/09/2017. Medical practitioner s name: Dr Pawel MIKLASZEWICZ

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1 PUBLIC RECORD Date: 05/09/2017 Medical practitioner s name: Dr Pawel MIKLASZEWICZ GMC reference number: Primary medical qualification: Type of case Review - Non-compliance with a performance assessment Summary of outcome Conditions for 12 months Review hearing directed Tribunal: Legally Qualified Chair Lay Tribunal Member: Medical Tribunal Member: Lekarz 1992 Akademia Medyczna w Krakowie Outcome on non-compliance Non-compliance not found Mr Dharmesh Patel Mrs Angela Buckley Miss Ayanthi Gunasekera Legal Assessor: Tribunal Clerk: NA Mrs Sam Montgomery Attendance and representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Mr Terry Falcão of Stephens Scown LLP Ms Emma Gilsenan, Counsel Attendance of press / public 1

2 The tribunal agreed, in accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004, that the press and public be excluded from those parts of the hearing where matters under consideration were deemed confidential. Determination on consideration of non-compliance 05/09/2017 Dr Miklaszewicz: 1. During proceedings the tribunal determined, under Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004 (the Rules), that the press and public be excluded from those parts of the hearing where the Tribunal considered. However as this hearing also relates to non-compliance a public determination will be provided. 2. This is a review of your case following a (MPT) hearing which concluded in November 2016 (the 2016 Tribunal). Background 3. The Tribunal has had regard to the background of the case. You were referred to the GMC by Dr A, Co-Medical & Operations Director of Devon Partnership NHS Trust and your educational supervisor at the time, by of 5 October Dr A reported that, apart from a brief period of time in 2014, you had not been allowed to work with any patients unsupervised since October 2013 and had been undergoing remedial training. Dr A was of the view that, despite a huge amount of support from Devon Partnership Trust this doctor when well or unwell is not safe to practise and would put patients at risk if he was not constantly supervised. 4. The GMC received further information from Devon Partnership NHS Trust, in October 2014, which raised issues about your clinical performance including concerns about: a. repeated clinical mistakes; b. poor prescribing; c. poor performance in record keeping or other administrative tasks essential to patient safety; d. lack of familiarity with basic clinical/administrative procedures and guidelines; e. failure to work effectively and/or collaboratively with colleagues. 5. On 16 September 2015, the GMC sent you a letter notifying you that the Assistant Registrar had decided that you should be directed under Rule 7(3) and Schedule 1 of the Fitness to Practise Rules 2004 to undergo an assessment of your performance ( PA ). The GMC requested your completed PA portfolio by 14 October

3 6. The GMC sent you further letters by post and/or and your responses, as follows: 21 October 2015 requesting your completed PA portfolio by no later than 28 October 2015, 30 October 2015 to notify you that a failure to agree to undergo a PA could result in a referral to the Service, On 1 December querying whether you were yet able to engage with the PA direction and requesting your PA portfolio by 8 December January 2016 to notify you that the Assistant Registrar had reviewed this matter and had decided that you should be further directed to undergo a PA. The GMC requested your completed PA portfolio by 24 February March requesting your completed PA portfolio by no later than 15 March The letter also notified you that if you failed to complete the PA without good reason, the Registrar may refer the matter to the Medical Practitioners Tribunal Service for a non-compliance hearing. 15 March you telephoned the GMC to request an extension for your PA portfolio which was granted until 18 March March 2016 you provided your partially complete PA portfolio and advised the GMC that you accepted the PA direction. 22 March requesting further information in the PA portfolio by no later than 29 March The notified you that a failure to do so may result in the GMC implementing its non-compliance procedures. 11 April you telephoned the GMC who advised you that you needed to provide your completed PA portfolio by 15 April 2016 to avoid the possibility of referral to a non-compliance tribunal of the Service. 12 April 2016 further telephone call to the GMC when you advised that you would attempt to complete your PA portfolio by 15 April You did not provide a completed PA portfolio. 10 August notifying you that the Assistant Registrar had decided to refer your failure to undergo the PA to a non-compliance tribunal of the Service. 3

4 7. The 2016 Tribunal had regard of the large volume of documentation, from several sources, which set out wide-ranging concerns regarding your general clinical performance. It took into account that you contested some of the information that was before it regarding your performance. It also noted that a PA would involve an independent assessment of your clinical skills and knowledge, and would establish whether or not there were concerns with your current clinical practice. 8. In all the circumstances, the 2016 Tribunal determined that the GMC s direction to undergo a PA was reasonable. It also considered that you had failed to comply with the GMC s direction, given that you had not undergone a PA and you, yourself, had acknowledged a failure to comply with the GMC s direction. Further, that Tribunal was not satisfied that your failure to comply was unavoidable or otherwise excusable. It concluded that the GMC had explained clearly the need for you to comply with its direction and the possible consequences of any failure to comply. You were also provided with time extensions to permit you to provide your portfolio on several occasions, but did not provide the information requested. Whilst the 2016 Tribunal accepted that you may have been confused about the GMC investigation process and the PA requirements, it was satisfied that you were not only aware of the need to comply but were also aware of the consequences of any failure to do so. In the circumstances, it found that there had been non-compliance. 9. The 2016 Tribunal determined to impose conditions on your registration for a period of 12 months. It considered that you required this period in order to allow you to comply with the direction for a PA. Furthermore, it considered that the conditions imposed were sufficient to address patient safety and the public interest, in particular by the imposition of a condition that required you to be closely supervised. 10. The 2016 Tribunal indicated in its determination that a review tribunal would be assisted by receiving: a report from you clinical supervisor(s); evidence that you have kept your medical skills and knowledge to date; testimonials from those for whom you have worked. Review Tribunal 11. This Tribunal has met to review your case. It has considered, under Rule 22A of the Rules, whether there has been a failure to comply with an assessment under Schedule 1 of the Rules. 12. In reaching its decision, the tribunal has given careful consideration to all of the oral and documentary evidence adduced in this case. 4

5 13. The 2016 Tribunal found that the GMC s direction, that you undergo a PA, was reasonable given the information received, from several sources, which set out wide-ranging concerns regarding your general clinical performance. This Tribunal remains of that view. It notes that, since that hearing, you have undertaken the PA, which was conducted in April The Tribunal has been provided with the PA report, dated 24 May Your performance was assessed under eight categories and with reference to the professional standards described in the GMC publication Good Medical Practice. Your performance was found to be unacceptable in the following categories: Assessment; Relationships with Patients. 15. Your performance was found to be a cause for concern in the following categories: Maintaining Professional Performance; Relationships with patients. 16. Your performance was found to be acceptable in the following category: Clinical Management. 17. No judgements were made in the categories of Operative/Technical Issues, Record Keeping & Safety and Quality. 18. The Performance Assessment Team concluded that your professional performance had been deficient and that you were fit to practise on a limited basis. 19. The Tribunal has also taken into account the documents you have provided: Submissions a transcript of the third party interview with Dr A (undated), undertaken by the Performance Assessment Team, a document entitled Public sector: quick start guide to the public sector Equality Duty, a letter addressed to you, from the Trust, dated 3 March 2017, raising concerns about your probity, an confirming an interview for a clinical post on 13 September The Tribunal has considered the submissions made by Ms Gilsenan, on behalf of the GMC and those made by Mr Falcão, on your behalf. 5

6 21. Ms Gilsenan submitted that condition one of the non-compliance conditions has been complied with as you underwent a PA in April She submitted that the non-compliance order should be revoked. 22. Mr Falcão agreed with the GMC s submission. Tribunal s decision 23. Whilst the tribunal has borne in mind the submissions made, the decision regarding non-compliance is one for it to reach, exercising its own judgement. 24. On the basis of the PA report provided the Tribunal has determined that you have complied with the GMC s direction, under Rule 7(3) and Schedule 1 of the Fitness to Practise Rules 2004, to undergo an assessment of your PA. 25. In the circumstances the tribunal has determined that non-compliance has not been found. 26. The conditions currently imposed on your registration are hereby revoked. Confirmed Date 05 September 2017 Mr Dharmesh Patel, Chair 6