PHL/15374 – Dr Booth v Hampshire PCT – Removal from Medical Performers List

Judgement Number15374
CourtFirst-tier Tribunal (Health, Education and Social Care Chamber)
IN THE FIRST-TIER TRIBUNAL
(HEALTH, EDUCATION AND SOCIAL CARE CHAMBER)
PRIMARY HEALTH LISTS
Case No: PHL/15374
Tribunal Members
Mrs Debra Shaw - Chairman
Dr S Sharma - Professional Member
Mr W Nelson - Member
BETWEEN DR F M NURIA BOOTH
GMC No: 2216726
Appellant
and
HAMPSHIRE PRIMARY CARE TRUST
Respondent
Considered on 25th and 27th July 2011
DECISION WITH REASONS
The Application
1. This is an appeal by Dr Nuria Booth (Dr Booth) against the removal of her name from
the medical Performers List of Hampshire PCT (the PCT) under the provisions of
Regulations 10(4)(a) and (c) of the National Health Service (Performers Lists)
Regulations 2004 (as amended) and associated regulations (the Regulations) on
grounds of inefficiency and unsuitability.
History and Background
2. Dr Booth is a GP who has been included in the PCT’s Medical Performers list (or
equivalent) since 1992. Until May 2002 Dr Booth was in partnership with Pinehill
Surgery, Bordon but following a partnership dispute Dr Booth left and, with the
agreement of North Hampshire PCT (one of the PCT’s predecessor organisations),
established herself as a single handed practitioner working from Highview Surgery,
Bordon.
3. At the time of establishment in 2007 the PCT was advised that North Hampshire PCT
had had concerns regarding Dr Booth’s clinical governance arrangements over a
number of years and, in particular, concern was expressed regarding the chaotic
nature that prevailed over the management of the practice. The records showed that
North Hampshire PCT had asked Dr Booth to take part in an NCAS assessment and
that she had declined.
4. At the time of transition to the new PCT, Dr Booth had been contingently removed
from the North Hampshire PCT Medical Performers List and she had agreed to
comply with a number of actions contained in an Action Plan. The PCT was aware
that North Hampshire PCT’s Head of Primary Care, Clinical Governance Manager
and PRIMIS Facilitator had provided support to facilitate Dr Booth achieving the
conditions set out.
5. As the case history was complex, in 2007 the PCT undertook an independent review of
Dr Booth’s compliance with the Action Plan. The PCT determined that Dr Booth had
sought to comply with all of the conditions, although it was concerned as to the
sustainability of such improvements given that Dr Booth’s income was low and she
was unable to afford an experienced manager to support her in the running of the
practice.
6. The PCT worked with Dr Booth to identify if it was feasible to take on the running of
the practice through an APMS contract and also supported her in her endeavours to
enter into an agreement with Chilvers McCrea, an alternative provider of primary care
services, but neither of these options reached fruition.
7. The PCT continued to provide support to Dr Booth on an ad hoc basis. The contingent
removal was lifted in January 2008 and replaced with a voluntary arrangement that
allowed the PCT to meet with Dr Booth on a regular basis.
8. On 11th August 2009, the GMC wrote to the PCT regarding a complaint from one of
Dr Booth’s patients (patient M) which referred to the death of one daughter from
Ewings Sarcoma which it was alleged Dr Booth failed to diagnosis, and the
medication prescribed to another daughter. The PCT then received 2 further
complaints: the first on 17th November 2009 was from solicitors acting on behalf of
a patient alleging breach of confidentiality, and the second received on 8th December
2009 referred to prescribing issues.
9. The complaints were considered by a PCT Performance Screening Group (PSG) on
23rd February 2010. The PSG agreed that due to the complaints raised and the
concerns regarding Dr Booth’s record keeping; ability to use the computer system; the
chaotic and disorganised consulting room; the continued lack of progress in relation to
the Quality & Outcome Framework and the fact that she was a negative outlier on
generic prescribing utilisation in comparison with other practices in the PCT, she
should be referred to NCAS for an assessment.

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