That being registered under the Medical Act 1983 (as amended):

Transcription

1 PUBLIC RECORD Dates: 21/08/ /08/2017 Medical Practitioner s name: Dr Robert CODDINGTON GMC reference number: Primary medical qualification: Type of case New - Misconduct BM BS 2014 University of Nottingham Outcome on impairment Impaired Summary of outcome Suspension, 2 months. Immediate order imposed Tribunal: Lay Tribunal Member (Chair) Medical Tribunal Member: Medical Tribunal Member: Mrs Lucy Reid Mr Mike Hayward Dr Paul Nolan Legal Assessor: Tribunal Clerk: Miss Carey Johnston QC Mr Sewa Singh Attendance and Representation: Medical Practitioner: Medical Practitioner s Representative: GMC Representative: Present and represented Mr Simon Gurney, Counsel Miss Elizabeth Acker, Counsel Allegation and Findings of Fact That being registered under the Medical Act 1983 (as amended): 1. On or around 5 May 2015, you made a request to Ms A at Nottingham University Hospitals NHS Trust (the Trust ) for annual leave, to include the dates of 28 to 31 July 2015 inclusive ( the Request ). 1

2 2. You did not attend work at the Trust to fulfil your role as the Doctor covering ward C5 on: a. 30 July 2015; b. 31 July in its entirety 3. On the dates set out at paragraph 2 above you knew or ought to have known that: a. in order for the Request to have been approved, you would have needed to find cover for ward C5 in the afternoon of each of 28 to 31 July 2015; b. you had not arranged approved cover for ward C5 for the afternoons of 30 and 31 July 2015; c. you had only submitted a formal Application for Annual Leave for the dates of 28 and 29 July 2015; d. you did not have approval from the Trust for annual leave on 30 and 31 July in its entirety 4. On 30 July 2015, you falsely claimed to Ms A that: a. you had returned to the UK from Spain; b. the reason why you could not attend work that day at the Trust was because you had developed the medical condition in Schedule 1; c. you had left your phone in Spain so you were uncontactable. d. your EObs mobile phone was out of battery and you had left the charger in Spain; (Amended following a successful application under Rule 17(6) in its entirety 5. On 31 July 2015, you falsely claimed in contacts with Trust staff that: a. the reason why you could not attend work that day at the Trust was because you still had the medical condition in Schedule 1; 2

3 b. you were in Lincolnshire; c. you were uncontactable because: i. you had left your mobile phone in Spain; ii. iii. your EObs mobile phone was out of battery and you had left the charger in Spain; (Deleted following a successful application under Rule 17(6) the landline telephone in Lincolnshire was undergoing maintenance; d. you had booked a return flight for 29 July 2015 from Spain to the UK; e. you had missed the flight at paragraph 5d. above. in its entirety 6. When making the claims set out at paragraphs 4 and 5 above, you knew that: a. you were not in the UK, but in Spain; b. you were not suffering from the medical condition in Schedule 1; c. you were contactable; d. you had not booked a return flight for 29 July 2015 and had only booked a return flight for 1 August in its entirety 7. In reporting by voic your absence on sickness grounds on 30 and 31 July 2015, you were acting in breach of the Trust sickness policy. 8. In reporting by voic your absence on sickness grounds on 31 July 2015, you were acting in contravention of a direction from Ms A to speak directly with a colleague at the Trust. 9. Your actions as set out at paragraphs 7 and 8 above were intended to deceive your colleague about the reasons for your absence. 10. Your actions and/or omissions at paragraphs 4 to 9 and above were: 3

4 a. misleading; b. dishonest. Attendance of Press / Public The hearing was all heard in public. Determination on preliminary procedural matters, Facts and Impairment - 22/08/2017 Dr Coddington: Amendments to the Allegation 1. Ms Elizabeth Acker, Counsel, on behalf of the GMC, made an application to amend paragraphs 4 and 5 of the allegation under Rule 17(6) of the General Medical Council (GMC) (Fitness to Practise) Rules 2004 (as amended) ( the Rules ). She submitted that the amendment was to ensure accuracy and would not result in any injustice to you in doing so. Mr Simon Gurney, Counsel, on your behalf, agreed to the amendment. The tribunal therefore agreed to amend these paragraphs as follows: - Paragraph 4 to read: a.. b.. c.. d. your EObs mobile phone was out of battery and you had left the charger in Spain - To delete paragraph 5 (c)(ii) Admissions 2. At the outset of the hearing, you admitted the allegation in its entirety, which the tribunal announced as admitted and found proved. The Tribunal s Findings 3. The tribunal has made the following findings on the facts: 4

5 1. On or around 5 May 2015, you made a request to Ms A at Nottingham University Hospitals NHS Trust (the Trust ) for annual leave, to include the dates of 28 to 31 July 2015 inclusive ( the Request ). 2. You did not attend work at the Trust to fulfil your role as the Doctor covering ward C5 on: a. 30 July 2015; b. 31 July in its entirety 3. On the dates set out at paragraph 2 above you knew or ought to have known that: a. in order for the Request to have been approved, you would have needed to find cover for ward C5 in the afternoon of each of 28 to 31 July 2015; b. you had not arranged approved cover for ward C5 for the afternoons of 30 and 31 July 2015; c. you had only submitted a formal Application for Annual Leave for the dates of 28 and 29 July 2015; d. you did not have approval from the Trust for annual leave on 30 and 31 July in its entirety 4. On 30 July 2015, you falsely claimed to Ms A that: a. you had returned to the UK from Spain; b. the reason why you could not attend work that day at the Trust was because you had developed the medical condition in Schedule 1; c. you had left your phone in Spain so you were uncontactable. d. your EObs mobile phone was out of battery and you had left the charger in Spain; in its entirety 5. On 31 July 2015, you falsely claimed in contacts with Trust staff that: 5

6 a. the reason why you could not attend work that day at the Trust was because you still had the medical condition in Schedule 1; b. you were in Lincolnshire; c. you were uncontactable because: i. you had left your mobile phone in Spain; ii. iii. your EObs mobile phone was out of battery and you had left the charger in Spain; the landline telephone in Lincolnshire was undergoing maintenance; d. you had booked a return flight for 29 July 2015 from Spain to the UK; e. you had missed the flight at paragraph 5d. above. in its entirety 6. When making the claims set out at paragraphs 4 and 5 above, you knew that: a. you were not in the UK, but in Spain; b. you were not suffering from the medical condition in Schedule 1; c. you were contactable; d. you had not booked a return flight for 29 July 2015 and had only booked a return flight for 1 August in its entirety 7. In reporting by voic your absence on sickness grounds on 30 and 31 July 2015, you were acting in breach of the Trust sickness policy. 8. In reporting by voic your absence on sickness grounds on 31 July 2015, you were acting in contravention of a direction from Ms A to speak directly with a colleague at the Trust. 9. Your actions as set out at paragraphs 7 and 8 above were intended to deceive your colleague about the reasons for your absence. 6

7 10. Your actions and/or omissions at paragraphs 4 to 9 and above were: Background a. misleading; b. dishonest. 4. You are a doctor with full registration with the GMC. At the time of the events in question, you worked as a Foundation Year 1 (FY1) Junior Doctor at the Nottingham University Hospitals NHS Foundation Trust (the Trust ). 5. It is alleged that on or around 5 May 2015, you made a request to Ms A, Junior Doctors Senior Coordinator for Surgery at the Trust, for annual leave to include the dates of 28 to 31 July Ms A advised you that you needed to find appropriate cover for the dates you had requested before she could approve your request. As you were unable to secure appropriate cover for 30 and 31 July 2015, you submitted your annual leave request form for 28 and 29 July 2015, which was approved. It was understood by Ms A that you would provide cover for a colleague on 30 and 31 July You travelled to Spain on the evening of 27 July On 30 July 2015, you left a voic message on Ms A s contact number to the effect that you had returned from Spain but had developed XXX and would not be in work that day. You stated that you were uncontactable as you had left your phone in Spain and would not have access to it until the 31 July 2015 as it was being posted back to you. Ms A attempted to phone you on your mobile and noted an international ring tone. Ms A ed you to ask when you had returned to the UK and requested an alternative contact number. She also inquired as to the likelihood of you returning to work on 31 July 2015 because as you know it will leave [ward] C5 uncovered. You responded to Ms A s shortly afterwards stating that you had returned to the UK on the 29 July 2015, that you did not have an alternative contact number and that your family would bring your phone back when they returned on Sunday. You also stated that you were still suffering from XXX and would be unlikely to be able to work the next day and were currently XXX trying to recover. 7. On 31 July 2015 at 07:33, you left a voic message informing Ms A s colleague that you remained unwell and would not be attending work that day. 8. On the afternoon of 31 July 2015, the Trust Admin Registrar attempted to contact you by phone and left a voic message and sent you an . You returned his call and stated that you were still unwell at your parent s address. You further stated that you were phoning from an internet connection because the landline was not working. You were advised to contact Mr B, Consultant Orthopaedic 7

8 Trauma Surgeon at the Trust. You contacted Mr B later the same afternoon and told him that you were still in Spain but had missed the flight you had booked for 29 July 2015 because you were still sick. 9. On 4 August 2015 you admitted to Mr B that you had lied about being in the UK and about having booked a return flight for 29 July The matter was subsequently brought to the attention of Health Education East Midlands (HEEM) who then referred it to the GMC. Evidence 10. The evidence before the tribunal from the GMC included witness statements from your former senior colleagues: Mr B, dated 13 March 2017 Dr C, Director of Foundation Training for the East Midlands, for HEEM, dated 11 April 2017 Ms A dated 26 April 2017 (first) and 4 May 2017 (supplementary) Mr D, Admin Registrar, dated 11 May You accepted their evidence and the tribunal also accepted it in its entirety. 12. The tribunal also received evidence from you which included: Two witness statements from you dated 12 July 2017 and 18 August 2017, and your oral evidence Testimonials from former colleagues Feedback forms in relation to your presentation regarding probity Witness statement of Mr E, Area Manager, Lincolnshire Music Service A character reference from your parents. Impairment 13. Having announced the facts admitted and found proved, the tribunal considered whether your fitness to practise is currently impaired by reason of misconduct. In doing so, it has taken account of all the evidence adduced, together with the submissions made by both Counsel. Submissions on behalf of the GMC 14. Ms Acker submitted that your fitness to practise is impaired by virtue of your dishonest actions which were repeated over a long period and to a number of colleagues. Ms Acker said that honesty was a fundamental tenet of the medical profession and that your actions had breached that tenet and had brought the 8

9 profession into disrepute. She referred the tribunal to certain paragraphs of GMP and relevant authorities. Submissions on your behalf 15. Mr Gurney submitted to the tribunal that you had specifically accepted that your fitness to practise is impaired. He told the tribunal that you had reflected extensively and remediated your dishonest conduct. He referred the tribunal to the steps you have taken to increase the understanding of dishonesty, as well as the testimonials from your colleagues attesting to your good clinical work and character. Mr Gurney said that you recognise you made serious errors and that you had insight into your dishonest actions. Mr Gurney accepted that the public interest demands a finding of impairment. The Tribunal s Approach 16. Whilst the tribunal has considered the submissions made, it has borne in mind that there is no burden or standard of proof at this stage. It is a matter for this tribunal, exercising its own judgement, to determine whether your fitness to practise is currently impaired. 17. Throughout its deliberations, the tribunal has been mindful of its responsibility to uphold the overarching objective as set out in the Medical Act 1983 (as amended). That objective is the protection of the public and involves the pursuit of the following: a. to protect, promote and maintain the health, safety and wellbeing of the public b. to maintain public confidence in the profession c. to promote and maintain proper professional standards and conduct for members of the profession. Misconduct 18. The tribunal first considered whether the facts found proved are of a sufficiently serious nature to amount to misconduct, and concluded that they were. You have accepted that your dishonest behaviour amounts to misconduct. 19. In reaching this decision, the tribunal had regard to paragraphs 1 and 65 of GMP. These state: 1. Patients need good doctors. Good doctors make the care of their patients their first concern:. are honest and trustworthy, and act with integrity and within the law. 9

10 65. You must make sure that your conduct justifies your patients trust in you and the public s trust in the profession. 20. From the evidence it is clear that you: were aware of the Trust Sickness Policy and made a deliberate decision to disregard it knowingly left ward C5 without adequate cover deliberately made yourself uncontactable lied about your whereabouts lied about your travel arrangements lied about your state of health. 21. In the circumstances the tribunal takes the view that your dishonest behaviour fell far below the standards of probity expected of a medical practitioner. Impairment 22. In reaching its decision on impairment, the tribunal considered the issues of insight, remediation and risk of repetition. In relation to insight, the tribunal noted the evidence in your witness statement at paragraph 3.9 where you stated I accept that from this point in time I told a series of lies. I lied when I contacted the hospital and said that I was at home but unwell, and had left my phone in Spain and was uncontactable because of a problem with my parent s landline. I also lied when I spoke to Mr B and said that I had a return flight booked for 29 th July that I missed due to illness. I also accept that when I told Dr C during our meeting that I intended to book a flight on the 29 th but was prevented due to illness that this was also a lie. In my response to the Rule 7 letter stated that I had become profusely unwell XXX on the 28 th July, and so I decided not to book my flight home as I would have been unable to work. This was also untrue. I did not become ill on the trip. 23. In your evidence to the tribunal, you said that you continued to lie to your clinical and educational supervisors, and to other colleagues because having started the lie, you were then in a state of panic and terrified of the consequences, and felt unable to change your story. The tribunal noted that it was not until this year after your interim statement to the GMC in January 2017, that you realised that you needed to be honest with your colleagues and tell them the whole truth. It also noted that you had indicated at an early stage that you would admit the allegation and you duly did so. 24. The tribunal took account of the self-reflection you have undertaken, in which you have recognised that what you did was wrong. The tribunal also took into account your evidence that you had taken steps to help yourself and other colleagues to better understand the importance of honesty and integrity in the medical profession. The tribunal took the view that these matters demonstrated that 10

11 you are developing insight, particularly since January 2017, into your actions and that you accept that your actions breached GMP. 25. The tribunal noted that your reflection led you to devise and run training for other medical colleagues on the importance of honesty in the medical profession. The tribunal noted excellent feedback from your peers and senior colleagues. The tribunal also noted that you had been asked to continue with this programme by medical educators. It considers these to be steps you have taken towards remedying your misconduct. 26. In considering the risk of repetition, the tribunal noted that you appear now to understand how your actions had the potential to adversely affect the reputation of the profession. However, it was not until January 2017 that you decided to be open and honest with your colleagues and tell them the whole truth, which leads the tribunal to conclude that there remains a low risk of repetition. 27. The tribunal also concluded that your behaviour, which involved a serious breach of the fundamental tenet of honesty and integrity, has brought the medical profession into disrepute. Your failure to uphold the proper standards of behaviour expected by doctors undermines the public confidence in the profession. 28. Accordingly, the tribunal has determined that your fitness to practise is currently impaired by reason of your misconduct. Determination on Sanction - 24/08/2017 Dr Coddington: 1. Having determined that your fitness to practise is impaired by reason of your misconduct, the tribunal has now considered what action, if any, it should take with regard to your registration. The tribunal has considered your evidence at this stage of the proceedings, and the submissions made by Ms Acker, on behalf of the GMC and those made by Mr Gurney, on your behalf. Submissions on behalf of the GMC 2. Ms Acker submitted that the appropriate sanction in this case is one of suspension. 3. She submitted that there were a number of aggravating factors in your case. The initial lie relating to your return to the UK, your availability by phone and travel arrangements, was maintained over two to three days. It was communicated to a number of colleagues over multiple facilities including telephone, and voic . This initial lie was told by you in the full knowledge that it would result in a lack of cover on the ward. Furthermore, she submitted that you then perpetuated 11

12 an adapted lie in your meetings with Mr B on 4th August, Dr C on 17th August, and in your apology on 2nd September. This continued during the initial stages of the GMC case, and to your referees over an 18 month period. It was not until January 2017 that you accepted your dishonest actions and revealed the whole truth to your colleagues. 4. She submitted that honesty is one of the most fundamental tenets of the medical profession and your actions had put the operation of the hospital at risk, and had placed patients at risk by leaving the ward without cover. 5. Ms Acker acknowledged a number of mitigating factors. She made the point that whilst it should not take the advice of a defence representative to prompt you to tell the whole truth, you had been without any representation in the initial meetings with Mr B and Dr C which had left you in a uniquely unassisted position. She further stated that you had made a full and frank admission, and had undertaken a considerable amount of reflection over the preceding 8 months. She acknowledged that you were otherwise a very good and useful practitioner and the tribunal may wish to consider the circumstances of the trip to Spain. The provision of holiday allowance to junior doctors was unusual and you had attempted to raise the issue with Mr B at an earlier date. Furthermore, she stated that the tribunal may consider that whilst your misconduct was serious, you have adequately accepted and remedied your faults. She said that the amount of reflection and sharing of your situation is significant. She concluded that it would be in the public interest for you to be able to continue to practise. 6. She referred the tribunal to relevant sections of the Sanctions Guidance (May 2017) (SG) and stated that only a period of suspension would sufficiently mark the seriousness of the misconduct. Submissions on your behalf 7. Mr Gurney submitted that you have admitted the facts and impairment and accepted on your behalf, that anything short of a suspension would not be in the public interest. He conceded that suspension in your case would be both appropriate and proportionate, however erasure would be both unnecessary and disproportionate. He referred the tribunal to a number of authorities citing the public interest in keeping an otherwise competent and skilled doctor in the profession. He submitted that it was important to take into account your attitude and approach towards the allegations. 8. Mr Gurney stated you accept that you made a number of serious errors of judgement which resulted in a risk to patient safety, a disregard of the Trust sickness policy and that you had abused your position of trust with your colleagues. He referred the tribunal to a number of mitigating factors including that at the time of the events you were very young, naïve and foolish. He submitted that the tribunal 12

13 may consider the nature of your trip to Spain to be of some relevance, and that although your insight may have been belated, it has been a developing process. He referred the tribunal to the remediation that you have undertaken which has involved making your misconduct public to your peers, using your own mistakes to educate others. 9. Mr Gurney submitted that the evidence of remediation and insight was compelling. He referred the tribunal to a number of powerful testimonials, which provide a wider perspective on your general character. He also submitted that erasure would be disproportionate in your case, bringing a premature end to an otherwise promising career. The Tribunal s Decision 10. The decision as to the appropriate sanction, if any, to impose in your case is a matter for this tribunal exercising its own judgement. In reaching its decision, the tribunal has had regard to the SG and the statutory overarching objective of sanctions, which includes: protecting and promoting the health, safety and wellbeing of the public promoting and maintaining public confidence in the profession promoting and maintaining proper professional standards and conduct. 11. The tribunal recognises that the purpose of a sanction is not to be punitive, although it may have a punitive effect. Throughout its deliberations, the tribunal has applied the principle of proportionality, balancing your interests with the public interest. 12. The tribunal has already provided a detailed determination on facts and impairment and it has taken those matters into account during its deliberations on sanction. It has also taken into account the submissions made by Ms Acker and Mr Gurney. 13. Before reaching its decision on what sanction, if any, to place on your registration, the tribunal considered any mitigating and aggravating factors in your case. Mitigating factors 14. The tribunal noted that you had made full admissions at the commencement of the hearing. It regarded you as being a credible witness providing honest and candid answers to difficult questions during your oral evidence. It considers that your actions in relation to your trip to Spain were partly as a result of your misplaced loyalty to the band, which included young musicians with health problems. 13

14 15. The tribunal has also accepted the compelling evidence provided by your senior colleagues attesting to your character and good clinical practice. These included some very candid comments about the impact of your continued lie in the context of your relationship with them. The tribunal noted that, when questioned about your decision to tell your colleagues the whole truth in January 2017, you accepted that as a result of your actions, this had led them to question their own judgement of you. However, despite your late admission to them, they continue to support you. Aggravating factors 16. The tribunal noted that you repeated the lie about your illness over a prolonged period of time to your colleagues and your regulator. You knowingly left ward C5 without adequate cover, which affected patient safety and impacted on your colleagues. It is clear from the testimonials from your senior colleagues that they were affected by your dishonesty. You accepted during your evidence that it was only when you realised the full implications that your actions may have on your registration that you told the whole truth. No action 17. The tribunal first considered whether to conclude the case by taking no action. It determined that, given the serious nature of the concerns identified, and the absence of any exceptional circumstances, it would be neither sufficient, proportionate, nor in the public interest to conclude this case by taking no action. Conditions 18. The tribunal next considered whether it would be sufficient to impose conditions on your registration. It had regard to paragraphs 82 and 84 of the SG which set out guidance on the imposition of conditions and bore in mind that any conditions imposed would need to be appropriate, proportionate, workable and measurable. 19. The tribunal decided that, in view of its findings on impairment, and given the serious concerns identified in relation to your conduct, which involves dishonest behaviour, conditional registration would not be a sufficient or proportionate sanction to meet the public interest in your case. Suspension 20. The Tribunal then considered whether it would be appropriate to suspend your registration, and if so for what period. 14

15 21. The tribunal had regard to the principle of proportionality, weighing the interests of the public against your interests. It had regard to paragraphs which state: 91 Suspension has a deterrent effect and can be used to send out a signal to the doctor, the profession and public about what is regarded as behaviour unbefitting a registered doctor. Suspension from the medical register also has a punitive effect, in that it prevents the doctor from practising (and therefore from earning a living as a doctor) during the suspension, although this is not its intention. 92 Suspension will be an appropriate response to misconduct that is so serious that action must be taken to protect members of the public and maintain public confidence in the profession. A period of suspension will be appropriate for conduct that is serious but falls short of being fundamentally incompatible with continued registration (ie for which erasure is more likely to be the appropriate sanction because the tribunal considers that the doctor should not practise again either for public safety reasons or to protect the reputation of the profession). 93 Suspension may be appropriate, for example, where there may have been acknowledgement of fault and where the tribunal is satisfied that the behaviour or incident is unlikely to be repeated. The tribunal may wish to see evidence that the doctor has taken steps to mitigate their actions 22. The tribunal also had regard to paragraph 97 of SG which provides a list of factors, where suspension may be appropriate. It found the following factors were present in your case: a. A serious breach of Good medical practice, but where the doctor s misconduct is not fundamentally incompatible with their continued registration, therefore complete removal from the medical register would not be in the public interest. However, the breach is serious enough that any sanction lower than a suspension would not be sufficient to protect the public or maintain confidence in doctors. e. No evidence that demonstrates remediation is unlikely to be successful, eg because of previous attempts or a doctor s unwillingness to engage. f. No evidence of repetition of similar behaviour since incident. g: The tribunal is satisfied the doctor has insight and does not pose a significant risk of repeating behaviour. 15

16 23. The tribunal heard evidence from you on the first day of these proceedings in relation to impairment, and on the third day in relation to sanction. You told the tribunal that giving these presentations had provided you with a profound period of learning and personal growth. Whilst you had found the experience extremely difficult, it was also incredibly rewarding. You indicated to the tribunal that you wanted to continue with these presentations in order to stop anyone else from making the same mistake. It was obvious to the tribunal that you had undertaken further reflection on the implications of your misconduct prompted by the questions posed to you by tribunal members. The tribunal was also satisfied that you will continue to give your presentation on the importance of probity to your colleagues to share your experience and learning. The tribunal had before it evidence of the feedback provided by your colleagues commending your honesty during these sessions. It considered that continuing these sessions will assist you in achieving full insight and remediation. 24. The tribunal was provided with a number of feedback forms from colleagues who had attended your presentations on probity. They refer to the clear evidence of reflection, insight and remorse that you have demonstrated. In particular, your presentation was described as a Good, open, honest autopsy of an error in judgement that will prevent other juniors from making similar errors. The tribunal also noted an invitation from Mr F, Consultant Paediatrician, at the Chesterfield Royal Hospital NHS Foundation Trust and Professor of Medical Education at the University of Sheffield, to help us highlight to our medical students the extraordinary responsibility we have to our patients in relation to probity and integrity. It takes a story like yours to make it real to them. The tribunal was particularly impressed with your ongoing efforts to share your learning and reflection as a result of your misconduct. It is clear that you have provided this reflection to a number of organisations and colleagues, including the Trust in which your initial misconduct took place. 25. You told the tribunal about your misconduct that it was the greatest mistake that I ve ever made. Not a day has gone by that I haven t regretted it, and the tribunal accepted this. It is satisfied that there is no significant risk of you repeating your behaviour, an assessment with which your referees concurred. 26. Nevertheless, the tribunal concluded that given the seriousness of the misconduct in your case, anything short of suspension would not have the sufficient deterrent effect or send out the right signal to members of the public or to the medical profession about what is appropriate behaviour. Taking into account your insight and significant reflection, reinforced by your evidence at this stage of the proceedings, the tribunal is satisfied that a short period of suspension is both appropriate and proportionate in these circumstances. 27. In determining the length of the suspension, the tribunal took into account the factors in paragraph 100 of SG: 16

17 a the risk to patient safety/public protection b the seriousness of the findings and any mitigating or aggravating factors c ensuring the doctor has adequate time to remediate. 28. The tribunal is satisfied that in your case there is no ongoing risk to patient safety. Indeed the public will benefit from your continued clinical skills which have been commended by your senior colleagues. Whilst the seriousness of the finding clearly warrants a suspension, the mitigating factors allow for a shorter duration. The tribunal is also satisfied that as a result of the level of remediation that you have undertaken thus far, and your plans to continue with this, a period of two months will provide adequate time for you to fully remediate. 29. The tribunal considered that a review would serve no useful purpose in your case and therefore decided one is not required. Determination on Immediate Order - 24/08/2017 Dr Coddington: 1. Having determined that your registration should be made subject to a period of suspension, the tribunal considered, in accordance with Section 38 of the Medical Act 1983 as amended, whether to impose an immediate order on your registration. Submissions 2. Ms Acker submitted that an immediate order was necessary. Ms Acker referred the tribunal to paragraphs 172 and 173 of SG and submitted that the public interest required that an immediate order be imposed to maintain public confidence in the profession. 3. Mr Gurney referred the tribunal to paragraph 172 and submitted that, in view of the tribunal s finding, an immediate order was not necessary. He said that you posed no risk to patient safety. Mr Gurney said that the effect of an immediate order would be to increase the length of the substantive sanction of suspension to a period of three months. Tribunal s decision 4. The tribunal took into account the relevant paragraphs of the SG in relation to when it is appropriate to impose an immediate order. 5. Paragraph 172 of the SG (May 2017 version) states: 17

18 The tribunal may impose an immediate order if it determines that it is necessary to protect members of the public, or is otherwise in the public interest, or is in the best interests of the doctor 6. The tribunal considered the seriousness of the matters which led to the finding of misconduct and the circumstances of your case. It is satisfied that there is no requirement to protect members of the public. However, the tribunal has determined that an immediate order is otherwise in the public interest to maintain confidence in the profession. 7. The tribunal determined to make an immediate order of suspension which takes effect immediately. 8. The substantive order of suspension, as already announced, will take effect 28 days from when notice is deemed to have been served upon you, unless you lodge an appeal in the interim. If you lodge an appeal, the immediate order of suspension will remain in force until such time as the outcome of any appeal is determined. 9. That concludes your case. Confirmed Date 24 August 2017 Mrs Lucy Reid, Chair 18