[2014] EWHC 1151 (Admin); Supperstone JThis case is a useful reminder of the importance for health professionals of recording safeguarding concerns and how a failure to do so may amount to
[2014] EWHC 1151 (Admin); Supperstone J
This case is a useful reminder of the importance for health professionals of recording safeguarding concerns and how a failure to do so may amount to misconduct.
O was a registered nurse and health visitor. While the responsible health visitor for child A, she failed to record several observations, including that A's mother had threatened to remove A from the country as she was "fed up with the social care system." O explained that she did not record the comments as (1) she did not believe A's mother would take A out of the country and (2) she herself "knew how it felt to be victimised by Social Services".
The Panel found that O's fitness to practise was impaired by reason of misconduct as she had placed child A at risk of harm and had failed to safeguard her interests. The Panel stated that the public would expect a nurse of O's experience to record all interactions and observations with an at-risk child. The Panel considered that a 30 month caution order was appropriate.
The High Court held that the Panel correctly applied a two-stage test of first considering whether the facts amounted to misconduct and, if so, whether O's fitness to practise was impaired. The Panel had also correctly applied the Shipman Report guidance in considering whether O had put a patient at unwarranted risk of harm and/or brought the nursing profession into disrepute.
The Court then held that the Panel had been entitled to conclude that the misconduct was of a particularly serious nature and that public confidence would be undermined if impairment was not found, despite describing it as not "at the higher end of the spectrum of seriousness" at the interim order stage. The court clarified that the test for the making of an interim order and the test for assessing the issue of current impairment are not the same. As to the former, in the present case the issue was whether there was an immediate risk to the public interest if the registrant was allowed to practise at all. When deciding the substantive issue of whether the registrant's fitness to practise was currently impaired, the court held that the issue was whether the misconduct had in the past brought the nursing profession into disrepute or was liable to do so in the future.
It is interesting to compare this case to that of Spencer v General Osteopathic Council [2012] EWHC 3147 (Admin), where the High Court held that a failure to make adequate notes of an otherwise properly conducted consultation did not amount to unacceptable professional conduct. While the specific actions of Spencer and O were similar in not adequately recording their contact with a patient, it was the safeguarding concerns in O's case that led the Panel and the Court to find that public confidence would be undermined if her fitness to practise was not found to be impaired. Lawyers and professionals should therefore bear in mind the importance of context in cases where record-keeping is an issue.
This case is a useful reminder of the importance for health professionals of recording safeguarding concerns and how a failure to do so may amount to misconduct.
O was a registered nurse and health visitor. While the responsible health visitor for child A, she failed to record several observations, including that A's mother had threatened to remove A from the country as she was "fed up with the social care system." O explained that she did not record the comments as (1) she did not believe A's mother would take A out of the country and (2) she herself "knew how it felt to be victimised by Social Services".
The Panel found that O's fitness to practise was impaired by reason of misconduct as she had placed child A at risk of harm and had failed to safeguard her interests. The Panel stated that the public would expect a nurse of O's experience to record all interactions and observations with an at-risk child. The Panel considered that a 30 month caution order was appropriate.
The High Court held that the Panel correctly applied a two-stage test of first considering whether the facts amounted to misconduct and, if so, whether O's fitness to practise was impaired. The Panel had also correctly applied the Shipman Report guidance in considering whether O had put a patient at unwarranted risk of harm and/or brought the nursing profession into disrepute.
The Court then held that the Panel had been entitled to conclude that the misconduct was of a particularly serious nature and that public confidence would be undermined if impairment was not found, despite describing it as not "at the higher end of the spectrum of seriousness" at the interim order stage. The court clarified that the test for the making of an interim order and the test for assessing the issue of current impairment are not the same. As to the former, in the present case the issue was whether there was an immediate risk to the public interest if the registrant was allowed to practise at all. When deciding the substantive issue of whether the registrant's fitness to practise was currently impaired, the court held that the issue was whether the misconduct had in the past brought the nursing profession into disrepute or was liable to do so in the future.
It is interesting to compare this case to that of Spencer v General Osteopathic Council [2012] EWHC 3147 (Admin), where the High Court held that a failure to make adequate notes of an otherwise properly conducted consultation did not amount to unacceptable professional conduct. While the specific actions of Spencer and O were similar in not adequately recording their contact with a patient, it was the safeguarding concerns in O's case that led the Panel and the Court to find that public confidence would be undermined if her fitness to practise was not found to be impaired. Lawyers and professionals should therefore bear in mind the importance of context in cases where record-keeping is an issue.