OT struck off after removing 70 cases from holding list

Team manager struck off after she removes 71 cases from holding list without further enquiries being made beforehand

Published on 21st January 2019

An occupational therapist who struck more than 70 cases from a holding list to "manage a high number of referrals" has been struck from the Health and Care Professions Council register.

Linda Hawkins, a Team Manager for Adult Social Services at Norfolk County Council, struck off 71 cases from a holding list when none should have been closed or abandoned without further enquiries being made.

The Health and Care Professions Tribunal Service Panel said: "The Registrant’s misconduct was extremely serious; her deliberate actions placed a large number of service users at serious risk of harm, through their safeguarding needs not being met."

Ms Hawkins began working at Norfolk from from 28 February 2011. One of her responsibilities was to review and manage a holding list of cases awaiting allocation and requiring further work to be completed. The holding list was a list of individuals that had been referred to the team in order for an assessment to be undertaken. The purpose of the holding list was to ensure that all referrals were stored in one central place where they could be monitored and reviewed.

Council guidance stated that in terms of the holding list, the duty manager should assign any remaining cases to the holding list. Before doing so, the duty manager must ensure the following information is recorded on the Arrange Assessment I Review activity:

• where the person lives
• the nature of the referral
• whether the case is for a Social Worker, Occupational Therapist  or Assistant Practitioner
• information about carers (if applicable)
• continuing Healthcare (if applicable)
• whether it is a hospital case not ready for discharge (if applicable)

"The Duty manager must assess the priority of each case and add the priority category to the activity. They should then reassign the activity to the relevant holding list," the guidance added.

The concerns came to light when a Practice Consultant Social Worker came across “Case 8” on 14 June 2016. The matter was escalated to the Council's Service Manager, subsequently to the Head of Safeguarding and then to the Head of Operations.
An investigation ensued and it was found that between 7 and 10 June 2016, Ms Hawkins had removed 71 cases from the holding list without undertaking further work that was required to ensure the safety and wellbeing of the service users.

Of the 71 cases it was identified that none should have been closed or abandoned without further enquiries being made. It followed there would have been no further contact with the individual service users unless they themselves had made further contact with the Council. The holding list was a significant number of the total referrals at the time.

The HCPC's case was that the potential consequences of Ms Hawkins' conduct were significant; service users could have been left in a vulnerable position, left at risk or led to a breakdown in the family situation, or the service user not receiving the care that they need. There was an ancillary risk of reputational damage to the Council.

Ms Hawkins did not attend the hearing but three witnesses gave evidence.

Ms Hawkins' line manager SK told the Panel that Ms Hawkins accepted having removed the cases from the holding list when she had challenged her, and that her explanation was that she had done this as a way of managing the high number of referrals. SK said that there was nothing unusually onerous about Ms Hawkins' workload, and she had told Ms Hawkins that all of the cases should be returned by her to the holding list, but this was not done.

SK told the Panel: "It is not appropriate under any circumstances to simply abandon a case from the holding list. … it would be necessary to contact the individual service user or their family to determine if the circumstances had changed. If an assessment was no longer required, there is a process to follow for closing the case. Cases should not be removed from the holding list in any other circumstances."

The Panel stated that there was no evidence that Ms Hawkins understands the culpability of the behaviour that led to the finding of misconduct, or that she has at any stage reflected upon her behaviour. The Panel found that she has demonstrated no insight and does not appear to have recognised that what she did was wrong and the potential consequences of her actions. In the absence of any remediation or the demonstration of insight, the Panel could not exclude the risk of repetition of such misconduct by Ms Hawkins.

The Panel determined that Ms Hawkins' current fitness to practise is impaired by reason of her misconduct. The Panel stated that no lesser sanction than a striking off order would reflect the nature and gravity of the Registrant's misconduct, particularly in light of her lack of insight, failure to remediate and refusal to engage with her regulator.

Linda Hawkins was struck off the register.

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