Failure to provide adequate care (fitness to practise case study)

Standards of conduct, performance and ethics (updated in August 2012)
Standard 1. You must act in the best interests of service users
Standard 6. You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another practitioner

Standards of proficiency – social workers in England (updated in January 2017)
Standard 1. Be able to practise safely and effectively within their scope of practice
Standard 1.1. Know the limits of their practice and when to seek advice or refer to another professional
Standard 1.3. Be able to undertake assessments of risk, need and capacity and respond appropriately
Standard 2. Be able to practise within the legal and ethical boundaries of their profession
Standard 2.2. Understand the need to promote the best interests of service users and carers at all times
Standard 2.3. Understand the need to protect, safeguard and promote the wellbeing of children, young people and vulnerable adults

A professional body raised a concern that a Biomedical Scientist had acted beyond her scope of practise. The registrant ran a private laboratory and was contacted by a patient in relation to a number of health concerns, though they never met in person. According to the registrant, the patient was suffering from a number of complex health problems, including anxiety, depression and insomnia.

The registrant conducted a HPLC urine test on a urine sample provided to her by the patient, and her analysis of that sample was sent to the patient who subsequently approached his GP. On the basis of the registrant’s report, the patient was referred to a specialist in metabolic diseases at a London hospital. After assessing the patient, the specialist was concerned about the registrant’s actions in relation to her assessment of the patient and raised a concern with the relevant professional body, who contacted the HCPC.

The panel found that the registrant’s care of the patient fell short of the standards expected of a Biomedical Scientist and amounted to misconduct. Although the panel accepted that the registrant was well-meaning, they felt that the results and report of the urine analysis together with her emails to the patient had the potential to confuse the patient with its provision of a significant amount of misleading information. Indeed, it may have led to causing the patient anxiety and psychological harm.

The panel felt that the registrant’s conduct was remediable, although the registrant would need to recognise the error of her ways and unless she did so, there was a high likelihood of repetition. The panel found that, when questioned, the registrant’s evidence about her recent professional development was vague, and the panel also judged that the registrant was not familiar with current biomedical science practice and methodology. In the view of the panel, the registrant’s evidence demonstrated she was unclear and unconvincing about accreditation and quality assurance in respect of her laboratory, and these were contributory factors to the registrant’s inability to understand the proper limits to her scope of practice.