Case Digest
2009,
2008,
2007,
2006,
2005,
2004,
2003,
2002,
Miscellaneous
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2009
| Case Type |
Appeal against contingent removal |
| Document Abstract |
The PCT contingently removed the pharmacist in this case on grounds that her conduct over a number of years had a prejudicial impact on the efficiency of services. The condition is that an independent consultant occupational health physician should assess the pharmacist and any identified concerns be dealt with to the satisfaction of the PCT. After a three day hearing during which the appeal panel heard evidence of the pharmacist's behaviour, sometimes described as bizarre, it refused the appeal and upheld the contingent removal giving a period of 8 weeks for the assessment to be made. |
| Document Link |
March 14742 |
| Case Type |
Application for National Disqualification |
| Document Abstract |
The PCT applied for a National Disqualification following an appeal against removal from the local list being dismissed. Reviewing the grounds for removal (working whilst being suspended by the GMC) the Panel concluded they were serious; unlikely to be remedied and given the Performer's history, justified National Disqualification for a period of two years. |
| Document Link |
March 15057 |
| Case Type |
Application for National Disqualification |
| Document Abstract |
The PCT applied for National Disqualification following the appellant withdrawing his application for judicial review of the FHSAA Panel's earlier decision not to allow his appeal. The Panel took into account the nature and gravity of the reasons for removal from the local list (deep seated attitudinal problems, lack of a sense of personal responsibility, unsubstantiated allegations of racism and lack of candour) and determined they went beyond merely local difficulties and justified National Disqualification. |
| Document Link |
March 14502 |
| Case Type |
Removal from List |
| Document Abstract |
*14822. Appeal against removal from Performers list. The Performer was removed on efficiency based upon a range of issues including fraudulent and inappropriate prescribing; an inability to work with colleagues; inability to make progress with specialist training and lack of honesty. After considering the evidence, the Panel refused the appeal and confirmed removal. The serious nature of the allegations did not admit of contingent inclusion. |
| Document Link |
Jan2009/14822.PDF |
2008
| Document Abstract |
14628.*Appeal against refusal to join Medical Performers list. The Appellant is a German doctor who has applied to join a number of PCTs around the country in order to perform OOH work. He was refused by the PCT on grounds of efficiency based upon the results of references considered by the PCT. The Appellant challenged the contents of the various references, attempting to diminish the complaints about record keeping, inappropriate referrals and clinical management. After considering the evidence, the Panel concluded there were far reaching concerns about the capabilities and efficiency of the Appellant and dismissed the appeal. |
| Document Link |
Oct2008/14628.PDF |
| Document Abstract |
14625.*Appeal against removal from the Medical Performers List. The Appellant was removed from his local list following discovery of the fact that he failed to disclose relevant criminal convictions to intended employers as required by his conditional admission to the list and, further, worked whilst being suspended by the GMC. There was no meaningful challenge to the evidence. The Appellant based his appeal upon the fact he was a good, caring and competent G.P. Appeal refused, removal confirmed. |
| Document Link |
Oct2008/14625.PDF |
| Case Type |
Removal from List |
| Case Type |
Refusal to include |
| Document Abstract |
14164. Appeal against refusal to include on the Performers List. The PCT was not satisfied with references supplied by the intended Performer and refused his application. The Performer submitted a further reference following his appeal which the Panel directed the PCT to consider before proceeding with the appeal. The PCT did so but remained dissatisfied. The appeal heard evidence of the Performer':s background and considered the references and concluded the decision not to include the Performer was correct. Appeal dismissed. |
| Case Type |
Removal from List |
| Document Abstract |
*13847. Appeal against removal from Performers List. A G.P. was removed on grounds of efficiency and unsuitability based upon a wide range of allegations ranging from patient management; inappropriate use of drugs; charging for NHS services; management of a slimming clinic; patient confidentiality and honesty and probity. Allegations considered at length. Appeal dismissed. Performer removed from List. |
| Document Link | September2008/13847.PDF |
| Case Type |
Removal from List |
| Document Abstract |
14496. Appeal against removal from Medical Performers List. The Performer was removed from the List on the unsuitability ground on the basis he solicited and obtained loans from patients. The evidence was clear that the doctor had asked for and obtained money from patients. Appeal dismissed and National Disqualification ordered. |
| Document Link |
September2008/14496.PDF |
| Case Type |
Removal from List |
| Document Abstract |
*14526. Appeal against removal from Performers List. A G.P. was removed on grounds of efficiency based upon a persistent and deep-seated resistance to the appraisal process; a failure to respond adequately or at all to the PCT attempt to discharge its regulatory functions and an unnecessary and wasteful use of resources in trying to complete the appraisal process. Oral evidence by the PCT was considered together with the performers written responses. The Panel concluded the performer showed no insight into the need to comply with regulatory requirements intended to maintain and improve the quality of patient care. The appeal was dismissed. |
| Document Link |
September2008/14526.PDF |
| Case Type |
National Disqualification |
| Document Abstract |
14598. National Disqualification. Application made on dismissal of appeal against removal on the unsuitability ground following extensive sexualised behaviour toward patients. Full details in case number 14279. National Disqualification ordered. |
| Document Link |
September2008/14598.PDF |
| Case Type |
Contingent Removal |
| Document Abstract |
*13149. Appeal against contingent removal from the dental performers list. The appellant was contingently removed on evidence of a number of cases showing inappropriate clinical management. She appealed on the basis the contingent removal was disproportionate to the findings against her. The Appeal Panel heard the evidence and considered the allegations in detail following which it confirmed the decision to contingently remove. Consideration was given to amending the conditions but on balance the Panel found the conditions to be appropriate. |
| Document Link |
July2008/13149.PDF |
| Case Type |
Removal from List |
| Document Abstract |
*13911. Appeal against removal from medical performers list. The appellant was removed on grounds of unsuitability and efficiency. As a preliminary point the Panel decided the appellant failed to comply with directions as to the conduct of the appeal. In particular he failed to file any statements as directed. As such he was refused the opportunity to give evidence. The Panel was satisfied the respondent had fabricated blood pressure measurements and epilepsy reviews in order to qualify for QOF points; demonstrated sub-standard and potentially harmful clinical care and signed sick notes without having recently examined the patient. The behaviour amounted to inefficiency and unsuitability. The appeal was refused and national disqualification directed |
| Document Link |
July2008/13911.PDF |
| Case Type |
National Disqualification |
| Document Abstract |
*14125. Application for National Disqualification. Detailed consideration of a Performer':s repeated failings to ':make the grade':; previous findings of dishonesty; numerous administrative and managerial deficiencies including practising without support of ancilliary staff; failure to put audit plans in place; failure to submit to personality management; failed to comply adequately or at all with previous conditions and failure to take any remedial action in respect of previously identified failings in practice. Extensive mitigation considered but National Disqualification directed. |
| Document Link |
July2008/14125.PDF |
| Case Type |
National Disqualification |
| Document Abstract |
*14277. Appeal against removal from the Pharmaceutical List. On a preliminary point the Panel found that on the particular circumstances it was entitled to consider that the trading name, the name of the limited company and the superintendent pharmacist were essentially one and the same entity and could each be treated as the appellant even though only the name of the limited company appeared on the list. The named individual was sole shareholder, director and superintendent pharmacist. Following detailed consideration of the evidence the Panel determined the appellant should be removed on the grounds of inefficiency based upon failure to disclose previous convictions; failure to keep proper records relating to controlled drugs; failing to disclose investigations by RPSGB; over ordering repeat prescriptions; failing to maintain proper records with regard to stock; putting public finance at risk by excessive dispensing and incorrect claims and inadequate clinical governance.
Contingent removal was considered but found inappropriate to address fundamental issues of behaviour and approach. The failing were so serious as to justify national disqualification. |
| Document Link |
June2008/14277.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*14076. Appeal against removal from medical Performers List. This appeal was heard over a seven day period and involved specific allegations of sexual misbehaviour by a performer toward patients; the Panel found the allegations proved. The decision re-visits the issue of standard of proof and also deal with directions following the appellant':s decision not to give evidence. The appeal was lost. National Disqualification to be considered following written representations. |
| Document Link |
June2008/14076.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
14149. Application for national disqualification from Dental List. The Performer was removed from his local list on grounds of unsuitability and efficiency. He did not appeal the removal. The PCT took the view the standard of behaviour was such that merited national disqualification. The performer did not attend the hearing. After hearing evidence of a catalogue of complaints both clinical and managerial the Panel was satisfied the degree of seriousness of matters together justified national disqualification. |
| Document Link |
Mar2008/14149.pdf |
| Case Type |
Conditional Inclusion |
| Document Abstract |
14181. Appeal against conditional inclusion in a Dental List. The PCT imposed conditions of supervision for a 6 month period and a restriction on practise limited to a particular dental surgery on the grounds the applicant had been out of the NHS for some years. The applicant objected to the condition relating to supervision on the grounds that it was contrary to the opinion of her referee – a senior and distinguished orthodontist. The Panel considered the matter afresh and concluded that it was a reasonable, necessary and proportionate response encouraging and leading to efficient delivery of care. |
| Document Link |
Mar2008/14181.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*13833. Appeal against removal from List. The PCT removed a practitioner on grounds of inefficiency based on allegations of inappropriate behaviour toward patients with sexualised overtones. Evidence submitted by the PCT from the patients comprised in part unsigned statements and in part signed statements. No oral evidence from patients were called. The Panel concluded that in the absence of oral evidence and bearing in mind the nature of the allegations it could not be satisfied to the required standard the complaints of sexualised behaviour had been made out. It did hear oral evidence from the investigating officer of the PCT and from the Appellant. It made findings adverse to the Appellant in respect of attempts to mislead those charged with investigating the complaints. In particular he lied about two telephone calls made to patients and also failed to tell the truth about his dismissal from a practice with which he had been involved. On the basis of that essential dishonesty he was removed from the list on the grounds of unsuitability. |
| Document Link |
Feb2008/13833.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*14109. Appeal against removal from Performers List. The Appellant had not performed medical services within the PCT area for 12 months. The Panel sympathised with the Appellant who is prevented from performing medical services in this country for reasons beyond his control. The Panel noted there was no allegation of improper practise or suggestion of unfitness but the fact remains that the PCT should be able to manage its list as it thinks fit, subject to the obligation of fairness. The Panel concluded that the PCT decision was reasonable, proportionate and fair. |
| Document Link |
Jan2008/14109.pdf |
2007
| Case Type |
Extension to suspension |
| Document Abstract |
13838. Application to extend suspension. The PCT applied for a third extension to a suspension on the grounds that possible proceedings in relation to the death of a patient were still being considered. The application was some two years after the event. The full circumstances of the application were considered including the age of the Performer; narrow scope of clinical issue concerning the deceased; the Performer':s acceptance of the need for retraining if she wished to return to practice and the fact there was no identifiable need to protect members of the public. In the circumstances the panel decided not to extend the suspension. |
| Document Link |
Dec2007/13838.pdf |
| Case Type |
Refusal to include |
| Document Abstract |
*13613. Appeal against refusal to join Dental List. The PCT refused the Appellant':s application to join the Dental List on a number of grounds including failure to disclose refusals by another PCT; inadequate references and failure to understand or put into effect his professional duties when confronted by what he claims as unsafe dental practice by others. After a comprehensive review of the evidence the Panel confirmed the decision not to include on the basis the references were unsatisfactory; he was unsuitable because of his failure to disclose a previous refusal and that inclusion would be prejudicial to the efficiency of the services given his attitude to poor practice as he perceived it. |
| Document Link |
Aug2007/13613.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*13633. Appeal against removal from Performers List for breach of conditions. The Appellant is a dentist and was made subject to conditional inclusion on a Performers List with conditions relating to inspection of surgery premises; clinical care; audit and review; business management; and personality management. The Panel considered alleged breaches of each condition in turn and the Appellant':s explanation tendered in respect of each breach. It concluded the Appellant demonstrated a reluctance to accept responsibility for his own shortcomings; lacked meaningful insight and the breaches were fundamental to efficient delivery of dental services. Appeal dismissed – Appellant removed from Performers List. |
| Document Link |
Aug2007/13633.pdf |
| Case Type |
Vary conditions |
| Document Abstract |
13203. Application to vary conditions following decision to contingently remove. Following a decision of the Panel to contingently remove a Practitioner on terms to be agreed between the parties, if possible, the case came back following disagreement on certain conditions, principally a condition which required the Practitioner to inform intended employees of the conditions. The Panel decided that conditions should be capable of being enforced and put into practice, and decided that the condition requiring the Practitioner to inform intended employers of the remaining conditions was entirely appropriate, informing as they do, intended employers of the Performers restrictions on practice. |
| Document Link |
July2007/13203.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*13231. Appeal against removal from Performers List. The Appellant was removed from his local list on grounds of unsuitability and inefficiency based upon evidence of clinical shortcomings and inadequate/ inappropriate practice management. The allegations were wide ranging and included reference to adverse findings against the Practitioner by an Employment Tribunal and ongoing GMC conditions. After considering expert evidence tendered by the Practitioner and credibility issues in respect of non clinical issues, the Panel concluded conditional inclusion was a rational and proportionate response, the conditions intended to ensure the Practitioner no longer practised single handed and to ensure continuing peer review was in place. |
| Document Link |
July2007/13231.pdf |
| Case Type |
Removal from List |
| Document Abstract |
*13738 Appeal against removal from Performers List. The Appellant is a German national recruited to perform our of hours services. The PCT removed him from its list because he had not performed services within its area for the preceding 12 months. The Appellant maintains he still wished to provide out of hours services in England and needed to be on a list for that purpose; he would apply to the appropriate PCT when he found a placement but in the meantime wished to remain on the respondent PCT':s list. The Panel was mindful of the appraisal/administrative responsibilities PCTs have for those on lists and understood the reluctance of the PCT to have those responsibilities for a non-performing practitioner. Appeal refused, the Panel advised the practitioner to first identify the agency which would provide him with work and then make an application to the appropriate PCT. |
| Document Link |
July2007/13738.pdf |
| Case Type |
Refusal to include |
| Document Abstract |
*13743. Appeal against refusal to join Performers List. The Appellant is an experienced and well thought of prison doctor but had no experience of general practice beyond that of a registrar in 1989-90. Her particular interest was psychiatry. She was currently working as a G.P. for BUPA. The Local Health Board refused the application on grounds of unsuitability suggesting the Appellant needed to attend a substantial returner programme before being considered sufficiently current in knowledge and experience. The Panel agreed and refused the appeal. |
| Document Link |
July2007/13743.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13625. Appeal against removal from Performers List. The Appellant had a history of alcohol dependency requiring intervention by the GMC in 1998. He was convicted of a drink/driving offence in 1997 and again in October 2006. The PCT took the view the second offence justified removal on the grounds os suitability. After considering the mitigation, the Panel agreed that removal was appropriate. |
| Document Link |
June2007/13625.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
13650. Application for National Disqualification. An application made by a PCT for National Disqualification from Dental Lists based upon alcohol dependency compromising patient safety. No specific allegations of clinical deficiencies wre made but the dentist's inability to avoid consuming alcohol during working hours was a patient risk to future safety. Despite attempts at rehabilitation and considerable PCT support, the risk to patient safety outweighed the considerable attempts to maintain the dentist in practice. The deficiencies were more than local concerns but struck at the heart of dental practice. National Disqualification ordered. |
| Document Link |
June2007/13650.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13478. Appeal against removal from Performers List. Following discovery that the GP left signed blank prescription and sick notes for use by surgery staff in his absence he was removed from the list. Evidence showed this practice had been going on for some years and that approx. 2,000 blank prescription forms had been signed. Further there was evidence of inadequate medical cover for the practice population. The Panel concluded the conduct was so serious as to justify removal on grounds of unsuitability. It remains to consider national disqualification. |
| Document Link |
May2007/13478.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
13624. Application for National Disqualification. A PCT refused to allow a limited company to join its Ophthalmic List on the grounds a director of the applicant company failed to disclose serious previous convictions despite being required to do so by the application process. The Appellant abandoned his appeal leaving the PCT to continue with an application for national disqualification. In opposing the application the Appellant pointed to many years unblemished service and the fact the allegations against him were old. The Panel concluded there was an element of deliberate dishonesty in making the application, and that the elements of probity and high standards of those working within the service had been breached. This was a proper case for National Disqualification. |
| Document Link |
May2007/13624.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13383. Appeal against removal from Performers List. A local decision to remove on grounds of unsuitability following conviction for indecent assault. Much of the argument taken up with decision to proceed both at local level and appeal notwithstanding criminal appeal not yet run its full course. Final appeal to Europe envisaged. Decision to proceed with the FHSAA appeal. Removal ordered and National Disqualification directed. |
| Document Link |
Mar2007/13383.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13423. Appeal against removal from Performers List. A decision to remove on efficiency grounds, in particular failure to comply with reasonable request for NCAA assessment. Thorough recital of the evidence leading to questions relating to the performer':s integrity and competence. Removal ordered and, following argument, National Disqualification directed. |
| Document Link |
Mar2007/13423.pdf |
| Case Type |
Contingent Removal |
| Document Abstract |
*13046. Appeal against contingent removal from Performers List. The Practitioner was contingently removed from a Performers List. He appealed the decision. The Panel was satisfied the evidence justified removal on grounds of efficiency but deemed conditions, different to those imposed by the PCT, would remedy the inefficiency. Contingent removal ordered. See decision for conditions. |
| Document Link |
Feb2007/13046.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
13375. National Disqualification. An order for National Disqualification was made against a locum GP found to have engaged in Consensual Sexual Intercourse with a Patient in surgery premises. |
| Document Link |
Jan2007/13375.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
13378. National Disqualification. The Practitioner did not appeal the PCT':s decision to remove him from the List but resisted an application for National Disqualification. The Practitioner had an unfortunate history of substance misuse going back to 1999. With substantial help he had been able to maintain his practice until in early 2006 it was again found he had retained drugs from his practice for his own use. In its decision the Panel took into account that, at the time of the hearing, the GMC had made no adverse finding against the Practitioner, but being satisfied on the evidence the allegations of fraud and efficiency had been made out and having regard to the non-local issues involved, ordered National Disqualification |
| Document Link |
Jan2007/13378.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13331. Appeal against removal from Dental List. The Practitioner appealed against a decision to remove him from the List on grounds of efficiency. The Panel considered the case on the papers – the parties having previously agreed. It considered a range of issues relating to the competency of the Practitioner who had been recruited from Poland and the attempts to deal with some areas by the employing practice limiting the type of work and by involvement of the PCT in training issues. The Panel was satisfied removal on efficiency grounds was made out and dismissed the appeal |
| Document Link |
Jan2007/13331.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13361. Appeal against removal from Performers List. A locum performer was removed from a local List for failing to establish he had performed services within the area of the PCT within the previous 12 months. Although that fact was proved, evidence showed he had performed services within the area for about 18 days during a period immediately following the 12 months period. The decision to remove is discretionary and the Panel found that removal in those circumstances would be disproportionate and therefore allowed the appeal. |
| Document Link |
Jan2007/13361.pdf |
2006
| Case Type |
National Disqualification |
| Document Abstract |
National Disqualification. Following a decision to disallow the Performer's appeal, at a later hearing, the panel proceeded to order national disqualification. The decision explains clearly the matters to be considered in terms of efficiency and also considers the local/national context. |
| Document Link |
Nov2006/13421.pdf |
| Case Type |
National Disqualification |
| Document Abstract |
13238. National Disqualification. The Performer was originally contingently removed from the list. His appeal to the FHSAA was struck out because of his failure to comply with directions. Following a detailed review of his practice the PCT finally removed the Practitioner from the list. There was no appeal. The PCT applied for a National Disqualification based upon numerous shortcomings identified in its comprehensive report. In support, it also held evidence to the effect the Practitioner had deliberately misled the FHSAA as to his movements in order to defer his earlier appeal against the decision to contingently remove him. The Panel was satisfied the allegations were sufficiently serious to justify National Disqualification. |
| Document Link |
Nov2006/13238.pdf |
| Case Type |
Removal from List |
| Document Abstract |
13266. Removal from List. The Performer was removed on grounds of efficiency following a comprehensive assessment over a lengthy period. His appeal was based on the grounds that the GMC with knowledge of all the facts considered him fit for restricted practice and that it was for the PCT to put arrangements in place to enable the practitioner to comply with the restrictions on his practice. After reviewing the inefficiency allegations, the Panel determined that the PCT was free to come to a different decision to the GMC on the same facts and, in the particular circumstances, it was not an appropriate case for the PCT to supervise or monitor the practitioner':s restricted practice. Removal ordered. |
| Document Link |
Nov2006/13266.pdf |
| Case Type |
Termination of Contract |
| Document Abstract |
13222. Termination of Contract. The practitioner appealed against termination of his GMS contract. The termination related to the practitioners bankruptcy. The appeal notice lacked detail and it was not clear if the appeal related to whether he was actually bankrupt (an issue to be resolved by the FHSAA under a direction from the Secretary of State) or the exercise of the PCT':s discretion to terminate (to be dealt with by the National Health Service Litigation Authority Appeal Unit) under the dispute resolution process. As the first case of its kind and in the absence of a particularised appeal the FHSAA found as a fact the practitioner was bankrupt. Subsequently the adjudicator under the dispute resolution confirmed the PCT was right to terminate the contract. In future it is expected the dispute resolver appointed by the Secretary of State will be the panel members appointed by the FHSAA, enabling both issues to be considered together. |
| Document Link |
Oct2006/13222.pdf |
| Case Type |
Refusal to include |
| Document Abstract |
The applicant is a Spanish dentist who applied to join a Dental List. Questions as to the authenticity of references provided in support of the application were raised. Doubts remained following investigation by the Local Counter Fraud Specialist who concluded three of the references contained exactly the same wording, the header on the references appeared to have been downloaded or copied from University of Madrid and two references were from the same person but with a different signature. In addition none of the documents describing themselves as references spoke of clinical practice in two recent posts which lasted at least three months'. There was no explanation and alternative referee. Appeal refused. |
| Document Link |
Sept2006/13122.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Appellant was removed from the PCT's list on the sole ground of efficiency based upon inappropriate clinical care; inappropriate prescribing and poor record keeping and management. The panel heard evidence over a number of days'. The Appellant decided not to give evidence. After considering the evidence the panel found each of the specific allegations proved. It considered whether it should contingently remove the practitioner but after taking into account his lack of insight, determined that contingent removal could only be effective if a practitioner appreciated his shortcomings and was willing to work to remedy them. The appeal was lost and the practitioner removed from the Respondent's list. |
| Document Link |
Aug2006/12359.htm |
| Case Type |
Conditional Inclusion |
| Document Abstract |
The Appellant is a practising Consultant Paediatrician who wished to provide out of hours G.P. care. Conditions relating to acceptance on a G.P. returner scheme, six months' full-time G.P. training and review before being admitted to a list were amended by the Panel to enable the training to be one day per week over a 12 months' period. Other conditions were not amended. The resultant training was the equivalent of about 50% of that originally required which, in the opinion of the Panel, was adequate bearing in mind the Appellants ongoing clinical practice. |
| Document Link |
Aug 2006/13066.htm |
| Case Type |
National Disqualification |
| Document Abstract |
In an unopposed application the Panel imposed a National Disqualification on a dentist sentenced to three years' imprisonment for fraud against the Dental Practice Board amounting to some £600,000. It further determined there was no realistic prospect of a successful review of the national disqualification within two years' and replaced that period by one of five years'. |
| Document Link |
Aug 2006/13073.htm |
| Case Type |
National Disqualification |
| Document Abstract |
The Panel imposed a National Disqualification on a G.P. convicted of 22 charges of obtaining drugs by deception. The drugs were required for self use. It found there was no realistic possibility of the disqualification being successfully reviewed in two years' and replaced that period with one of five years'. |
| Document Link |
Aug 2006/13063.htm |
| Case Type |
Refusal to include |
| Document Abstract |
In considering the appellant's application to join its list the PCT obtained references from two persons who were not named as referees by the applicant. The two named referees identified the two actual referees as persons better able to comment on the applicant. Without reference to the applicant the PCT obtained written references from the second pair. The references were generally unsatisfactory. The appellant argued the PCT should not have obtained the secondary references without his knowledge. One of the referees was the subject of a complaint by the appellant so the reference should be ignored.Whilst expressing some concern about the practical way the PCT had approached the issue of references, the panel determined the PCT was not wrong to rely on both references as essentially the only material it could work from. The panel re-considered the references and read them alongside material tendered by the appellant at the hearing. After doing so it was satisfied the references were unsuitable, refused the appeal and refused admission to the PCT's list. |
| Document Link |
July2006/12216.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The Practitioner commenced work the day after making an application to join a List but before the application was granted. She became caught up in investigations concerning the practice. Both she and the agency through which she obtained employment were genuinely unaware of the breach of regulations and she stopped work as soon as the breach was pointed out. The refusal was based on inefficiency and unsuitability. On the basis the Practitioner had been accepted on to another list the PCT barely resisted the appeal. The Panel found the breach of regulations technical with no intention to deceive and it did not, by itself, make the Practitioner unsuitable. There was no evidence of inefficiency. Appeal allowed. |
| Document Link |
June 2006/12333 2012334.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The application was refused on a number of grounds including unsatisfactory references, inefficiency and failure to indicate the applicant intended to work within the area of the PCT.The appeal was allowed following consideration of new references; satisfactory evidence of the Practitioners intention to practice as a locum and satisfactory evidence of the Practitioners co-operation in ongoing assessment. |
| Document Link |
June 2006/12187.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The applicant worked as a medical officer in the armed forces for a number of years. He applied to join a Performers' List to undertake locum duties. Whilst references did not doubt the practitioner's clinical competencies they did emphasis he had no recent experience with aged persons or children. His experience over the previous 20 years or so was restricted to serving military personnel. The panel agreed with the PCT in it's view that references were not satisfactory. As it also decided the references determined the practitioner was unsuitable to be on a list it could not consider conditional inclusion. The regulatory provision requiring an applicant to provide satisfactory evidence that he intended to perform services within the area of the PCT does not apply to an armed forces GP. |
| Document Link |
April2006/12034.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The applicant is a limited company providing cash and carry facilities to corporate and individual members' only. The appeal panel agreed with the PCT decision that by virtue of the membership scheme only members' would be entitled to General Optical Services; entitlement would be based on a fee (the joining fee) and that it is contrary to the ethos of the NHS and discriminatory to offer treatment to restricted groups of individuals. The Company was unsuitable to be on an optical list. |
| Document Link |
April2006/12175.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Appellant appealed against a decision to remove him from a Performers List on the grounds he could not demonstrate he performed services within the PCT's area for the preceding 12 months' and unsuitability, specifically failing to notify the PCT of an ongoing investigation and failing to provide an appraisal. After hearing the evidence the panel found as a fact the Appellant had not performed services within the area of the PCT for the relevant period and that the decision to remove on that ground was right. In light of that finding the Panel took the view it was unnecessary to make specific findings on unsuitability. |
| Document Link |
March2006/12166.htm |
| Case Type |
National Disqualification |
| Document Abstract |
The practitioner did not appeal against removal from the local list or attend the hearing of the application for national disqualification. He wrote to say he denied the allegations against him requiring the Panel to consider the specific allegations in turn. After considering issues of inappropriate prescribing and a catalogue of what was described in general as inappropriate behaviour the Panel was satisfied the practitioner was unsuitable to be included in any list held by a PCT nationally. National Disqualification granted. |
| Document Link |
February2006/12051.htm |
2005
| Case Type |
Removal from List |
| Document Abstract |
In confirming a decision to remove, the Panel was also called upon to consider a number of Human Rights issues including; adjournment on non-attendance of practitioner; inequality of arms on funding and possible bias of the panel. The decision deals at length with such issues before going on to dismiss the appeal on grounds of unsuitability, relying on adverse findings in a High Court decision in which the practitioner was joint defendant and involved findings of fraud. |
| Document Link |
October 2005/11691.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT was not satisfied with references supplied by the practitioner. It refused his application on the grounds of efficiency and unsuitability. The Panel allowed the practitioner to tender other favourable evidence at the hearing which had not been before the PCT when it made the decision appealed. The Panel allowed contingent inclusion on to the dental list. Conditions dealt with an Adverse Risk Management programme devised and implemented by Dental Protection Limited in conjunction with the PCT's Dental Advisor; amendments to the practitioner's brochure and referring orthodontic patients for specialist treatment. |
| Document Link |
Sept 2005/11838.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Practitioner was removed from the list on the grounds of efficiency and unsuitability, following unsuccessful attempts by him to satisfy the PCT as to his satisfactory clinical performance. The Panel considered attempts by the Practitioner to pass the National Summative Multi Choice Question Assessment and also findings by the GMC. Despite time and opportunity being presented to the Practitioner, he continued to demonstrate significant clinical failings. The Panel confirmed the decision to remove the Practitioner and after proper submissions found that the lack of fundamental core knowledge and professional skills affected the Practitioner wherever he sought to practice and justified national disqualification. |
| Document Link |
July 2005/11575 20DECISION.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Practitioner was convicted of fraud against the Dental Practice Board in the sum of £15,000 and voluntarily repaid a further £70,000 without admission. The Panel agreed with the decision to remove the Practitioner on the single ground of fraud. In considering if it should contingently remove the Practitioner, the Panel felt the level of dishonesty undermined the confidence which should be inspired by a NHS practitioner and could not be repaired by contingent removal. The Practitioner did not oppose an application for national disqualification. |
| Document Link |
July 2005/11631 20ND 20DECISION.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Practitioner appealed against a decision to remove him from the list on the grounds of efficiency based upon repeated failure to satisfy the PCT on his clinical competence following an assessment by the NCAA. After a review of the deficiencies identified by the NCAA and the opportunities and time given to the Practitioner to remedy them the Panel concluded that the Practitioner's skills and performance was below the expected level. Sufficient time had elapsed for the Practitioner to remedy his shortcomings. The attempts were unsuccessful. The appeal was dismissed and the Panel determined that the Practitioners' shortcomings justified national disqualification. |
| Document Link |
July 2005/11690 20DECISION.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Practitioner was removed on grounds of efficiency and unsuitability. The Panel made findings relating to the practitioner's performance in dealing with complaints; the manner in which he dealt with the PCT; failure to engage in a 10 point plan to remedy perceived administrative difficulties and his inability to deal effectively with issues raised by the Dental Practice Board. The findings amounted to unsuitability and inefficiency and the panel confirmed the decision to remove. The decision also deals with introduction of late evidence and explains why the panel did not go on to impose a national disqualification. |
| Document Link |
June 2005/11213,11214,11215.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The decision at local level was based on two grounds namely unsuitability and inadequate clinical references. Following the local decision, satisfactory references were provided leaving unsuitability as the only issue before the appeal panel. The practitioner had been convicted of two charges of common assault committed during the same incident occurring within the surgery. The GMC had issued a warning in respect of that matter. In allowing the appeal the Panel took into account (amongst other things), the particular stresses on the practitioner at the time of the incidents; the length of time since the offences; the practitioner's otherwise unblemished career and his demeanour at the hearing. |
| Document Link |
March 2005/11447.htm |
| Case Type |
Refusal to include |
| Document Abstract |
Although the PCT had failed to particularise the decision at local level it was agreed at the hearing the decision should be treated as a refusal to join the list on the grounds of unsuitability. The particular allegation is that his application failed to disclose he had been subject to disciplinary proceedings. Evidence disclosed findings adverse to the practitioner were made by a Dental Discipline Committee in 2003 and by an Independent Review Panel in 2001 - both findings relating to the same patient. The Panel was unconvinced by the practitioner's attempts to excuse the non-disclosure. It was satisfied the practitioner deliberately withheld the information and after reminding itself of the importance of truthful disclosure found, in the circumstances, the practitioner unsuitable to be admitted to the list. The proportionality of that decision was influenced in part by the fact the practitioner was on the PCT's Supplementary List. The Panel decided that he should remain on that list subject to conditions relating to clinical competences identified at the time the adverse findings were made. In passing, the Panel commented on the dangers of PCT's obtaining information on which it intended to rely over the telephone without a proper record being kept and also the need for decisions at PCT level to comply with the necessary regulations, in this case GDS. |
| Document Link |
March2005/11393.htm |
| Case Type |
Refusal to include |
| Document Abstract |
Although on the list of an adjoining PCT, the practitioner's application to join a neighbouring PCT was refused on the grounds of unsuitability. For the purposes of the appeal he produced an ongoing Performance Assessment undertaken at the request of the PCT on whose list he was registered. Although on the Dental List of the adjoining PCT he was working in that area as an assistant. His present application was to enable him to resume practice, at least initially, as a single-handed principal. The Panel acknowledged there had been improvements in shortcomings identified by the Performance Assessment but was mindful there had been a larger than average number of complaints against the practitioner over the years. He continued to receive support under the Performance Assessment and could also rely on guidance from his present practice owner, neither of which would be readily available if he resumed practice as a principal in another area. At least one complaint was still outstanding. In the event the Panel dismissed the appeal. Upon hearing from the PCT that it would welcome another application in, say, six months', the Panel indicated what the practitioner should do to help with that application. |
| Document Link |
March 2005/11557.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The Practitioner applied to join the Respondent's dental list and provided the necessary references. The PCT determined that one of the references was unsatisfactory and refused the application. The Practitioner appealed, relying on the fact that a personality clash with the writer of the reference affected the tone of the reference. The Panel considered the nature of the relationship between the Practitioner and his referee and also the content of the second reference. It concluded that the decision not to include was right and dismissed the appeal. |
| Document Link |
January 202005/11444.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The Appellant is employed as a Consultant Renal Physician and applied to join the Respondents performers list. The Appellant worked in his wife's general practice on Saturday mornings and occasionally at other times during the year. The application was refused on the basis that the references did not satisfy the Performers list Regulations 4(2)(f) and such references that had been provided were not satisfactory under Reg 6(1)(b). The Panel determined that a reference from the Appellant's wife lacked the necessary impartiality and that other references were insufficiently up to date. The Panel also remarked on the fact that a certificate dated 6 November 1996 certifying an acquired right to practice in the social security system of the U.K. as a general medical practitioner does not extend to the right to practice as a principal without satisfying additional training regulations. |
| Document Link |
January 202005/11419.htm |
2004
| Case Type |
Refusal to include |
| Document Abstract |
The PCT was not satisfied with references provided by the Practitioner. The FHSAA held that it was unnecessary for the PCT to contact named referees if the Practitioner, instead of simply providing names and addresses, provided a full reference direct to the PCT. The purpose of references was to assist in deciding the applicants suitability to perform primary health care. Non - clinical references from other areas of practice would be seldom helpful. |
| Document Link |
December 2004/11404.htm |
| Case Type |
National Disqualification |
| Document Abstract |
The PCT applied for a national disqualification in the mistaken belief it had properly and lawfully removed him from it's Performers List. It became clear that the provision upon which it thought it could remove the Practitioner had only come into force after the removal. As a consequence the removal had not been lawfully effected. The FHSAA could not therefore proceed to consider a national disqualification. It was not open to The FHSAA to reconsider the original removal which had been expressed to be made on mandatory grounds. If the PCT wished to proceed on an amended ground of unsuitability it would have to reconvene and decide the matter locally giving the Practitioner the opportunity to make representations. |
| Document Link |
December 2004/11402.htm |
| Case Type |
Removal from List |
| Document Abstract |
The Practitioner was contingently removed by the FHSAA. One condition required compliance with a National Summative Assessment within a specified period. The Practitioner failed to comply with the condition. The PCT proceeded to remove the Practitioner from the list. On appeal the PCT conceded that it should have given the Practitioner notice of its intention and offered him the opportunity to make representations under 10(8) of the Performers Lists Regulations. Appeal allowed by consent. |
| Document Link |
November 2004/11350.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT refused an application to join its PMS list on the basis that the appellant failed to disclose his application to join an unrelated PCT in 2002 had been refused on the basis of conditions imposed on his practice by the GMC. He did disclose the nature of those proceedings in the instant application. The panel considered the nature of the original application and the practitioner's understanding that he had withdrawn his application because he knew it would not be granted. He had disclosed to the present PCT the GMC proceedings so it was aware of problems in the past. He did not intend to mislead it. In all the circumstances the panel allowed the appeal and ordered the appellant's name to be entered on the respondent's PMS list subject to the two conditions on his practice imposed by the GMC. |
| Document Link |
June 2004/11065.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT used findings of the GMC relating to inappropriate and indecent behaviour upon which to base its refusal to allow the appellant to join its supplementary list. It found the conduct made the practitioner both unsuitable and would also compromise efficiency. The practitioner contended that the GMC had imposed conditions for 18 months'. This had been served and he should be allowed to go back to practice. The panel looked closely at the attitude of the practitioner both in respect of the allegations and subsequently and concluded that he was unsuitable to be included on the supplementary list. The Panel reserved the issue of a national disqualification to a later hearing. |
| Document Link |
June 2004/11098.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The appellant had been convicted of dishonesty in relation to his previous ophthalmic practice. He was sentenced to 18 months imprisonment suspended for 2 years'. At the end of the period of suspension he applied to join the lists of a number of PCT's some of which allowed him on to its lists subject to conditions, those, the subject of this appeal refused to allow him to join the lists. Following a review of the evidence the Panel concluded that the appellant should be allowed to join the lists subject to the sole condition that he not be allowed to run his own independent practice - a condition to be reviewed by the PCT's after 12 months. The hearing was on the papers. The appellant sought to introduce further evidence outside time limits imposed by the Panel in directions. That evidence was not admitted because of its lateness and that sufficient time had been allowed for the appellant to respond to the direction but insufficient time was left before the hearing for the PCTs to respond. |
| Document Link |
June 2004/10982–10988, 2011004, 2011005, 2011015, 2011016.htm |
| Case Type |
National Disqualification |
| Document Abstract |
The respondent is an optometrist found guilty by the GOC of dishonestly appropriating £85,000 over a three year period. She further waived her entitlement to fees of £15,000. The was removed from the PCT's list but for personal reasons did not appeal. The PCT applied for national disqualification. The Panel considered the deliberate nature of the 'offences' and the sum involved. It considered the difficulties in monitoring a practice in which the respondent might become engaged, and decided that a national disqualification was a proportionate response. |
| Document Link |
June 2004/11121.htm |
| Case Type |
Conditional Inclusion |
| Document Abstract |
The PCT included the appellant on its PMS list subject to conditions relating to the chaperoning of female patients and notification to intended employers of that condition. The issue arose as to whether the case related to 'unsuitability' or 'inefficiency'. Conditions could not be imposed in respect of the former but could if the latter. The conditions were imposed because of allegations of a sexual nature. The panel concluded that although there could be an overlap between unsuitability and efficiency, this case is clearly one of unsuitability. If the allegations could be proved to the required standard the appellant must be removed. He could not be made the subject of conditions. The panel considered the evidence and concluded that it could not be satisfied to the required standard the allegations had been proved. Even if it was an 'efficiency' case the panel did not feel, on the evidence, it would have been able to impose conditions. Appeal allowed.Note: The Panel commented that it was inappropriate for the officer of the PCT charged with investigating the allegations to also act for the PCT at the hearing. She thereby became advocate and main witness. Complex issues arose which should have had the benefit of legal advise/representation |
| Document Link |
June 2004/Ref.anon.htm |
| Case Type |
Conditional Inclusion |
| Document Abstract |
In support of her application to join the dental supplementary list the appellant gave the names of three referees. The references that came back were entirely satisfactory. The PCT took it upon itself to also ask for a reference from a practitioner for whom the appellant had worked for a short time (less than three months') That reference was not so satisfactory and as a result conditions were imposed. The panel found that it was wrong of the PCT to consult with a person not named as referee, especially when the appellant had worked for him for a matter of weeks' and where the practice manager of that practice had given her a general reference covering that period. There was evidence of a personality clash between the appellant and the consultee which was likely to have coloured the reference. Appeal allowed - conditions removed. |
| Document Link |
May 2004/10960.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The practitioner appealed against a decision not to allow him to join the list made on the grounds of unsuitability, efficiency and dissatisfaction with references. The panel dismissed the appeal on the basis of failure to disclose a number of previous cases of breach of service; previous bankruptcy; failure to undertake adequate re-training to address deficiencies in clinical practice identified by the General Dental Council in 1998 ;inadequacy of references and a failure to provide sufficient information to enable an enhanced CRB check to be carried out.The panel also ordered a national disqualification, finding that the facts were not peculiar to the particular PCT but would be relevant wherever the appellant practised. In the circumstances a national disqualification was rational and proportionate. |
| Document Link |
March 2004/10823, 10918.htm |
| Case Type |
Practice Vacancy |
| Document Abstract |
The appellant appealed against refusal to appoint him to a vacancy on a mixture of grounds including the fact he was asked medical questions by panel members' he considered less qualified; the decision had been made before the interview because some the panel members' were connected socially; he had a better understanding of community needs and the interview panel was biased on religious grounds.The PCT called evidence and was able to rebut allegation. Appeal dismissed. |
| Document Link |
March 2004/10937.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT refused an application to join the Medical list on the grounds that the applicant failed to disclose that he was the subject of an investigation by the GMC and that in respect of the same incident was subject to an investigation by another health authority. It concluded that failure to disclose (rather than the incident itself) made the applicant unsuitable to join the list. After fully considering the facts and in particular the timing of relevant events the Panel allowed the appeal, finding (i) a complaint to the GMC was not an investigation for the purposes of the legislation until it is accepted by a screener and passed to the Preliminary Proceedings Committee for investigation, (ii) although there had been technical breaches of the regulations in the language used by the applicant in his application, the PCT knew from other sources the details of the single complaint against the practitioner and that it had been satisfactorily resolved.In all the circumstances a refusal to join the medical list on grounds of unsuitability was a disproportionate response. |
| Document Link |
Jan2004/10682.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT refused an application to join the Supplementary List on the grounds that references were unsatisfactory, unsuitability, conduct prejudicial to efficiency of the services and inability to show he has for the required period or intends to provide general medical services in the area of the PCT. In the particular circumstances of the case ( the applicant had been removed from the medical list in 2002) the Panel were of the view that the PCT should have taken a flexible approach to references. Unsuitability and efficiency were inextricably intertwined - both relating to professional competence- and that as the appellant wanted to join the Supplementary List to enable him to proceed with training to make up for previously identified shortcomings the Panel could admit him to the list subject to conditions. The Panel also found that Reg.15 National Health Services (General Medical Services Supplementary List) Regulations could not bear an interpretation which would admit an appeal against the mandatory grounds for refusing an application to join a supplementary list found in Reg 6(2). This was surprising considering the subjective view which can be taken of Reg.6(2)(a) (intention to provide services). In finding it effectively had no jurisdiction to deal with the intention to practise issue the Panel nevertheless found informally that the appellant did intend to provide general medical services in the area of the PCT.NOTE: Although the appeal against refusal to join on the discretionary grounds found in Reg.6(1) was allowed, the fact there is no appeal against the 'intention to provide services' condition (6(2)) means that the practitioner is unable to join the list unless the PCT modifies its view in the light of the Panel's remarks. |
| Document Link |
Jan2004/10780.htm |
| Case Type |
National Disqualification |
| Document Abstract |
A free standing application by a PCT for national disqualification of a general practitioner whose registration had been made the subject of conditions imposed by the GMC's Interim Orders Committee to deal with psychiatric and alcohol related problems. The G.P. was in single handed practice, had left the country and could not be contactable. The Panel dealt with Article 6 provisions relating to a fair hearing; concluded that provision had not been breached and nationally disqualified the G.P. from all lists specified in Sec.49N(1) Health & Social Care Act 2001. |
| Document Link |
Jan 2004/10784.htm |
| Case Type |
Extension to suspension |
| Document Abstract |
Although The Family Health Services Appeal Authority (Procedure )Rules as amended do not make reference to extensions of time to file appeals the Panel were of the view that Article 6 of the European Convention should engage to enable a practitioner removed from a supplementary list to at least apply for an extension of time. The Panel considered the FHSAA regulations and also Part 52 (Appeals) of the White Book which suggests that an extension should be allowed if the applicant can make out 'good reason' or 'convincing excuse'. In the particular circumstances the practitioner left the Country without leaving any forwarding address. The PCT corresponded with the applicant's wife who remained in the UK. It was satisfied that the practitioner must have known of the PCT's decision to remove him; his suggestion he did not was implausible. No convincing excuse or good reason had been made out. Application to extend time to file appeal refused. |
| Document Link |
Jan2004/10860.htm |
2003
| Case Type |
Refusal to include |
| Document Abstract |
Under Regulation 7A(1)(C) the PCT declared that it was not satisfied with references produced by the Appellant in support of his application to join its Opthalmic list. It became clear that the PCT was dissatisfied because one referee made observations about the record keeping of the Appellant. There was no question concerning the Appellants clinical competence. The panel indicated that it was minded to allow the Appellant on to the list subject to conditions which would permit the PCT to monitor the Appellants' record keeping. The parties were able to agree the terms of those conditions which included the drawing up of a protocol relating to record keeping. The conditional inclusion was to be reviewed after six months' during which the PCT was entitled to monitor the record keeping. |
| Document Link |
December 2003/10750.htm |
| Case Type |
Practice Vacancy |
| Document Abstract |
The Appellant set out a number of grounds alleging unfairness/procedural irregularities in the way the PCT dealt with a vacancy for a single handed practitioner. Most complaints did not amount to issues of law. One aspect of the appointment procedure was of concern. On the day of the interviews a member of the interview panel took the successful applicant on a visit to the practice premises. That panel member was asked to sit on the panel at short notice. She unsuccessfully tried to find someone else to drive the candidate to the premises. The successful candidate and the member of the panel were together for about 20minutes. Whilst there was no suggestion of any impropriety, the circumstances were such that a reasonable observer might fear that the appointment procedure was not carried out fairly. Appeal allowed - PCT directed to re-advertise and to ensure appointments panel does not contain any of those who sat on the first application. |
| Document Link |
December 2003/10778.htm |
| Case Type |
Contingent Removal |
| Document Abstract |
Following an allegation that a practitioner had inappropriately invaded the personal space and inappropriately touched a practice nurse, the PCT contingently removed the practitioner from the supplementary list. The original decision was expressed to be on the grounds of unsuitability. Perhaps realising that it is not possible to contingently remove for unsuitability the PCT contingently removed on the efficiency ground. Following admissions that there had been an invasion of the nurse's personal space and that there may have been inadvertent physical contact, the panel determined that although there is an overlap between efficiency and unsuitability, the facts in the present case could not, on a reasonable interpretation, amount to inefficiency. Appeal allowed - contingent removal revoked. |
| Document Link |
December 2003/10779.htm |
| Case Type |
Removal from List |
| Document Abstract |
Following a number of concerns about the clinical performance of a G.P. he was suspended from the list to enable a comprehensive review to be undertaken by the NCAA. The review concluded by recommending the option of extending the suspension and referring the case to the GMC. Eventually the PCT removed the practitioner from its list. The appeal took five days' during which the nature of the NCAA review was considered at length. The practitioner was not able to accept many, if any, of the procedures adopted during the review and maintained at all times he was clinically up to date and competent. The Panel concluded that the practitioner's competence in a number of areas was deficient and there were areas where he failed to meet acceptable standards. The shortcomings were such that patients were at risk. It considered whether it should contingently remove the practitioner but concluded that because the practitioner could not accept his shortcomings, retraining would be ineffective. After informing the practitioner that it was thinking of a national disqualification, the Panel adjourned the case. On resuming, and after hearing further submissions, the Panel ordered a national disqualification. |
| Document Link |
December 2003/10447.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The Appellant was an 81years' old Doctor who last practised some 12 years' previously. Since 1995 he coordinated medical topics for an institution of further education. The panel considered grounds on which the PCT must refuse an application (Reg 4(2)), and the discretionary grounds (Reg.6(1). After a thorough review of the attempts by the PCT to assess and monitor the current competency of the Appellant, the panel concluded that the decision to refuse inclusion on the list on the grounds of prejudice to the efficiency of the service was right. |
| Document Link |
November2003/10689.htm |
| Case Type |
Removal from List |
| Document Abstract |
The practitioner had retired from general practice and wished to join the supplementary list. His application was refused because of concerns that, whilst in practice, he failed to follow guidance of the PCT on clinical matters and failed to meet the NCAA to attempt to address perceived clinical shortcomings. Refusal was on the grounds of unsuitability and efficiency. The panel identified particular shortcomings in prescribing and clinical and professional development. In considering the appeal the panel took into account 30 years' unblemished service to the community and the fact that the concerns identified by the PCT were more relevant to a principal rather than an assistant. The panel allowed the appeal and permitted the appellant to join the supplementary list on condition that he follows all protocols, systems and practices, particularly relating to prescribing, put in place by any principal whom he assists from time to time. |
| Document Link |
October2003/10634.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The PCT refused an application to join its supplementary list on two grounds, firstly, a failure to provide two clinical references as provided for by the Regulations, and secondly, inefficiency, evidenced by previous complaints arising from general practice. The panel received evidence on the specific complaints and concluded they did amount to inefficiency and that, as a fact, an insufficient number of references had been provided. In the circumstances the local decision not to allow the appellant to join the supplementary list was justified. |
| Document Link |
/October2003/10679.htm |
| Case Type |
Removal from List |
| Document Abstract |
The PCT removed the practitioner on the grounds that continued inclusion in the list would be prejudicial to the efficiency of the services which those on the list undertake to provide. A range of concerns had been expressed ranging from staffing issues, prescribing, computerisation, follow up care and targeting achievement.. Practice reviews revealed the need for urgent reviews of record keeping and chronic disease management, amongst other general practice weaknesses. Extensive recommendations were made by the P.C.T's Medical Director which were either not complied with at all or only partly complied with. 40% of cases reviewed gave rise to concern. 4 cases required urgent action. After considering specific allegations, the panel came to the view that the decision at local level was right and dismissed the appeal. It then went on to consider whether it should order a national disqualification. After inviting submissions it concluded that the deficiencies highlighted by the case went beyond local issues or the list upon which the practitioner might seek to exercise practice It ordered a national disqualification from all lists |
| Document Link |
October2003/10626.htm |
| Case Type |
National Disqualification |
| Document Abstract |
The practitioner is a dentist convicted of a number of counts of fraud on the NHS by claiming for work that had not been done. Although the amounts involved were small (£150 or thereabouts) he was sentenced to three months': imprisonment. The practitioner did not attend the application for national disqualification or submit any written reasons. The panel ordered national disqualification on the basis of fraud. |
| Document Link |
August2003/10482.htm |
| Case Type |
Removal from List |
| Document Abstract |
The practitioner was removed from the medical list on the grounds of efficiency. An independent review panel identified a number of deficiencies in the practitioners professional performance namely; providing or arranging investigations and treatment including prescribing and chronic disease management, record keeping, diagnosis, working outside limits of competence, communication with colleagues and patients etc. Similar concerns had been raised with the GMC which imposed conditions on the practitioners registration. The panel was satisfied that continued inclusion of the practitioner on the list would be prejudicial to the services which those included in the list undertake to provide. After considering whether the inefficiency was such that it merited removal, the panel ordered contingent removal of the practitioner from the list. See the decision for details of the conditions intended and designed to remove the inefficiency complained of. |
| Document Link |
July2003/10525.htm |
| Case Type |
National Disqualification |
| Document Abstract |
Application to the FHSAA for a review of a national disqualification imposed by The National Health Service Tribunal. The applicant applied for a review of a national disqualification imposed by The National Health Service Tribunal in 1996. On a preliminary issue the panel held that the FHSAA was not a body to which appeals were made in respect of decisions of The National Health Service Tribunal so it was unnecessary for them to reconsider the merits of the original disqualification or whether it breached the Human Rights Act. The jurisdiction of the FHSAA was to review the disqualification which limited the panel to considering matters arising after the disqualification rather than events leading to it or the decision itself. The panel considered evidence of the applicant':s medical practice since disqualification and the fact he had practised firstly in Scotland and then for the Armed Forces with positions obtained for him by a locum agency. It came to the view that he failed to undertake any CPD and failed to disclose to any employer the fact of his national disqualification. No references could be produced as to his clinical performance since disqualification and there was no evidence to demonstrate he had learned from the mistakes leading to the disqualification. In the circumstances the panel confirmed the national disqualification. |
| Document Link |
July2003/10370.htm |
| Case Type |
Refusal to include |
| Document Abstract |
The appellant had been a G.P. in practice for many years. Between May 1996 and December 1999 he worked as a locum with none of his appointments lasting more than three weeks' with many only a few days'. He was overseas until his application to join the list in October 2002. Admission to the list was refused under Reg.4(2)(i) of the Supplementary List Regulations on the basis that he was unable to provide names and addresses of two referees willing to provide clinical references relating to two recent posts which lasted at least three months' and that he failed to provide a full explanation and alternative referees. Appeal refused. |
| Document Link |
May2003/10474.htm |
| Case Type |
Vary conditions
Practice Vacancy |
| Document Abstract |
The appellant's alleged that a decision not to appoint them to a practice vacancy was unlawful because the number of persons comprising the appointments panel was inadequate; two members of the panel were not independent; the successful applicant took in to the interview another practitioner who was to provide management services and who was known to the appointments panel; bias was demonstrated by two members of the appointments panel; the panel failed to give any or sufficient weight to the strengths of the appellant's application.The panel dealt with each allegation in turn. The panel was satisfied that the number of persons who comprised the appointment board was appropriate given all the circumstances; that there was no evidence to suggest that any members of the appointments panel were partial or biased in favour of the successful applicant; that attendance at the interview by a person other than an applicant was, in the circumstances of that application, appropriate and that consideration of the appointment board papers shows that it gave full consideration and weight to the appellant's application. Appeal dismissed |
| Document Link |
May2003/10454.htm |
| Case Type |
Removal from List |
| Document Abstract |
The HA removed appellant from the list of dental practitioner on the grounds of inefficiency and/or unsuitability. The evidence upon which the decision was taken was very extensive falling under a number of heads including clinical competence and practice standards, attitude and handling of patients, plus a criminal conviction. The facts giving rise to the allegations extended over many years. The FHSAA panel issued directions to the appellant, requesting that he provide further particulars of his appeal. The directions drew the appellant's attention to the power of the panel to dismiss the appeal if they were not complied with. The appellant did not show cause or comply with the directions, and the panel therefore dismissed the appeal. Following an application by the HA, the panel held a further hearing on 19 December 2002 to consider the matter of a National Disqualification. The appellant did not attend. Order for National Disqualification made |
| Document Link |
February2003/10172a.htm |
| Case Type |
National Disqualification |
| Document Abstract |
Health Authority removed practitioner from the medical list following a criminal conviction for various sexual offences, and a term of imprisonment greater than six months. PCT applied to the FHSAA for National Disqualification. The FHSAA allowed the application on the grounds that it was hard to imagine a worse breach of the trust placed in the Respondent as a doctor. The FHSAA also determined that there is no realistic prospect of a successful review within two years', and as such the practitioner may not request a review before five years' have elapsed.The panel also found that although the appellant's name had been removed from the Medical Register by the GMC i.e. he was no longer a 'medical practitioner', TheFHSAA had jurisdiction to order a National Disqualification by virtue of sec.49(2) of The Health & Social Care Act 2001 which refers to an application being made against 'a person.' |
| Document Link |
February2003/10352.htm |
2002
| Case Type |
Contingent Removal |
| Document Abstract |
The Health Authority contingently removed appellant from its Supplementary Medical List on the grounds of unsatisfactory clinical performance prejudicial to the efficiency of general medical services. Between the date of removal and the hearing of the appeal an appropriate training plan was put in place which addressed the concerns of the Health Authority. Objections to the appeal were withdrawn and the appellant unconditionally restored to the list. |
| Document Link |
November2002/10145.doc |
| Case Type |
National Disqualification |
| Document Abstract |
The Health Authority, after refusing inclusion on it's Supplementary List, applied for a National Disqualification on the grounds that the practitioner provided a false declaration to the HA with his application to join supplementary list. The panel concluded that the practitioner's failure to disclose an unsatisfied judgment for a substantial amount arising from clinical negligence was dishonest, and his failure to acknowledge the Court Order against him demonstrated a lack of responsibility and probity on his part. National Disqualification ordered. |
| Document Link |
November2002/10197.htm |
| Case Type |
Conditional Inclusion |
| Document Abstract |
The HA conditionally included the appellant on its GMS Supplementary List, the conditions being that her".personal development plan satisfactorily addresses the concerns raised in relation to communication and teamwork so as not to compromise the efficiency of the service'. The appeal was allowed. The panel concluded that the HA's reliance on a reference which (without explanation) differed materially from one given by the same referee about one month earlier could not justify inclusion subject to a condition. |
| Document Link |
October02/10114.htm |
| Case Type |
Practice Vacancy |
| Document Abstract |
In accordance with the provisions of 18D of the NHS (GMS) Regulations 1998 (as amended), the Health Authority did not appoint the appellants to a practice vacancy. The appeal was allowed on the grounds that the HA had erred in law in that there was no decision of the MPC whether the number of doctors undertaking to provide general medical services in the locality was adequate (Reg. 12) this and other failures to comply with substantial parts of Part III of the Regulations went beyond a minor or inconsequential oversight. The applications were remitted to the HA (or its successor) for re-determination. |
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10014&10015.htm |
| Case Type |
Practice Vacancy |
| Document Abstract |
The practitioner was appointed to a vacancy subject to references. On appointment no references were available. The Chairman of the appointment panel took it upon himself to speak to one of the named referees who was reluctant to give a reference despite having given an earlier reference for other purposes. The referee finally expressed a view. The chairman reported to the appointment panel and recommended the offer be withdrawn. A second named referee was not approached at all.The appeal panel found that it was improper to obtain a reference from a clearly unwilling referee; the Chairman's report to the appointment panel was not balanced by consideration of the appellant's locum history at the subject practice; even if the second reference would have made no difference, fairness required that it be obtained and considered because it might have gone some way to redressing the unfavourable impression given by the first referee. Failures by the PCT amounted to procedural irregularities leading to unfairness and the case was remitted to the PCT for re-consideration. |
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Decisions/10021.htm |
Miscellaneous
| Case Type |
Removal from List |
| Document Abstract |
The appellant was removed from the Performers List on grounds of unsuitability and inefficiency. There were a number of allegations of sexually inappropriate behaviour all of which the Panel found to be proved. In preliminary applications the Panel dealt with issues of patient confidentiality and anonymity and stay of proceedings. The decision addresses the burden and standard of proof in what were essentially criminal allegations; the significance of the practitioner not giving evidence and good character. |
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| Case Type |
Refusal to include |
| Document Abstract |
The applicant had difficulty in providing references from referees who were 'clinical equivalent'. He had recently completed a 12 months' suspension by the GOC for serious professional misconduct. The application was submitted on 10th August 2004. Correspondence and conversations between the applicant and PCT continued until February 2005 whereupon the PCT gave notice his application would be refused unless outstanding matters were dealt with within 28 days'. On 11th March the application was formally refused because the applicant had not met the deadline. A satisfactory reference was provided on 11th March which the PCT refused to accept as it was out of time. The Panel determined there was no statutory or regulatory time limit for dealing with applications and whereas a PCT's desire not to have applications outstanding for long periods is understandable, in this case the applicant kept the PCT fully informed and it should have been more flexible by considering the late reference. |
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| Case Type |
Extension to suspension |
| Document Abstract |
14739. Contested application for extension to suspension. The Performer had been suspended pending Police investigation of allegations of sexual misbehaviour toward patients. The investigation had been completed and a decision made that there was to be no prosecution. The Performer contended that the decision should be final and he be allowed back in practice. The Appeal Panel considered the balance between patient safety and public interest and the right of the Performer to work and concluded the balance was in favour of the PCT. Extension granted – PCT warned as to possibilities should it be unable to complete the local determination before expiration of the extension. |
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| Case Type |
Appeal against refusal to include on dental list |
| Document Abstract |
The PCT refused an application to join the list by a Performer who had been suspended for 12 months by the GDC in respect of a single act of covering up wrong treatment. After full consideration of the evidence the Panel allowed the appeal, finding amongst other things, the Performer was contrite, had continued to work in a subordinate capacity within dental health during his suspension, his dental competency was not in doubt, he had taken steps to ensure the position in which he had found himself and which led to the proven allegation against him could not be repeated. |
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| Case Type |
National Disqualification |
| Document Abstract |
The PCT removed practitioner from its list of Medical Practitioners and applied to the FHSAA for a National Disqualification on grounds of unsuitability. The practitioner had been convicted of a number of offences which were sexual in nature, and involved children. The FHSAA panel decided to nationally disqualify on the grounds that he would not be suitable for employment as a GP whilst under a Rehabilitation Order; the significant period of time over which the offences took place; that the practitioner compromised his integrity and principles of both moral and ethical behaviour, and in making a job application without disclosing the convictions the panel raising further doubts about his integrity. |
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| Case Type |
Refusal to include |
| Document Abstract |
The PCT was not satisfied with clinical references in respect of a practitioner who had undertaken a number of short term locum posts. The appellant had not provided a full explanation and alternative references for period or periods of employment which lasted for less than three months' (Reg.4(2)(i). Neither individually nor collectively did the references come up to the required standard. On appeal it was held that the decision was justified. |
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| Case Type |
Practice Vacancy |
| Document Abstract |
The President ruled that failure by a PCT to make clear in an advertisement for a vacancy that successful applicants should be qualified to fill the role of GP trainer was not a point of law enabling unsuccessful candidates to appeal. |
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| Case Type |
Removal from List |
| Document Abstract |
On joining the dental list the appellant declared that he had not been the subject of an investigation by any licensing, regulatory or other body into his professional conduct. Further enquiries revealed he had been found to be in breach of his terms of service on six occasions between 1975 and 1989. He was removed from the list. Between the appeal being lodged and the hearing, discussions between the practitioner and the PCT resulted in the practitioner being restored to the list on the basis that the PCT accepted there was no deliberate attempt to mislead it in the original declaration. Appeal allowed by agreement. |
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| Case Type |
Vary conditions |
| Document Abstract |
The PCT suspended a practitioner under Reg.13(1)(b) NHS (General Medical Services Supplementary List) Regulations 2001' pending the outcome of court proceedings.' Believing it was required to do so, it applied to The FHSAA for an extension of the suspension shortly before six months' of the suspension had run. In remarking that Reg.13 and corresponding provisions in The Health & Social Care Act and GMS and GDS regulations are widely misinterpreted, the President ruled that a suspension expressed in these terms does not have to be extended by order of The FHSAA and will run until the proceedings are concluded. For guidance, the six months' limit in a suspension expressed in these terms is for a period of suspension imposed after the outcome of court proceedings are known. |
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| Case Type |
Removal from List |
| Document Abstract |
The appellant was convicted of eight counts of fraud in respect of claims for patients who had not been treated. The sum involved was £6,000. The PCT removed the practitioner from the Medical List. The appeal to the FHSAA was adjourned to await the outcome of an appeal against conviction to the Court of Appeal. In the event the appeal was successful. The PCT withdrew opposition to the appeal which was allowed by the FHSAA. |
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| Document Abstract |
Sec. 49I(6)(b) National Health Act 1977 as amended - Considering it was necessary to do so for the protection of the public, the PCT suspended the practitioner for a period of six months' pending criminal investigations and an assessment of the respondent's clinical practice. In considering the application on the papers the panel came to the view that it was necessary for the protection of the public for the suspension to continue. It also considered that a further period of four months' would be sufficient to deal with outstanding matters and made an order accordingly. |
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| Case Type |
Refusal to include |
| Document Abstract |
The practitioner had been convicted of sixteen counts of false accounting and given a suspended prison sentence. He applied to join the lists of two adjoining PCT's, both of which refused the application on the grounds that the practitioners' intended domiciliary work would be difficult, and therefore inefficient, to monitor and supervise - a necessary condition having regard to the practitioner's background. The practitioner appealed but before the hearing agreed with both PCT's terms for his conditional inclusion on the list. Appeal allowed to the extent necessary to enable the agreed conditional inclusion to be put into effect |
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| Case Type |
Refusal to include |
| Document Abstract |
The PCT refused the application on the grounds that it considered the applicant unsuitable to be included on the list and that it was not satisfied with the references provided on behalf of the applicant. The panel dismissed the appeal on the basis that the appellant had failed to provide the names and addresses of two referees who were willing to provide satisfactory references in respect of two recent posts as an ophthalmic medical practitioner or optician which lasted for three months' without significant break, or where not possible, a full explanation and alternative referees. The position with regard to references was unsatisfactory and the PCT was entitled to come to the decision it had. |
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| Case Type |
Extension to suspension |
| Document Abstract |
In granting a second unopposed extension of a suspension from the medical list the panel directed that any further application should be supported by a full or interim report by the National Clinical Assessment Authority. |
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| Case Type |
Application to extend appeal period |
| Document Abstract |
13282. Application to extend appeal period. Consistent with FHSAA practice, a late appeal was listed for a panel to consider whether time should be extended. Following full argument and particularly Blackett v Nursing and Midwifery Council 2004EWHC 1494(Admin) the Panel concluded it had no powers to extend time. Application refused.
Note: Decision will lead to likely review of practice to list late appeals. |
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| Case Type |
Extension to suspension |
| Document Abstract |
14110. Application for extension to suspension. The PCT applied for an extension to suspension. The Panel considered the facts, in particular the delay in formulating a case for removal; the lack of prompt referral to NCAS; there was no formal evidence of the need to act for protection of the public and generally a lack of resources allocated to dealing with the substantive reasons giving rise to the suspension. It refused the application for suspension. |
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| Case Type |
Removal from List |
| Document Abstract |
*14224. Appeal against removal from List. The Appellant was removed on the grounds that he had not performed services within the area of the PCT within the previous 12 months and that he was in breach of his undertaking to participate in the PCT':s appraisal process. The hearing was on the papers with the Appellant submitting a number of documents showing he had worked in England during the relevant period but none of the evidence indicated he had worked within the area of the PCT. There was evidence that the Appellant had satisfactorily completed an appraisal shortly before the hearing but in the absence of material showing he had worked within the area of the PCT as required the appeal was dismissed and the Appellant removed from the List. The Panel pointed out that PCT':s have a management responsibility to performers named on its list and it is perfectly proper to remove those not performing in the area for the required period. |
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| Case Type |
Refusal to include |
| Document Abstract |
13339. Appeal against refusal to include on Performers List. A Practitioner was denied access to a list on grounds of his failure to act on removal from a previous list and upon grounds of efficiency, in particular a seemingly idiosyncratic approach to prescribing benzodiazapines. The Panel allowed the appeal and admitted the Practitioner to the list subject to conditions set out in the decision designed to deal with the inefficiency. |
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| Case Type |
National Disqualification |
| Document Abstract |
13408 and 13494. (consolidated) Appeal against refusal to join Ophthalmic List. The Appellant is a limited company and applied to join the lists of two PCTs. Both refused the applications on the grounds that the director of the company making the application failed to disclose relevant previous and current investigations by a regulatory authority against him. The Respondents view is that such failure made the applicant unsuitable to be included on the list or in the alternative inefficient. Following a comprehensive review of the evidence the Panel concluded that failure to disclose comparatively minor previous investigations did not make render the Appellant unsuitable. Refusal to register on that ground was disproportionate. The Panel were concerned about other aspects of the Appellant':s practice and admitted the Appellant to the lists subject to conditions relating to practice where peer review was available and a ban on making domiciliary optometric assessments. |
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