View
212
Download
0
Category
Preview:
Citation preview
Page 1 of 24
Conduct & Competence CommitteeSubstantive Meeting
Date: 17 – 18 January 2013
Held at
Temple Court, 13a Cathedral Road, Cardiff, CF11 9HA
And
23 May 2013
At23 Portland Place London, W1B 1PZ
Registrant: Lynn Pollard
NMC PIN: 92I2318E
Part(s) of the register: Adult Nursing 1995
Type of Case: Misconduct
Area of Registered Address: England
Panel Members: Stephen Redmond (Chair/ Lay Member)Helen Bishop (Registrant Member)Jeanette Whitford (Lay Member)
Legal Assessor: Nicholas Leviseur (January 2013)David Richards (23 May 2013)
Panel Secretary: Alexandra Scott
Facts found not proved: 1 and 4(d)
Facts found proved: 2(a), 2(b), 3, 4(a), 4(b) and 4(c)
Fitness to practise: Impaired
Sanction: Striking Off Order
Interim order directed: Interim Suspension Order for aperiod of 18 months
Page 2 of 24
Proof of Service:
Notice of this meeting was sent to Ms Pollard’s registered address by the Nursing and
Midwifery Council (NMC) on 13 December 2012. The Notice was sent by recorded
delivery and by first class post to Ms Pollard’s registered address. The Notice made
clear that the case would be considered at a meeting, which would be held in private,
shortly after 10 January 2013. The Notice set out the allegations made against Ms
Pollard, invited her to make a response, detailed the documents which the panel would
consider and also made clear the panel’s powers in disposing of the case.
The panel took account of the copies of an extract from the NMC's recorded delivery
post book and Royal Mail Track and Trace documentation as evidence of service.
In the light of all the information available, the panel has determined that Notice of this
meeting has been served in accordance with the requirements of Rules 11A and 34 of
the Nursing and Midwifery Council Fitness to Practise Rules (2004), as amended.
Charges:
That whilst working as a registered nurse in the Endoscopy Department at SalisburyNHS Trust (“the Trust”):
1. On or around 30 th July 2009, you failed to provide an acceptable standard ofcare to patient A, who was on a sliding scale test for blood glucose and had aninsulin pump, in that you failed to monitor patient A’s blood sugar level and / orleft the insulin pump clamped off
2. You did not supervise students to an acceptable standard on one / more of thefollowing occasions:
a. On or around 2nd- 3rd July 2009 you allowed Student Nurse Phillip Scaifeto draw up a controlled drug, unsupervised
b. On or around 18th July 2009 you gave a Student Nurse, Naomi Wallace,an inappropriate level of responsibility by designating her as the first nurseand allowing her to carry out biopsies
Page 3 of 24
3. You were rude and / or behaved unprofessionally towards patients’ relatives, forexample, on an unknown date, in response to a question from a patient’s sonabout how long his father would be in theatre, you responded with words to theeffect of “I don’t know, you tell me” and / or made a “V” sign directed at thepatient’s son when his back was turned and / or did so within view of the patient
4. You were rude to / about colleagues, for example:
a. On a number of unknown dates in 2009 you ignored or interrupted staffthat were attempting to handover to you and / or refused to handoverinformation to some members of staff
b. On or around 2nd July 2009 you said words to the effect of “I hope itsterminal” in front of colleagues after being told that Staff Nurse Taylor wason sick leave
c. On a number of dates in 2009 you swore whilst on duty
d. On a date in 2009 when asked by Staff Nurse, Helen Hambling to plug ina pump that was alarming you threw the lead at her
And in relation to the above, your fitness to practise is impaired by reason of yourmisconduct.
Amendment to Charge 4(b)
In respect of this Charge 4(b), the panel sought legal clarification on 23 May 2013 when
reviewing the case. The panel had concerns that the evidence before the panel did not
reflect the date specified in the Charge.
The legal assessor, Mr Richards advised that generally the date alleged in a charge is
not material. He advised that if the date is such that it would mislead a registrant then it
is important as the charge may become unclear. He advised to first ask itself given the
evidence in the bundle, does the date 2 July 2009 mislead the registrant as to the
allegation being made. If the panel found that it does not, then the panel can disregard
the date.
Page 4 of 24
He also advised the panel on the test for amending the charge. He referred the panel to
Rule 28, He advised the panel to ask itself whether any prejudice may be caused to Ms
Pollard if the charge were to be amended.
The panel gave consideration to amending Charge 4(b) that currently reads:
b. On or around 2nd July 2009 you said words to the effect of “I hope its terminal”
in front of colleagues after being told that Staff Nurse Taylor was on sick
leave
To read
b. On or around 15 June 2009 you said words to the effect of “I hope its
terminal” in front of colleagues after being told that Staff Nurse Taylor was on
sick leave
The panel reminded itself that Ms Pollard is not present at the proceedings and would
not have the opportunity to comment on the amendment. However the panel does not
consider that the proposed amendment would cause Ms Pollard any prejudice, rather
would serve to clarify the charge and reflect the evidence. The panel therefore decided
to amend Charge 4(b) accordingly.
Determination on the findings of fact:
The allegations in this case surround Ms Pollard’s employment as a Registered Nurse
in the Endoscopy Department at Salisbury NHS Trust (the Trust).
Initial complaints were made concerning Ms Pollard’s conduct at work in 2006 she
received a formal warning under the Trust’s bullying and harassment policy. Ms 1,
Senior Nurse for Endoscopy and Radiology at the Trust, commencing her employment
following this. In response to these complaints a decision was made in 2007, for Ms
Pollard to be taken through the informal stage of the capability proceedings. In July
2008 the decision was made that the formal stage of the capability procedure would be
Page 5 of 24
initiated as there had not been sufficient improvement in Ms Pollard’s behaviour or
attitude and because a number of staff had made complaints.
On 9 July 2009 Ms 1 received a complaint from Ms 2, Staff nurse, concerning an
incidents on 2 and 3 July 2009. It was alleged that when Ms Pollard heard that Mr 3,
Staff Nurse, was off sick, she commented words to the effect of “I hope its terminal”.
Ms 1 received another complaint regarding 3 July 2009, where it was alleged that Ms
Pollard left an unsupervised student nurse to draw up drugs including Buscopan.
On 30 July 2009, Ms 1 was notified by Ms 4, Staff Nurse of a clinical incident involving
Ms Pollard. Ms 4 alleged that on 30 July 2009, when she returned from lunch at
12.30pm, she found that Ms Pollard had not checked the blood sugar for Patient A since
10am. Ms 4 also alleged that the pump was clamped off and was alarming.
It is also alleged that on or around 18 July 2009 Ms Pollard gave a student nurse, Ms 5,
an inappropriate level of responsibility by designating her as the first nurse and allowing
her to carry out biopsies.
Further it is alleged that in 2009, whilst Ms Pollard was working with Ms 6, Staff Nurse,
asked Ms Pollard to go and look at and plug in a machine that was alarming into the
mains. It is alleged that Ms Pollard did not do this and threw the lead at Ms 5, for her to
plug the machine in.
During 2009 there were also allegations that Ms Pollard swore whilst on duty, and
ignored and or interrupted staff during handover, or refused to hand over information.
There are further allegations that Ms Pollard was rude and unprofessional towards
patients’ relatives.
Mr 3 made a complaint to which was brought the attention of Mr 7, Directorate Senior
Nurse for Ambulatory Care, regarding Ms Pollard’s conduct towards him. As a result Mr
7, decided to start disciplinary procedures, and the capability procedure was
suspended. During this time Ms Pollards was redeployed to Day Surgery.
Page 6 of 24
Ms 8, was asked by the Trust to undertake the disciplinary investigation and Mr 7
assisted her. During the investigation Ms 8 had meetings with Ms Pollard. Ms Pollard
was on long term sick leave for much of the period during the investigatory procedure.
She contacted Mr 7 in December 2009 to advise that she was fit to return to work.
A disciplinary hearing was held on 9 March 2010 and Ms Pollard was dismissed on 10
March 2010.
Findings of Fact
The panel reminded itself that the burden of proof rests with the Nursing and Midwifery
Council (NMC) and that it should consider whether, on the balance of probabilities, the
facts alleged were more likely than not to have occurred.
The panel accepted the advice of the legal assessor.
The panel considered the witness statements of:
Ms 1, Senior Nurse for Endoscopy and Radiology at the Trust,
Ms 10, Consultant Radiographer at the Trust,
Ms 11, Nurse Endoscopy Practitioner at the Trust,
Ms 12, Staff Nurse at the Trust,
Dr 13, Specialist Registrar in Gastro-Enterology Department at Portsmouth
Hospital
Ms 6, Staff Nurse at the Trust
Ms 14, Registered General Nurse on the bank in the Rheumatology Department
at the Trust,
Ms 15, Lead Nurse for Bowel Cancer for the Bowel Cancer Screening
Programme at the Trust,
Ms 2, Band 5 Nurse at the Trust,
Ms 7, Directorate Senior Nurse for Ambulatory Care,
Ms 16, Radiography Helper at the Trust,
Page 7 of 24
Ms 17, Staff Nurse at the Trust,
Ms 8, Associate Directorate Senior Nurse in Medicine at the Trust,
Ms 18, Colorectal Nurse Specialist at the Trust,
Mr 3, Endoscopy Nurse at the Trust,
Ms 19, Specialist Screening Practitioner at the Trust,
Ms 9, Healthcare Support Worker at the Trust,
Ms 21, Staff Nurse at the Trust,
Ms 22, Staff Nurse at the Trust.
Ms 4, Bank Nurse in the Endoscopy Department
The panel notes that some of the evidence contained within in the witness statements
concerns other allegations. The panel heard and accepted the legal assessor’s advice.
He advised the panel to put matters not contained within the charges out of its mind.
This is an experienced panel and has put that information out of its mind.
The panel notes that Ms Pollard is unable to attend a substantive meeting and has
drawn no adverse inferences from the absence of Ms Pollard.
Charges
That whilst working as a registered nurse in the Endoscopy Department at SalisburyNHS Trust (“the Trust”):
From the evidence before the panel, it is satisfied that Ms Pollard was working as a
Registered Nurse in the Endoscopy Department at the Trust.
1. On or around 30th July 2009, you failed to provide an acceptable standard of
care to patient A, who was on a sliding scale test for blood glucose and had an
insulin pump, in that you failed to monitor patient A’s blood sugar level and / or
left the insulin pump clamped off
Not found proved
Page 8 of 24
The panel has considered the Adverse Event Report Form Sheet 1, completed by Ms 4
and dated 30 July 2009 and the witness statement of Ms 4.
The panel first considered whether Ms Pollard had a duty to provide an acceptable
standard of care to Patient A, who had a sliding scale test insulin pump prescribed.
The panel also considered whether Ms Pollard had a duty to monitor Patient A’s blood
sugar level and/or left the insulin pump clamped off.
In the Adverse Event Report Form Sheet 1, completed by Ms 4 dated 30 July 2009
states “I returned from lunch at 12:30hrs and checked the room 3 patients for ¼ hourly
observations. I noticed that Patient A had not had her blood sugar checked since her
return to the ward at 1000hours. S/N Pollard had recorded the result and had sent the
pump and documented it. At 12.30hours, I checked the blood sugar because it had not
been taken since 1000hours. I went to get another S/N to check the …with me as we
needed to change to 1.0ml and we noticed the pump was clamped off and was
alarming…”.
Further in her witness statement Ms 4 states, “I handed over a patient who had come
out of room 3 post ERCP and had advised Lynn that she needed her blood sugar
carried out. After that I was admitting and discharging patients from the other rooms as
was Ms 11. I was asked to go to lunch at 12 noon and when I returned at 12:30pm I
found that no blood sugars had been taken for this patient who was on a sliding scale
and an insulin pump. Furthermore, the insulin pump was clamped off. It is not unusual
for the pump to be switched off during the procedure, but monitoring continues
throughout”.
In light of the above, the panel has evidence that it is uncommon practice for the pump
to be clamped off.
The panel has evidence to suggest that Ms Pollard stated that she had undertaken
Patient A’s observations. The panel has no patient notes for Patient A. Without Patient
A’s notes, that panel has no evidence, outside of Ms 4’s witness statement, to enable it
to conclude that Ms Pollard did not undertake observations, care for Patient A
appropriately or that Patient A was on a sliding scale test for blood glucose.
Page 9 of 24
Further the panel has no evidence that Ms Pollard had a responsibility to monitor
Patient A’s blood sugar level and what steps Ms Pollard should have taken to provide
an acceptable standard of care to a patient on a sliding scale test for glucose.
The panel could therefore not conclude that Ms Pollard had a responsibility to provide
an acceptable standard of care to Patient A concerning Patient A’s medical condition, or
did not provide an acceptable standard of care for Patient A. Nor was the panel able to
conclude that Ms Pollard had a duty to monitor Patient A’s blood sugar level and/or left
the insulin clamped off.
As a result the panel is unable to conclude that Ms Pollard failed to provide the above
care, because there is no evidence to determine that she had a duty to. The panel has
therefore found charge 1 not proved.
2. You did not supervise students to an acceptable standard on one / more of the
following occasions:
a. On or around 2nd- 3rd July 2009 you allowed Student Nurse Phillip Scaife
to draw up a controlled drug, unsupervised
Found Proved
The panel has considered the witness statement of Ms 2 and Ms 12 and Ms 2’s
contemporaneous statement prepared for the Trust dated 3 July 2009
Ms 2 in her witness statement states that “I recall an incident on 2 July 2009 when Ms
Pollard allowed a student nurse to draw up controlled drugs without supervision.
Student nurses should not be allowed to do this, someone should be supervising them
at all times. The students name was [Mr 23]. I saw [Mr 23] in the treatment room
drawing up the controlled drugs. Ms Pollard had left him in the room doing this. When I
saw this I went in and supervised him.”
Page 10 of 24
Ms 2’s Statement for the Trust dated 3 July 2009 gives a corroborates the above
statement.
Ms 12 in her witness statement states “I also recall an incident when a student,
assigned to me, was being looked after by Ms Pollard when I was not on duty. The
student was called 23, although I cannot remember his surname”
The panel were impressed by Ms 2’s witness statements, which are supported by the
statement of Ms 12. The panel had regard to undated meeting notes from 14
September 2009 that state “Lynn said this was a third year student and Lynn had taken
responsibility for it”.
The panel accepts Ms 2 and Ms 12’s account of the incidents, and concluded that on
the balance of probabilities Ms Pollard allowed student nurse, Mr 23 to draw up a
controlled drug unsupervised. The panel therefore found Charge 2(a) proved.
b. On or around 18th July 2009 you gave a student nurse, Naomi Wallace, an
inappropriate level of responsibility by designating her as the first nurse and
allowing her to carry out biopsies
Found Proved
The panel has considered the witness statement of Ms 9’s and Ms 9’s statement
prepared for the Trust,
Ms 9 in her witness statement indicates that on 18 July 2009, Ms Pollard was the first
nurse on duty and that there was a student nurse on duty. She continues to state “The
student nurse asked me if she could act as the first nursing in the procedure. I said that
she should ask Ms Pollard. Ms Pollard said that it was fine and let her act as the first
nurse. Ms Pollard allowed the student nurse to take biopsies. She should not have
allowed her to do this”.
Page 11 of 24
In the witness statement of Ms 9 for the Trust she states “On Friday afternoon, I was
working with Lynn and her student Nurse, Ms 5, I was second nurse. I asked Naomi if
she would like to work as second nurse. No she said I’m going to ask to be first nurse.
How else will I get experience she said? Lynn came in and said it was ok, that Ms 5
could be first nurse all afternoon and even let her take biopsies”.
The panel has no response from Ms Pollard in relation to this charge.
The panel accepts Ms 9’s account of the incident, and concluded that on the balance of
probabilities Ms Pollard gave Ms 5, an inappropriate level of responsibility by
designating her as the first nurse and allowing her to carry out biopsies. The panel
therefore found Charge 2(b) proved.
3. You were rude and / or behaved unprofessionally towards patients’ relatives, for
example, on an unknown date, in response to a question from a patient’s son
about how long his father would be in theatre, you responded with words to the
effect of “I don’t know, you tell me” and / or made a “V” sign directed at the
patient’s son when his back was turned and / or did so within view of the patient
Found Proved
The panel has considered the witness statement of Ms 9, Ms 16, Ms 21 and Ms 14.
Ms 9 in her witness statement says “A relative came in and asked about a patient. In
response to the relative Ms Pollard said that they were recovering and she told the
relative ‘to go away and come back later’. The relative asked how long the patient
would be in recovery for and Ms Pollard snapped back saying that it would be around
half an hour. When the relative turned away I recall seeing Ms Pollard putting two
fingers up in a ‘V’ sign at the relative’s back. The relative would not have seen this but
the patient was sitting up on a trolley and could see it”.
In her witness statement Ms 16 states “I confirm what I have said in that statement that
the patient’s son came up and asked how long his father would be. Ms Pollard’s
Page 12 of 24
response was ‘I don’t know you tell me’. The son replied ‘I don’t know that is why I am
asking you’. As he turned around Ms Pollard did a “V” sign behind his back”.
Ms 21 in her statement for the Trust states “Lynn can be inappropriate when she talks to
patients and relatives, she can be loud and rude sometimes”.
Ms 14 in her witness statement says “I also recall that she was rude on the phone to
patients’ relatives. If the relatives rang up to ask how long a patient would be, we would
suggest that they went to have a cup of tea and come back later. Often if a relative
asked Ms Pollard how long the procedure would take she’d say “how long is a piece of
string?’ and scowl at them”
The panel has no evidence of any response from Ms Pollard in relation to this charge.
The panel accepts Ms 9, Ms 16, Ms 21 and Ms 14 account of the incidents, and
concluded that on the balance of probabilities Ms Pollard was rude and unprofessional
towards patients’ relatives. The panel therefore found Charge 3 proved.
4. You were rude to / about colleagues, for example:
a. On a number of unknown dates in 2009 you ignored or interrupted staff
that were attempting to handover to you and / or refused to handover
information to some members of staff
Found Proved
The panel has considered the witness statements of Mr 3, Ms 6, Ms 17, Ms 2 and Ms
14.
In his witness statement Mr 3 states “Ms Pollard refused to handover patients to me if
she was working in the Treatment Room and I was working in Recovery Area of the
ward. The Nurses in the Treatment Room would tell me about the observations and
how the procedure had gone because Ms Pollard would just ignore me and handover to
someone else. She would seek out other people to handover to, even if I was the
appropriate person to handover to. Sometimes she would say “coffee with two sugars”
Page 13 of 24
and that was her handover. She would just throw the charts at me and bark instructions
that would make me feel very undermined”
In her witness statement Ms 6 states, “I recall that Ms Pollard would not handover
patients to Mr 3. This was very noticeable. If Ms Pollard came out of the treatment room
with a patient and Mr 3 was working on the ward she would walk away. Mr 3 did try to
get along with her but she was constantly ignoring him or being rude. Ms Pollard would
either ignore Mr 3 or handover to other nurses even if they were busy and Mr 3 was
available”.
In her witness statement Ms 17 states “I recall incidents relating to Ms Pollard, for
example, if Mr 3, one of the other nurses, was working in the Recovery Area of the Unit,
Ms Pollard would refuse to hand over to him. She would come out of a Treatment room
and would not hand over to Mr 3, but would come and find someone else to take the
handover”.
Ms 2 in her witness statement states, “Ms Pollard nitpicked constantly regarding my
work. She would not hand over patients to me and would totally blank and ignore me if I
was the nurse available for handover”.
Ms 14 in her witness statement states “Ms Pollard also refused to handover to me.
Nurses are either working in the rooms where the procedures are done or sometimes
allocated to the recovery area in Endoscopy. If Ms Pollard was bringing a patient out of
the Procedure Room and I was the Nurse in the Recover Area she would just ignore me
and find somebody else to hand over to”.
The panel accepts Mr 3, Ms 6, Ms 17, Ms 2 and Ms 14 account of the incidents, and
concluded that on the balance of probabilities Ms Pollard on a number of occasions
ignored or interrupted staff that were attempting to hand over to her and refused to hand
over information to some members of staff. The panel therefore found Charge 4(a)
proved.
Page 14 of 24
c. On or around 2nd July 2009 you said words to the effect of “I hope its terminal”
in front of colleagues after being told that Staff Nurse Taylor was on sick
leave
Found Proved
The panel has considered the witness statement of Ms 2 and her statement to Ms 1
dated 2 July 2009.
Ms 2, witness statement “On one occasion in June 2009 I overheard Ms Pollard
commenting about Staff Nurse Mr 3 in an inappropriate manner. Ms Pollard had heard
that Mr 3 was on sick leave and Ms Pollard responded with words to the effect of ‘I hope
its terminal’.
The panel has also noted Ms 2’s statement to Ms 1 that states “On Monday 15th June
SN Mr 3 was off sick. I was in a room with (Ms Pollard) preparing for a list, and hearing
from…that (Mr 3) was at the doctors, Ms Pollard comment that she hoped it was
terminal”.
The panel accepts that Ms Pollard made a comment using words to the effect of “I hope
it’s terminal”. However the evidence before the panel indicates that Ms Pollard made
these comments on 15 June 2009.
As a result of the evidence before the panel, it concluded that on the balance of
probabilities that on 15 June 2009 Ms Pollard used words to the effect of “I hope its
terminal” in front of colleagues regarding Mr 3.
d. On a number of dates in 2009 you swore whilst on duty
Found Proved
The panel has considered the witness statements of Ms 2, Mr 3, Ms 15 and Mr 24.
Page 15 of 24
Ms 2 in her witness statement says, “I recall on one occasion bringing a sedated patient
out of a room on a trolley. Ms Pollard said ‘mind your hands’ and I said something like
‘they’re fine’. In response to this, Ms Pollard said something to me like ‘fuck off’. She
definitely used the ‘F’ word”.
Mr 3 in his witness statement says “Ms Pollard would also swear on the Unit. She would
whinge about equipment and say things like ‘the fucking equipment’. This would be in
the hearing of patients and other staff. I would estimate that this was about once a
month, regular enough for me to remember”.
Ms 15 in her witness statement says “Ms Pollard would often swear. She would say
crude words at nurses’ station which was in the middle of the Unit. For example, I recall
her saying ‘arse’, but not directly to a patient. I was not very happy with that and I would
look at her and say ‘Lynn!’.”
Mr 24, “I noticed that Ms Pollard would frequently lose her temper with nurses and use
crude language. She would tell them off in a violent manner if she was in a bad mood.
On one occasion a nurse dropped a sterile piece of equipment. Ms Pollard really
berated the nurse”,
The panel accepts Ms 2, Mr 3, Ms 15 and Mr 24’s account of Ms Pollard’s use of
language, and concluded that on the balance of probabilities she swore whilst on duty.
The panel therefore found Charge 4(c) proved.
e. On a date in 2009 when asked by Staff Nurse Helen Hambling to plug in a
pump that was alarming you threw the lead at her
Found Not Proved
The panel has considered the witness statement of Ms 6 and Ms 6’s statement
prepared for the Trust.
Page 16 of 24
Ms 6, in her witness statement says, “Ms Pollard was working nearby in the Recovery
Area and was doing something with her phone. I asked her to go and look at the alarm.
I recall that the alarm needed to be plugged into the mains. Someone had glanced at it
whilst they were doing the patient’s observations and said that the battery was getting
low. The whole pump would lock down if the battery died and would need a key to
unlock. It was so important it was plugged into the mains as soon as possible. I asked
Ms Pollard if she could plug it in and she just threw the lead at me saying “Can’t you
deal with it, I’m busy”.
Ms 6 in her statement for the Trust says, “Once I was coordinating, Lynn was looking
after patients in the ward area, but sitting at the nurses station, reading. A pump was
alarming, so I asked ‘Oh what’s that’. I guess it’s a pump’ she replied. So as she made
no effort to move I asked if it was plugged it at which she threw the lead at me. It was
part of a sliding scale regime and she showed no regard for the patient’s safety”.
The panel accepts that an incident occurred in which Ms Pollard threw a lead at her.
However the only evidence before the panel, regarding this incident is that of Ms 6. Ms
6’s evidence regarding the incident is inconsistent. In the Statement for the Trust dated
21 October 2009, Ms 6 makes no mention of asking Ms Pollard to plug in a pump that
was alarming, there is also a differing account of what Ms Pollard was doing when the
alarm sounded.
In light of the inconsistent evidence before the panel, it determined that on the balance
of probabilities, whilst Ms Pollard did throw a lead at Ms 6, she was not asked to plug it
in by Ms 6. The panel therefore found charge 4(d) not proved.
Determination on Impairment:
The panel has considered, on the basis of the matters found proved, whether Ms
Pollard’s fitness to practise is currently impaired by reason of misconduct. It has had
regard to all the evidence. The panel has accepted the advice of the legal assessor.
Page 17 of 24
The panel was referred to the 2008 NMC, The code: Standards of conduct,
performance and ethics for nurses and midwives (“the Code”) and the Council for
Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011]
EWHC 927 (Admin) (Grant) , Roylance v General Medical Council (No 2) [2000] 1 A.C.
311 (Roylance), Ronald Jack Cohen v General Medical Council [2008] EWHC 581
(Admin) (Cohen), Yeong v General Medical Council [2009] EWHC 1923 (Admin) and
Nandi v GMC [2004] EWHC 2317(Admin). The panel has exercised its own judgement in
determining the issues before it and in this context it has considered the public interest.
Misconduct
In considering whether Ms Pollard’s fitness to practice is impaired by reason of
misconduct, the panel has taken account of all the evidence.
The panel also considered the case of Nandi in which Mr Justice Collins defines
misconduct as “conduct which would be regarded as deplorable by fellow practitioners”.
The panel consider that Ms Pollard’s conduct was inappropriate and would be regarded
as deplorable by fellow practitioners.
The panel has considered the preamble of the 2008 NMC Code: Standards of Conduct,
Performance and Ethics for Nurses and Midwifes, (“The Code”) which requires all
Registered nurses to:
make the care of people your first concern, treating them as individuals and
respecting their dignity
work with others to protect and promote the health and wellbeing of those in
your care, their families and carers, and the wider community
provide a high standard of practice and care at all times
be open and honest, act with integrity and uphold the reputation of your
profession.
The panel also considered paragraphs:
1 You must treat people as individuals and respect their dignity.
Page 18 of 24
3 You must treat people kindly and considerately.
21 You must keep your colleagues informed when you are sharing the care of others.
23 You must facilitate students and others to develop their competence.
24 You must work cooperatively within teams and respect the skills, expertise andcontributions of your colleagues.
25 You must be willing to share your skills and experience for the benefit of yourcolleagues.
61 You must uphold the reputation of your profession at all times.
The panel concluded that Ms Pollard had breached the above parts of the Code.
The panel found that Ms Pollard allowed Student Nurse Mr 23 to draw up a controlled
drug unsupervised. The distribution of controlled drugs are monitored very carefully.
Common practice is that even Registered Nurses will not draw up a controlled drug
independently. Ms Pollard was responsible for teaching a student nurse correct
practice, and allowed him to undertake unsafe practice.
The panel found that on 18 July 2009 Ms Pollard gave a student nurse an inappropriate
level of responsibility by designating her as first nurse and allowing her to carry out
biopsies. Ms Pollard allowed a student nurse to undertake an invasive procedure, under
the supervision of a senior health care assistant. A staff member who themselves is unable
to act in this role or perform this skill. The panel considered the case of Nandi, and
consider that Ms Pollard’s conduct would be considered unprofessional and deplorable.
The panel found that Ms Pollard behaved unprofessionally towards patients’ relatives, with
a specific example of making a “V” sign directed at the patient’s son and responding to
questions regarding the patient with “I don’t know, you tell me”. The panel considers that
Ms Pollard’s behaviour is completely inappropriate, unacceptable and unprofessional. The
panel considered the case of Nandi, and consider that Ms Pollard’s conduct would be
considered unprofessional and deplorable.
Page 19 of 24
The panel found that on a number of unknown dates in 2009, Ms Pollard refused to
handover information to on patients’ clinical conditions to some staff members and swore
whilst on duty. Handing over information is critical to safe nursing practice, it ensures
colleagues can provide effective care to patients. Ms Pollard’s conduct was inappropriate
and had the potential to put patients at risk. Ms Pollard swore on the ward, in front of
patients on numerous occasions. Swearing on duty is never acceptable and is
unprofessional. The panel considered the case of Nandi, and consider that Ms Pollard’s
conduct would be considered unprofessional and deplorable.
The panel concluded that the failures demonstrated and proved in the charges
amounted to serious misconduct.
Impairment
The panel next went on to consider whether Ms Pollard’s fitness to practise is currently
impaired by reason of her misconduct.
The panel has exercised its own judgement in determining the issues before it and in
this context it has considered the need for appropriate weight to be given to the
protection of the public, the maintenance of public confidence in the profession and the
upholding of proper standards of conduct and behaviour.
For this purpose the panel had careful regard to the questions posed by Lady Justice
Smith in her fifth Shipman Report. The panel first considered whether Ms Pollard:
(a) had put a patient or patients at unwarranted risk of harm;
(b) had brought the profession into disrepute, and
(c) had breached one of the fundamental tenets of the professions;
The panel concluded that by reason of Ms Pollard’s misconduct she had put patients at
unwarranted risk of harm, had brought the profession into disrepute and had breached
one of the fundamental tenets of the profession.
The panel next considered whether Ms Pollard is liable in the future to:
Page 20 of 24
(a) put a patient or patients at unwarranted risk of harm;
(b) bring the profession into disrepute;
(c) had breached one of the fundamental tenets of the professions;
The panel considered whether Ms Pollard’s misconduct is easily remediable; whether it
has been remedied and whether it is likely to be repeated. The panel had regard to all
the circumstances of the case and also to the issue of Ms Pollard’s insight in respect of
her misconduct.
The panel has evidence that whilst there were concerns regarding Ms Pollard’s
behaviour, there were no concerns regarding her Ms Pollard’s clinical practice.
However, Ms Pollard’s behaviour was not an isolated incident and the panel considers
that Ms Pollard’s misconduct is serious. The panel has not had the benefit of receiving
evidence from Ms Pollard regarding her remorse or insight. Nor does it have any
information to suggest that Ms Pollard has apologised for her actions. The panel has no
evidence of any steps Ms Pollard has taken to remedy her failings and has not had the
benefit of seeing any references or testimonials. Ms Pollard had received a warning in
relation to her inappropriate behaviours and received support and training to overcome
her issues, but she had not respond to this whilst employed at the Trust. The panel was
unable to conclude that Ms Pollard has insight and remorse.
In light of the evidence received at this stage, the panel is of the view that there remains
a real risk that Ms Pollard could put patients at unwarranted risk of harm, bring the
profession into disrepute and breach fundamental tenets of the professions.
The panel considered that the nature of Ms Pollard’s misconduct requires a finding of
impairment for the protection of the public, to uphold and declare proper professional
standards and to maintain the public confidence in the professions.
For all the reasons outlined above, the panel has determined that Ms Pollard’s fitness to
practise is currently impaired by reason of her misconduct.
Page 21 of 24
Determination on Sanction:
In reaching its decision on sanction, the panel has considered all the evidence that has
been placed before it. It has exercised its own independent judgement.
The panel has taken account of the Council’s Indicative Sanctions Guidance. The panel
has had regard to the public interest, which includes the protection of the public, the
maintenance of confidence in the profession and in the NMC as a regulator. It has
applied the principle of proportionality, weighing the interests of the public with Ms
Pollard’ interests, and has taken into account the mitigating and aggravating factors in
this case.
The panel has accepted the advice of the legal assessor.
The panel first considered taking no action and gave consideration to paragraphs 60-62
of the Indicative Sanctions Guidance. The panel determined that Ms Pollard’s
misconduct requires a sanction to mark the serious departure from the professional
standards set out within the NMC Code and in order to maintain the reputation of the
profession. For these reasons the panel has concluded that taking no action would be
wholly inappropriate and not in the public interest.
The panel next considered whether to impose a Caution Order and gave consideration
to paragraphs 63-65 of the Indicative Sanctions Guidance. The panel does not consider
that Ms Pollard’s impairment is at the lower end of the spectrum. The panel noted that a
Caution Order would not impose any restriction on Ms Pollard’s ability to practise. In
view of the serious nature of Ms Pollard’s misconduct, the panel has concluded that the
imposition of a Caution Order would not be sufficient to satisfy the public interest in this
case. The panel accordingly determined that a Caution Order would be inadequate and
inappropriate.
The panel next considered a Conditions of Practice Order and considered paragraphs
66, 67 and 68 of the Indicative Sanctions Guidance.
Page 22 of 24
The panel is of the view that the nature of Ms Pollard’s misconduct could not be
addressed by such an order. The panel consider that Ms Pollard’s conduct
demonstrated potential deep seated attitudinal and personality issues. The panel has no
information regarding Ms Pollard’s current circumstances or anything to suggest that Ms
Pollard would be willing to comply with a Conditions of Practice Order. Further the panel
notes that Ms Pollard underwent an extensive capabilities programme with the Trust,
yet her inappropriate conduct continued. The panel is not satisfied that Conditions of
Practice could be drafted that would adequately reflect the seriousness of this case or
would appropriately address the misconduct found. The panel considered that there
were no conditions of practice which would meet the criteria of being appropriate,
proportionate, workable and measurable in respect of her misconduct. For these
reasons the panel has concluded that a Conditions of Practice Order would not be a
sufficient or appropriate sanction and would not be in the public interest.
The panel next considered a Suspension Order and considered paragraphs 69, 70 and
71 of the Indicative Sanctions Guidance. The panel is of the view that Ms Pollard’s
misconduct represent a serious departure from the standards set out in the Code.
The panel notes that there is evidence to suggest that there were no concerns
regarding Ms Pollard’s technical capabilities as a Registered Nurse. However her
inappropriate conduct and behaviour were not isolated incidents, rather the charges
comprise numerous incidents of misconduct. The panel has no evidence to suggest that
Ms Pollard has taken steps to remediate her conduct, and the panel is not satisfied that
Ms Pollard has insight or remorse into her conduct. As a result the panel concluded that
there is a real risk of repetition. Ms Pollards treatment of colleagues was completely
unacceptable. The panel considers that whilst there is no evidence of harm caused to
patients in this case, refusing to handover to colleagues appropriately and leaving
student nurses unsupervised, has the potential to cause real patient harm, and prevents
colleagues from providing appropriate care. Further Ms Pollard failed to respect and
uphold patients’ dignity and she acted inappropriately to patients’ relatives. The panel
found that the misconduct found demonstrated deep seated attitudinal issues and a lack
of compassion.
Page 23 of 24
The panel is not satisfied that a Suspension Order would sufficiently mark the
seriousness of Ms Pollard’ misconduct, maintain public confidence in the nursing and
midwifery professions and serve to declare and uphold proper standards of conduct and
performance.
The panel concluded that a Striking Off Order was appropriate in this case and has
considered paragraphs 74, 75, 76 and 77 of the Indicative Sanctions Guidance. Ms
Pollard’s misconduct reflects serious breaches of the Code. There are numerous
incidents of serious misconduct and the panel considers that if Ms Pollard were allowed
to practise there would be a real risk of repetition and potential for patient harm. The
panel has therefore concluded that Ms Pollard’s failings are fundamentally incompatible
with her continued registration as a nurse.
In all of the circumstances the panel has concluded that a Striking Off Order is the only
appropriate and proportionate sanction in response to Ms Pollard’s misconduct. The
panel recognises that this order will have very significant implications for Ms Pollard but
it is satisfied that the public interest outweighs her interest in all the circumstances of
this case. Accordingly the panel has determined to instruct the registrar to strike Ms
Pollard from the register.
Ms Pollard will be notified of the panel’s decision in writing. The Striking Off Order will
come into effect 28 days after the service of the notification of the panel’s decision upon
her. If Ms Pollard were to appeal the panel’s decision the order will not take effect until
the appeal has been concluded.
Determination on Interim order
The panel is required to consider whether it is necessary to impose an interim order to
cover the appeal period before the Striking Off Order can take effect or to cover any
time required to consider an appeal of this decision.
Page 24 of 24
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 on one or more of three grounds; for the protection of the public,
otherwise in the public interest or in the registrant’s own interest. The panel may make
an Interim Conditions of Practice order or an Interim suspension order for a maximum of
18 months.
The panel heard and accepted the legal assessor’s advice.
The panel has concluded that it is necessary to impose an Interim Suspension Order for
the maximum period of 18 months on the grounds of public protection and that it is
otherwise in the public interest. In imposing the Interim Suspension Order the panel
relies on the reasons for its findings on facts, impairment and sanction which it gave in
respect of the striking off order. These detail the seriousness of the facts found, the risk
of repetition and the risk to patients. The panel has determined that the period of the
interim order shall be 18 months to allow for any appeal.
The panel was mindful that the effects of any interim order would be to immediately
restrict the registrant’s ability to work as a nurse, but considered that it is necessary in
the circumstances of this case to make the order.
If at the end of the appeal period Ms Pollard has not lodged an appeal, the interim order
will lapse and be replaced by a Striking Off Order. However if Ms Pollard does lodge an
appeal the interim order will continue to run for the period imposed or until the appeal is
decided.
Recommended