Notice Of Allegation:
Your fitness to practise is impaired by reason of your misconduct and/or lack of competence whilst in the employ of Bracknell Forest NHS Trust in particular that you;
a)
viewed and used inappropriate websites during working hours between the dates of March 2005 to July 2005
b)
used the internet excessively during working hours between the dates of March 2005 to July 2005
c)
Behaved inappropriately towards patients and staff members.
Committees Finding:
1. Ms Fuller has not attended this hearing, nor has she been represented.
The Panel is satisfied that there has been good service of notice of these proceedings on her at her registered address and that there is therefore jurisdiction to proceed in her absence.
Further, the Panel is also satisfied that it is appropriate to proceed with the hearing in her absence.
2. At this stage of the proceedings the Panel is considering whether the allegations are well founded.
There are two allegations.
One is that Ms Fuller’s fitness to practise as a registered health professional is impaired by reason of her misconduct.
The other is that her fitness to practise is impaired by reason of her lack of competence.
In deciding whether the allegations are well founded or not the Panel has approached the task in the following stages:
a. To decide what facts falling within the parameters of the particulars have been proved by the HPC.
b. Having decided what facts have been proved, then to decide whether those facts demonstrate misconduct or lack of competence.
c. If (and only if) misconduct or lack of competence is demonstrated, then to decide whether that misconduct or lack of competence has the consequence that Ms Fuller’s fitness to practise is currently impaired.
3. In deciding whether matters have been proved, the Panel has reminded itself throughout that it is for the HPC to prove the allegations.
It is not for Ms Fuller to disprove them or any element of them.
Although the standard to which the HPC is required to prove the allegation is the civil standard of the balance of probabilities, in view of the fact that serious misconduct is alleged against Ms Fuller the Panel would expect to find particularly cogent evidence before finding any matter proved.
4. It is necessary to mention the nature of the evidence introduced by the HPC.
That evidence is similar, if not identical, to the evidence relied upon by the Trust in the disciplinary proceedings against Ms Fuller.
The Panel is satisfied that the factual evidence tendered is admissible and relevant to the issues it has to decide.
The Panel has, however, wholly ignored the conclusions reached by the Trust on the basis of that evidence.
It is the task of this Panel to make its own decision on the basis of the factual evidence tendered, and this the Panel has done.
5. As already recorded, Ms Fuller has not attended this hearing.
There has therefore been no direct evidence from her given to the Panel.
However, the Panel has considered all that she said about the relevant incidents in the context of the Trust’s disciplinary process.
6. Ms Fuller was a Senior 1 Podiatrist employed by the Berkshire East Primary Care Trust based at Upton Hospital, Slough.
The allegations in the main arise out of her work in that capacity in the period from March 2005 until she was suspended from that employment in July 2005.
7. The facts found by the Panel are as follows:
a. The Panel finds that there was both inappropriate and excessive internet usage in the period from March 2005.
In particular:
i. Ms Fuller frequently accessed websites that were wholly unrelated to her work.
These included shopping sites such as “ebay”, and entertainment sites that included stories that verged on the erotic.
The Panel should make it clear that there is no suggestion that any websites were either pornographic or obscene, but the Panel has no hesitation in finding that it was inappropriate for a health professional to access the sites when at work.
ii. The use of the internet for the accessing of inappropriate, non-work related sites was extensive.
An example is the usage on 22nd March 2005 when, during a working day, Ms Fuller was accessing internet sites frequently throughout and the longest period between accessing the internet was about 51 minutes.
b. On two occasions Ms Fuller treated patients while her partner (who was unconnected with the department) was present in the treatment room.
She has also treated patients while speaking on her mobile phone.
Inappropriate behaviour towards patients was also demonstrated by an occasion when Ms Fuller swore in front of a nun who was being treated and by another occasion when she performed a mock-Nazi salute when a female patient spoke about losing her husband in the war.
c. While accepting the evidence of AW that Ms Fuller could sometimes be good fun to work with, nevertheless the Panel finds that she would also shout at and belittle colleagues in front of others, including, on occasions, patients waiting to be treated.
Inappropriate behaviour towards other members of staff was also shown by Ms Fuller demonstrating her martial arts skills in close proximity to other staff members.
On one occasion this resulted in her making physical contact with the side of the face of a colleague, although this contact did not result in physical injury.
This incident occurred in front of a patient in the waiting room.
d. In addition Ms Fuller showed colleagues photographs of her partner which were inappropriate and explicit.
Again, the images are not alleged to have been pornographic, but rather showed some elements of nudity in the context of the wearing of bondage gear.
She would also discuss her personal sex life explicitly.
These activities on the part of Ms Fuller were unsolicited by the colleagues concerned, and persisted in even when those colleagues made it clear that they were not interested in the images or the discussion.
8. The conduct found by the Panel was all deliberate behaviour of a sort which the Panel is satisfied Ms Fuller knew full well she should not have been indulging in.
Further, in relation to the behaviour exhibited towards patients and staff the Panel is satisfied that she behaved in this way to demonstrate her authority.
The effect of it was to undermine colleagues in respect of whom, as a Senior 1, she was a clinical lead and as such should have been a role model.
They represent very clear breaches of the HPC’s standards 3, 13 and 16 of the Standards of conduct, performance and ethics.
For these reasons the Panel finds that the facts found demonstrate misconduct on the part of Ms Fuller.
They are not issues of lack of competence.
9. The misconduct found by the Panel clearly impaired Ms Fuller’s fitness to practise at the time it was committed.
The Panel has had no positive evidence that the position is now any different.
The conclusion must therefore be that Ms Fuller’s fitness to practise is currently impaired.
10. It follows that the misconduct allegation is well founded.
11. Since announcing the finding on the allegation the Panel has heard further submissions on sanction.
On behalf of the HPC, Ms Norris has merely reminded the Panel of the sanction options and the Indicative Sanctions Policy document.
The HPC does not submit that the Panel should adopt any particular sanction.
12. Ms Fuller has not engaged with this HPC process at any stage.
It follows that the Panel has no information as to what, if any, work Ms Fuller is now undertaking.
13. The Panel is reminded that the purpose of a sanction is not to punish, but is only to be imposed to the extent that it is necessary to protect the public or to maintain confidence in the profession and the HPC’s regulatory process.
As this is a case of misconduct the full range of sanctions is available.
14. The misconduct found by the Panel is far too serious to result in no further action or a caution order.
Quite apart from the fact that conditions of practice would not be appropriate to prohibit deliberate misconduct, Ms Fuller’s failure to engage with this process results in conditions of practice being inappropriate.
15. The Panel has very carefully considered whether a suspension order would meet the circumstances of this case.
It has come to the conclusion that it would not.
The reasons for this conclusion are that the behaviour amounting to misconduct was deliberate and repeated and was persisted in when colleagues exposed to it made it clear that they wished Ms Fuller to desist.
This fact demonstrates both a lack of insight and an inability or unwillingness to modify her behaviour.
As there has been no engagement with this process the Panel can only assume that Ms Fuller is still a person who would be either unable or unwilling to resolve matters.
It therefore follows that a suspension order would serve no useful purpose.
16. It follows that the only appropriate sanction that will adequately protect the public is a striking-off order.
For the reasons set out above the Panel is satisfied that such an order is proportionate, not by reason of the gravity of any particular act but because of the totality of the behaviour and, more importantly, the failure to acknowledge and address shortcomings.
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