Alfred Smith
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Allegation
As a registered Podiatrist/Chiropodist (CH35283):
1. Between 07 December 2019 and 07 May 2021:
a. In relation to one or more of the service users at Schedule A you did not:
i. Obtain and/or record informed consent, adequately or at all;
ii. Obtain and/or record a history, adequately or at all; and/or ,
iii. Record your clinical decision making, adequately or at all.
b. You did not complete and/or record an adequate treatment plan for one or more of the service users set out in Schedule B, in that the treatment plans lacked detail.
c. In relation to one or more of the service users set out at Schedule C you did not:
i. Complete and/or record any or any adequate assessment; and/or, ii. Complete and/or record any or any adequatediagnosis.
d. In relation to one or more of the service users set out at Schedule D you did not:
iii. Complete and/or record any or any adequate review plan; and/or,
i. Complete and/or adequately record any onward referral.
2. On one or more occasions between 28 July 2020 and 12 May 2021, you did not maintain accurate records, in that:
a. On 28 July 2020, in Service User K’s records, you wrote that Service User K’s wound was both “1x1mm in size” and/or “100% epithelialized”, which was not clinically accurate.
b. On 04 May 2021, in Service User P’s records, you recorded that Service User P’s new lesion was on the right foot, when it was on the left foot.
c. On 12 May 2021, in Service User N’s records, you wrote that you “made 2 Otoform Wedges”, when this was not the case.
3. On one or more occasions between 16 March 2021 and 05 May 2021, you did not provide adequate and/or effective treatment to service users, in that:
a. You did not adequately dress the wounds of one or more service users on one or more of the dates set out in Schedule E.
b. You did not demonstrate effective and/or efficient scalpel skills on one or more service users on one or more of the dates as set out in Schedule F.
c. You did not discuss treatments options and/or outcomes with one or more service users, adequately or at all, on one or more of the dates set out in Schedule G.
4. On one or more occasions between 22 March 2021 and 13 May 2021, you did not adequately assess and/or diagnose service users, in that:
a. You did not conduct thorough and/or further questioning to better understand one or more of the service user presentations on one or more of the dates as set out in Schedule H.
b. On 12 April 2021, for one and/or two service user’s you did not conduct a biomechanical assessment, adequately or at all.
c. On 06 May 2021, during your assessment of a service user you did not look or adequately look at their foot shape and/or notice they had Equinus.
d. On 12 May 2021, during your assessment of one or more service user’s you did not:
i. Observe a service user standing and/or notice a Limb Length Discrepancy.
ii. Notice that a service user’s interdigital pain was due to their right third toe under riding their second toe.
5. On one or more occasions between 14 April 2021 and 17 May 2021, you did not sweep the clinic between service users and/or clean the clinic at the end of the day.
6. Between 16 April 21 and 5 May 2021 you did not manage used clinical instrument packs in line with infection and prevention control guidelines.
7. [redacted]
8. The matters set out in particulars 1, 2, 3 and 4 constitute lack of competence and/or misconduct.
9. The matters set out in particulars 5 and 6 constitute misconduct.
10. By reason of the matters set out above, your fitness to practise is impaired by reason of lack of competence and/or misconduct and/or your health.
Finding
Preliminary Matters
Service
1. The Hearings Officer provided an unredacted copy of the service documentation to the Panel, totalling 6 pages, which included:
a. a copy of the notice of hearing dated 26 July 2024;
b. a copy of the unredacted certificate of registration dated 26 July 2024 which contained the Registrant’s registered postal and email addresses;
c. a delivery receipt dated 26 July 2024 indicating that the Registrant was sent the Notice of Hearing on 26 July 2024 via his registered email address;
d. an email dated 11 July 2024 from the Registrant’s Representative confirming that the Registrant was aware of the scheduling of the hearing and would not be attending.
2. The Panel noted that it was not required to assess whether the Registrant had received the notice of hearing, merely to be satisfied that the HCPC had served notice properly. The duty to ensure that registered details are up to date rests with the Registrant. The Panel was conscious that the Registrant was represented throughout the proceedings and indicated via his representative that he would not be attending the hearing.
3. The Panel received advice from the Legal Assessor, which it accepted and applied, and had regard to the Practice Note entitled ‘Service of Documents’ published by the HCPC for the assistance of Panels and Registrants. The Panel was satisfied that the HCPC had discharged its obligations to effect service upon the Registrant in accordance with Rules 3 and 6 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’) – it therefore found that good service had been effected.
Proceeding in absence
4. The Presenting Officer applied for the hearing to proceed in the absence of the Registrant. She told the Panel that the Registrant had engaged with the regulatory investigation but did not wish to attend the hearing. This position was confirmed to the Panel by the Registrant’s Representative in email correspondence, who reiterated that the Registrant confirmed his response to the allegations before the Investigating Committee Panel (‘ICP’) and voluntarily absented himself from the hearing.
5. The Panel received legal advice, which it accepted and applied, and considered the Practice Note issued by the HCPTS in relation to “Proceeding in the Absence of the Registrant”. It noted that while there is a presumption that registrants will attend a hearing, the Panel has discretion to determine whether to proceed with the hearing in the event that a registrant is not in attendance. It noted that the hearing was to consider a disposal by consent and that the Registrant and his representative were both clearly also aware of the hearing and actively supported it proceeding in their absence. They did not apply for an adjournment.
6. The Panel was conscious of its overarching objective of protecting the public, and the factors identified in the case of R v Hayward [2001] EWCA Crim 168 in considering whether to proceed in absence or not. It was satisfied that the public interest in progressing matters in this case outweighed the limited prejudice which may be caused to the Registrant by proceeding in his absence. The Panel was aware that proceedings should not be adjourned without good cause, which was absent in this case, and that the Registrant specifically requested that the matter be heard in his absence.
7. The Panel did not believe that any useful purpose would be served by adjourning the proceedings to attempt to secure his future attendance. It determined that the Registrant had voluntarily absented himself from the proceedings.
8. In all the circumstances of this case, the Panel was content to exercise its discretion to continue the hearing in the absence of the Registrant.
Proceeding in Private
9. The HCPC applied for the entirety of the hearing to be conducted in private because the allegation was inextricably linked with the Registrant’s health. The Presenting Officer submitted that the Panel had discretion to allow the application pursuant to Rule 10 of the Health and Care Professions Council (Health Committee) (Procedure) Rules 2003 (“the Rules”) and that the hearing should proceed in private to protect the private life of the Registrant.
10. The Registrant’s Representative, in an email to the HCPC dated 11 July 2024, requested that the hearing be conducted in private, and therefore supported the application.
11. The Panel received legal advice from the legal assessor, which it accepted and applied, and had regard to the HCPTS practice note entitled ‘Conducting Hearings in Private’ and the Rules.
12. The Panel noted that the documents supplied to it reference the health of the Registrant throughout. It was satisfied that his health condition was inextricably linked to the alleged lack of competence.
13. The Panel was content that issues related to health are sensitive and personal and therefore do engage the private life exemption under Article 6 of the European Convention on Human Rights. Whilst conscious that there is a presumption that fitness to practice proceedings will take place in public, the Panel was unable to identify a way by which it could protect the private life of the Registrant if the hearing proceeded in public. The Panel was satisfied that the protecting the privacy of personal health information was a compelling reason to conduct the entirety of the hearing in private.
Order
ORDER: The Registrar is directed to remove the name of Alfred Smith from the Register with immediate effect.
Notes
No notes available
Hearing History
History of Hearings for Alfred Smith
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 06/09/2024 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |