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It was Thursday evening, 8pm and the link worker and I finally left the clients’ house because I now felt satisfied the baby would come to no harm, having consulted with various agencies. (We usually finish work at 5pm. The link worker was excellent.) Next morning I phoned one of our child protection advisers to tell her what had been happening. She gave her approval and congratulated me on my actions.
Later that afternoon, the specialist adviser for health visitors phoned and asked to speak to me on my own. The nursing auxiliary left the room and then the adviser told me there were queries about my involvement with a particular family and that it was not appropriate for me to remain at work. I would hear the nature of the allegations being made as soon as possible. I was so shocked I have a vague memory of thanking her….
The auxiliary came back into the room. When I told her what had happened she went white and sat down shocked and in disbelief. She was very concerned for my safety driving home and when I declined to have her drive me, followed me part way home to make sure I was alright.
The worst way of letting someone know they have been suspended must be by letter. The next to worst way must be on a Friday afternoon by phone! All weekend to stew over it. Shock, anger, shame…. The emotions are endless.
I eventually received an apology from the organisation for this but never from the person herself. We had previously been on good terms and as a manager, this person had been excellent at giving personal support to her staff. However I had been involved in several new initiatives which had needed her action and which added to her impossible workload. She had become ‘distant’ in her relationship for the last couple of years. I believe her personal feelings clouded her professional judgement.
I received a letter detailing 4 allegations against me.
Investigatory meeting 5 days later by the person making the allegations! My complaint about her lack of impartiality was ignored! Human resources manager firmly on her side to support her. A number of assertions made at the meeting by her were later found to be untrue.
Outcome of meeting – the director of primary care decided one allegation should stand and I should face a disciplinary hearing.
The trust produced a piece of evidence from a police inspector, the evening prior to the hearing preventing time for a considered response. (I already had a police witness statement refuting this beyond doubt but the copy of the fax ‘threw’ my union rep. I had to raise it myself in my defence.) Moreover a solicitor who saw the fax at a subsequent date, immediately spotted that the copy of the fax of entries to a police log were out of date order to support the investigation manager’s evidence. The investigation manager had already written a note on a hospital document claiming that an event had taken place that had not and for which she had no evidence. In other words, there were dodgy goings on! Why? I will never know.
The chair of the disciplinary hearing and the independent witness did not read my lengthy defence prior to the hearing due to a failure of their human resources department to provide them with the document.
At the hearing, the investigation manager argued for an hour that I should face all four allegations. She finally accepted that I should face two of them. The union regional officer conceded this for fear we should never proceed. Again the investigation manager presented inaccuracies in her case.
Meanings of words are critical. ‘She cannot be woken’ can mean ‘she was unconscious/drunk’ or ‘she has been up every night this week and now it is my turn. Leave her alone.’ What different conclusions may then be drawn. And how tired we all were and how adversarial it all was that no-one spotted the glaring evidence against the first interpretation. The accused stands guilty and has to prove their innocence in the present situation.
I was asked about the size of my caseload. I had regularly covered a colleague’s caseload for lengthy periods of absence (six months at one time) and helped out with others. It was already a heavy caseload but these were normal for that organisation and area. I said nothing!
The union rep was making out a strong case. Then I was asked if this situation was a course for concern. Of course. There was a big sigh from the rep and joy from the investigation manager. I had taken special care for several years to see that all was OK. I would have been negligent not to have done so. I still find myself thinking about all this some years later!
The hearing lasted six hours. The chair phoned later to say no further disciplinary action was to be taken but I was to undertake some further training. What an insult. I felt like giving up.
The letter gave no verdict on the allegations brought against me. If I had acted inappropriately, what would have been the appropriate action? It also included an error of fact, a measure of the inadequacies (understatement) of the hearing.
My husband and children were very, very angry about the whole thing and the distress they had witnessed. They could not believe the lack of loyalty from my employers when they knew how hard I had worked for the good of clients. One of them wrote to the chairman of the organisation to complain. In his reply the chairman stated that I had ‘been cleared of professional shortcomings’. Hurray! Their letter did not spell that out to me.
As there had been no disciplinary action taken, I was unable to appeal. Injustice is one of the hardest things to live with. My colleagues were incensed by what had happened (I had been able to keep in touch through my union branch) and did not doubt my ability to practice. Their belief in me was precious. My GP who was very supportive throughout, and who had known other patients in similar situations, pointed out that the opinion of my colleagues, who worked with me and who knew my work, was the opinion that really mattered. I had received a constant flow of cards and flowers of support. It was amazing.
To my surprise, I was unable to physically go into the management block after my return to work. When my line manager (who had been bypassed in the suspension and who had nothing to do with the process) left me a phone message to get in touch with her, I started to shake and my colleagues had to calm me before I dared to call back. I asked her never to leave a message without also saying what she wanted to speak with me about. She sounded surprised but agreed to do it. (I had never been off sick in 8 years until these events took place. I had never been of a nervous disposition either.)
I had already been planning to work nearer home and was able to leave three weeks after my return to work. I was fortunate to be given a good reference and the new organisation were willing to trust their own judgement and give me a chance.
My colleagues gave me a fantastic send off but of course, no managers were invited! What a sad way to end my work with them.
Setting the scene!
Background – Dynamic health visiting team – change of most of our practice in three years.
Important team member left. New member, team ethos changed radically. Comments about my communication with colleagues and clients.
To try and resolve these:-
Saw counsellor in occupational health; helpful insights
Requested clinical supervision; also helpful
Anonymous (as much as it can be) exit questionnaire with clients (and agreement with audit manager); very positive and some very interesting comments that informed some practice changes for me.
Fundamental disagreement with the team; meetings failed to resolve situation; team asked me to leave the office.
Staff shortage at a different health centre; was asked to join.
Change of team
New dynamic of the new team, restorative and healing; valiant part time colleague had struggled on with needy full time caseload. Within a couple of months, up to date; starting to develop new initiatives and work in depth with some families.
Complex case; realised situation had changed radically; no allocated social worker; sent fax proposing different outcome to case conference (reverting back to original proposal by social worker). Sent same fax to child protection team.
Three days later called to manager’s office urgently. Not invited to bring colleague but did.
Suspended pending investigation. Complete shock. However, this happened to me four years previously in another organisation so I knew the process. I had been through the trauma and devastation then, though this was also extremely distressing of course. (The allegations against me were not upheld and the trust chairman stated that I had ‘been cleared of professional shortcomings’). I asked to continue with clinic work and groups but request was denied.
At the investigation interview, explained why I sent the fax. Explanation ignored.
Record keeping examined by two managers. Report written by clinical supervisor without prior agreement with me, in spite of written, signed contract that all discussions were confidential and reports would only be written with both our agreement.
Investigation report full of fresh allegations, unrelated to the allegation of potentially putting a child at risk. Written refutation ignored. Accept recommendations of retraining in child protection procedures and full assessment of ability to function as a health visitor or face disciplinary action.
As the same people would be conducting the disciplinary hearing, opted for six month assessment.
Person who wrote ambiguous and unhelpful clinical supervision report, appointed to supervise. Unable to trust this person. Said this at a meeting with person present. Told there was no alternative except disciplinary action (again). Regional union rep and local rep managed to have the supervisor changed. Occupational health doctor helpful.
Suspension continued while all this was being arranged. Finally lifted after eight and a half months.
The assessment of my practice
Very painful returning to work. It was humiliating, lonely and very stressful. My confidence had been undermined and I had no trust in management. However, I was working in a different area with a different manager over seeing the assessment, who tried to be neutral in it all.
The assessor, a community practice teacher, was very supportive, (as were the rest of the team), and fair. I was also asked to keep a portfolio of the assessment.. Six months later the assessor wrote a positive report detailing the sections of the assessment, finding no problems and recommending a return to practice.
The thought of the waste of time and public money was irksome. And I kept protesting my innocence, that I could not have put a child at risk because processes would not allow it. I had also set up a web site to give support and information to fellow sufferers and to campaign against these horrendous miscarriages of justice. The people making contact were describing very similar events and processes.
At the beginning of the assessment process I was given a different local union rep who was incensed by what had happened and gave me very good advice during the assessment process, but who could not accompany me to meetings as she worked for a different trust and her employers would not sanction it. Initially I went to assessment meetings unaccompanied. One of my daughters came to the last one and could not believe what was going on – no policies or procedures being followed. She was allowed to speak and asked for timescales for a decision.
Child protection assessment
For the other part of the assessment, I insisted the designated nurse for child protection undertake the assessment of my child protection work, as I considered she was the only practitioner who had the authority to do this and because serious allegations had been made against my ability to do the work safely. I also felt badly let down by the adviser who had supervised my practice during the four years I had worked for the trust and who had never indicated any concerns.
I asked the designated nurse why I had been suspended without asking me first for my side of the story, but she made no reply.
I went through the case that had caused my suspension and she listened but had no comment or suggestions about what I might have done wrongly. I showed her my systems failure analysis but again, no comment. (The director of nursing had sent her thanks for it but they already did that. Kind regards!)
I thought it was the social services manager who had initiated the whole process (my apologies to him!) and when I asked her about it she replied that the report was back in the office and she could not comment without reading it.
I attended all the child protection training required, We covered all the ground that she considered necessary to establish my safety to practise and I took on some child protection cases. She then wrote a detailed and positive report, finally recommending that I was safe to return to unsupervised practice. The whole process had taken just over six months.
So now what ?
Silence. Nothing new about that! By email, I asked what was happening. I was told the investigating manager and my former manager were meeting to discuss the outcome of the assessment. I was asked to give the investigating manager sight of my portfolio, which I did. It was returned to me without comment.
Silence again. Another email and I was told those two managers were meeting with the director of nursing and the Deputy Director of Human Resources to discuss a verdict.
I was informed of a meeting with the Director of Nursing. This was brought forward a week and was now to be held with the Director of Hospital and Community Services.
I received a letter by recorded delivery, informing me that the Clinical Governance Professional Review Group had considered my case and decided I displayed a lack of judgement evidenced in my seeming inability or refusal to accept that I acted outside process and created unnecessary risk. Therefore the purpose of the meeting was to outline a decision taken by the full trust board and my future with the Trust.
The outcome of the meeting was my instant dismissal. It was a shocking experience.
The fulltime union officer
My impression was that the union regional officer had at first believed I was ‘guilty’ in some way and had ignored the unsubstantiated allegations. He had intervened to have the assessor changed and he had told the local rep to contact the trust when the suspension dragged on interminably. Now he got involved at my dismissal meeting and was a witness to the breaching of employment law. My case was taken by the union’s solicitors and an appeal was lodged with the Employment Tribunal. Endless waste of public money………………
I signed on with the local job centre. I tried to get work as a health visitor but without success. An agency almost employed me until their human resources (HR) director spoke to the previous HR director.
Referral to the Nursing and Midwifery Council
Then six months after my dismissal I received a bundle of papers from the regulatory body, the Nursing and Midwifery Council (NMC) informing me that my previous employers had alleged unfitness to practise and that my case was to go before the investigatory committee in a month’s time. I was invited to send a response.
The trust had requested that I not be given sight of the four statements of allegations which, until now, had been kept confidential to protect the authors. Thankfully, the NMC did not uphold their request.
I now understood reasons for the recommendations. I also saw that the social services manager had stated, eight days after my suspension, that it was not possible for what I had done (send a fax) to trigger off a chain of events that would put a child at risk. And a child protection adviser who didn’t know my work, had set the alarm bells ringing (I still don’t understand how she managed it!) and that the designated nurse for child protection had been very economical with the truth. How very sad.
I wrote a 13 page response with another 25 pages of appendices supporting my evidence and the investigatory panel decided that there was no case to answer. The reasons they gave were that there was no evidence of impairment of fitness to practise. ‘The assessment documentation indicated that the supervision was successful and that the respondent is competent and has insight’.
I applied to the agency once more, the previous HR manager gave a ‘non-descript’ reference and at last I returned to practise through an agency eight months after my dismissal. I have very little trust in NHS managers and never want to work in the NHS again.
The Employment Tribunal
The Employment Tribunal (ET) was due to be heard the same month, but the solicitors for the trust, said they were bringing up to six witnesses to give evidence against me and would need more time. Two days were agreed and a date everyone could manage was fixed, 14 months after my dismissal.
Shortly after, the solicitors put in a settlement offer of £10,000. Some months later they increased this to £15,000. I wanted an apology and the freedom to tell my story for the campaign, to stop this sort of disaster re-occurring. By now I had over a hundred NHS employees, mostly nurses, who had made contact through the web site, with similar stories.
On the afternoon prior to the Tribunal hearing, a final settlement agreement was reached as the sum offered was more than the ET would award if I had a barrister cleverer than the trust’s, (I had learnt from other people’s cases that it is not about justice and fairness). I had been given an apology and it had been accepted that I would use my case in the campaign but not name the people responsible.
Cost of my case?
My case must have cost a lot, well above the £21,400 average for non-NHS staff the National Audit Office figure reached in their 2003 report. Not working properly from my suspension until my dismissal 17 months later, the cost of the assessments, training, meetings, a substantial settlement that I am not allowed to disclose although the Department of Health has said this must not happen and finally solicitors fees. £200.000?
The end will arrive for me when the Department of Health gives all NHS staff the same rights as the doctors and dentists. (They are currently in breach of the 2002 Employment Law and have acknowledged it.)
I am very grateful to a fellow campaigner who has written a clear explanation of the illegalities of the Department’s actions. These are in the campaign section of the website www.suspension-nhs.org
The icing on the cake will be when the health sector unions set up specialist teams to give advice in such cases as at present , they are failing many of the members by their lack of understanding of processes and their absence of action.
Some of the stories people have, relate to false allegations with investigations but no suspension. This one is typical of some of them.
It was a very busy clinic. after Christmas and in the school holidays. There were just myself and the very able auxiliary nurse present. Parents brought children by arrangement, to have their babies’ immunisation programmes completed. Others heard what was happening and requested the same. Checked their parent held records to confirm what they were saying and administered the immunisations. Unscheduled immunisations’ forms completed with their signatures. Auxiliary nurse assisted with the paperwork.
Next morning, one parent phoned, very upset. Baby unwell – did I give a particular vaccine because child should not have it. There had been nothing to say this in the parent held records. Tried to contact GP. Not available. Bleeped senior paediatric houseman at local hospital. He arranged for the baby to be admitted immediately. Baby discharged several hours later. Illness not vaccine related.
Family made formal complaint.
Investigation interview with manager and representative from human resources. Took experienced colleague. We expected a clinical discussion and some recognition of my prompt actions that had protected the organisation from any legal action.
We came out of the meeting an hour later totally shocked at what had transpired.
The family had written in large letters and since the clinic, that the vaccine was not to be given Manager agreed it had been there at the time of the clinic and that I had missed it or ignored it.
Upheld another of their accusations, their word against mine. That I had given the vaccine was undisputed. A fourth allegation that was obviously impossible was thrown out.
Outcome – I was to receive counselling. During the counselling session I became very upset at what had happened. Felt betrayed by the manager. During the whole period of the investigation, work output dropped to a very low level. Very hard to concentrate. Very distressing.
Have since found out that this sort of event is not uncommon with outcomes that are far more damaging eg a two year written warning on file.
No right of appeal.
STORY no: 4 told by a family member.
After Sarah (not her real name), who worked as a community psychiatric nurse, was involved in a car accident whilst travelling between two of the trust’s clinics, she received a telephone call while she was still recovering from her injuries – she had to be cut out of her car after a tractor entered the main road from a laneway and ran over her car – from her Line Manager pleading with her to return to work and he could give her a job for 3 days a week so she could get used to being back at work again.
Against family advice she did so. The nurse she was taking over from was also her Shop Steward and worked a 5 day week at the same job. She inherited from him about 50 files with no notes in them. She was also getting about 10 to 12 new referrals a week on top of a caseload of 150 patients she was still to see. She approached her Line Manager for help and he told her to Prioritise!
She asked him how she could do so as she didn’t know any of the patients, hadn’t seen them and there were no notes in their files. She was told to do whatever she could but as the nurse before her (working 5 days) never needed any help, her Line Manager couldn’t see why Sarah (working 3 days) would need assistance to catch up. With his mind-set she had absolutely no chance!
Eventually a doctor wrote in to complain that a referral of his hadn’t been seen in 3 weeks. Then the manure hit the fan and it was all her fault with her Line Manager saying he had no idea she was behind in seeing new referrals.
Then she was posted to another area with a new nurse being brought in to do her previous post at 5 days a week, which they refused her permission to do. Her new post meant her driving over 150 miles a day with the damaged spine she received in the accident. She made management very well aware of her bad back and that driving distances aggravated it but she was forced to do so.
Eventually she was forced to take time off as her back was now giving her so much pain she was coming home at night and lying on the floor for up to 2 hours to try to get some ease from the pain.
I then suggested she sue the Trust for the pain & suffering she was going through and I made an appointment to see my solicitor. He suggested she should contact her Trade Union as that’s what they are there for. She did so and they in turn referred her to their Solicitors. At the end of the day it was found that a particular Trust Manager was negligent in forcing her to drive long distances with the foreknowledge it could cause her already damaged spine further damage and Sarah was awarded £3,500 for her pain & suffering. A princely sum!
After the settlement someone else now decided to change her ‘patch’ once more. This time her daily driving was increased to 250+ miles daily. She approached top level management about this and then had a meeting with one of them accompanied by their Human Resources Manager. The HRM said to her, “Sarah, you are not registered as a disabled person, just go and do the job you are sent to do” which she did. This lasted a few months again followed by a long period of absence as a result of back pain. All as predicted.
Then they sent her to see the Trust’s own doctor who went ballistic when she told him where she had been sent to work. It turned out he had personally intervened and had arranged for her to work at a neighbouring clinic where driving was reduced to a minimum.
It was this job she returned to work to do. After about six weeks the team she worked with were having their weekly working lunch in a pub with the new psychiatrist, who said he had something important to do at the Trust’s HQ. Off he went. Without saying anything to Sarah, the important thing he had to do was to make an official complaint about her. He alleged a patient she was seeing had saved up her tablets and had taken an overdose without Sarah being aware of it. The patient had boasted to the doctor how she had stored the tablets away where Sarah couldn’t find them.
As a result of this charge the Trust now added a charge of her not keeping proper notes on her patients when she was working 3 days a week.
She was instructed to work on the wards until a Disciplinary Hearing was arranged. She went off sick with the stress instead with our doctor immediately giving her a Sick note for 6 months.
A very difficult neighbour stood in the middle of her garden one day shortly afterwards and swallowed an overdose in full view of the neighbours. In hospital she told the Psychiatrist that Sarah was the reason for all her illnesses. The fact that her life was in a mess had nothing to do with her very public attempted suicide. Next thing, Sarah was summoned to the Trust HQ where she was again informed that the same doctor had made a further official complaint about her, this time about the neighbour.
A couple of weeks later she received a further letter asking her to report to HQ. She believed this was to give her a date for a hearing. It wasn’t. Again she was informed the same doctor had made a further complaint that she had discussed a patient with the patient’s partner just before she went off ill. This was supposed to have taken place in the patient’s own home a month previously. Sarah’s own diaries proved she had not visited that patient’s house for over 20 months and she was one of the patients that Sarah always insisted on seeing at the Clinic.
They eventually found she had no case to answer on 2 of the doctor’s complaints and the other case regarding the neighbour remains outstanding after years.
When the Disciplinary Hearing did take place, it was Chaired by the man who was found at fault when she sued the Trust. The other member was the Human Resources Manager who broke European and the Employment Legislation when she refused to recognise that Sarah should have been treated by them as a disabled person.
They got their revenge by demoting her from the top of a G Grade to a D Grade, to work on the wards under strict supervision when they found her guilty of not keeping proper records. These were the ones inherited from her Shop Steward. They refused to listen when she told them about how she had inherited the files in the first place.
The Shop Steward was well aware of all that was happening but he failed to step forward and admit he was at fault. He also withdrew support just prior to this meeting as did the regional officer for the union Amicus.
Because of the situation Sarah felt she could not involve any other members of staff to accompany her to the Disciplinary Hearing or to her Appeal, just in case whoever did support her would be their next target. Therefore she faced both kangaroo courts alone.
As for her colleagues, except for a couple, they didn’t even phone her. It seems they were afraid of it rubbing off onto them as well. Her Line Manager has now taken early retirement, possibly in an attempt to try to avoid having to answer for his actions.
Sarah’s solicitor received a copy of her Employment Record and her Line Manager had clearly recently written some notes which were backdated. Some actually had more than one date on them and fortunately she had kept a record of every meeting she had with him.
Although he never had reason to give her any warnings regarding her work, to look as if he had, he had inserted one note that he had given her a verbal warning at a particular time on a particular date. At that exact date and time we were attending a family celebration 25 miles away from where he said he had this imaginary meeting with her! Nor is there any record of this so called Verbal Warning being put on paper. On another date when he said he had a meeting with her, we were out of the country.
I still hope that one day the Trust managers will apologise to Sarah for the way they have treated her.
And of course, she has been so damaged by all this, she has left the NHS and started a whole new career.