PUBLIC RECORD. Record of Determinations Medical Practitioners Tribunal

Transcription

1 PUBLIC RECORD Date: 30/01/2018 Medical Practitioner s name: Dr Jessica STROUDLEY GMC reference number: Primary medical qualification: Type of case Review - Misconduct Summary of outcome Suspension revoked MB BCh 1982 University of Wales Outcome on impairment Not Impaired Tribunal: Legally Qualified Chair Lay Tribunal Member: Medical Tribunal Member: Miss Nicola Murphy Ms Jacqueline Telfer Dr Shehleen Khan Tribunal Clerk: Mrs Sam Montgomery Attendance and Representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Mr Alan Jenkins, Counsel, instructed by RadcliffesLeBrasseur Mr Thomas Coke-Smyth, Counsel Attendance of Press / Public The hearing was all heard in public. 1

2 Determination on Impairment - 30/01/2018 Dr Stroudley: Background 1. Your case was first considered by a Fitness to Practise Tribunal in July 2017 (the 2017 Tribunal). 2. This Tribunal has noted the background of your case. You were working as a Consultant Radiologist at Ealing Hospital NHS Trust (the Trust). You admitted and the 2017 Tribunal found that between 22 May 2012 and 28 May 2013 you undertook paid work for another employer during periods of sick leave (on one occasion), study leave (on five occasions) and when otherwise contracted to work for the Trust. Further, that you failed to inform the Trust of this work. You admitted and the 2017 Tribunal found some aspects of your conduct misleading and dishonest. 3. The 2017 Tribunal had regard to Good Medical Practice ( GMP ) (2013), paragraph 77: 77 You must be honest in financial and commercial dealings with patients, employers, insurers and other organisations or individuals. It also had regard to GMP (2006), paragraph 73: 73 You must be honest in financial and commercial dealings with employers, insurers and other organisations or individuals 4. The 2017 Tribunal determined that, taken together, the single instance of working whilst on sick leave in 2013 and the five instances of working whilst on study leave between 2012 and 2013 were sufficiently serious a departure from GMP as to amount to misconduct. The tribunal also determined that any one of these instances alone was sufficiently serious a breach of GMP so as to meet the threshold of misconduct, particularly as you had previously received formal advice and guidance from your employer regarding the need to comply with its absence policies. It also considered that fellow practitioners would regard your conduct as deplorable. The 2017 Tribunal was of the opinion that you were aware of what was expected, but nevertheless infringed the policy in a wilful manner. In summary, the 2017 Tribunal determined that the facts found proved amounted to misconduct, both individually and collectively. 5. The 2017 Tribunal considered that you had insight into your conduct. It acknowledged that you had made unqualified admissions to the allegation and had apologised for your conduct. However the 2017 Tribunal was concerned that, whilst you had referred to personal and professional difficulties at the material time, you 2

3 did not suggest that these issues led to your behaviour and you provided no explanation as to why you behaved as you did. Further, it had not received any evidence that your contrition had extended to repaying the Trust for the salary received when you were working elsewhere. 6. The 2017 Tribunal determined that your attempts to remedy your misconduct had been limited and, as such, was not able to safely conclude that your misconduct was highly unlikely to be repeated. Whilst it regarded the risk of you repeating your misconduct as low, it found your fitness to practise impaired on the grounds that your misconduct had not been sufficiently remedied. It also determined that public confidence in the medical profession and the need to uphold proper standards for that profession would be adversely affected if a finding of impairment were not made. 7. The 2017 Tribunal determined to suspend your registration for a period of six months which it considered would sufficiently mark your dishonest conduct; afford you the opportunity to develop the insight found to be lacking and to make reparation for your misconduct. It also directed that a review should take place. 8. You were advised that the review Tribunal would be assisted by receiving the following: Evidence that you have kept your medical skills and knowledge up-todate; Evidence you attempted to reimburse the Trust with the defrauded money; Evidence of reflection to adequately explain why you behaved in the way you did; Where you have identified stressors that may have contributed to your dishonest conduct, evidence that you have taken steps to deal with such stressors in the future. For example, if you identify that workplace interpersonal conflicts were a significant factor, evidence that you have undertaken training in methods to resolve conflicts; Any other information which might assist the tribunal reviewing your case. Today s Review Hearing 9. This Tribunal has today reviewed your case and has considered, in accordance with Rule 22(f) of the Rules, whether your fitness to practise is impaired. Evidence 10. The Tribunal had regard to the bundle of documents you provided, which included, but was not limited to: 3

4 A reflective statement (undated) prepared in December 2017; A further reflective statement (undated) prepared in January 2018; Evidence of ongoing continuing professional development (CPD) and reflective notes; Evidence of attendance at Multi-Disciplinary Clinical Meetings at Charing Cross Hospital, on a wide range of Radiological areas; Appraisal document, dated 6 October 2017 Correspondence with the Trust in relation to repayment of defrauded money. 11. In your reflective statement, prepared in December 2017, you stated that you now realise that working on study days and sick days was dishonest and wrong and not befitting conduct for a medical practitioner. You stated that you would never behave like that again and are ashamed of your previous misconduct. You referred to financial difficulties you were experiencing at the time but acknowledged that this was no excuse for your actions. You also referred to conflict between staff members within the department you were working in and issues raised with you by your clinical director. You accept that you should have made efforts to engage and interact with the clinical director to try and find a resolution through dialogue. You referred to your attendance at a week-long intensive course in Medical Ethics; a workshop entitled Building resilience and Avoiding Burnout ; and courses and Multi- Disciplinary Clinical Meetings in radiology. You provided your reflections on the courses attended and certificates of attendance at courses and confirmation of bookings for future MPS Workshops entitled Mastering Professional Interactions and Achieving Safer and More Reliable Practise. You also stated that since your retirement in 2013 you have worked in Teleradiology. 12. In a further reflective statement (undated) you explained in detail your personal and professional circumstances at the time of your misconduct and reiterated the financial difficulties in which you found yourself. You also explained your current personal circumstances. You provided further certificates of attendance on courses and your reflections on those courses. 13. The Tribunal noted the from Professor A confirming that you had attended multiple Multi-Disciplinary Clinical Meetings on a wide range of Radiology at Charing Cross Hospital. In his opinion your medical skills and knowledge are very up to date. 14. The Tribunal had regard to the appraisal document provided, dated 6 October It noted the comments made by Mr B, your appraiser: Jessica spoke openly and honestly about her difficulties with the GMC. She expressed remorse about the incident and had been following the recommendations of the GMC meticulously Whilst under suspension she had 4

5 attended a number of courses and CPD events to maintain her radiology skills 15. You also provided correspondence with the Trust, including a letter of 16 January 2018 confirming you had repaid monies owed to the amount of 833. Submissions 16. The Tribunal has considered the submissions made by Mr Coke-Smyth, Counsel, on behalf of the GMC and those made by Mr Jenkins, Counsel, on your behalf. 17. Mr Coke-Smyth submitted that he has no positive submission, either way, in relation to impairment and it is a matter for the Tribunal to determine. He submitted that the Tribunal may take the view that the six month suspension has served the public interest and the Tribunal may wish to focus on whether there is a likelihood of repetition of the misconduct. He submitted that you have complied with what was suggested by the previous Tribunal and it is a matter for this Tribunal as to whether it is satisfied on the evidence provided that you have remediated your misconduct. 18. Mr Jenkins submitted that you have met all the requirements of the previous Tribunal. He submitted that there is very little risk of repetition as the financial burdens placed upon you have reduced. He informed the Tribunal that you no longer work for the NHS and now work from home. He submitted that the misconduct occurred five to six years ago and there has been no repetition. You have learnt a salutary lesson and this supports a reduction in a repetition of risk. 19. Mr Jenkins submitted that in all the circumstances the risk of repetition has been addressed. He also submitted that you have kept you skills and knowledge up to date; you have reflected on your past misconduct; explained your past behaviour and now repaid the Trust. He submitted that, in all the circumstances, the Tribunal should find that your fitness to practise is no longer impaired. In addition, public confidence in the profession has now been upheld by the imposition of a period of suspension. The Tribunal s Approach 20. Whilst the Tribunal has borne in mind the submissions made, the matter of impairment is one for it to determine, exercising its own judgement. 21. The Tribunal is aware of its overarching objective which is to protect, promote and maintain the health, safety and well-being of the public, to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional standards and conduct for the medical profession. 5

6 22. In determining whether a finding of current impairment of fitness to practise is necessary, the tribunal took into account the issues of insight, remediation and the risk of repetition. The Tribunal is aware that the onus is on you to provide evidence to demonstrate that your fitness to practise is no longer impaired. The Tribunal s Decision 23. The 2017 Tribunal found that you had acted dishonestly by undertaking paid work for another employer during periods of sick leave and study leave when otherwise contracted to work for the Trust as a Consultant Radiologist at the Trust. 24. This Tribunal accepts the opinion expressed by the previous Tribunal that, although dishonest conduct is always a serious matter, your misconduct related to six days in a career spanning more than thirty years. No patients were directly harmed as a result of your dishonesty. That Tribunal concluded that whilst serious, your misconduct is not at the highest end of the scale. 25. The Tribunal has considered the substantial amount of written evidence which has been presented today which demonstrates the steps you have taken to explain and address your previous misconduct. In particular it has borne in mind the issue of your insight and the likelihood of repetition which was central to the concerns raised by the 2017 Tribunal. 26. The Tribunal considers that you have been very pro-active in addressing the issues raised. You have examined your previous behaviour and now fully appreciate the severity of your misconduct. You have taken steps to remedy your failings, to demonstrate your insight and to maintain and update your medical knowledge and skills. 27. The Tribunal is satisfied that you have fully addressed the previous Tribunal s concerns. It is also satisfied that it is highly improbable that there will be a repetition of your behaviour. In reaching this decision it has had regard to the evidence of a change in your financial situation; the evidence of a 31 year career in the NHS and length of time since the incident with no repetition of such behaviour. It also noted that you now practice from home and no longer work within your previous environment which you found stressful. 28. The Tribunal is impressed by the extensive targeted CPD undertaken in relation to training in methods to deal with stressors and resolve conflicts, and in your specialty of Radiology. It also noted that you have attended multiple Multi- Disciplinary Clinical Meetings and acknowledges that this would have involved explaining the fact of your current suspension. 29. In addition, you have made substantial efforts to correspond with the Trust and to reimburse the defrauded money. 6

7 30. In all the circumstances the Tribunal has determined that your fitness to practise is no longer impaired by reason of your misconduct. 31. The Tribunal notes that suspension for a period of six months was imposed to mark the seriousness of your misconduct and to afford you the opportunity to remedy and make reparation for your misconduct. The evidence provided supports that you have done all that has been asked of you, and more, during the period of suspension. You have been pro-active and undertaken targeted CPD to address your misconduct. In all the circumstances, the Tribunal considers that it is appropriate to revoke the suspension imposed on your registration with immediate effect. The Tribunal considers that the public interest in the profession has now been served by the imposition of a period of suspension. 32. That concludes this hearing. Confirmed Date 30 January 2018 Miss Nicola Murphy, Chair 7