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Conduct & Competence CommitteeSubstantive Meeting

Date: 17 – 18 January 2013

Held at

Temple Court, 13a Cathedral Road, Cardiff, CF11 9HA

And

23 May 2013

At23 Portland Place London, W1B 1PZ

Registrant: Lynn Pollard

NMC PIN: 92I2318E

Part(s) of the register: Adult Nursing 1995

Type of Case: Misconduct

Area of Registered Address: England

Panel Members: Stephen Redmond (Chair/ Lay Member)Helen Bishop (Registrant Member)Jeanette Whitford (Lay Member)

Legal Assessor: Nicholas Leviseur (January 2013)David Richards (23 May 2013)

Panel Secretary: Alexandra Scott

Facts found not proved: 1 and 4(d)

Facts found proved: 2(a), 2(b), 3, 4(a), 4(b) and 4(c)

Fitness to practise: Impaired

Sanction: Striking Off Order

Interim order directed: Interim Suspension Order for aperiod of 18 months

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Proof of Service:

Notice of this meeting was sent to Ms Pollard’s registered address by the Nursing and

Midwifery Council (NMC) on 13 December 2012. The Notice was sent by recorded

delivery and by first class post to Ms Pollard’s registered address. The Notice made

clear that the case would be considered at a meeting, which would be held in private,

shortly after 10 January 2013. The Notice set out the allegations made against Ms

Pollard, invited her to make a response, detailed the documents which the panel would

consider and also made clear the panel’s powers in disposing of the case.

The panel took account of the copies of an extract from the NMC's recorded delivery

post book and Royal Mail Track and Trace documentation as evidence of service.

In the light of all the information available, the panel has determined that Notice of this

meeting has been served in accordance with the requirements of Rules 11A and 34 of

the Nursing and Midwifery Council Fitness to Practise Rules (2004), as amended.

Charges:

That whilst working as a registered nurse in the Endoscopy Department at SalisburyNHS Trust (“the Trust”):

1. On or around 30 th July 2009, you failed to provide an acceptable standard ofcare to patient A, who was on a sliding scale test for blood glucose and had aninsulin pump, in that you failed to monitor patient A’s blood sugar level and / orleft the insulin pump clamped off

2. You did not supervise students to an acceptable standard on one / more of thefollowing occasions:

a. On or around 2nd- 3rd July 2009 you allowed Student Nurse Phillip Scaifeto draw up a controlled drug, unsupervised

b. On or around 18th July 2009 you gave a Student Nurse, Naomi Wallace,an inappropriate level of responsibility by designating her as the first nurseand allowing her to carry out biopsies

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3. You were rude and / or behaved unprofessionally towards patients’ relatives, forexample, on an unknown date, in response to a question from a patient’s sonabout how long his father would be in theatre, you responded with words to theeffect of “I don’t know, you tell me” and / or made a “V” sign directed at thepatient’s son when his back was turned and / or did so within view of the patient

4. You were rude to / about colleagues, for example:

a. On a number of unknown dates in 2009 you ignored or interrupted staffthat were attempting to handover to you and / or refused to handoverinformation to some members of staff

b. On or around 2nd July 2009 you said words to the effect of “I hope itsterminal” in front of colleagues after being told that Staff Nurse Taylor wason sick leave

c. On a number of dates in 2009 you swore whilst on duty

d. On a date in 2009 when asked by Staff Nurse, Helen Hambling to plug ina pump that was alarming you threw the lead at her

And in relation to the above, your fitness to practise is impaired by reason of yourmisconduct.

Amendment to Charge 4(b)

In respect of this Charge 4(b), the panel sought legal clarification on 23 May 2013 when

reviewing the case. The panel had concerns that the evidence before the panel did not

reflect the date specified in the Charge.

The legal assessor, Mr Richards advised that generally the date alleged in a charge is

not material. He advised that if the date is such that it would mislead a registrant then it

is important as the charge may become unclear. He advised to first ask itself given the

evidence in the bundle, does the date 2 July 2009 mislead the registrant as to the

allegation being made. If the panel found that it does not, then the panel can disregard

the date.

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He also advised the panel on the test for amending the charge. He referred the panel to

Rule 28, He advised the panel to ask itself whether any prejudice may be caused to Ms

Pollard if the charge were to be amended.

The panel gave consideration to amending Charge 4(b) that currently reads:

b. On or around 2nd July 2009 you said words to the effect of “I hope its terminal”

in front of colleagues after being told that Staff Nurse Taylor was on sick

leave

To read

b. On or around 15 June 2009 you said words to the effect of “I hope its

terminal” in front of colleagues after being told that Staff Nurse Taylor was on

sick leave

The panel reminded itself that Ms Pollard is not present at the proceedings and would

not have the opportunity to comment on the amendment. However the panel does not

consider that the proposed amendment would cause Ms Pollard any prejudice, rather

would serve to clarify the charge and reflect the evidence. The panel therefore decided

to amend Charge 4(b) accordingly.

Determination on the findings of fact:

The allegations in this case surround Ms Pollard’s employment as a Registered Nurse

in the Endoscopy Department at Salisbury NHS Trust (the Trust).

Initial complaints were made concerning Ms Pollard’s conduct at work in 2006 she

received a formal warning under the Trust’s bullying and harassment policy. Ms 1,

Senior Nurse for Endoscopy and Radiology at the Trust, commencing her employment

following this. In response to these complaints a decision was made in 2007, for Ms

Pollard to be taken through the informal stage of the capability proceedings. In July

2008 the decision was made that the formal stage of the capability procedure would be

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initiated as there had not been sufficient improvement in Ms Pollard’s behaviour or

attitude and because a number of staff had made complaints.

On 9 July 2009 Ms 1 received a complaint from Ms 2, Staff nurse, concerning an

incidents on 2 and 3 July 2009. It was alleged that when Ms Pollard heard that Mr 3,

Staff Nurse, was off sick, she commented words to the effect of “I hope its terminal”.

Ms 1 received another complaint regarding 3 July 2009, where it was alleged that Ms

Pollard left an unsupervised student nurse to draw up drugs including Buscopan.

On 30 July 2009, Ms 1 was notified by Ms 4, Staff Nurse of a clinical incident involving

Ms Pollard. Ms 4 alleged that on 30 July 2009, when she returned from lunch at

12.30pm, she found that Ms Pollard had not checked the blood sugar for Patient A since

10am. Ms 4 also alleged that the pump was clamped off and was alarming.

It is also alleged that on or around 18 July 2009 Ms Pollard gave a student nurse, Ms 5,

an inappropriate level of responsibility by designating her as the first nurse and allowing

her to carry out biopsies.

Further it is alleged that in 2009, whilst Ms Pollard was working with Ms 6, Staff Nurse,

asked Ms Pollard to go and look at and plug in a machine that was alarming into the

mains. It is alleged that Ms Pollard did not do this and threw the lead at Ms 5, for her to

plug the machine in.

During 2009 there were also allegations that Ms Pollard swore whilst on duty, and

ignored and or interrupted staff during handover, or refused to hand over information.

There are further allegations that Ms Pollard was rude and unprofessional towards

patients’ relatives.

Mr 3 made a complaint to which was brought the attention of Mr 7, Directorate Senior

Nurse for Ambulatory Care, regarding Ms Pollard’s conduct towards him. As a result Mr

7, decided to start disciplinary procedures, and the capability procedure was

suspended. During this time Ms Pollards was redeployed to Day Surgery.

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Ms 8, was asked by the Trust to undertake the disciplinary investigation and Mr 7

assisted her. During the investigation Ms 8 had meetings with Ms Pollard. Ms Pollard

was on long term sick leave for much of the period during the investigatory procedure.

She contacted Mr 7 in December 2009 to advise that she was fit to return to work.

A disciplinary hearing was held on 9 March 2010 and Ms Pollard was dismissed on 10

March 2010.

Findings of Fact

The panel reminded itself that the burden of proof rests with the Nursing and Midwifery

Council (NMC) and that it should consider whether, on the balance of probabilities, the

facts alleged were more likely than not to have occurred.

The panel accepted the advice of the legal assessor.

The panel considered the witness statements of:

Ms 1, Senior Nurse for Endoscopy and Radiology at the Trust,

Ms 10, Consultant Radiographer at the Trust,

Ms 11, Nurse Endoscopy Practitioner at the Trust,

Ms 12, Staff Nurse at the Trust,

Dr 13, Specialist Registrar in Gastro-Enterology Department at Portsmouth

Hospital

Ms 6, Staff Nurse at the Trust

Ms 14, Registered General Nurse on the bank in the Rheumatology Department

at the Trust,

Ms 15, Lead Nurse for Bowel Cancer for the Bowel Cancer Screening

Programme at the Trust,

Ms 2, Band 5 Nurse at the Trust,

Ms 7, Directorate Senior Nurse for Ambulatory Care,

Ms 16, Radiography Helper at the Trust,

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Ms 17, Staff Nurse at the Trust,

Ms 8, Associate Directorate Senior Nurse in Medicine at the Trust,

Ms 18, Colorectal Nurse Specialist at the Trust,

Mr 3, Endoscopy Nurse at the Trust,

Ms 19, Specialist Screening Practitioner at the Trust,

Ms 9, Healthcare Support Worker at the Trust,

Ms 21, Staff Nurse at the Trust,

Ms 22, Staff Nurse at the Trust.

Ms 4, Bank Nurse in the Endoscopy Department

The panel notes that some of the evidence contained within in the witness statements

concerns other allegations. The panel heard and accepted the legal assessor’s advice.

He advised the panel to put matters not contained within the charges out of its mind.

This is an experienced panel and has put that information out of its mind.

The panel notes that Ms Pollard is unable to attend a substantive meeting and has

drawn no adverse inferences from the absence of Ms Pollard.

Charges

That whilst working as a registered nurse in the Endoscopy Department at SalisburyNHS Trust (“the Trust”):

From the evidence before the panel, it is satisfied that Ms Pollard was working as a

Registered Nurse in the Endoscopy Department at the Trust.

1. On or around 30th July 2009, you failed to provide an acceptable standard of

care to patient A, who was on a sliding scale test for blood glucose and had an

insulin pump, in that you failed to monitor patient A’s blood sugar level and / or

left the insulin pump clamped off

Not found proved

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The panel has considered the Adverse Event Report Form Sheet 1, completed by Ms 4

and dated 30 July 2009 and the witness statement of Ms 4.

The panel first considered whether Ms Pollard had a duty to provide an acceptable

standard of care to Patient A, who had a sliding scale test insulin pump prescribed.

The panel also considered whether Ms Pollard had a duty to monitor Patient A’s blood

sugar level and/or left the insulin pump clamped off.

In the Adverse Event Report Form Sheet 1, completed by Ms 4 dated 30 July 2009

states “I returned from lunch at 12:30hrs and checked the room 3 patients for ¼ hourly

observations. I noticed that Patient A had not had her blood sugar checked since her

return to the ward at 1000hours. S/N Pollard had recorded the result and had sent the

pump and documented it. At 12.30hours, I checked the blood sugar because it had not

been taken since 1000hours. I went to get another S/N to check the …with me as we

needed to change to 1.0ml and we noticed the pump was clamped off and was

alarming…”.

Further in her witness statement Ms 4 states, “I handed over a patient who had come

out of room 3 post ERCP and had advised Lynn that she needed her blood sugar

carried out. After that I was admitting and discharging patients from the other rooms as

was Ms 11. I was asked to go to lunch at 12 noon and when I returned at 12:30pm I

found that no blood sugars had been taken for this patient who was on a sliding scale

and an insulin pump. Furthermore, the insulin pump was clamped off. It is not unusual

for the pump to be switched off during the procedure, but monitoring continues

throughout”.

In light of the above, the panel has evidence that it is uncommon practice for the pump

to be clamped off.

The panel has evidence to suggest that Ms Pollard stated that she had undertaken

Patient A’s observations. The panel has no patient notes for Patient A. Without Patient

A’s notes, that panel has no evidence, outside of Ms 4’s witness statement, to enable it

to conclude that Ms Pollard did not undertake observations, care for Patient A

appropriately or that Patient A was on a sliding scale test for blood glucose.

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Further the panel has no evidence that Ms Pollard had a responsibility to monitor

Patient A’s blood sugar level and what steps Ms Pollard should have taken to provide

an acceptable standard of care to a patient on a sliding scale test for glucose.

The panel could therefore not conclude that Ms Pollard had a responsibility to provide

an acceptable standard of care to Patient A concerning Patient A’s medical condition, or

did not provide an acceptable standard of care for Patient A. Nor was the panel able to

conclude that Ms Pollard had a duty to monitor Patient A’s blood sugar level and/or left

the insulin clamped off.

As a result the panel is unable to conclude that Ms Pollard failed to provide the above

care, because there is no evidence to determine that she had a duty to. The panel has

therefore found charge 1 not proved.

2. You did not supervise students to an acceptable standard on one / more of the

following occasions:

a. On or around 2nd- 3rd July 2009 you allowed Student Nurse Phillip Scaife

to draw up a controlled drug, unsupervised

Found Proved

The panel has considered the witness statement of Ms 2 and Ms 12 and Ms 2’s

contemporaneous statement prepared for the Trust dated 3 July 2009

Ms 2 in her witness statement states that “I recall an incident on 2 July 2009 when Ms

Pollard allowed a student nurse to draw up controlled drugs without supervision.

Student nurses should not be allowed to do this, someone should be supervising them

at all times. The students name was [Mr 23]. I saw [Mr 23] in the treatment room

drawing up the controlled drugs. Ms Pollard had left him in the room doing this. When I

saw this I went in and supervised him.”

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Ms 2’s Statement for the Trust dated 3 July 2009 gives a corroborates the above

statement.

Ms 12 in her witness statement states “I also recall an incident when a student,

assigned to me, was being looked after by Ms Pollard when I was not on duty. The

student was called 23, although I cannot remember his surname”

The panel were impressed by Ms 2’s witness statements, which are supported by the

statement of Ms 12. The panel had regard to undated meeting notes from 14

September 2009 that state “Lynn said this was a third year student and Lynn had taken

responsibility for it”.

The panel accepts Ms 2 and Ms 12’s account of the incidents, and concluded that on

the balance of probabilities Ms Pollard allowed student nurse, Mr 23 to draw up a

controlled drug unsupervised. The panel therefore found Charge 2(a) proved.

b. On or around 18th July 2009 you gave a student nurse, Naomi Wallace, an

inappropriate level of responsibility by designating her as the first nurse and

allowing her to carry out biopsies

Found Proved

The panel has considered the witness statement of Ms 9’s and Ms 9’s statement

prepared for the Trust,

Ms 9 in her witness statement indicates that on 18 July 2009, Ms Pollard was the first

nurse on duty and that there was a student nurse on duty. She continues to state “The

student nurse asked me if she could act as the first nursing in the procedure. I said that

she should ask Ms Pollard. Ms Pollard said that it was fine and let her act as the first

nurse. Ms Pollard allowed the student nurse to take biopsies. She should not have

allowed her to do this”.

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In the witness statement of Ms 9 for the Trust she states “On Friday afternoon, I was

working with Lynn and her student Nurse, Ms 5, I was second nurse. I asked Naomi if

she would like to work as second nurse. No she said I’m going to ask to be first nurse.

How else will I get experience she said? Lynn came in and said it was ok, that Ms 5

could be first nurse all afternoon and even let her take biopsies”.

The panel has no response from Ms Pollard in relation to this charge.

The panel accepts Ms 9’s account of the incident, and concluded that on the balance of

probabilities Ms Pollard gave Ms 5, an inappropriate level of responsibility by

designating her as the first nurse and allowing her to carry out biopsies. The panel

therefore found Charge 2(b) proved.

3. You were rude and / or behaved unprofessionally towards patients’ relatives, for

example, on an unknown date, in response to a question from a patient’s son

about how long his father would be in theatre, you responded with words to the

effect of “I don’t know, you tell me” and / or made a “V” sign directed at the

patient’s son when his back was turned and / or did so within view of the patient

Found Proved

The panel has considered the witness statement of Ms 9, Ms 16, Ms 21 and Ms 14.

Ms 9 in her witness statement says “A relative came in and asked about a patient. In

response to the relative Ms Pollard said that they were recovering and she told the

relative ‘to go away and come back later’. The relative asked how long the patient

would be in recovery for and Ms Pollard snapped back saying that it would be around

half an hour. When the relative turned away I recall seeing Ms Pollard putting two

fingers up in a ‘V’ sign at the relative’s back. The relative would not have seen this but

the patient was sitting up on a trolley and could see it”.

In her witness statement Ms 16 states “I confirm what I have said in that statement that

the patient’s son came up and asked how long his father would be. Ms Pollard’s

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response was ‘I don’t know you tell me’. The son replied ‘I don’t know that is why I am

asking you’. As he turned around Ms Pollard did a “V” sign behind his back”.

Ms 21 in her statement for the Trust states “Lynn can be inappropriate when she talks to

patients and relatives, she can be loud and rude sometimes”.

Ms 14 in her witness statement says “I also recall that she was rude on the phone to

patients’ relatives. If the relatives rang up to ask how long a patient would be, we would

suggest that they went to have a cup of tea and come back later. Often if a relative

asked Ms Pollard how long the procedure would take she’d say “how long is a piece of

string?’ and scowl at them”

The panel has no evidence of any response from Ms Pollard in relation to this charge.

The panel accepts Ms 9, Ms 16, Ms 21 and Ms 14 account of the incidents, and

concluded that on the balance of probabilities Ms Pollard was rude and unprofessional

towards patients’ relatives. The panel therefore found Charge 3 proved.

4. You were rude to / about colleagues, for example:

a. On a number of unknown dates in 2009 you ignored or interrupted staff

that were attempting to handover to you and / or refused to handover

information to some members of staff

Found Proved

The panel has considered the witness statements of Mr 3, Ms 6, Ms 17, Ms 2 and Ms

14.

In his witness statement Mr 3 states “Ms Pollard refused to handover patients to me if

she was working in the Treatment Room and I was working in Recovery Area of the

ward. The Nurses in the Treatment Room would tell me about the observations and

how the procedure had gone because Ms Pollard would just ignore me and handover to

someone else. She would seek out other people to handover to, even if I was the

appropriate person to handover to. Sometimes she would say “coffee with two sugars”

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and that was her handover. She would just throw the charts at me and bark instructions

that would make me feel very undermined”

In her witness statement Ms 6 states, “I recall that Ms Pollard would not handover

patients to Mr 3. This was very noticeable. If Ms Pollard came out of the treatment room

with a patient and Mr 3 was working on the ward she would walk away. Mr 3 did try to

get along with her but she was constantly ignoring him or being rude. Ms Pollard would

either ignore Mr 3 or handover to other nurses even if they were busy and Mr 3 was

available”.

In her witness statement Ms 17 states “I recall incidents relating to Ms Pollard, for

example, if Mr 3, one of the other nurses, was working in the Recovery Area of the Unit,

Ms Pollard would refuse to hand over to him. She would come out of a Treatment room

and would not hand over to Mr 3, but would come and find someone else to take the

handover”.

Ms 2 in her witness statement states, “Ms Pollard nitpicked constantly regarding my

work. She would not hand over patients to me and would totally blank and ignore me if I

was the nurse available for handover”.

Ms 14 in her witness statement states “Ms Pollard also refused to handover to me.

Nurses are either working in the rooms where the procedures are done or sometimes

allocated to the recovery area in Endoscopy. If Ms Pollard was bringing a patient out of

the Procedure Room and I was the Nurse in the Recover Area she would just ignore me

and find somebody else to hand over to”.

The panel accepts Mr 3, Ms 6, Ms 17, Ms 2 and Ms 14 account of the incidents, and

concluded that on the balance of probabilities Ms Pollard on a number of occasions

ignored or interrupted staff that were attempting to hand over to her and refused to hand

over information to some members of staff. The panel therefore found Charge 4(a)

proved.

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c. On or around 2nd July 2009 you said words to the effect of “I hope its terminal”

in front of colleagues after being told that Staff Nurse Taylor was on sick

leave

Found Proved

The panel has considered the witness statement of Ms 2 and her statement to Ms 1

dated 2 July 2009.

Ms 2, witness statement “On one occasion in June 2009 I overheard Ms Pollard

commenting about Staff Nurse Mr 3 in an inappropriate manner. Ms Pollard had heard

that Mr 3 was on sick leave and Ms Pollard responded with words to the effect of ‘I hope

its terminal’.

The panel has also noted Ms 2’s statement to Ms 1 that states “On Monday 15th June

SN Mr 3 was off sick. I was in a room with (Ms Pollard) preparing for a list, and hearing

from…that (Mr 3) was at the doctors, Ms Pollard comment that she hoped it was

terminal”.

The panel accepts that Ms Pollard made a comment using words to the effect of “I hope

it’s terminal”. However the evidence before the panel indicates that Ms Pollard made

these comments on 15 June 2009.

As a result of the evidence before the panel, it concluded that on the balance of

probabilities that on 15 June 2009 Ms Pollard used words to the effect of “I hope its

terminal” in front of colleagues regarding Mr 3.

d. On a number of dates in 2009 you swore whilst on duty

Found Proved

The panel has considered the witness statements of Ms 2, Mr 3, Ms 15 and Mr 24.

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Ms 2 in her witness statement says, “I recall on one occasion bringing a sedated patient

out of a room on a trolley. Ms Pollard said ‘mind your hands’ and I said something like

‘they’re fine’. In response to this, Ms Pollard said something to me like ‘fuck off’. She

definitely used the ‘F’ word”.

Mr 3 in his witness statement says “Ms Pollard would also swear on the Unit. She would

whinge about equipment and say things like ‘the fucking equipment’. This would be in

the hearing of patients and other staff. I would estimate that this was about once a

month, regular enough for me to remember”.

Ms 15 in her witness statement says “Ms Pollard would often swear. She would say

crude words at nurses’ station which was in the middle of the Unit. For example, I recall

her saying ‘arse’, but not directly to a patient. I was not very happy with that and I would

look at her and say ‘Lynn!’.”

Mr 24, “I noticed that Ms Pollard would frequently lose her temper with nurses and use

crude language. She would tell them off in a violent manner if she was in a bad mood.

On one occasion a nurse dropped a sterile piece of equipment. Ms Pollard really

berated the nurse”,

The panel accepts Ms 2, Mr 3, Ms 15 and Mr 24’s account of Ms Pollard’s use of

language, and concluded that on the balance of probabilities she swore whilst on duty.

The panel therefore found Charge 4(c) proved.

e. On a date in 2009 when asked by Staff Nurse Helen Hambling to plug in a

pump that was alarming you threw the lead at her

Found Not Proved

The panel has considered the witness statement of Ms 6 and Ms 6’s statement

prepared for the Trust.

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Ms 6, in her witness statement says, “Ms Pollard was working nearby in the Recovery

Area and was doing something with her phone. I asked her to go and look at the alarm.

I recall that the alarm needed to be plugged into the mains. Someone had glanced at it

whilst they were doing the patient’s observations and said that the battery was getting

low. The whole pump would lock down if the battery died and would need a key to

unlock. It was so important it was plugged into the mains as soon as possible. I asked

Ms Pollard if she could plug it in and she just threw the lead at me saying “Can’t you

deal with it, I’m busy”.

Ms 6 in her statement for the Trust says, “Once I was coordinating, Lynn was looking

after patients in the ward area, but sitting at the nurses station, reading. A pump was

alarming, so I asked ‘Oh what’s that’. I guess it’s a pump’ she replied. So as she made

no effort to move I asked if it was plugged it at which she threw the lead at me. It was

part of a sliding scale regime and she showed no regard for the patient’s safety”.

The panel accepts that an incident occurred in which Ms Pollard threw a lead at her.

However the only evidence before the panel, regarding this incident is that of Ms 6. Ms

6’s evidence regarding the incident is inconsistent. In the Statement for the Trust dated

21 October 2009, Ms 6 makes no mention of asking Ms Pollard to plug in a pump that

was alarming, there is also a differing account of what Ms Pollard was doing when the

alarm sounded.

In light of the inconsistent evidence before the panel, it determined that on the balance

of probabilities, whilst Ms Pollard did throw a lead at Ms 6, she was not asked to plug it

in by Ms 6. The panel therefore found charge 4(d) not proved.

Determination on Impairment:

The panel has considered, on the basis of the matters found proved, whether Ms

Pollard’s fitness to practise is currently impaired by reason of misconduct. It has had

regard to all the evidence. The panel has accepted the advice of the legal assessor.

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The panel was referred to the 2008 NMC, The code: Standards of conduct,

performance and ethics for nurses and midwives (“the Code”) and the Council for

Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011]

EWHC 927 (Admin) (Grant) , Roylance v General Medical Council (No 2) [2000] 1 A.C.

311 (Roylance), Ronald Jack Cohen v General Medical Council [2008] EWHC 581

(Admin) (Cohen), Yeong v General Medical Council [2009] EWHC 1923 (Admin) and

Nandi v GMC [2004] EWHC 2317(Admin). The panel has exercised its own judgement in

determining the issues before it and in this context it has considered the public interest.

Misconduct

In considering whether Ms Pollard’s fitness to practice is impaired by reason of

misconduct, the panel has taken account of all the evidence.

The panel also considered the case of Nandi in which Mr Justice Collins defines

misconduct as “conduct which would be regarded as deplorable by fellow practitioners”.

The panel consider that Ms Pollard’s conduct was inappropriate and would be regarded

as deplorable by fellow practitioners.

The panel has considered the preamble of the 2008 NMC Code: Standards of Conduct,

Performance and Ethics for Nurses and Midwifes, (“The Code”) which requires all

Registered nurses to:

make the care of people your first concern, treating them as individuals and

respecting their dignity

work with others to protect and promote the health and wellbeing of those in

your care, their families and carers, and the wider community

provide a high standard of practice and care at all times

be open and honest, act with integrity and uphold the reputation of your

profession.

The panel also considered paragraphs:

1 You must treat people as individuals and respect their dignity.

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3 You must treat people kindly and considerately.

21 You must keep your colleagues informed when you are sharing the care of others.

23 You must facilitate students and others to develop their competence.

24 You must work cooperatively within teams and respect the skills, expertise andcontributions of your colleagues.

25 You must be willing to share your skills and experience for the benefit of yourcolleagues.

61 You must uphold the reputation of your profession at all times.

The panel concluded that Ms Pollard had breached the above parts of the Code.

The panel found that Ms Pollard allowed Student Nurse Mr 23 to draw up a controlled

drug unsupervised. The distribution of controlled drugs are monitored very carefully.

Common practice is that even Registered Nurses will not draw up a controlled drug

independently. Ms Pollard was responsible for teaching a student nurse correct

practice, and allowed him to undertake unsafe practice.

The panel found that on 18 July 2009 Ms Pollard gave a student nurse an inappropriate

level of responsibility by designating her as first nurse and allowing her to carry out

biopsies. Ms Pollard allowed a student nurse to undertake an invasive procedure, under

the supervision of a senior health care assistant. A staff member who themselves is unable

to act in this role or perform this skill. The panel considered the case of Nandi, and

consider that Ms Pollard’s conduct would be considered unprofessional and deplorable.

The panel found that Ms Pollard behaved unprofessionally towards patients’ relatives, with

a specific example of making a “V” sign directed at the patient’s son and responding to

questions regarding the patient with “I don’t know, you tell me”. The panel considers that

Ms Pollard’s behaviour is completely inappropriate, unacceptable and unprofessional. The

panel considered the case of Nandi, and consider that Ms Pollard’s conduct would be

considered unprofessional and deplorable.

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The panel found that on a number of unknown dates in 2009, Ms Pollard refused to

handover information to on patients’ clinical conditions to some staff members and swore

whilst on duty. Handing over information is critical to safe nursing practice, it ensures

colleagues can provide effective care to patients. Ms Pollard’s conduct was inappropriate

and had the potential to put patients at risk. Ms Pollard swore on the ward, in front of

patients on numerous occasions. Swearing on duty is never acceptable and is

unprofessional. The panel considered the case of Nandi, and consider that Ms Pollard’s

conduct would be considered unprofessional and deplorable.

The panel concluded that the failures demonstrated and proved in the charges

amounted to serious misconduct.

Impairment

The panel next went on to consider whether Ms Pollard’s fitness to practise is currently

impaired by reason of her misconduct.

The panel has exercised its own judgement in determining the issues before it and in

this context it has considered the need for appropriate weight to be given to the

protection of the public, the maintenance of public confidence in the profession and the

upholding of proper standards of conduct and behaviour.

For this purpose the panel had careful regard to the questions posed by Lady Justice

Smith in her fifth Shipman Report. The panel first considered whether Ms Pollard:

(a) had put a patient or patients at unwarranted risk of harm;

(b) had brought the profession into disrepute, and

(c) had breached one of the fundamental tenets of the professions;

The panel concluded that by reason of Ms Pollard’s misconduct she had put patients at

unwarranted risk of harm, had brought the profession into disrepute and had breached

one of the fundamental tenets of the profession.

The panel next considered whether Ms Pollard is liable in the future to:

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(a) put a patient or patients at unwarranted risk of harm;

(b) bring the profession into disrepute;

(c) had breached one of the fundamental tenets of the professions;

The panel considered whether Ms Pollard’s misconduct is easily remediable; whether it

has been remedied and whether it is likely to be repeated. The panel had regard to all

the circumstances of the case and also to the issue of Ms Pollard’s insight in respect of

her misconduct.

The panel has evidence that whilst there were concerns regarding Ms Pollard’s

behaviour, there were no concerns regarding her Ms Pollard’s clinical practice.

However, Ms Pollard’s behaviour was not an isolated incident and the panel considers

that Ms Pollard’s misconduct is serious. The panel has not had the benefit of receiving

evidence from Ms Pollard regarding her remorse or insight. Nor does it have any

information to suggest that Ms Pollard has apologised for her actions. The panel has no

evidence of any steps Ms Pollard has taken to remedy her failings and has not had the

benefit of seeing any references or testimonials. Ms Pollard had received a warning in

relation to her inappropriate behaviours and received support and training to overcome

her issues, but she had not respond to this whilst employed at the Trust. The panel was

unable to conclude that Ms Pollard has insight and remorse.

In light of the evidence received at this stage, the panel is of the view that there remains

a real risk that Ms Pollard could put patients at unwarranted risk of harm, bring the

profession into disrepute and breach fundamental tenets of the professions.

The panel considered that the nature of Ms Pollard’s misconduct requires a finding of

impairment for the protection of the public, to uphold and declare proper professional

standards and to maintain the public confidence in the professions.

For all the reasons outlined above, the panel has determined that Ms Pollard’s fitness to

practise is currently impaired by reason of her misconduct.

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Determination on Sanction:

In reaching its decision on sanction, the panel has considered all the evidence that has

been placed before it. It has exercised its own independent judgement.

The panel has taken account of the Council’s Indicative Sanctions Guidance. The panel

has had regard to the public interest, which includes the protection of the public, the

maintenance of confidence in the profession and in the NMC as a regulator. It has

applied the principle of proportionality, weighing the interests of the public with Ms

Pollard’ interests, and has taken into account the mitigating and aggravating factors in

this case.

The panel has accepted the advice of the legal assessor.

The panel first considered taking no action and gave consideration to paragraphs 60-62

of the Indicative Sanctions Guidance. The panel determined that Ms Pollard’s

misconduct requires a sanction to mark the serious departure from the professional

standards set out within the NMC Code and in order to maintain the reputation of the

profession. For these reasons the panel has concluded that taking no action would be

wholly inappropriate and not in the public interest.

The panel next considered whether to impose a Caution Order and gave consideration

to paragraphs 63-65 of the Indicative Sanctions Guidance. The panel does not consider

that Ms Pollard’s impairment is at the lower end of the spectrum. The panel noted that a

Caution Order would not impose any restriction on Ms Pollard’s ability to practise. In

view of the serious nature of Ms Pollard’s misconduct, the panel has concluded that the

imposition of a Caution Order would not be sufficient to satisfy the public interest in this

case. The panel accordingly determined that a Caution Order would be inadequate and

inappropriate.

The panel next considered a Conditions of Practice Order and considered paragraphs

66, 67 and 68 of the Indicative Sanctions Guidance.

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The panel is of the view that the nature of Ms Pollard’s misconduct could not be

addressed by such an order. The panel consider that Ms Pollard’s conduct

demonstrated potential deep seated attitudinal and personality issues. The panel has no

information regarding Ms Pollard’s current circumstances or anything to suggest that Ms

Pollard would be willing to comply with a Conditions of Practice Order. Further the panel

notes that Ms Pollard underwent an extensive capabilities programme with the Trust,

yet her inappropriate conduct continued. The panel is not satisfied that Conditions of

Practice could be drafted that would adequately reflect the seriousness of this case or

would appropriately address the misconduct found. The panel considered that there

were no conditions of practice which would meet the criteria of being appropriate,

proportionate, workable and measurable in respect of her misconduct. For these

reasons the panel has concluded that a Conditions of Practice Order would not be a

sufficient or appropriate sanction and would not be in the public interest.

The panel next considered a Suspension Order and considered paragraphs 69, 70 and

71 of the Indicative Sanctions Guidance. The panel is of the view that Ms Pollard’s

misconduct represent a serious departure from the standards set out in the Code.

The panel notes that there is evidence to suggest that there were no concerns

regarding Ms Pollard’s technical capabilities as a Registered Nurse. However her

inappropriate conduct and behaviour were not isolated incidents, rather the charges

comprise numerous incidents of misconduct. The panel has no evidence to suggest that

Ms Pollard has taken steps to remediate her conduct, and the panel is not satisfied that

Ms Pollard has insight or remorse into her conduct. As a result the panel concluded that

there is a real risk of repetition. Ms Pollards treatment of colleagues was completely

unacceptable. The panel considers that whilst there is no evidence of harm caused to

patients in this case, refusing to handover to colleagues appropriately and leaving

student nurses unsupervised, has the potential to cause real patient harm, and prevents

colleagues from providing appropriate care. Further Ms Pollard failed to respect and

uphold patients’ dignity and she acted inappropriately to patients’ relatives. The panel

found that the misconduct found demonstrated deep seated attitudinal issues and a lack

of compassion.

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The panel is not satisfied that a Suspension Order would sufficiently mark the

seriousness of Ms Pollard’ misconduct, maintain public confidence in the nursing and

midwifery professions and serve to declare and uphold proper standards of conduct and

performance.

The panel concluded that a Striking Off Order was appropriate in this case and has

considered paragraphs 74, 75, 76 and 77 of the Indicative Sanctions Guidance. Ms

Pollard’s misconduct reflects serious breaches of the Code. There are numerous

incidents of serious misconduct and the panel considers that if Ms Pollard were allowed

to practise there would be a real risk of repetition and potential for patient harm. The

panel has therefore concluded that Ms Pollard’s failings are fundamentally incompatible

with her continued registration as a nurse.

In all of the circumstances the panel has concluded that a Striking Off Order is the only

appropriate and proportionate sanction in response to Ms Pollard’s misconduct. The

panel recognises that this order will have very significant implications for Ms Pollard but

it is satisfied that the public interest outweighs her interest in all the circumstances of

this case. Accordingly the panel has determined to instruct the registrar to strike Ms

Pollard from the register.

Ms Pollard will be notified of the panel’s decision in writing. The Striking Off Order will

come into effect 28 days after the service of the notification of the panel’s decision upon

her. If Ms Pollard were to appeal the panel’s decision the order will not take effect until

the appeal has been concluded.

Determination on Interim order

The panel is required to consider whether it is necessary to impose an interim order to

cover the appeal period before the Striking Off Order can take effect or to cover any

time required to consider an appeal of this decision.

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Article 31 of the Nursing and Midwifery Order 2001 outlines the criteria for the

imposition of an interim order. The panel may only make an interim order if it is satisfied

that it is necessary on one or more of three grounds; for the protection of the public,

otherwise in the public interest or in the registrant’s own interest. The panel may make

an Interim Conditions of Practice order or an Interim suspension order for a maximum of

18 months.

The panel heard and accepted the legal assessor’s advice.

The panel has concluded that it is necessary to impose an Interim Suspension Order for

the maximum period of 18 months on the grounds of public protection and that it is

otherwise in the public interest. In imposing the Interim Suspension Order the panel

relies on the reasons for its findings on facts, impairment and sanction which it gave in

respect of the striking off order. These detail the seriousness of the facts found, the risk

of repetition and the risk to patients. The panel has determined that the period of the

interim order shall be 18 months to allow for any appeal.

The panel was mindful that the effects of any interim order would be to immediately

restrict the registrant’s ability to work as a nurse, but considered that it is necessary in

the circumstances of this case to make the order.

If at the end of the appeal period Ms Pollard has not lodged an appeal, the interim order

will lapse and be replaced by a Striking Off Order. However if Ms Pollard does lodge an

appeal the interim order will continue to run for the period imposed or until the appeal is

decided.