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Matthew  Ruck

Matthew Ruck

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Physiotherapist struck off following investigations by Keoghs and Mulsanne Insurance

News And Events18/05/2020

In January 2018 physiotherapist, Adeyinka Adeshina, was handed an 18 month suspension following investigations by Keoghs and Mulsanne Insurance. Following further hearings, Mr Adeshina’s name has now been struck from the register.

Suspicious Activity and Suspension


The original investigation, as detailed here, arose when a personal injury claim from a 13 year old minor following a single vehicle incident was referred to Keoghs by Mulsanne Insurance due to concerns over alleged physiotherapy treatment.

Mr Adeshina, the director of Physique Rehab Ltd, had delivered 11 sessions of physiotherapy to the claimant over the phone despite descriptions giving the impression that it was physical hands-on treatment. In fact the physiotherapist spoke with the claimant’s mother via a non-professional interpreter, did not physically examine the claimant and left her mother, an unqualified person, to carry out the treatment.

Following further investigations it was uncovered that Mr Adeshina had previously been suspended from the HCPC register following a conviction for possessing counterfeit currency and making off without payment. Interestingly, his suspension between November 2015 and March 2016 overlapped with two of the treatment sessions in question.

Keoghs reported Mr Adeshina to the Health and Care Professions Tribunal Service (HCPTS), who opened an investigation with evidence provided by Keoghs and Mulsanne, and which lead to an initial 18 month interim suspension from the HCPC register.

Struck off

Since the original decision several interim hearings have taken place, with a final hearing on 30/04/2020, following which the Registrar was directed to strike the name of Mr Adeyinka Adeshina from the register. Mr Adeshina did not attend the hearing.

It was found that:

  • Providing physiotherapy treatment by telephone in this instance was not clinically appropriate.
  • Mr Adeshina put the claimant at risk of harm. She was vulnerable due to her age and due to the language barrier. The treatment he had identified as being required could not be carried out by telephone. There was a risk that the registrant’s diagnosis of the claimant was incorrect because of the limited assessment that was possible without face to face contact.
  • He had acted dishonestly and had brought the physiotherapy profession into disrepute.
  • He was not of previous good character. There was no evidence of his insight or remorse and no apology. He was liable to repeat this behaviour in the future.

Considerations

The facts of this case, whilst perhaps extreme, will not come as a complete surprise to anyone who works within the claims industry. Remote and telephone-led treatments are almost ubiquitous and there are important points in this decision which are perhaps of wider application.

The HCPTS Panel received expert evidence from a physiotherapist. Her opinion in respect of remote telephone-led treatment was that;

…although it was not “gold standard”, it may be acceptable practice for a physiotherapist to conduct up to a maximum of two physiotherapy sessions (including the initial assessment) by telephone … there is a process, described by the Registrant as “triage”, where clinicians make an initial assessment of a patient by telephone and rule out the possibility that another form of medical intervention is required. If symptoms are minor and resolve quickly, the assessment and advice process can be completed entirely through telephone triage.”

Whilst in this specific case, it was not appropriate to undertake even the triage by telephone it may be clinically appropriate in some circumstances. However, even then;

“ … for any patient it would not be clinically appropriate to provide physiotherapy treatment by telephone beyond the initial triage session, which might require up to two sessions …By the conclusion of the second session, at the latest, the physiotherapist would identify the need for physiotherapy treatment, which would require face to face contact, or the patient’s symptoms would be mild and resolve without requiring physiotherapy intervention.”

The nature, extent and duration of the injuries was also relevant to determining whether remote treatment was appropriate, with the physiotherapist highlighting;

“…that [the claimant’s] symptoms had been present for eleven weeks and involved multiple areas (right arm, neck, lower back, and knees).”

And in respect of the geographical distance between the claimant and the physiotherapist, the point was raised that;

“…there was a significant geographical distance of approximately ninety miles between [the claimant] and the registrant’s clinic address… this is not an acceptable distance because the option of hands on treatment was not available.”

The full decision can be found here.

Comment

Following the decision, Healthcare-Enabled Fraud Strategy Lead for Keoghs, Matthew Ruck, said;

“A medical professional being struck off is not to be taken lightly and this result is testament to the hard work by the teams at Mulsanne and Keoghs. We continue to recommend that insurers undertake full validation of any claims for rehabilitation that they receive in order to confirm exactly what treatment, if any, has actually been undertaken and to ensure that the documents received in support are accurate and honest. In the absence of specific expert evidence there will always be difficulty establishing whether a particular mode of treatment is clinically appropriate in a given case, however this decision provides a useful guide and hopefully will serve as a warning to those healthcare professionals who may be tempted to submit or support exaggerated, misleading or entirely false treatment claims.”

Paul Twilley, Claims Director at Mulsanne Insurance Company Limited, added;

“This case is an excellent outcome and a good demonstration of our robust Medical Care Fraud strategy in which we work in partnership with Keoghs to diligently investigate and defend any unmeritorious claims for rehabilitation. We shall continue to report any instances of malpractice and to take other appropriate enforcement steps to ensure that this sort of unacceptable behaviour is stopped in its tracks.”