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comments or suggestions about Patient A’s treatment, nor did it raise any clinical issues. For this reason, the Panel has concluded that, viewed in isolation, a panel considering this matter could not properly regard the entry as a sufficiently serious breach of standards to support a finding of misconduct. In relation to Paragraph 1b concerning Dr Brier’s unauthorised entry in Patient A’s drug chart, the Panel took account of the following guidance:- The New Doctor (2009) at Paragraph 6 states: “Good clinical care F1 doctors must: (a) demonstrate that they recognise personal and professional limits, and ask for help from senior colleagues…….when necessary. (b) know about and follow our guidance on the principles of Good Medical Practice and the standards of competence, care and conduct expected of doctors registered with the GMC. (c) demonstrate that they are taking increasing responsibility, under supervision and with appropriate discussion with colleagues, for patient care, putting the patient at the centre of their practice by: … (ix) using medicines safely and effectively (under supervision) including giving a clear explanation to patients” Good Medical Practice (GMP) at Paragraph 5 states that: “Wherever possible, you should avoid providing medical care to anyone with whom you have a close personal relationship” This Panel considers that it would be open to a panel to conclude that Dr Brier’s conduct is in breach of all of the above guidelines. In particular, the Panel was concerned that Dr Brier appeared not to have recognised the impropriety involved in altering the prescription of a patient for whom he was not responsible. This was done despite Dr Brier having no formal standing within the East Sussex Hospitals NHS Trust where Patient A was being treated and without the agreement of the clinicians in charge of the patient. The Panel is satisfied that a panel, properly advised, could find this action sufficiently serious to amount to misconduct. The Panel then went on to consider whether this misconduct could properly form the basis of a finding of impairment. In so doing, it has taken account of the agreed witness statement of Mr B, Director of Medical Education at Barnet and Chase Farm Hospitals NHS Trust (Dr Brier’s employers). Mr B stated that he had discussed the allegations with Dr Brier and that, in his opinion, Dr Brier had genuinely reflected on the inappropriateness of his behaviour and was unlikely to make similar errors of 4
judgement in the future. As a result, the Trust had not considered it appropriate to limit Dr Brier’s activities or responsibilities in the remainder of his F1 post. The Panel has also borne in mind that the errors of judgement in this case arise from a single incident and that Dr Brier has accepted from an early stage that his actions were inappropriate and admitted all charges against him. The Panel considered that, on the basis of the evidence adduced, a panel would be bound to conclude that his misconduct had been remediated, that Dr Brier had insight into the matters at issue, and that there was no significant risk of repetition. However, notwithstanding the issue of remediation, the Panel recognises that before reaching a decision of no impairment, a panel considering the matter would need to take account of the requirement to protect the public interest. This includes not only the protection of patients, but also the maintenance of public confidence in the profession, and the declaring and upholding of proper standards of conduct and behaviour. In this respect, the Panel has been guided by paragraph 101 in the judgement of Cox J in the case of Grant [2011] EWHC 927 (Admin) which states:- The Committee should therefore have asked themselves not only whether the Registrant continued to present a risk to members of the public, but whether the need to uphold proper professional standards and public confidence in the Registrant and in the profession would be undermined if a finding of impairment of fitness to practise were not made in the circumstances of this case. “ In considering this question, the Panel has borne in mind the following factors: that at the time of these events Dr Brier was a young and relatively inexperienced doctor seeking to assist an elderly patient; that he communicated precisely what he had done to the relevant parties (albeit that they were inappropriate and unauthorised); that there were no harmful consequences of his actions. Given also the evidence on insight and remediation, and the fact that Dr Brier’s actions did not involve dishonesty or abuse of trust, the Panel considers that a panel could not properly conclude that the public interest would be undermined by a finding of no impairment. In all the circumstances therefore the Panel is satisfied that, taken at its highest, the evidence adduced by the GMC could not lead a panel to conclude that Dr Brier’s fitness to practice is impaired by reason of his misconduct. Accordingly, the Panel has acceded to your application under Rule 17(2)(g) that there is no case to answer. Confirmed Date: Chairman 5
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