Fitness to PractiSe Panel

17 October 2006

7th Floor, St James’s Buildings, 79 Oxford Street, Manchester, M1 6FQ

 

Name of Respondent Doctor:       Dr Richard WILSON

 

Registered Qualifications:              MB ChB 1978 Dund SR

 

Registered Address:                        South Yorkshire

                                                              

Registration Number:                      2339513

 

Type of Case:                                     Review case of impairment by reason of: misconduct

 

Panel Members:                                Mrs M Clark-Glass, Chairman (Lay)

                                                               Prof R Gupta (Medical)

                                                               Mr A Simanowitz (Lay)

 

Legal Assessor:                                Mr T Ward

 

Secretary to the Panel:                    Miss L Pearce

                                                               Miss L Meads

 

Representation:

GMC: Mr R Kitching, Counsel, instructed by GMC Legal.

 

Doctor: Present and represented by Mr T Haycroft, Counsel, instructed by RadcliffesLeBrasseur Solicitors.

 

Determination on impaired fitness to practise

 

“Dr Wilson: In October 2002 the Professional Conduct Committee found you guilty of serious professional misconduct and determined that conditions should be imposed on your registration for a period of three years. 

 

At that hearing the Committee found proved that, on 2 March 1997, you signed an agreement to act as an investigator for a clinical trial to assess the safety and efficacy of Voglibose compared with placebo and Glibenclamide.  In signing this agreement, you had responsibility to conduct the study in accordance with protocol and in accordance with the principles of the Declaration of Helsinki. The Committee considered that as a doctor with experience of conducting clinical trials, you knew or should have known the importance of protocols and protocol amendments for the purposes of conducting a clinical study, and that such studies should be completed accurately and with care.

 

You admitted that during the course of the study period you acted in contravention of that agreement in a variety of ways. You failed to carry out any, or perform any adequate, physical examinations during Visit 1 of the patients recruited to the trial. You did not conduct adequate examinations of joints as specifically required by the protocol. You knowingly completed the Clinical Report Forms incorrectly; indicating that you had carried out examinations when you knew you had not done so and permitted seven patients to participate in the study when you knew they should have been excluded.

 

Sister A was your research nurse throughout the study. You admitted that you failed to supervise Sister A in her role of assisting in the conduct of the trial, and the Committee found that you had failed to train her adequately in this role.

 

The Committee considered that it was your responsibility, as the investigator conducting the study, to ensure that the protocol governing the trial was adhered to. The Committee found that you showed a lamentable lack of involvement in the conduct of the trial and permitted Sister A to withdraw some patients’ original medication and place them on placebo without your involvement as the physician investigator.

 

The Committee considered that the ultimate responsibility for the conduct of the trial was yours; you should have exercised an overall review of patients participating in the trial and been aware of, and approved any, changes in patients’ treatment.  Further to this, it was for you to obtain informed consent from patients participating in the study; you failed to do so and delegated your responsibility to Sister A.

 

In the light of its findings the Committee found that you acted irresponsibly and considered that your conduct fell short of the standards to be expected of a medical practitioner and that you acted contrary to the patients’ interests in your management of the trial. In the light of the findings the Committee found you guilty of serious professional misconduct.

 

The Committee went on to consider whether it was necessary to take action in relation to your registration. The Committee noted that at the outset of the proceedings you had admitted most of the charges, had told the Committee that you recognised your failures in relation to the study and that you deeply regretted your actions and the consequences for others. The Committee were satisfied that you had shown insight into your actions and took into account the evidence placed before it of xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx the Voglibose trial.  The Committee noted the testimonials submitted on your behalf, took into account that there were no previous findings against you and accepted that you were a clinically competent doctor. The Committee determined that conditions should be placed on your registration for a period of 36 months.

 

In October 2005 a Fitness to Practise Panel, applying the General Medical Council’s Preliminary Proceedings Committee and Professional Conduct Committee (Procedure Rules) 1988, reviewed your case.  That Panel determined to vary the conditions placed on your registration for a period of 12 months as follows:

 

1.         Before you return to clinical practice;

 

a.         your training needs must be identified to provide that they are fully met under the supervision of a consultant psychiatrist specialising in substance misuse,

 

b.         you must attend and demonstrate successful completion of a course in advanced cardiac life support,

 

c.         you must complete a 6 to 8 week clinical observer attachment in a recognised addictions unit,

 

d.         you shall cause a report relating to a, b, and c above to be submitted to the GMC by your supervisor,

 

2.         You shall not participate in any clinical research.

 

3.         Your clinical practice shall be in supervised posts within the NHS or in the post of Clinical Medical Officer at the Mimosa Recovery Unit (“The Unit”) under the supervision of Dr B Trathern, Dr D Britto, or Dr D Thoms.

 

4.         You shall work part time only and you shall not undertake any out of hours duties.

 

5.         Your clinical work shall be closely supervised by, and shall be overseen by, the Clinical or Medical Director of the relevant NHS Trust or by a Consultant Psychiatrist at the Unit.

 

6.         You shall only prescribe in the course of your duties and you shall not prescribe medication for your own personal use. Any prescriptions shall be issued in accordance with the protocols and policies of the Unit.

 

7.         You shall inform the GMC caseworker, responsible for your case, before undertaking any clinical position for which registration is required.

 

8.         Before commencing any medical practice you shall inform your employer and any potential employer in respect of medical work requiring registration with the GMC that you are subject to conditions imposed by this Panel and shall inform that person of conditions 1 to 7 restricting your practice.

 

The Panel has today resumed consideration of your case under the GMC (Fitness to Practise) Rules 2004. Rule 22(f) is in the following terms:

 

“the FTP Panel shall consider and announce its finding on the question of whether the fitness to practise of the practitioner is impaired or whether the practitioner has failed to comply with any requirement imposed upon him as a condition of registration, and shall give its reasons for that decision.” 

 

The Panel has taken into account all the evidence placed before it including the correspondence between the GMC, the Postgraduate Dean of South Yorkshire and South Humber and RadcliffesLeBrasseur Solicitors, the submissions made by Mr Kitching on behalf of the GMC and the submissions made by Mr Haycroft on your behalf.

 

The Panel has heard today that you have now been away from medical practice for over four years and your training needs have not been addressed. Further your medical skills have not been utilised during that time. Mr Haycroft on your behalf made no submissions in relation to your fitness to practise being impaired. In all the circumstances the Panel is satisfied that your fitness to practise is impaired.

 

Furthermore you have been unable to comply with the following conditions imposed in October 2005:

 

“1.        Before you return to clinical practice;

 

a.         your training needs must be identified to provide that they are fully met under the supervision of a consultant psychiatrist specialising in substance misuse,

 

c.         you must complete a 6 to 8 week clinical observer attachment in a recognised addictions unit,

 

d.         you shall cause a report relating to a, [b,] and c above to be submitted to the GMC by your supervisor”.

 

The Panel is of the view that there has been a technical failure on your part to comply with the above conditions and agrees with Mr Haycroft’s submission on your behalf that this was not wilful. The GMC has accepted that this was brought about by your inability to find appropriate training for your needs. However, your inability to comply with these conditions reinforces the Panel’s view that your fitness to practise is impaired.

 

The Panel will now invite further submissions as to the appropriate sanction, if any, to be imposed on your registration.”

 

Determination on sanction

 

“Dr Wilson: Having made and announced its finding that your fitness to practise is impaired, the Panel has considered what action, if any, it should take with regard to your registration. The Panel has had regard to all the evidence adduced today. It has considered the submissions made by Mr Kitching on behalf of the GMC, and the submissions made by Mr Haycroft on your behalf. The Panel has taken account of the GMC’s Indicative Sanctions Guidance and of the principle of proportionality.

 

The Panel first considered whether it would be sufficient for the protection of patients, members of the public, in the public interest and in your own interests to conclude your case and take no further action on your registration. The Panel noted that you have been out of practice for over four years and that your training needs have not been addressed as envisaged by the previous Panel. In the circumstances, therefore, the Panel considered it would not be sufficient to allow you to return to unrestricted practice at this time.

 

The Panel has heard from you today the reasons why you decided not to accept the post of Clinical Medical Officer at the Mimosa Recovery Unit and that you have not found any other suitable post since. You told the Panel the Post Graduate Dean suggested looking outside the region.  You stated that you want to live and work within the same region although you may be moving to Scotland in the near future.

 

You also told the Panel you attended the Royal College of Physicians Update in Medicine and SIMMS Lecture in November 2005 and you joined the Medical Council on Alcohol where you attended a meeting on 23 November 2005. In March 2006 you successfully completed an Advanced Life Support Course and subsequently completed a number of other CPD courses. You have shown the Panel that you subscribe to the Lancet and BMJ on a regular basis to keep your medical knowledge up to date.  

 

The Panel took into account your own evidence and the submissions made on your behalf. It noted that both Mr Kitching and Mr Haycroft submitted that conditions would be appropriate and proportionate. The Panel itself is of the view that since you have been out of practice for over four years it is necessary to impose further conditions prior to any return to practice. The Panel considers that before you return to practise a period of retraining and supervision is required to ensure the safety of patients, to maintain public confidence in the profession, and to uphold proper standards of conduct.

 

The Panel has therefore determined that for a further 2 years your registration will be subject to the following varied conditions:

 

1.         Any employment you find requiring registration with the GMC must be in a managed environment;

           

2.         Before you return to clinical practice you must with your prospective employer identify the training needs required of any post you are offered. Your prospective employer and the training needs must be notified to and approved by the GMC;

 

3.         You must complete any training programme identified by those needs to the satisfaction of your employer and the GMC before returning to clinical practice;

 

4.         Whilst providing medical services which require you to be registered with the GMC, you must place yourself, and remain under the supervision of, a workplace supervisor who is a fully registered senior practitioner nominated by your employer and agreed by the GMC;

 

5.         You must notify the GMC promptly of any post you accept for which registration with the GMC is required and provide the GMC with the contact details of your employer;

 

6.         You must find and then appoint a mentor, who must be approved by the GMC;

 

7.         You must allow the GMC to exchange information with your employer, or any organisation for which you provide medical services, and any individuals involved in your supervision and mentoring;

 

8.         You shall not participate in any clinical research;

 

9.         You shall work part time only and you shall not undertake any out of hours duties;

 

10.       You shall only prescribe in the course of your duties and you shall not prescribe medication for your own personal use. Any prescriptions shall be issued in accordance with the protocols and policies of your place of work;

 

11.       You shall inform the GMC caseworker, responsible for your case, before undertaking any clinical position for which registration is required;

 

12.       At the time of application, in respect of medical work requiring registration with the GMC, you shall inform any potential employer that you are subject to conditions imposed by this Panel and shall inform that person of conditions 1 to 11 restricting your practice.

 

In determining the period of two years, the Panel considers this to be sufficient time to enable you to attempt to fulfil these requirements. In the event that you are unable to obtain employment subject to these conditions, any future Panel would need to look closely at the efficacy and practicality of any further conditions.

 

The Panel will resume consideration of your case at a meeting to be held before the end of the period of conditional registration. It will then consider whether it should take further action in relation to your registration. You will be informed of the date of that meeting, which you will be expected to attend.

 

Shortly before that date you will be asked to furnish the Council with the names of professional colleagues and other persons of standing (who need not be registered with the GMC), to whom the Council may apply for information, as to their knowledge of your conduct since the hearing of this case.

 

The effect of the foregoing direction is that, unless you exercise your right of appeal, your registration will be subject to the above conditions for a period of 2 years beginning 28 days from the date on which notice of this decision is deemed to have been served upon you.  The previous order of conditional registration will remain in place until the new direction takes effect.

That concludes this case.”

Confirmed

 

October 2006                                                                                                             Chairman