HEARING HEARD IN PUBLIC SEFTON, Kirsty Louise Registration No: 207951 PROFESSIONAL CONDUCT COMMITTEE JULY 2014 Outcome: Erasure with immediate suspension Kirsty Louise SEFTON, a dental nurse, registered as of 2 East Park Road, Macclesfield, Cheshire SK11 7FH; NVQ L3 Dental Nursing & VRQ L3 Dental Nursing City & Guilds 2011 was summoned to appear before the Professional Conduct Committee on 10 July 2014 for an inquiry into the following charge: Charge That, being a registered dental care professional: Your fitness to practise is impaired by reason of misconduct in that: 1. From October 2012, you advertised your services in laser teeth whitening as a registered dental nurse when providing tooth whitening is beyond your scope of practice as a dental nurse. 2. Your behaviour in relation to (1) above was: (a) Unprofessional; (b) Misleading; and/or (c) Dishonest. On 10 July 2014 the Chairman made the following statement regarding the finding of facts: Ms Sefton is neither present nor represented at this hearing. At the outset, on behalf of the General Dental Council (GDC), you made an application to proceed in her absence, pursuant to Rule 54 of the GDC (Fitness to Practise) Rules 2006 (the Rules). In reaching its decision, the Committee took into account your submissions and it accepted the advice of the Legal Adviser. The Committee first considered whether Ms Sefton had been notified of this hearing in accordance with Rules 13 and 65. It saw the Notification of Hearing, dated 28 May 2014, which was sent to Ms Sefton s registered address and to her current address, the details of which were obtained by a Search Agent instructed by the GDC. The Committee saw the associated Royal Mail receipts confirming that copies of the Notification of Hearing had been signed for at both addresses. On the basis of this information, the Committee was satisfied that all reasonable efforts had been made in accordance with the Rules to notify Ms Sefton of this hearing. The Committee next considered whether to exercise its discretion to proceed with the hearing in Ms Sefton s absence. It took into account the legal advice that it should approach this issue with the utmost care and caution. It bore in mind the interests of justice and fairness, as well as the public interest in the expeditious consideration of this case. SEFTON, K L Professional Conduct Committee July 2014 Page -1/5-
The Committee was satisfied from the documentation before it that Ms Sefton has received information about her case from the GDC, but has not engaged with the regulatory process. Ms Sefton has not made contact to request an adjournment of her case and the Committee was of the view that an adjournment of today s hearing would not make her attendance on a future date any more likely. The Committee had regard to the nature of the allegations, which raise serious issues of patient safety and it concluded that the public interest outweighed the interests of Ms Sefton. In all the circumstances, the Committee determined that it was fair and in the interests of justice to proceed with the hearing in her absence. This case concerns an allegation that Ms Sefton practised beyond her scope of practice as a dental nurse by advertising her services in laser teeth whitening. It is further alleged that in doing so, her behaviour was unprofessional, misleading and/or dishonest. The Committee received documentary evidence, which included the witness statement of Mr Matt Dunphy, Interim Project and Information Officer for the GDC, signed and dated 8 April 2014. With his statement, Mr Dunphy exhibits the original complaint made to the GDC in relation to tooth whitening treatment provided to the complainant s friend by Ms Sefton. Mr Dunphy also exhibits screenshots from Facebook and Twitter accounts where tooth whitening services were advertised by MK Tooth Whitening between October 2012 and October 2013. Information contained within these social media pages indicated to the GDC that Ms Sefton placed these advertisements. Both accounts contained a mobile number for Ms Sefton, which was included within her application for registration with the GDC, and they also made reference to Milton Keynes, an area with which Ms Sefton was connected. The Facebook advertisement offered Mobile Laser Teeth Whitening and Nail Treatments by Kirsty, Fully Qualified Dental Nurse and Beauty Therapist. It further stated Laser teeth whitening in the comfort of your own home carried out by a qualified and GDC registered dental nurse The Twitter account also made reference to a registered and qualified dental nurse. The Committee has considered all the evidence presented to it. It has taken account of your submissions and it has accepted the advice of the Legal Adviser. The Committee has considered each head of charge separately, bearing in mind that the burden of proof rests with the GDC and that the standard of proof is the civil standard, that is, whether the allegations are proved on the balance of probabilities. The Committee also took into account the legal advice regarding the two stage test to be applied in relation to the allegation of dishonesty. It noted that it must first consider whether Ms Sefton s behaviour was dishonest by the ordinary standards of reasonable and honest people, and if so, whether she realised that by those standards her behaviour was dishonest. I will now announce the Committee s findings in relation to each head of charge: 1. Proved. The Committee was satisfied on the evidence received that it was Ms Sefton who advertised laser tooth whitening services under the name MK Tooth Whitening. Ms Sefton is registered with the GDC as a dental nurse. The Committee had regard to the GDC s current and previous Scope of Practice guidance for Dental Nurses, both of which confirm that tooth whitening falls outside their scope of practice. SEFTON, K L Professional Conduct Committee July 2014 Page -2/5-
2. (a) Proved. 2. (b) Proved. 2. (c) Proved. It is clearly unprofessional to offer services outside of one s scope of practice. In her advertisements, Ms Sefton emphasised that she was a qualified, GDC registered dental nurse. The Committee was satisfied that any member of the public reading these advertisements could reasonably presume that she was trained, qualified and indemnified to carry out the services she was offering. Her behaviour was therefore misleading. The Committee was satisfied that Ms Sefton s behaviour would be considered dishonest by the ordinary standards of reasonable and honest people. It was also satisfied that Ms Sefton knew that she was being dishonest by those standards. As a registered dental nurse, she would have known that she was offering a service that was outside of her scope of practice. Further, she knew that she would have received personal financial gain for any services she did carry out in contravention of the GDC s guidance. We move to Stage Two. On 10 July 2014 the Chairman announced the determination as follows: Ms Sefton is neither present nor represented at this hearing. The Committee has considered all the evidence presented to it. It has taken account of your submissions made on behalf of the General Dental Council (GDC) and it has accepted the advice of the Legal Adviser. From October 2012 to October 2013, Ms Sefton advertised her services in laser teeth whitening as a registered dental nurse when providing tooth whitening is beyond her scope of practice as a dental nurse. Her behaviour in this respect was unprofessional, misleading and dishonest. Misconduct The Committee first considered whether the facts found proved in this case amounted to misconduct. It took into account that misconduct in this regulatory context is a serious falling short of the standards expected of a registered dental professional. The Committee was satisfied that Ms Sefton s behaviour as highlighted in this case was a clear breach of the professional standards she was expected to adhere to as a dental nurse. By offering laser tooth whitening services, she failed to comply with the clear Scope of Practice guidance for dental nurses, which is contained within the GDC s Scope of Practice publication of April 2009 (updated November 2013). Her behaviour demonstrates a complete disregard for the GDC, as her regulatory body, and also her willingness to place financial gain before the safety of patients. The Committee has found that Ms Sefton s proven behaviour amounted to misconduct. Impairment The Committee next considered whether Ms Sefton s fitness to practise is currently impaired by reason of her misconduct. In reaching its decision, the Committee has exercised its own SEFTON, K L Professional Conduct Committee July 2014 Page -3/5-
independent judgement. It has borne in mind that its duty is to protect the public interest, which includes the protection of patients, the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour. The Committee was satisfied that Ms Sefton s fitness to practise was impaired at the time of the events in questions. While the Committee was of the view that dishonesty is not easily remediable, in deciding whether Ms Sefton s fitness to practise is currently impaired, it did consider whether there is any indication of remediation on her part. The Committee has received no such evidence. Ms Sefton has not engaged at all with the GDC, to the extent that she has even allowed her practising certificate to lapse. Consequently, there is no evidence that she has any insight into her behaviour. She has shown no recognition or understanding of why her behaviour was wrong and therefore the Committee decided that there is a risk that she could repeat her wrongdoing. In the circumstances, the Committee remains concerned about the real risk to patient safety. It also considered that public confidence in the dental profession would be undermined if a finding of impairment were not made in this case. The Committee has therefore determined that Ms Sefton s fitness to practise is currently impaired. Sanction The Committee considered what sanction, if any, to impose on Ms Sefton s registration. It reminded itself that the purpose of a sanction is not to be punitive, although it may have that effect, but to protect patients and the wider public interest. The Committee took into account the Guidance for the Professional Conduct Committee (November 2009). It considered the range of sanctions available to it, starting with the least serious. The Committee applied the principle of proportionality, balancing the public interest with Ms Sefton s own interests. Given the serious nature of Ms Sefton s misconduct, which raises concerns about patient safety, the Committee determined that it would be wholly inappropriate to conclude this case without taking any action in respect of her registration. It reached the same conclusion in respect of a reprimand. These courses of action would not provide any protection for the public, nor would they maintain public confidence in the dental profession. The Committee considered whether to impose conditions on Ms Sefton s registration. Notwithstanding the fact that Ms Sefton s has allowed her practising certificate to lapse, the Committee concluded that conditional registration would not be appropriate in this case. It has made serious findings, which include a finding of dishonesty. Further, Ms Sefton has already demonstrated a failure to comply with the Scope of Practice guidance issued by her professional body. In these circumstances, the Committee decided that it could not formulate any workable conditions which would afford the necessary public protection, as well as satisfy the public interest. The Committee considered whether to suspend Ms Sefton s registration. However, it determined that a period of suspension would not be a sufficient or appropriate sanction, given the gravity of Ms Sefton s misconduct and her continuing lack of engagement and insight. She was advertising treatment that she was neither trained nor qualified to carry out and therefore, if given the opportunity, could have caused serious harm to patients. As a registered dental nurse she would have known that to offer such a service is beyond her scope of practice. The Committee was satisfied that the behaviour that has been demonstrated by Ms Sefton is incompatible with her continued registration as a dental nurse. SEFTON, K L Professional Conduct Committee July 2014 Page -4/5-
In all the circumstances, the Committee has determined that the only appropriate and proportionate sanction is to erase Ms Sefton s name from the Register for Dental Care Professionals (the Register). Unless she exercises her right of appeal, her name will be erased from the Register 28 days from the date when notice of this determination is deemed to have been served upon her. However, the Committee now invites submissions from you, as to whether her registration should be suspended immediately, pending the taking effect of its substantive determination for erasure. In deciding whether to impose an immediate order of suspension on Ms Sefton s registration, the Committee has considered your submission on behalf of the GDC that such an order should be made. It has accepted the advice of the Legal Adviser. The Committee has determined that it is necessary for the protection of the public and is otherwise in the public interest to impose an immediate order of suspension on Ms Sefton s registration. It has made serious findings in this case which raise issues of patient safety and it has determined that she is not fit to remain registered as a dental nurse. It would therefore be inconsistent not to suspend her registration immediately. The Committee also decided that an immediate order is required to maintain public confidence in the dental profession and this regulatory process. The effect of the foregoing determination and this order is that Ms Sefton s registration will be suspended from the date on which notice is deemed to have been served upon her. Unless she exercises her right of appeal, her name will be erased from the Register for Dental Care Professionals 28 days from the date of deemed service. Should Ms Sefton exercise her right of appeal, this immediate order for suspension will remain in place until the resolution of any appeal. The interim order currently on Ms Sefton s registration is hereby revoked. That concludes this hearing. SEFTON, K L Professional Conduct Committee July 2014 Page -5/5-