Conduct and Competence Committee · Page 1 of 39 Conduct and Competence Committee Substantive...

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Conduct and Competence Committee Substantive Hearing 23-24 November 2015 Nursing and Midwifery Council, 2 Stratford Place, Montfichet Road, London, E20 1EJ

Name of registrant: Deborah Jane Olsen

NMC Pin: 96I0815E

Part(s) of the register: Registered Nurse – Sub Part 1

Adult – 23 September 1999

Area of registered address: Leicester

Type of case: Misconduct

Panel members: Clive Powell (chair, lay member)

Anne Ward (registrant member)

John Liddington (lay member)

Legal Assessor: Mark Sullivan

Panel Secretary: Nilima Ali

Representation: Nursing and Midwifery Council (NMC): Represented by Michael Collis, Case

Presenter, instructed by the NMC Regulatory

Legal Team

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Mrs Olsen: Mrs Olsen was not present and not

represented

Facts found proved: 1, 2.1, 2.3, 3, 4, 5, 6.1, 6.2, 6.3, 7, 8 and 9

Facts found not proved: 2.2

Fitness to practise: Impaired

Sanction: Striking off order

Interim Order: Interim suspension order

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Determination on service The panel received information from Mr Collis on behalf of the Nursing and Midwifery

Council (“NMC”) that the Notice of Hearing had been served in accordance with The

Nursing and Midwifery Council (Fitness to Practise) Rules Order of Council 2004 (“the

Rules”). The panel accepted the advice of the legal assessor.

The Notice of Hearing was sent by first class post and recorded delivery on 11

September 2015 to Ms Olsen’s registered address as recorded on WISER, the system

supporting the NMC’s Register. It contained the correct and relevant particulars of the

hearing. The panel concluded that service had been effected in accordance with Rules

11 and 34.

Determination on proceeding in the absence of Mrs Olsen

The panel considered whether to exercise its discretion to proceed in Mrs Olsen’s

absence, in accordance with Rule 21(2)(b).

The panel had regard to all the information before it. It heard submissions from Mr Collis

and accepted the advice of the legal assessor.

Mr Collis invited the panel to proceed in the absence of Mrs Olsen, pursuant to Rule

21(2)(b). He submitted that Mrs Olsen had been properly served with the Notice of

Hearing in accordance with the Rules and that it would be in the interests of justice to

proceed today.

Mr Collis referred the panel to Mrs Olsen’s ‘Your response to the charges’ forms, signed

and dated 3 July and 14 September 2015. In those forms, Mrs Olsen indicated that she

would not be in attendance at this hearing.

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Mr Collis also referred the panel to an email exchange between Mrs Olsen and an NMC

case officer, on 9 November 2015, during the course of which she confirmed that she

would not be attending the hearing and that she was content for the hearing to proceed

in her absence.

Mr Collis further referred to an email from Mrs Olsen to the NMC case officer, dated 22

November 2015, in which she asked for an assurance “that my case will not be

adjourned…”

Mr Collis informed the panel that there were three witnesses due to give evidence on

behalf of the NMC. He submitted that all three witnesses would be inconvenienced if the

hearing did not proceed today. He further informed the panel that Mrs Olsen had

provided a number of responses to the allegations; a bundle of these responses had

therefore been prepared on her behalf and would be put before the panel, should it

decide to proceed in her absence.

In the light of Mrs Olsen’s unequivocal stance that she would not be in attendance, Mr

Collis submitted that the panel could properly conclude that she had voluntarily

absented herself. In all of those circumstances, Mr Collis invited the panel to proceed in

the absence of Mrs Olsen.

The panel, in considering this matter, had regard to the public interest in the expeditious

disposal of the case, the potential inconvenience caused to a party or any witnesses to

be called by that party, and fairness to Mrs Olsen.

The panel gave careful regard to the guidance of Lord Bingham of Cornhill in the case

of R v Hayward, Jones and Purvis [2001] EWCA Crim 168 and exercised the ‘utmost

care and caution’ in coming to its decision.

The Royal Mail ‘Track & Trace’ printout confirmed that the recorded delivery Notice had

been delivered and signed for on 12 September 2015. The Notice of Hearing had been

delivered and signed for in the printed name of “Olsen”, on 12 September 2015.

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Subsequent to the delivery and receipt of the Notice, Mrs Olsen had communicated with

the NMC, on a number of occasions, to confirm that she would not be attending the

hearing. In those circumstances, the panel was satisfied that Mrs Olsen was aware of

the hearing and that in not attending today, she had voluntarily absented herself.

Further, there had been no request for an adjournment; rather, she clearly indicated that

she did not want the hearing to be adjourned.

The panel had in mind the public interest in the expeditious disposal of cases. It also

took into account that there were a number of witnesses due to give evidence on behalf

of the NMC.

In all of the circumstances, the panel concluded that it was in the public interest to

proceed today, and that it would not be unfair to Mrs Olsen to hear the case in her

absence.

For all these reasons the panel determined to proceed in the absence of Mrs Olsen.

The panel will take into account, in its consideration of the case, Mrs Olsen’s written

responses to the allegations. The panel, as advised by the legal assessor, will probe

any areas of apparent weakness in the case against Mrs Olsen and take account of any

such points in her favour as the evidence permits.

Charges read

That you, a registered nurse, whilst employed by Care Staffing UK as an agency nurse:

1. Worked in the role of a registered nurse at Berrystead Nursing Home and Aberry

House Care between 18 November 2013 and 19 May 2014 whilst subject to an

interim suspension order upon your nursing registration;

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2. Failed to inform the following organisations that you were under investigation by the

Nursing and Midwifery Council:

2.1 Berrystead Nursing Home:

2.2 Aberry House Care Home:

2.3 Care Staffing UK.

3 Your conduct at charge 2 was dishonest in that you sought to conceal that you were

under investigation by the Nursing and Midwifery Council;

4 On an application form for Care Staffing UK, completed on or around 8 November

2013, you answered “no” when asked “Are you/have you been under/undergoing

any clinical investigation or suspension?”.


under investigation by the Nursing and Midwifery Council.

6 Failed to inform the following organisations that your nursing registration was subject

to an interim suspension order:



6.3 Care Staffing UK;

7 Your conduct at charge 6 was dishonest in that you sought to conceal that your

nursing registration was subject to an interim suspension order

8 Failed to declare on a Nursing and Midwifery Council personal contact and

employment details form, completed on or around 9 April 2014, that you were

working as an agency nurse.

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9 Your conduct at Charge 8 was dishonest in that you sought to conceal that you had

been working as a nurse whilst subject to an interim suspension order on your

nursing registration.

And in light of the above, your fitness to practise is impaired by reason of your

misconduct

Determination on facts

The background to this case was presented as follows:

The allegations in this case concerned Mrs Olsen’s failure to inform various

organisations for whom she worked that she was subject to an NMC referral, which was

separate and distinct from this case (“the first referral”); subsequently failing to inform

those organisations that she had been made the subject of an interim suspension order

as a result of the first referral; and failing to inform the NMC that she was working as a

registered nurse through an agency whilst suspended.

Mrs Olsen’s first referral to the NMC was on 20 March 2013. As a result of the first

referral, Mrs Olsen was made the subject of an interim suspension order which was

imposed on 13 November 2013. Despite this interim suspension order, Mrs Olsen

obtained work through Care Staffing UK (“the Agency”), having completed the relevant

forms on 8 November 2013 in order to obtain work through the Agency. Mrs Olsen

worked shifts at Berrystead Nursing Home (“Berrystead”) from 23 November 2013 to 19

May 2014. She also worked shifts at Aberry House Care Home (“Aberry House”) from

22 December 2013 to 9 March 2014.

Charge 1 related to Mrs Olsen working as a registered nurse at Berrystead and Aberry

House, whilst subject to an interim suspension order.

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Charge 2 related to Mrs Olsen’s failure to inform the Agency, Berrystead and Aberry

House that she was under investigation by the NMC.

Following her referral to the NMC on 20 March 2013, Mrs Olsen was sent a notice of

referral letter, dated 28 August 2013, informing her that her conduct was being

investigated and that her case would be referred to an Investigating Committee. On 29

October 2013, she was sent a notice that her case would be listed for an interim order

hearing. She responded to the notice by way of an email, on 30 October 2013,

confirming that she could not attend the first intended interim order hearing. On the

basis of this email, it was the NMC’s case that she would have known, at the time that

she had applied to join the Agency that she was under investigation by the NMC.

Charge 3 asserted that Mrs Olsen’s failure to inform the above organisations that she

was under an NMC investigation was a dishonest one, in that it was a deliberate

attempt to conceal that information.

Charge 4 concerned an application form completed by Mrs Olsen, for the Agency, on or

around 8 November 2013. When asked “Are you/have you been under/undergoing any

clinical investigation or suspension?”, she answered “no”.

In respect of charge 5, it was the NMC’s case that Mrs Olsen’s response in that

application form was dishonest as, by the time she had completed it, and based on her

contact with the NMC on 30 October 2013, she was well aware that she was under

investigation by the NMC. In that regard, it was the NMC’s case that Mrs Olsen’s

conduct was a deliberate attempt to conceal that fact.

Mrs Olsen was made subject to an interim suspension order in relation to the first

referral. The interim order was imposed by a panel of the Investigating Committee at an

interim order hearing on 13 November 2013. Mrs Olsen sent an email to the NMC on 20

November 2013, regarding the interim suspension order that had just been imposed.

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By the time that Mrs Olsen had worked her first shift through the Agency, at Berrystead,

on 23 November 2013, it was the NMC’s case that she was well aware of the fact that

she was subject to an interim suspension order. Charge 6 concerned Mrs Olsen’s

failure to inform the Agency, Berrystead and Aberry House of the interim suspension

order. In relation to charge 7, it was the NMC’s case that Mrs Olsen’s failure to inform

the above organisations was a dishonest one, in that it was a deliberate attempt to

conceal that fact.

As to charge 8, Mrs Olsen had completed an NMC personal contact and employment

details form, on or around 9 April 2014. This was received by the NMC on 16 April 2014.

In that form, Mrs Olsen indicated that she had no employment and was not undertaking

any work as an agency nurse. Whilst her work at Aberry House concluded in March

2014, she continued to work at Berrystead through to May 2014. It was the NMC’s case,

at charge 9, that Mrs Olsen’s failure to declare the true position of her working status

was dishonest, in that it was a deliberate attempt to conceal that fact.

In reaching its determination on facts, the panel had regard to all the evidence adduced,

including all the exhibited documents and Mrs Olsen’s written responses to the NMC. It

heard submissions from Mr Collis on behalf of the NMC. The panel had in mind that the

burden of proof rests with the NMC and that the facts must be proved on the balance of

probabilities.

The panel heard oral evidence, on behalf of the NMC (together with their written

statements), from the following witnesses:

• Mrs 1, Home Manager of Berrystead;

• Mr 2, Accountant for Berrystead;

• Mr 3, Case Investigations Manager at the NMC.

Mrs 1 was a clear, consistent and credible witness, who provided direct evidence in

relation to some of the charges, and useful, contextual evidence in relation to the Home.

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She spoke positively in relation to Mrs Olsen’s abilities as a nurse. In the panel’s view,

she was a fair and objective witness, who bore Mrs Olsen no malice.

Mr 2 was a credible witness who provided useful, contextual evidence in relation to the

staffing invoice system.

Mr 3 was also a credible witness, who provided clear and factual evidence in relation to

the chronology of events following Mrs Olsen’s first NMC referral.

The panel also received into evidence an unchallenged witness statement from Ms 4,

signed and dated 20 February 2015.

The panel drew no adverse inference from Mrs Olsen’s non-attendance at this hearing.

It had careful regard to her various written responses to the NMC. However, in the

panel’s view, those responses were inconsistent and, at times, implausible. By way of

an example, Mrs Olsen communicated with the NMC, by way of an email, on 20

November 2013, confirming that she was aware that she had been suspended by the

NMC and that she was not allowed to work as a nurse. On 16 December 2014, Mrs

Olsen stated that she was unaware of the suspension as she believed that it would only

come into force if she were found ‘guilty’ at the substantive hearing.

The panel made the following findings of fact in respect of the charges:

That you, a registered nurse, whilst employed by Care Staffing UK as an agency nurse:

1. Worked in the role of a registered nurse at Berrystead Nursing Home and Aberry

House Care between 18 November 2013 and 19 May 2014 whilst subject to an

interim suspension order upon your nursing registration;

The panel had regard to the witness statement of Mr 3, NMC Case Investigation

Manager, in which he confirmed that an interim suspension order was imposed on Mrs

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Olsen’s registration, by a panel of the Investigating Committee, on 13 November 2013.

A letter was sent to Mrs Olsen on 18 November 2013 informing her of the interim order.

Mrs Olsen’s interim suspension order was confirmed by a Conduct and Competence

Committee at an interim order review meeting on 9 May 2014. This decision was

communicated to Mrs Olsen by way of a letter dated 15 May 2014.

The panel had regard to the witness statement of Mr 2, Accountant for Berrystead. In

that statement, Mr 2 confirmed that Mrs Olsen worked at the Home; by way of evidence,

he exhibited invoices that were paid to the Agency, which showed that Mrs Olsen

worked at the Home on numerous occasions. In his oral evidence, Mr 2 indicated that

the amount that was paid to Mrs Olsen, as recorded in the staffing invoices, was the

rate that was paid to nurses, as opposed to that paid to healthcare assistants.

Mrs 1, Home Manager of Berrystead, provided a witness statement to the NMC, in

which she confirmed that Mrs Olsen worked a total of 39 shifts and that she worked

each shift as a registered nurse. Furthermore, Mrs 1 stated that Mrs Olsen had worked

some night shifts, during the course of which she would have been the only registered

nurse on duty, responsible for the care of up to 42 residents.

In her oral evidence before the panel, Mrs 1 disputed the assertion made by Mrs Olsen

that she was working at Berrystead as a carer. Mrs 1 confirmed that Mrs Olsen had

been employed to work as a registered nurse. She referred the panel to staffing

invoices from Berrystead; she stated that the amount that was paid to Mrs Olsen was in

fact the amount that was ordinarily paid to nurses.

In her NMC witness statement, Ms 4, Residential Manager of Aberry House, confirmed

that Mrs Olsen worked approximately 12 night shifts at the Home and that she worked

as the sole nurse on duty on each of these shifts, responsible for the care of between

34 and 36 residents.

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The panel had regard to an email from Mrs Olsen to the NMC, dated 6 November 2015,

in which she indicated that her “role was no different to a senior carer”.

The panel also had sight of Mrs Olsen’s Care Staffing Worker Agreement, signed 8

November 2013, in which the role in question was described, interchangeably, as a

‘healthcare worker’ and a ‘care worker’. The panel accepted Mr Collis’ submission that

‘healthcare worker’ and ‘care worker’ were generic terms used in the Agreement. It took

account of a reference to the NMC, contained within the Agreement, which would have

been superfluous if Mrs Olsen’s role was in fact one of a healthcare assistant, given that

the NMC had no jurisdiction over such workers. The panel also took account of Mrs

Olsen’s application form to the Agency, dated 8 November 2013, in which she identified

that the position that she was applying for was that of a nurse.

The panel took account of the evidence that Mrs Olsen was subject to an interim

suspension order which was imposed on 13 November 2013. A letter was sent to Mrs

Olsen on 18 November 2013, in which she was informed that an interim suspension

order had been imposed and that it would take effect from 13 November 2013.

On the basis of the evidence before it, the panel was satisfied, to the requisite standard,

that Mrs Olsen, having applied for the position of a nurse for the Agency, had

undertaken nursing shifts at Berrystead and Aberry House between 18 November 2013

and 19 May 2014, whilst she was subject to an interim suspension order.

Accordingly, the panel found charge 1 proved.

2. Failed to inform the following organisations that you were under investigation by the

Nursing and Midwifery Council:



2.3 Care Staffing UK.

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Mrs 1 stated, in her witness statement, that she was not aware that Mrs Olsen was

under investigation by the NMC at the time she worked at Berrystead.

Mrs 1 confirmed that if an agency nurse was subject to an NMC referral and an interim

suspension order, she would have expected to have been informed of this by both the

nurse and the Agency. She told the panel that Mrs Olsen had ample opportunity to

inform Berrystead of this information.

Mrs 1 confirmed that if Mrs Olsen had informed Berrystead of the ongoing NMC

investigation, she may not have been allowed to continue working as a nurse.

Mrs 1 disputed the assertion by Mrs Olsen that she (Mrs Olsen) had informed

Berrystead of the first NMC referral. Mrs 1 confirmed that she had no knowledge of the

referral until her attention was drawn to the decision of the substantive NMC hearing,

published on the NMC website.

Mrs 1 confirmed that there were occasions when discussions were had about Mrs Olsen

joining Berrystead as a permanent nurse. She did not, however, accept the assertion

that during those conversations, Mrs Olsen had indicated that she could not consider a

permanent role at the Home until the conclusion of the substantive NMC hearing. Mrs 1

told the panel that Mrs Olsen had informed her that she had “family issues” and that

“[Mrs Olsen] told us that she had to go away for a week and that once she got the issue

[with her family] sorted, she would consider working for us. Under no circumstances did

she mention the NMC.” Mrs 1 confirmed that the week that was identified by Mrs Olsen

was in fact the week that the NMC substantive hearing was being held.

Mrs 1 told the panel that Mrs Olsen was a “confident nurse... her handovers were

extremely thorough... and she knew a lot about nursing issues... she was great.” She

went on to say that Mrs Olsen was “a very good nurse and we couldn’t understand why

she was working for an agency. She had said that she was working for a prison but

hadn’t elaborated. She just said that she was treated badly...”

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In reaching its decision, the panel took account of the following chronology of events:

Mrs Olsen was first referred to the NMC on 20 March 2013. She was notified of the

referral on 28 August 2013. On 29 October 2013, she was sent a notice that her case

would be listed for an interim order hearing. Mrs Olsen contacted the NMC on 30

October 2013, confirming that she would not be in attendance at the interim order

hearing. As a result of this, the interim order hearing that was scheduled to be heard on

4 November 2013 was adjourned until 13 November, to give her a further opportunity to

attend. On 8 November 2013, Mrs Olsen applied to work as a registered nurse for the

Agency.

The panel had regard to the NMC’s publication, The Code: Standards of conduct,

performance and ethics for nurses and midwives’ (May 2008), in particular paragraph

51, which states:

“You must inform any employers you work for if your fitness to practise is called into

question.”

The panel was satisfied that, as a registered nurse, Mrs Olsen had a duty to inform all

those that she worked for, not just the Agency, that she was under investigation by the

NMC.

In respect of charge 2.1, the panel was satisfied that at the time that Mrs Olsen began

working at Berrystead, she knew she was under investigation by the NMC. Mrs 1 told

the panel that she would have expected Mrs Olsen to inform her of the NMC

investigation; she confirmed that Mrs Olsen did not in fact inform her of it.

On the basis of the evidence before it, the panel found charge 2.1 proved.

In respect of charge 2.2, the panel had in mind Mr Collis’ submission that the only

evidence pertaining to Aberry House came from Ms 4, in the form of a witness

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statement, and that the statement itself was silent on the matter as to whether or not

Mrs Olsen had disclosed the NMC investigation to her.

No evidence was presented by the NMC in respect of charge 2.2. Accordingly, the

panel found this charge not proved.

In respect of charge 2.3, the panel had sight of Mrs Olsen’s application form for the

Agency, completed on or around 8 November 2014, in which she clearly indicated that

she had not been under, nor was she undergoing, “any clinical investigation or

suspension”. Although the documents in the application form were out of sequence, Mr

3 gave evidence that the relevant exhibit had been provided to the NMC by the Agency,

and that the page pertaining to the relevant question, although not signed or dated, was

part of the larger document signed by Mrs Olsen on 8 November 2014.

The panel interpreted the phrase “clinical investigation” broadly to refer to a registrant’s

clinical practice. On that basis, it was satisfied that the intention of the question was to

require a registered nurse to disclose whether his/her clinical practice had been, or

continued to be, subject to an investigation or suspension.

The panel was mindful of the fact that it had not been presented with any direct

evidence from a representative from the Agency, or a sworn witness statement with a

declaration of truth. However, on the basis of Mrs Olsen’s response in the application

form, the panel was satisfied, on the balance of probabilities, that she had not informed

the Agency that she was under investigation by the NMC.

Accordingly, the panel found charge 2.3 proved.


under investigation by the Nursing and Midwifery Council;

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In considering the issue of dishonesty, the panel had regard to the objective and

subjective tests set out in the case of R v Ghosh [1992] EWCA Crim 2, as adapted by

recent case law. It was also advised, by the legal assessor, to consider Mrs Olsen’s

motivation, in particular whether her conduct was a wilful or deliberate attempt to

mislead or conceal relevant and material facts, or whether she may have misinterpreted

or misunderstood her obligations.

The panel considered the following chronology of events:

Mrs Olsen was contacted, by way of a letter, on 28 August 2013, in which she was

informed of the NMC referral. She initiated contact with the NMC on 30 October 2013,

confirming that she was unable to attend the interim order hearing that was due to be

heard on 4 November 2013. On the basis of this contact with the NMC, the panel was

satisfied that, at the time Mrs Olsen was engaging with the Agency, she knew that she

was under investigation by the NMC.

The panel had regard to Mrs Olsen’s various written responses:

In her email to the NMC, dated 6 November 2015, she stated that the Agency was

aware of the NMC investigation, to which the Agency had responded that her role was

no different to that of a senior carer and that she did not require an NMC Pin to

administer medication.

In an email dated 22 June 2015, Mrs Olsen explained that “In answer to the allegations

made against me I sat with [Mrs 1] and told her everything about me being investigated

and what for...” Mrs 1 disputed this in her evidence before the panel.

Mrs Olsen’s assertion that she had made Mrs 1 aware of the NMC investigation was

vehemently denied by Mrs 1; she gave clear and detailed evidence to the contrary and

explained that had she been made aware of the investigation, Mrs Olsen may not have

been allowed to continue working at Berrystead. The panel accepted the evidence of

Mrs 1 on this point and therefore rejected the written response provided by Mrs Olsen.

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On the basis of Mrs 1’s evidence, the panel determined that Mrs Olsen wilfully and

deliberately concealed the fact that she was under investigation by the NMC from

Berrystead.

In relation to the Agency, the panel took account of Mrs Olsen’s response in the

application form for the Agency. In the panel’s view, Mrs Olsen’s failure to disclose that

she was under investigation by the NMC was a deliberate attempt to conceal that

information, for the purpose of securing employment.

Accordingly, the panel found charge 3, insofar as it related to charges 2.1 and 2.3,

proved.

4 On an application form for Care Staffing UK, completed on or around 8 November

2013, you answered “no” when asked “Are you/have you been under/undergoing

any clinical investigation or suspension?”.

The panel was referred to a copy of Mrs Olsen’s completed application form for the

Agency dated 8 November 2013. The panel has commented earlier on the basis on

which it accepted that Mrs Olsen completed that part of the application form. On the

relevant page, Mrs Olsen answered “no” to the question “Are you / have you been under

/ undergoing any clinical investigation or suspension?”

The panel therefore found charge 4 proved.


under investigation by the Nursing and Midwifery Council.

On 29 August 2013, Mrs Olsen was informed, by way of a letter, that the NMC had

received a referral regarding her fitness to practise. At the time that Mrs Olsen

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completed the application form for the Agency, the panel was satisfied that she was

clearly aware that she was under investigation by the NMC.

The panel considered whether there was any scope for Mrs Olsen to have

misunderstood that particular question in the application form. In the panel’s view, Mrs

Olsen would have understood that the purpose of that question was to identify whether

her clinical practice had been, or continued to be, subject to investigation or suspension.

This would undoubtedly have been a standard question on any nursing application form.

The panel noted that this question was preceded by another, standard, question which

required an applicant to disclose whether he/she had any criminal convictions in the UK

or abroad.

The panel was mindful that Mrs Olsen had provided no response in relation to charges

4 and 5.

On the basis of the evidence before it, and having regard to Mrs Olsen’s obligation as

set out in paragraph 51 of the Code which required her to inform any employer if her

fitness to practise was called into question, the panel was satisfied that Mrs Olsen

would not have mistaken or misunderstood the question that was asked, nor the

purpose of it. It therefore concluded that Mrs Olsen’s conduct was dishonest, in that she

deliberately sought to conceal from the Agency that she was under investigation by the

NMC.

Charge 5 was therefore found proved.

6 Failed to inform the following organisations that your nursing registration was subject

to an interim suspension order:



6.3 Care Staffing UK;

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On 13 November 2013 Mrs Olsen was made subject to an interim suspension order for

18 months. This was communicated to her by way of a letter on 18 November 2013. In

its determination on imposing the interim suspension order, the Investigating Committee

panel specifically stated that Mrs Olsen would not be able to work as a nurse for the

duration of the order.

Mrs 1 confirmed that she only became aware that Mrs Olsen had been suspended

when she was notified, by the Deputy Manager, of the decision of a Conduct and

Competence Committee that had been published on the NMC’s website. She confirmed

that neither Mrs Olsen nor the Agency informed her that Mrs Olsen was suspended

from nursing practice.

Mr 2 told the panel that when he became aware that Mrs Olsen’s registration had been

suspended, payments to the Agency were put on hold. He told the panel that he

immediately contacted the Agency, and was informed that they were unaware that Mrs

Olsen’s nursing registration had been suspended. He was later contacted by the

Director of the Agency, who informed him that there was no information on their files or

records about the interim suspension order.

In Ms 4’s witness statement, she confirmed that Mrs Olsen had informed her, on 27 May

2014, that she had been suspended from practice by the NMC. She stated that she was

not aware that Mrs Olsen had been suspended by the NMC, prior to this disclosure. She

further stated that the Agency had not disclosed that Mrs Olsen was subject to an

interim suspension order.

The panel had regard to Mrs Olsen’s various written responses:

Mrs Olsen sent an email to the NMC on 20 November 2013. In that email, she stated

that “Although I understand from the evidence in front of you why you have suspended

me please believe me you are all so wrong. If I cannot work as a nurse for however long

am I reembursed [sic] fee as not been allowed to work since I renewed it…”

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Mrs Olsen provided a response to the NMC, on a ‘Consent form for disclosure to

representative’, dated 16 December 2014, in which she stated that she was unaware

that she was suspended from nursing practice, “due to my belief that it would only come

into force if I was found guilty at hearing [sic].” She went on to state that at the time of

registering with the Agency, her nursing registration was not suspended. She also went

on to state that she had informed the Agency of the allegations, and that it had checked

her registration in her presence and noted that “there were no conditions in place.”

Mrs Olsen reiterated this stance in an email to the NMC dated 22 June 2015, and in the

‘Your response to the charges’ form, signed and dated 3 July 2015, in which she stated

that she had signed up to the Agency prior to the NMC investigation. In her email to the

NMC, dated 6 November 2015, she stated that the Agency was aware of the NMC

investigation, to which the Agency had responded that her role was no different to that

of a senior carer and that she did not require an NMC Pin to administer medication.

The panel considered Mrs Olsen’s various responses to be inconsistent and

contradictory. It was evident, from her email to the NMC on 20 November 2013, that she

was aware that her nursing registration had been suspended and that she was not able

to work as a registered nurse. In her response on 16 December 2014, she suggested

that she was unaware that she was suspended from nursing practice. The panel

therefore placed limited weight on the written accounts provided by Mrs Olsen.

In light of Mrs Olsen’s obligations under the NMC Code, the panel had no hesitation in

concluding that she was under a duty to inform all of those for whom she worked, or

performed nursing services, of the fact that she had been suspended.

In respect of charge 6.1, the panel was satisfied that Mrs Olsen had a duty to disclose

to Berrystead that her nursing registration was subject to an interim suspension order

and that, on the basis of Mrs 1’s evidence, she did not do so.


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In respect of charge 6.2, the panel had regard to the evidence of Ms 4, who confirmed

that Mrs Olsen had disclosed, on 27 May 2014, that she had been suspended by the

NMC. It noted that Mrs Olsen’s disclosure to Ms 4 was made after she had worked

approximately 12 shifts at Aberry House, whilst subject to an interim suspension order.

The panel accepted Mr Collis’ submission that, whilst this charge was not framed within

a specific time period, the true mischief alleged was that Mrs Olsen had failed to inform

a prospective employer that her nursing registration was subject to an interim

suspension order, prior to working for them. On that basis, the panel considered Mrs

Olsen’s late disclosure to Aberry House to be immaterial.

In respect of charge 6.2, the panel was satisfied that Mrs Olsen had a duty to disclose

to Aberry House, prior to undertaking any shifts at the Home, that her nursing

registration was subject to an interim suspension order, and that she did not do so.


In respect of charge 6.3, the panel was mindful that it was not presented with any direct

evidence from a representative from the Agency. However, it was satisfied on the

totality of the evidence before it that, between 18 November 2013 and 19 May 2014, the

Agency provided Mrs Olsen with nursing shifts at Berrystead and Aberry House. On that

basis, the panel inferred that the Agency must not have known that Mrs Olsen’s nursing

registration was subject to an interim suspension order.


7 Your conduct at charge 6 was dishonest in that you sought to conceal that your

nursing registration was subject to an interim suspension order

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The panel was satisfied, from Mrs Olsen’s response in her email to the NMC dated 20

November 2013, that she was aware that, as a result of the imposition of the interim

suspension order, she was not allowed to work as a registered nurse.

The panel was in no doubt that Mrs Olsen knew of the imposition of the interim

suspension order and that she was not able to work as a registered nurse whilst this

order was in place. Mrs Olsen undertook work as a registered nurse, this being

prohibited, and failed to inform either Berrystead, Aberry House or the Agency of the

existence of the interim suspension order.

The panel was in no doubt that Mrs Olsen’s failure to inform Berrystead, Aberry House

and the Agency that her nursing registration was subject to an interim suspension order

was a deliberate attempt to conceal the fact that she was not permitted to work as a

registered nurse for the duration of that order.

Accordingly, the panel found charge 7 proved.

8 Failed to declare on a Nursing and Midwifery Council personal contact and

employment details form, completed on or around 9 April 2014, that you were

working as an agency nurse.

The panel was referred to a copy of a Personal Contact and Employment Details Form,

completed by Mrs Olsen, in connection with the first referral. Mr 3 told the panel the

form had been signed and dated by Mrs Olsen on 9 April 2014, and was received by the

NMC on 16 April 2014. This form requires registrants to provide accurate details of any

employer.

The panel noted that in the form before it, Mrs Olsen had left blank the section requiring

details of any agency with which she was registered.

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Although the particular page was undated, the panel was satisfied that it formed part of

the larger document which had been submitted by Mrs Olsen to the NMC.

On the basis of the evidence before it, the panel found charge 8 proved.

9 Your conduct at Charge 8 was dishonest in that you sought to conceal that you had

been working as a nurse whilst subject to an interim suspension order on your

nursing registration.

It was clear to the panel that Mrs Olsen did not declare her employment as an agency

nurse when asked to do so. Mrs Olsen was aware that she was suspended from

practice. She has offered no explanation for her actions. In the panel’s judgement, by

not declaring her employment, Mrs Olsen set out to conceal the fact that she had

provided nursing services, in breach of the interim suspension order.

The panel concluded that Mrs Olsen’s failure to declare her employment as an agency

nurse, to the NMC, was a deliberate attempt to conceal the fact that she continued to

work as a nurse notwithstanding the interim suspension order

The panel therefore found charge 9 proved.

Application to admit into evidence decision letters in respect of the substantive hearing and substantive order review hearing, pertaining to Mrs Olsen’s first referral Mr Collis sought to admit the decision letters following the substantive hearing and the

substantive order review hearing, in relation to Mrs Olsen’s first referral.

Mr Collis informed the panel that the substantive hearing decision letter was included in

the original bundle as an exhibit adduced by Mr 3, which was served on Mrs Olsen well

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in advance of this hearing. When that bundle was served, Mrs Olsen was invited to

respond to it and to raise any objection, if this were the case. She raised no objection to

the admission of the decision letter.

A week prior to this hearing, Mrs Olsen was sent a copy of the decision letter following

the substantive order review hearing on 22 May 2015, along with other documents. She

was informed that this decision letter may also be put before the panel. Mr Collis

informed the panel that Mrs Olsen had responded to the NMC, effectively indicating that

she was content for any relevant material to be put before the panel.

Mr Collis submitted that the documents were relevant to the panel’s assessment of Mrs

Olsen’s current fitness to practise. He submitted that the matters giving rise to the first

referral may have demonstrated attitudinal issues on Mrs Olsen’s part. He submitted

that this case brought into focus the risk of Mrs Olsen acting inappropriately in the

future.

Mr Collis invited the panel to consider the public interest, in the light of the gravity of

these matters, when looked at in the context of the first referral.

The panel considered the submissions of Mr Collis. It accepted the advice of the legal

assessor, who referred to the case of Nicholas Pillai v General Medical Council [2009]

EWHC 1048, in which it was held that panels are “... clearly entitled to take into account,

at the stage at which they determine whether fitness to practise is impaired, material

other than the allegations which they have considered which suggest that it is either is

not impaired or that it is impaired.”

The panel had regard to Rule 31 of the Rules, which states:

Evidence

31.—(1) Upon receiving the advice of the legal assessor, and subject only to the

requirements of relevance and fairness, a Practice Committee considering an allegation

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may admit oral, documentary or other evidence, whether or not such evidence would be

admissible in civil proceedings (in the appropriate Court in that part of the United

Kingdom in which the hearing takes place).

At this stage of the hearing, the panel was not aware of the specific circumstances

giving rise to the first referral. It was, however, mindful that the present case arose as a

direct result of Mrs Olsen’s conduct following her first referral.

As to relevance, the panel was of the view that the decision letters would provide useful,

contextual information in relation to the background of the matters giving rise to the first

referral, which subsequently gave rise to this particular case. In addition, they would

indicate what, if any, steps Mrs Olsen had taken since the previous substantive hearing

to address the matters forming the subject matter of the first referral.

The panel acknowledged that Mrs Olsen was not in attendance and not represented, as

a result of which she was not in a position to speak to the contents of the documents.

However, the panel was mindful that the documents had already been served on her by

the NMC. She had the opportunity to raise any objection to the documents but had not

done so.

The panel recognised that the potentially prejudicial nature of the documents, insofar as

they could unduly influence the panel in its determination of this case, could make the

admission of the documents unfair to Mrs Olsen. However, the panel considered that

this potential unfairness would be mitigated by its assurance that it would only have

regard to the documents to the extent that they assist in understanding the background

of the matters giving rise to the first referral, and to what extent, if any, Mrs Olsen had

made progress in addressing any attitudinal concerns identified in that case.

Having considered this application with care, the panel determined that it was both

relevant and fair to admit the decisions letters. In reaching this decision, the panel was

conscious of its duty to protect the public and serve the public interest, by ensuring that

matters are explored fully and that its decisions are based on all available information.

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Determination on misconduct and impairment

Following its findings on facts, the panel invited submissions on misconduct and

impairment.

Mr Collis referred the panel to the case of Roylance v General Medical Council (No.2)

[2000] 1 AC 311, in particular to the judgment of Lord Clyde who described misconduct

as “a word of general effect, involving some act or omission which falls short of what

would be proper in the circumstances.” Mr Collis submitted that the professional

misconduct identified must be serious.

Mr Collis invited the panel to find that Mrs Olsen’s behaviour constituted misconduct

and that her fitness to practise is currently impaired. He referred the panel to the NMC’s

publication, ‘The Code: Standards of conduct, performance and ethics for nurses and

midwives’ (May 2008) (“the Code”) in particular, the preamble and paragraphs 51 and

61.

Mr Collis submitted that this case involved a sustained period of dishonest conduct,

leading to Mrs Olsen working as a registered nurse when she was suspended from

doing so by her professional regulator. In an effort to conceal her behaviour, she lied to

her regulator about her employment status at the time.

Mr Collis submitted that the charges undoubtedly represented a serious departure from

acceptable standards. He referred the panel to the case of Tait v Royal College of

Veterinary Surgeons [2003] UKPC 34 in which it was held that a finding of dishonesty

against a professional person was at the top end of the spectrum of gravity of

misconduct.

As to impairment, Mr Collis referred the panel to the observations of Mrs Justice Cox in

the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery

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Council (2) Grant [2011] EWHC 927 (Admin) and to the approach formulated by Dame

Janet Smith in her 5th Report on Shipman, which was cited with approval in that case. In

so referring, Mr Collis submitted that Mrs Olsen brought the profession into disrepute,

breached a fundamental tenet of the profession and acted dishonestly.

Mr Collis submitted that the charges represented a flagrant disregard, on the part of Mrs

Olsen, for her professional regulator, which brought the nursing profession into

disrepute. He further submitted that Mrs Olsen put her own interests above those of her

patients, the organisations for whom she worked and the nursing profession.

Mr Collis invited the panel to consider whether there was a risk of Mrs Olsen behaving

in a similar way in the future, and whether she had demonstrated any insight and

remorse into her conduct. He submitted that, in short, there was no evidence of insight

or remorse.

Mr Collis submitted that the matters in this case occurred when there was an ongoing

NMC investigation into the first referral. He contended that this strengthened the

argument that there was an attitudinal issue on Mrs Olsen’s part, which meant that there

was a serious risk of her behaving in a similar manner in the future.

In addition, Mr Collis referred the panel to paragraph 74 of the judgment in the case of

Grant. In so referring, he invited the panel to keep the public interest at the forefront of

its mind when considering whether Mrs Olsen’s fitness to practise is impaired. He

submitted that the nature of Mrs Olsen’s dishonesty and the disregard shown to her

regulator meant that this was such a case where public confidence in the profession

would be undermined if a finding of impairment were not made.

In all the circumstances of this case, Mr Collis invited the panel to find that Mrs Olsen’s

fitness to practise is currently impaired by reason of her misconduct.

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In reaching its decision, the panel had regard to all the evidence before it, including Mrs

Olsen’s written responses. It had regard to the submissions of Mr Collis on behalf of the

NMC, and it accepted the advice of the legal assessor.

The panel bore in mind that in relation to impairment by reason of misconduct, it must

engage in a two stage process: it must first consider whether, on the facts found proved,

Mrs Olsen’s conduct was sufficiently serious as to amount to misconduct, and secondly,

if so, whether her fitness to practise is currently impaired by reason of that misconduct.

The panel considered that by virtue of the facts found proved, Mrs Olsen breached the

following provisions of the Code:

The people in your care must be able to trust you with their health and wellbeing To justify that trust, you must:

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

profession.

As a professional, you are personally accountable for actions and omissions in your

practice, and must always be able to justify your decisions.

From the numbered standards:

51 You must inform any employers you work for if your fitness to practise is called into

question.

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

The panel was aware that not every instance of falling short from what would be proper

in the circumstances, and not every breach of the Code, would be sufficiently serious

that it could properly be described as misconduct. Accordingly, the panel had careful

regard to the context and circumstances of the matters found proved.

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As a registered nurse, Mrs Olsen had a duty to disclose to all those for whom she

worked that she was under investigation by the NMC and that her nursing registration

was suspended. Furthermore, she had a specific duty to inform the NMC of the details

of any agency through which she was providing nursing services. Mrs Olsen failed to

discharge these obligations.

This case involved the flagrant disregard of an order of a professional regulator,

compounded by a deception that was maintained over a long period of time. In the

panel’s view, this was not a momentary aberration or negligent act on Mrs Olsen’s part;

rather, her conduct was sustained, deliberate, self-serving and designed to mislead,

with the purpose of securing and continuing employment with the Agency. She

perpetuated her dishonest conduct when she concealed, from her regulator, the fact

that she was working as an agency nurse, in breach of the interim suspension order.

Furthermore, she stated, in December 2014, that at the time she accepted work through

the Agency, she was not aware of the suspension on her nursing registration, despite

having acknowledged, as early as 20 November 2013 that she was so aware.

Mrs Olsen’s dishonesty is directly related to her right to practise as a nurse. She

displayed a blatant disregard for the regulatory process, and in particular the NMC

investigation and interim suspension order that was imposed as a result of the first

referral.

The panel was in no doubt that Mrs Olsen’s conduct fell far below the standards

expected of a registered nurse. Taking the charges found proved, the panel was

satisfied that Mrs Olsen’s conduct was sufficiently serious as to amount to misconduct.

The panel then went on to consider the question of impairment. In considering Mrs

Olsen’s fitness to practise the panel reminded itself of its duty to protect patients and its

wider duty to protect the public interest, which includes declaring and upholding of

proper standards of conduct and behaviour, and the maintenance of public confidence

in the profession and the regulatory process.

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“Impairment of fitness to practise” has no statutory definition. However, the NMC has

defined “fitness to practise” as a registrant’s suitability to remain on the register without

restriction.

The panel was assisted by the observations of Mrs Justice Cox in the case of Grant:

“In determining whether a practitioner’s fitness to practise is impaired by reason of

misconduct, the relevant panel should generally consider not only whether the

practitioner continues to present a risk to members of the public in his or her current

role, but also whether the need to uphold proper professional standards and public

confidence in the profession would be undermined if a finding of impairment were not

made in the particular circumstances.”

[Paragraph 74]

The panel further took into account the approach formulated by Dame Janet Smith in

her 5th report of the Shipman inquiry, which was cited with approval in the case of Grant:

“Do our findings of fact in respect of the [registrant’s] misconduct […] show that [her]

fitness to practise is impaired in the sense that [she]:

a. has in the past acted and/or is liable in the future to act so as to put a patient

or patients at unwarranted risk of harm; and/or

b. has in the past brought and/or is liable in the future to bring the [nursing]

profession into disrepute; and/or

c. has in the past breached and/or is liable in the future to breach one of the

fundamental tenets of the [nursing] profession; and/or

d. has in the past acted dishonestly and/or is liable to act dishonestly in the

future.”

The panel was in no doubt that Mrs Olsen’s misconduct engaged limbs b), c) and d) as

listed above.

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With regard to future risk, the panel considered the questions posed in Cohen v General

Medical Council [2008] EWHC 581, namely whether Mrs Olsen’s conduct was easily

remediable, whether it had been remedied and whether it was highly unlikely to be

repeated. In considering these questions, the panel had particular regard to the issues

of insight and future risk.

Dishonesty is a very serious matter. Nurses occupy a position of privilege and trust

within society and are expected at all times to be honest, and to act with integrity. This

is a fundamental tenet of the profession. Through her actions, Mrs Olsen undermined

the trust and confidence placed in her by the organisations for whom she worked, her

regulator and the public. In the panel’s judgement, her dishonest conduct was persistent

and deliberate and, as such, is not easily remedied.

Mrs Olsen’s engagement with the NMC had been limited to providing written responses

to some of the allegations, which the panel has since found proved. Her responses

amounted to a denial of any wrongdoing. She claimed that she did not believe that she

had been suspended, which was blatantly untrue in light of her email to the NMC dated

20 November 2013. She also claimed that she had informed Mrs 1 of the first referral,

which the panel also found to be untrue. She had not presented the panel with any

evidence of remedial action she may have undertaken to address her misconduct since

the events in question. Consequently, the panel was unable to explore any insight she

may have developed since, or her understanding of the potential impact of her

dishonest conduct on patients, members of the public, her regulator and the wider

public interest in terms of public confidence in her as a registrant and the profession

generally. There was no expression or indication of remorse. There was no information

regarding her current employment status, nor any references or testimonials to attest to

her good character.

The panel noted the decision of the Conduct and Competence Committee at the

substantive order review hearing, in which it was found that there was an “absence of

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any information to suggest that Mrs Olsen has attempted to remediate her shortcomings

or develop any insight into the implications of her failings since the first hearing...”

In the absence of any evidence of remediation, remorse and insight, the panel was

unable to conclude that Mrs Olsen’s misconduct has been remedied. She has provided

no reassurance that her misconduct will not recur in the future. The panel, therefore,

concluded that there remained a significant risk of repetition of her misconduct, which in

turn would breach a fundamental tenet of the profession and bring the profession into

disrepute.

The panel was aware that any approach to the issue of whether fitness to practise

should be regarded as impaired must take account, not only of the need to protect the

public, but also the collective need to maintain confidence in the profession as well as

declaring and upholding proper standards of conduct and behaviour.

In the panel’s view, it is of paramount importance, for the protection of the public, that

only those registered nurses, who have a right to practise, do so.

The panel also considered whether the need to uphold professional standards, and the

integrity of NMC as a regulator, would be undermined if a finding of impairment of

fitness to practise were not made in the circumstances of this case. In the panel’s

judgement, a finding of no impairment would fundamentally undermine proper

professional standards and public confidence in the profession, and significantly

damage the regulatory process.

Accordingly, the panel determined that Mrs Olsen’s fitness to practise is currently

impaired by reason of her misconduct.

Determination on sanction

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In reaching its decision on sanction, the panel considered all the evidence before it,

including Mrs Olsen’s written responses to the NMC, together with the submissions of

Mr Collis on behalf of the NMC. The panel accepted the advice of the legal assessor.

Mr Collis referred the panel to the NMC’s ‘Indicative sanctions guidance for panels of

the Conduct and Competence Committee and Health Committee’ (June 2012) (ISG). He

also referred to the case of Parkinson v Nursing and Midwifery Council [2010] EWHC

1898 (Admin), in which Mr Justice Mitting said:

“A nurse found to have acted dishonestly is always going to be at severe risk of having

his or her name erased from the register. A nurse who has acted dishonestly, who does

not appear before the Panel either personally or by solicitors or counsel to demonstrate

remorse, a realisation that the conduct criticised was dishonest, and an undertaking that

there will be no repetition, effectively forfeits the small chance of persuading the Panel

to adopt a lenient or merciful outcome and to suspend for a period rather than direct

erasure.”

In reaching its decision, the panel took into account the guidance set out in the ISG. It

had regard to the principle of proportionality, weighing Mrs Olsen’s interests against the

public interest. The panel bore in mind that the purpose of a sanction is not to be

punitive, although it may have that effect, but is intended to protect patients and the

wider public interest. The wider public interest includes maintaining public confidence in

the profession and the NMC, and declaring and upholding proper standards of conduct

and behaviour.

The sanction imposed must be no more than is necessary to protect the public and

satisfy the public interest

The panel considered that the following mitigating and aggravating factors were relevant

in this case:

Mitigating

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• Mrs 1 commented positively on Mrs Olsen’s abilities and knowledge as a nurse,

and stated that Mrs Olsen was liked by colleagues and residents;

• There was no evidence of patient harm in this case.

Aggravating

• Mrs Olsen’s dishonesty was directly related to her right to practise as a

registered nurse. She sought to conceal the NMC investigation in relation to the

first referral, and the subsequent imposition of an interim suspension order, in

order to secure and continue providing nursing services through an agency. She

also lied to her regulator by actively concealing the fact that she was working as

an agency nurse, in breach of the interim suspension order.

• Mrs Olsen’s dishonesty persisted over a protracted period of time;

• There has been a previous regulatory finding made against Mrs Olsen, as a

result of which a substantive suspension order had been imposed;

• The Conduct and Competence Committee panel, in the substantive hearing in

relation to the first referral, clearly set out steps Mrs Olsen could take to address

the failures and issues identified. At the substantive order review hearing, that

panel found that she had provided no evidence of remediation and insight;

• Mrs Olsen has submitted written responses for the attention of this panel; those

responses were found to be inconsistent, implausible and untrue.

Under Article 29 of the Nursing and Midwifery Council Order 2001, the panel, when

considering sanction, should consider the following courses of action in ascending

order, beginning with the least restrictive: take no action, make a caution order for one

to five years, make a conditions of practice order for no more than three years, make a

suspension order for a maximum of one year or make a striking-off order.

The panel concluded that there were no exceptional circumstances in this case which

would justify taking no action on Mrs Olsen’s registration, given the seriousness of the

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misconduct found. Furthermore, the panel considered that taking no action would be

manifestly inappropriate and insufficient for the purposes of protecting the public and

upholding public confidence in the nursing profession and in the NMC as its regulator.

The panel then considered whether to make a caution order but it concluded that such

an order would be a wholly insufficient and disproportionate response in the light of the

panel’s findings thus far. Given the seriousness of Mrs Olsen’s dishonesty, the panel

concluded that it would not address the public interest if she were allowed to return to

practice without restriction. The panel further had in mind that this is the second NMC

finding made against Mrs Olsen in a relatively short period of time. The panel therefore

was of the view that a caution order would not mark the seriousness of the misconduct

found, nor would it protect the public or satisfy the wider public interest. This is not a

case at the lower end of the spectrum of impaired fitness to practise.

The panel next considered the imposition of a conditions of practice order. The panel

noted that this sanction primarily focuses on remedying identifiable areas of concern

within a registrant’s clinical practice or skills that may require retraining, assessment

and supervision. In addition, it requires the potential and willingness of a registrant to

respond positively to conditions.

This is not a case calling into question Mrs Olsen’s clinical competence. Conditions of

practice would not, therefore, be appropriate, workable or practical to address the

nature of the misconduct found in this case. In these circumstances the panel

determined that conditions could not be devised to address an attitudinal or behavioural

problem.

The panel therefore concluded that a conditions of practice order would not be sufficient

to protect the public or satisfy the wider public interest.

The panel next considered imposing a suspension order. A suspension order is

intended to convey a message to the registrant, the profession and the wider public as

to the gravity of the unacceptable and inappropriate behaviour, but which, in the

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particular circumstances of a case, falls short of being fundamentally incompatible with

continued registration. A period of suspension can also serve to provide a practitioner

with an opportunity to reflect on their misconduct and to take action to commence or

complete the process of remediation.

This case does not involve a single instance of misconduct. As previously determined

by the panel, this case involved the flagrant disregard of an order of a professional

regulator, compounded by a deception that was maintained over a long period of time.

At the substantive hearing in relation to the first referral, the panel determined that “Mrs

Olsen’s misconduct could be characterised as the exercise of very poor judgment but

that it did not reflect deep seated attitudinal issues.” Whilst that panel was, on the basis

of the specific matters before it, prepared to give Mrs Olsen the benefit of the doubt as

to her attitude and judgement, this present case demonstrates a continuing pattern of

deceitful behaviour, of which that panel would have been unaware. The first panel also

set out a number of recommendations that could assist a review panel. It was noted in

the decision letter following the substantive order review hearing that Mrs Olsen had

provided no evidence of remediation or insight, or made any effort to address the

matters set out by the first panel. The review panel decided that a further period of

suspension would be appropriate and proportionate, and would afford Mrs Olsen with

another opportunity to demonstrate insight and remediation. There is no evidence

before this panel that Mrs Olsen has taken any steps to do so.

Mrs Olsen’s dishonesty was directly related to her right to practise as a registered

nurse. She withheld material information relating to her fitness to practise in order to

secure and continue providing nursing services through an agency. She then lied to her

regulator by actively concealing the fact that she was working as an agency nurse, in

breach of the interim suspension order.

Mrs Olsen has provided this panel with no evidence of remediation, remorse or insight.

The written responses that she has submitted have been found to be inconsistent,

implausible and untrue.

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For all the reasons outlined, the panel determined that there was evidence of harmful

deep-seated personality or attitudinal problems.

The panel considered that whilst the public could be protected temporarily by the

imposition of a suspension order, it was not satisfied, in all the very serious

circumstances of this case, that such an order would satisfy the wider public interest, in

declaring and upholding standards of behaviour and maintaining public confidence in

the professions.

Mrs Olsen’s misconduct represented a significant and serious departure from the

standards expected of her as a registered nurse, demonstrating a fundamental lack of

probity, honesty and trustworthiness. The panel was mindful of the persistent nature of

Mrs Olsen’s dishonesty, her flagrant disregard for the interim suspension order and the

continuing absence of any expression of insight into the seriousness of her misconduct

and its impact on the reputation of the profession and the NMC.

For all those reasons, the panel concluded that Mrs Olsen’s misconduct is

fundamentally incompatible with continuing to be a registered nurse.

The panel therefore determined that a striking-off order is the proportionate and

appropriate sanction. A lesser sanction would not be sufficient to satisfy the wider public

interest in maintaining confidence in the profession and its regulator and in declaring

and upholding proper standards of conduct and performance.

The panel was mindful that such an order would have a significant personal and

financial impact on Mrs Olsen, although it had no particular information on that matter.

Nevertheless, the panel concluded that her interests were outweighed by the public

interest in this matter.

Accordingly, the panel has determined to direct the Registrar to strike Mrs Olsen’s name

from the Register.

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Mrs Olsen will be advised that her name will be removed from the NMC register. She

may not apply for restoration until five years after the date that this decision takes effect.

Anyone who enquires about her registration will be advised of this.

Determination on interim order The panel considered whether it is necessary to impose an interim order to cover the

appeal period before the substantive order takes effect, or to cover any time required for

an appeal of the substantive decision in this case to be heard.

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

imposition of an interim order. The panel may make an interim order on one or more of

three grounds:

• Where it is satisfied that it is necessary for the protection of members of the

public;

• Where it is satisfied that such an order is otherwise in the public interest;

• Where it is satisfied that such an order is in the interests of the registrant.

The panel may make an interim conditions of practice order or an interim suspension

order for a maximum of 18 months.

Mr Collis made an application for the imposition of an interim suspension order for a

period of 18 months, on the grounds that it is necessary for the protection of the public

and that it is otherwise in the public interest. He submitted that such an order is

appropriate and proportionate, in the light of the panel’s decisions on impairment and

sanction. Mr Collis reminded the panel that Mrs Olsen is already subject to a

substantive suspension order, in relation to the first NMC referral. That order will expire

on 23 December 2015, unless extended by the next review panel. Accordingly, he

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submitted that an 18 month interim order is necessary to allow for any appeal of the

substantive order made by this panel.

The panel accepted the advice of the legal assessor.

For all the reasons set out in the panel’s determination thus far, and in all the

circumstances of this case, the panel concluded that it is appropriate to impose an

interim order on the grounds that it is necessary for the protection of the public, and that

it is otherwise in the public interest. The panel first considered an interim conditions of

practice order, but for the reasons already outlined, it concluded that such an order

would not be appropriate or proportionate. The panel therefore concluded that it is

necessary to impose an interim suspension order. To do otherwise would be wholly

inconsistent with the panel’s decisions on impairment and sanction.

The panel decided that the order should run for a period of 18 months to allow for any

appeal process, and that such an order is both appropriate and proportionate.

If at the end of the appeal period of 28 days Mrs Olsen has not lodged an appeal, the

interim order will lapse and will be replaced by the substantive order. On the other hand,

if she does lodge an appeal, the interim order will continue to run until the conclusion of

that appeal.

That concludes these proceedings.

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