fitness to practise annual report 2017 · 2018-11-22 · health and care professions council...

Fitness to practise annual report 2017

1 April 2016 to 31 March 2017

2Health and Care Professions Council Fitness to practise annual report 2017

Contents

Executive summary 3

Introduction 6

Section 1: Cases received in 2016–17 10

Section 2: Investigating Committee Panels 20

Section 3: Interim orders 31

Section 4: Public hearings 34

Section 5: Suspension and conditions of practice review hearings 58

Section 6: Restoration hearings 61

Section 7: The role of the Professional Standards Authority and High Court cases 62

Section 8: How to raise a concern 63

Appendix one: Historical statistics 64


Executive summary

Welcome to the fourteenth fitness to practiseannual report of the Health and Care ProfessionsCouncil (HCPC) covering the period 1 April 2016to 31 March 2017. This report providesinformation about the work we do in consideringallegations about the fitness to practise of ourregistrants.

In 2016–17, the number of individuals on ourRegister increased by 2.5 per cent. The numberof new fitness to practise concerns we receivedincreased by 6.2 per cent (from 2,127 concerns in2015–16 to 2,259 in 2016–17). The proportion ofthe Register affected still remains low, with only0.64 per cent of registrants (or one in 164) beingsubject to a new concern in 2016–17.

Members of the public continue to be the largestcomplainant group, making up 41 per cent of thetotal number of concerns raised this year,although this has decreased by five per cent overthe last two years. Employers continue to be thesecond largest source of concerns, contributing26 per cent of the concerns raised. We have alsoseen an increase in the number of cases resultingfrom a self-referral made by registrants, with 462self-referral cases received in 2016–17 comparedto 429 cases in 2015–16 and 353 cases in

2014–15. Self-referrals constitute 20 per cent ofthe total number of concerns received.

Of the cases we progressed through the fitness topractise process in 2016–17:

− 1,854 cases were closed as they did not meetour Standard of Acceptance1;

− 653 cases were considered by an InvestigatingCommittee Panel (ICP);

− 445 cases were concluded at final hearings;and

− 222 review hearings were held.

We have seen an increase of almost 12 per centin the number of cases closed as they did notmeet our Standard of Acceptance. This has led toa 17 per cent decrease in the number of casesbeing considered by the ICP. Although fewercases have been considered by an ICP, there hasbeen an increase in the proportion of cases wherethe ICP has decided that there is a case for theregistrant to answer. The case to answer decisionrate in 2016–17 is 71 per cent compared to 63per cent in 2015–16 and 53 per cent in 2014–15.

This year, out of 653 cases considered, the ICPdecided that there was a case for the registrant to

answer in 443 cases (the remaining decisionswere 27 requests for further information and 183no case to answer). Of the case to answerdecisions, the complainant was a member of thepublic in five per cent of the cases. Theregistrant’s employer was the complainant in 62per cent and 22 per cent of the cases were fromregistrants’ self-referrals.

We have seen a significant increase in hearingsactivity this year, with 39 per cent more casesbeing concluded at a final hearing in 2016–17compared to 2015–16. This reflects the activitieswe have carried out to improve the time it takes toconclude cases including our older cases. Therewas also a ten per cent increase in the number ofreview hearings heard in 2016–17, compared tolast year. This year’s total hearings activity,including final, substantive review, interim order,restoration, ICP hearing days and preliminaryhearing days, amounted to 2,336 days in total,which is an increase of 31 per cent from 1,785last year.

1 The Standard of Acceptance is the threshold a concernabout a registrant must meet before we will investigate itas a fitness to practise allegation.


Executive summary

This year we have realigned the fitness to practisedirectorate to provide for greater specialisation inthe case management process. We havereviewed our approach to assessing risk,including determining whether we should applyfor an Interim Order. We have continued our focuson improving the time it takes for cases toprogress through the fitness to practise process.This has included ensuring that our older casesare concluded at a final hearing. We have alsoenhanced our arrangments for montoringperformance in this area. We will conitnue thiswork in the coming year. Other activities in 2016–17 have included a review of our approach tofitness to practise. This resulted in the publicationof HCPC’s Approach to Fitness to Practise inDecember 2016. This sets out our approach todelivering public protection through our fitness topractise work and emphasises that we will adopta proportionate and risk based approach whendealing with fitness to practise issues.

To enhance the independence of the adjudicationfunction, we commenced a project to establishthe Health and Care Professions Tribunal Service(HCPTS). Greater independence of this functionreinforces the separation of the investigation andadjudication of fitness to practise cases. It will

provide reassurance to those involved in fitness topractise cases that the decisions are made byindependent panels that are at arm’s length fromthe organisation that has investigated the cases.This project will be completed in April 2017.

We have continued to encourage feedback fromthose who use our services, our stakeholders andpartners and continuously review and improve ourprocesses, in light of this feedback and thechanging regulatory environment and law. Thecontinuous improvement of our processes is alsoinformed by our own quality assurance work andthe reviews undertaken by the ProfessionalStandards Authority.

We have continued to develop the supportmechanisms we provide to those who areinvolved in fitness to practise cases. This year wepublished an updated What happens if a concernis raised about me? brochure, which is aimed atregistrants who are subject to a fitness to practiseinvestigation. Fitness to practise employees alsoreceived training on mental health issues andawareness and were provided with new guidanceon managing suicidal contacts.

In 2016–17 we continued to work with a numberof other organisations that have the commonobjective of ensuring the safety and wellbeing ofmembers of the public through collaborating withthe Care Quality Commission (CQC), otherregulators and NHS and social care organisations.This included agreeing memoranda ofunderstanding with the three other social careregulators located in Northern Ireland, Scotlandand Wales or with the Office for Standards inEducation, Children’s Services and Skills (Ofsted).

We concluded our pilot of the provision ofmediation for our fitness to practise process. Thepilot identified that mediation had a very limitedrole to play in the conclusion of fitness to practisecases, although the option to use mediation inrelevant cases will remain open.

Looking forward, our priorities and work in 2017–18 will include evaluating the impact andimprovements achieved following the realignmentof our fitness to practise directorate, coupled withthe continued focus on the timely progression andconclusion of cases. The conclusion of the projectestablishing the HCPTS and a review of its impactwill also be a focus.


Executive summary

We will also explore the use and value of caseexaminers or screeners in the early stages of ourfitness to practise process, holding somehearings ‘on the papers’ and the use of electronicbundles.

We will continue to keep our policies underreview, including the review of our IndicativeSanctions Policy, and stand ready to take forwardany actions that may emerge from the researchthe HCPC has commissioned into understandingthe prevalence of fitness to practise cases aboutparamedics and social workers in England.

I hope you find this report of interest. If you haveany feedback or comments, please email these [email protected]

John BarwickActing Director of Fitness to Practise


Introduction

About us (the Health and Care ProfessionsCouncil) We are the Health and Care Professions Council(HCPC), a regulator set up to protect the public.To do this, we keep a Register of theprofessionals we regulate who meet ourstandards for their training, professional skills andbehaviour. We can take action if someone on ourRegister falls below our standards.

In the year 1 April 2016 to 31 March 2017 weregulated 16 professions.

− Arts therapists− Biomedical scientists− Chiropodists / podiatrists− Clinical scientists− Dietitians− Hearing aid dispensers− Occupational therapists− Operating department practitioners− Orthoptists− Paramedics− Physiotherapists− Practitioner psychologists− Prosthetists / orthotists− Radiographers− Social workers in England− Speech and language therapists

Each of the professions we regulate has one ormore ‘designated title’ which is protected by law.These include titles like ‘physiotherapist’ and‘dietitian’. Anyone who uses one of these titlesmust be on our Register. Anyone who uses aprotected title and is not registered with us isbreaking the law, and could be prosecuted. It isalso an offence for a person who is not aregistered hearing aid dispenser to perform thefunctions of a dispenser of hearing aids.

For a full list of designated titles and for furtherinformation about the protected function ofhearing aid dispensers, please visit our website atwww.hcpc-uk.org. Registration can be checkedat www.hcpc-uk.org/check or by calling+44(0)300 500 6184.

Our main functions To protect the public, we:

− set standards for the education and training,professional skills, conduct, performance, ethicsand health of registrants (the professionals whoare on our Register);

− keep a Register of professionals who meetthose standards;

− approve programmes which professionals mustcomplete before they can register with us; and

− take action when professionals on our Registerdo not meet our standards.

For an up-to-date list of the professions weregulate, or to learn more about the role of aparticular profession, see www.hcpc-uk.org/aboutregistration/professions

What is ‘fitness to practise’? When we say that a professional is ‘fit to practise’ we mean that they have the skills,knowledge and character to practise theirprofession safely and effectively. Registrants also need to keep their knowledge and skills up to date, to act competently and remain within the bounds of their competence.Maintaining fitness to practise also requiresregistrants to treat service users with dignity andrespect, to collaborate and communicateeffectively, to act with honesty, integrity andcandour and to manage any risk posed by theirown health.

What is the purpose of the fitness topractise process? The purpose of the fitness to practise process isto identify those registrants who are not fit topractise and, where necessary, to take steps torestrict their ability to practise. This provides


protection for the public and maintains confidencein the professions that we regulate.

Most health and care professionals adhere to thestandards without any intervention by the HCPC.Only a small minority of registrants will ever face anallegation that their fitness to practise is impairedand, of those, very few will have acted maliciously.

Sometimes professionals make mistakes or haveone-off instances of unprofessional conduct orbehaviour, which are unlikely to be repeated. Insuch circumstances, it is unlikely that theregistrant’s fitness to practise will be found to beimpaired. We are, therefore, unlikely to pursueevery isolated or minor mistake. However, if aprofessional is found to fall below our standards,we will take action.

Raising a fitness to practise concern Anyone can contact us and raise a concern abouta registered professional. This includes membersof the public, employers, the police and otherprofessionals. Further information about how totell us about a fitness to practise concern is in ourbrochure How to raise a concern, which isavailable on our website at www.hcpc-uk.org/publications/brochures

What types of cases can the HCPCconsider? We consider every case individually. However, aprofessional’s fitness to practise is likely to beimpaired if the evidence shows that they:

− were dishonest, committed fraud or abusedsomeone’s trust;

− exploited a vulnerable person;− failed to respect service users’ rights to make

choices about their own care; − have health problems that they are not

managing well and which may affect the safetyof service users;

− hid mistakes or tried to block our investigation;− had an improper relationship with a service

user;− carried out reckless or deliberately harmful acts;− seriously or persistently failed to meet

standards;− were involved in sexual misconduct or

indecency (including any involvement in childpornography);

− have a substance abuse or misuse problem; − have been violent or displayed threatening

behaviour; or− carried out other, equally serious, activities

which affect public confidence in the profession.

We can also consider concerns about whether anentry to the HCPC Register has been madefraudulently or incorrectly. For example, theperson may have provided false information whenthey applied to be registered or other informationmay have come to light since that means thatthey were not eligible for registration.

What can’t the HCPC do? We are not able to:

− consider cases about professionals who are notregistered with us;

− consider cases about organisations (we onlydeal with cases about individual professionals);

− get involved in clinical or social carearrangements;

− reverse decisions of other organisations orbodies;

− deal with customer service issues;− get involved in matters which should be

decided upon by a court;− get a professional or organisation to change the

content of a report;− arrange refunds or compensation;− fine a professional;− give legal advice; or− make a professional apologise.


What to expect We will take a proportionate and risk basedapproach when considering a registrant’s fitnessto practise.

New concerns about a professional’s fitness topractise that are raised with us, will be assessedagainst our Standard of Acceptance. If this is notmet, the case will be closed. If the Standard ofAcceptance is met, the case will be allocated to aCase Manager in our Investigations team, whomanage the case through to the InvestigatingCommittee Panel (ICP). The ICP will consider thecase and determine whether the case should beclosed at that stage or whether there is a case toanswer and the case should be referred for ahearing. If referred, our Case Progression andConclusion team will take over the managementof the case and work closely with our solicitors toprepare the case for a hearing.

Our Case Managers will keep everyone involvedin the case up-to-date with its progress andinformed about the process we are following andthe decisions that are being made. CaseManagers are neutral and do not take the side ofeither the registrant or the person who has madeus aware of the concerns. They will ensure that

we appropriately balance the rights of theregistrant against the need to ensure that weprotect the public.

Practice notes The HCPC publishes a number of practice notes,which provide guidance to the panels that makedecisions about fitness to practise cases and toassist those appearing before them. New practicenotes are issued on a regular basis and all currentnotes are reviewed to ensure that they are fit forpurpose.

As part of the project to establish the Health andCare Professions Tribunal Service (HCPTS), thePractice Notes were reviewed and updated thisyear and can be found on the HCPTS website atwww.hcpts-uk.org

Health and Care Professions TribunalService (HCPTS)Independent panels hear and determine fitness topractise cases on behalf of the HCPC's threePractice Committees: the Investigating, Conductand Competence and Health Committees. Panelmembers are drawn from a wide variety ofbackgrounds – including professional practice,education and management. Each panel will have

at least one lay member and one registrantmember. Lay panel members are individuals whoare not, and have never been, eligible to be on theHCPC Register. The registrant panel member willbe from the relevant profession. This ensures thatwe have the appropriate public and professionalinput in the decision-making process.

A legal assessor will be at every hearing. They donot take part in the decision-making process, butwill give the panel and the others involved adviceon law and legal procedure, ensuring that allparties are treated fairly. Any advice given topanels is stated in the public element of thehearing.

The HCPC’s Council members do not sit on ourFitness to Practise Panels. This is to maintainseparation between those who set Council policyand those who make decisions in relation toindividual fitness to practise cases. Thiscontributes to ensuring that our hearings are fair,independent and impartial. Furthermore,employees of the HCPC are not involved in thedecision-making process. This ensures decisionsare made independently and are free from anybias.


About this reportThe data in this report covers the period 1 April2016 to 31 March 2017. Please note that due torounding to one or two decimal points, somepercentage totals do not amount to exactly 100per cent.


Section 1:

Cases received in 2016–17

This section contains information about thenumber and type of fitness to practise concernsreceived about registrants. It also providesinformation about who raised these concerns. Aconcern is only classed as an ‘allegation’ when itmeets our Standard of Acceptance forallegations.

The Standard of Acceptance policy sets out theinformation we must have for a case to be treatedas an allegation. As a minimum this information:

− must be in writing (fitness to practise concernsmay also be taken over the telephone if acomplainant has any accessibility difficulties);

− the registrant must be sufficiently identified; and− must give enough detail about the concerns to

enable the professional to understand thoseconcerns and to respond to them.

The Policy also recognises that, while concernsare raised about only a small minority of HCPCregistrants, investigating them takes a great dealof time and effort. So it is important that HCPC’sresources are used effectively to protect thepublic and are not diverted into investigatingmatters which do not give cause for concern.Where cases are closed we will, wherever we

can, signpost complainants to other organisationsthat may be able to help with the issues they haveraised.

Further enquiries are made in cases that, onreceipt, do not meet the Standard of Acceptanceto identify whether it is capable of meeting theStandard and becoming an allegation that weshould investigate. If not, we have anauthorisation process to close the case.

For further information, please see the Standardof Acceptance for allegations policy and ourStandard of Acceptance explained factsheet onour website at www.hcpc-uk.org/publications/policy

Table 1 shows the number of cases received in2016–17 compared to the total number ofprofessionals registered by the HCPC (as of 31March 2017).


Section 1:


Table 1

Total number of cases received in 2016–17

The proportion of HCPC registrants who have had a fitness to practise concernraised about them has increased slightly, from 0.62 per cent of all professionalson the Register in 2015–16 to 0.64 per cent in 2016–17. A very smallproportion of the Register have concerns raised about them. This year, onlyone in 164 registrants were the subject of a new concern about their fitness topractise. It should be noted that in a few instances a registrant will be thesubject of more than one case.

Graphs 1a and 1b shows the number of fitness to practise concerns receivedbetween 2012–13 and 2016–17 compared to the total number of HCPCregistrants.

Table 2

Total numbers of cases and percentage of Register

Year

2016–17

Number ofcases

2,259

Totalnumber ofregistrants

350,330

% ofregistrantssubject to

complaints

0.64

Year

2012–132013–142014–152015–162016–17

Number ofcases

1,6532,0692,1702,1272,259

Number ofregistrants

310,942322,021330,887341,745350,330

% ofRegister

0.520.640.660.620.64


Section 1:


Graph 1a

Number of fitness to practise cases received by year 2012–13 to 2016–17

Graph 1b

Number of registrants on HCPC Register by year from 2012–13 to 2016–17

Num

ber

of

case

s

Year

1,000

1,500

500

0

2,000

2,500

2012–13 2013–14 2014–15 2015–16 2016–17

Num

ber

of

reg

istr

ants

Year

100,000

150,000

50,000

0

200,000

250,000

300,000

350,000

400,000

2012–13 2013–14 2014–15 2015–16 2016–17


Section 1:


Cases by profession and complainant type The following tables and graphs show informationabout who raised fitness to practise concerns in2016–17 and how many cases were received foreach of the professions the HCPC regulates. Thetotal number of cases received in 2016–17 was2,259.

Table 3 provides information about the source ofthe concerns which gave rise to these cases.Members of the public continue to be the largestcomplainant group, making up 40.9 per cent ofthe total number of concerns received. This hasdecreased from 2015–16 when the proportionwas 42.8 per cent.

Similarly employers continue to be the secondlargest source of concerns, comprising 26.4 percent of the total. This compares to 25 per cent in2015–16. The proportion of cases which were theresult of a self-referral by the registrant hasremained the same as last year, at just over 20per cent.

Table 3

Who raised concerns in 2016–17?

Article 22(6) of the Health and Social Work Professions Order 2001Article 22(6) of the Health and Social Work Professions Order 2001 enablesthe HCPC to investigate a matter even where a concern has not beenraised with us in the normal way (for example, in response to a media reportor where information has been provided by someone who does not want toraise a concern formally). This is an important way we can use our legalpowers to protect the public.

Who raised a concern

Article 22(6) / anonEmployerOtherOther registrant / professionalProfessional bodyPolicePublicSelf-referral

Total

Number

65596102681031

924463

2,259

%

2.926.44.5

30.41.4

40.920.5

100


Section 1:


Table 4a

Cases by profession and complainant type

Profession

Arts therapistsBiomedical scientistsChiropodists / podiatristsClinical scientistsDietitiansHearing aid dispensersOccupational therapistsOperating department practitionersOrthoptistsParamedicsPhysiotherapistsPractitioner psychologistsProsthetists / orthotistsRadiographersSocial workers in EnglandSpeech and language therapists

Total

%

0.92.43.90.41.10.43.73.7

033.55.43.7

03.9

36.50.6

100

%

0.10.1

30.20.61.63.20.40.15.68.9

10.40

1.562.61.5

100

%

100000

20000

200

100

10300

100

%

00

6.500

3.23.2

12.90

25.812.93.2

06.5

25.80

100

%

04.4

11.80

1.50

1.52.9

016.28.8

00

4.444.14.4

100

%

2220011

2.90

12.713.78.8

04.9

46.12.9

100

%

0.52.51.70.21.20.85.5

40

6.98.73.20.34.5

58.61.3

100

%

00

1.5000

1.54.6

020000

7.764.6

0

100

Self-referral

41118252

17170

15525170

18169

3

463

Public

11

2826

153041

5282960

1457814

924

Professionalbody

1000020002010130

10

Police

0020011408410280

31

Otherregistrant

038010120

116003

303

68

Other

222001130

1314905

473

102

Employer

31510175

33240

4152192

27349

8

596

Article 22(6)/ anon

001000130

130005

420

65

Total

1132695

192684571

295183143

275

1,22631

2,259


Section 1:


Article 22(6) is important in self-referral cases. We encourage all professionals on the HCPCRegister to self-refer any issue which may affect their fitness to practise. Standard 9 of theHCPC’s revised Standards of conduct,performance and ethics, which were published in January 2016, states that “You must tell us assoon as possible if:

− you accept a caution from the police or if youhave been charged with, or found guilty of, acriminal offence;

− another organisation responsible for regulating ahealth or social-care profession has takenaction or made a finding against you; or

− you have had any restriction placed on yourpractice, or been suspended or dismissed byan employer, because of concerns about yourconduct or competence”.

All self-referrals are assessed to determine if theinformation provided suggests the registrant’sfitness to practise may be impaired and whether itmay be appropriate for us to investigate thematter further using the Article 22(6) provision.

Graph 2

Who raised concerns in 2016–17?

Article 22(6) / anon (2.9%)

Employer (26.4%)

Other (4.5%)

Other registrant / professional (3%)

Professional body (0.4%)

Police (1.4%)

Public (40.9%)

Self-referral (20.5%)

26.4%

40.9%

20.5%

3%

2.9%

0.4%

4.5%

1.4%


Section 1:


The category ‘Other’ in Table 4a and Graph 2 willinclude solicitors acting on behalf ofcomplainants, hospitals / clinics (when not actingin the capacity of employer), colleagues who arenot registrants and the Disclosure and BarringService, who notify us of individuals who havebeen barred from working with vulnerable adultsand / or children. Other types of complainantsmay all fall within this category.

Table 4b provides information on the breakdownof cases received by profession and gives acomparison to the Register as a whole.

Table 4b

Cases by profession

Profession


Total

% ofregistrantssubject toconcerns

0.270.140.530.090.21

10.220.440.071.230.350.630.190.231.330.19

0.64

% of theRegister

1.156.543.691.622.6

0.7410.873.730.416.8515.16.450.3

9.1526.244.55

100

Number ofregistrants

4,02622,90212,9315,6639,1072,593

38,08013,0521,451

23,99252,91522,6041,063

32,07291,94415,935

350,330

% of totalcases

0.491.423.050.220.841.153.722.520.04

13.068.1

6.330.093.32

54.271.37

100

Number ofcases

1132695

192684571

295183143

275

1,22631

2,259


Section 1:


Graph 3

Cases by route to registration 2016–17

Cases by route to registration Graph 3 shows the number of cases by route toregistration and demonstrates a close correlationbetween the proportion of registrants whoentered the HCPC Register by a particular routeand the percentage of fitness to practise cases. In2016–17, 29 cases were received against‘grandparented’ registrants and 98 casesreceived involved international registrants, whichaccounts for four per cent of cases received.

Case closureWhere a case does not meet the Standard ofAcceptance, even after we have sought furtherinformation, or the concerns that have beenraised do not relate to fitness to practise, the caseis closed.

In 2016–17, 1,854 cases were closed withoutbeing considered by a panel of the HCPC’sInvestigating Committee, a 12 per cent increasecompared to 2015–16 (where 1,661 cases wereclosed in this way). In 2016–17, 488 cases (26per cent) that were closed in this way came frommembers of the public. This compares to 59 percent in 2015–16.

20

30

10

0

40

50

60

70

80

90

100

Grandparenting UK International

% of cases % of Register


Section 1:


In 2016–17, the average length of time for casesto be closed at this first closure point was amedian average of four months and a meanaverage of five months. Both the mean andmedian averages have decreased by one monthsince the previous year.

Table 6 provides information about the variationacross the professions for cases that are closedwithout consideration by an InvestigatingCommittee Panel.

There is a wide range of variation in thesepatterns of referral. For instance, social workersare the largest profession on the Register, andhave the most concerns raised. This professionalso has the largest number of cases that areraised by members of the public. 62.6 per cent ofthe cases received in relation to social workerswere received from members of the public.However, this profession has the largest numberof cases that are closed because the concernsdid not meet the Standard of Acceptance.

Physiotherapists are the second largestprofession, yet have a much lower rate ofconcerns raised than paramedics or socialworkers in England, and also have a lower rate of

Table 5

Length of time from receipt to closure of cases that are not considered by Investigating Committee

Number of months

0 to 2 months3 to 4 months5 to 7 months8 to 12 months13 to 15 months16 to 20 months21 to 24 months> 24 months

Total

Cumulative% of cases

30.758.381.393.595.798.198.9100

% of cases

30.727.5

2312.22.22.30.81.1

100

Cumulativenumber of

cases

5701,0801,5071,7341,7751,8181,8331,854

Number ofcases

57051042722741431521

1,854


Section 1:


closure due to not meeting the Standard ofAcceptance.

Paramedics are the profession with the secondlargest number of concerns raised, and are thefifth largest profession. Concerns about this groupare the second largest to be closed because theydo not reach the Standard of Acceptance.

Table 6

Cases closed by profession before consideration at Investigating Committee

Number of months

Arts therapistsBiomedical scientistsChiropodists / podiatristsClinical scientistsDietitiansHearing aid dispensersOccupational therapistsOperating Department PractitionersOrthoptistsParamedicsPhysiotherapistsPractitioner psychologistsProsthetists / orthotistsRadiographersSocial workers in EnglandSpeech and language therapists

Total

% of totalcases

0.30.92.50.20.7

13.21.70.1

11.57.77.40.12.7

58.71.2

100

Number ofcases

617474

131960311

214142137

150

1,08923

1,854


Section 2:

Investigating Committee Panels

The role of an Investigating Committee Panel (ICP)is to consider allegations made against HCPCregistrants and to decide whether there is a ‘caseto answer.’

An ICP can decide that:

− more information is needed;− there is a ‘case to answer’ (which means the

matter will proceed to a final hearing); or− there is ‘no case to answer’ (which means that

the case does not meet the ‘realistic prospect’test).

ICPs meet in private to conduct a paper-basedconsideration of the allegation. Neither theregistrant nor the complainant appears before theICP. The panel must decide whether there is a‘case to answer’ based on the documents beforeit. The test the ICP applies in order to reach itsdecision is the ‘realistic prospect’ test. Thismeans that the panel must be satisfied there is arealistic (or genuine) possibility that the HCPC,which has the burden of proof in respect of thefacts alleged, will be able to prove those factsand, based upon those facts, that the panelconsidering the case at a final hearing wouldconclude that:

− those facts amount to the statutory ground (iemisconduct, lack of competence, physical ormental health, caution or conviction or adecision made by another regulator responsiblefor health and social care); and

− the registrant’s fitness to practise is impaired byreason of the statutory ground.

Only cases that meet all three elements of the‘realistic prospect’ test (ie facts, ground(s) andimpairment) can be referred for consideration at afinal hearing. Panels must consider the allegationas whole. Examples of ‘no case to answer’decisions can be found on page 22.

In some cases there may be a realistic prospectof proving the facts. However the panel mayconsider there is no realistic prospect of thosefacts amounting to the ground(s) of the allegation.Similarly, a panel may consider that there issufficient information to provide a realisticprospect of proving the facts and establishing theground(s) of the allegation but there is no realisticprospect of establishing that the registrant’sfitness to practise is impaired. This could be for anumber of reasons: for example, because theallegation concerns a minor and isolated lapsethat is unlikely to recur, or there is evidence to

show the registrant has taken action to correctthe behaviour that led to the allegation beingmade and so there is no risk of repetition. Suchcases would result in a ‘no case to answer’decision and the case would not proceed to afinal hearing.

In these ‘no case to answer’ decisions, if there arematters arising which the panel considers shouldbe brought to the attention of the registrant, itmay include a learning point. Learning points aregeneral in nature and are for guidance only. Theyallow ICPs to acknowledge that a registrant’sconduct or competence may not have been ofthe standard expected and that they should beadvised on how they may learn from the event. In2016–17 ICPs issued learning points in 54 cases(eight per cent of the cases considered). This is inline with the figure (56) for 2015–16 (seven percent of the cases considered) and slightly morewhen we look at this as a proportion of the casesconsidered (an increase from seven to eight percent).

There were 653 cases considered by an ICP in2016–17, of which 27 were the panels hadrequested further information. The total number ofcases considered is a reduction of 17 per cent


Section 2:


from 2015–16 when 787 cases were consideredby an ICP. The decrease in the number of casesbeing considered by an ICP in 2016–17 reflectsthe increase in the number of cases that havebeen closed for not meeting the Standard ofAcceptance for allegations.

Graph 4 shows the percentage of ‘case toanswer’ decisions each year from 2012–13 to2016–17. The ‘case to answer’ rate for 2016–17was 71 per cent, an increase of eight per centfrom 2015–16.

Graph 4

Percentage of allegations with a case to answer decision

% o

f ca

ses

with

cas

e to

ans

wer

Year

50

55

45

40

60

65

70

75

2012–13 2013–14 2014–15 2015–16 2016–17


Section 2:


Type of issue

A social worker was alleged not to have recorded anumber of visits or recorded case notes, or in somecases had not recorded adequate case notes.

Reason for no case to answer decision

In their written response to the allegation the registrant accepted responsibility for the lack ofrecording and, taking this into account alongside all the other information gathered during theinvestigation, the Panel was able to conclude that there was a realistic prospect of proving the factsof the allegation. The Panel then went on to consider if there was a realistic prospect these factswould amount to one of the statutory grounds, in this case either misconduct or lack of competence.The Panel noted that the allegations related to 12 separate service users and had occurred over anumber of years. The Panel recognised too that accurate record keeping is a fundamentalprofessional responsibility. On this basis, it determined that there was a realistic prospect the allegedfacts would amount to misconduct and / or lack of competence.

Having reached this point the Panel was next required to apply the same realistic prospect test to thequestion of whether the registrant’s fitness to practise might be found by a final hearing panel to beimpaired by reason of the alleged misconduct or lack of competence. In doing so the Panel tookaccount of the context in which these allegations were referred to the HCPC. It noted that theregistrant had undertaken a new role following a reorganisation and that there had been extenuating

Decisions by Investigating Committee Panels

Table 7

Examples of no case to answer decisions

This table shows a range of cases that were considered by an Investigating Committee Panel in 2016–17. The examples describe the allegation and a brief rationale of thePanel’s decision of no case to answer.


Section 2:


Type of issue Reason for no case to answer decision

A practitioner psychologist was alleged to have madeinappropriate and / or offensive comments toward acolleague.

personal circumstances which had now improved. The Panel also took into account the level ofinsight demonstrated by the registrant into the shortcomings in their professional practice andactions they had already taken to remediate these deficiencies. In consequence and considering theallegation as a whole, the Panel concluded that there was not a realistic prospect of establishing thatthe registrant’s fitness to practise was currently impaired.

The comments made by the registrant had been directed towards a colleague in the workplace on asingle day. The registrant admitted they had made some, though not all, of the alleged commentsand the Panel was in consequence readily able to conclude there was a realistic prospect of proving,at least some of, the alleged facts. The Panel recognised too that, if proved, these facts were likely toconstitute misconduct.

In moving on to consider whether there was a realistic prospect of a final hearing panel finding theregistrant’s fitness to practise to be currently impaired by this misconduct the Panel recognised thatthe comments were made on a single day and could therefore be regarded as an isolated incident.The registrant had provided supportive references attesting to their general good character and hadreflected on their actions. With all this in mind the Panel determined that there was no realisticprospect of proving that the registrant’s fitness to practise was currently impaired. The Panel did,nonetheless, issue the registrant with a learning point reminding them of the importance ofcommunicating appropriately and sensitively with work colleagues.


Section 2:



A hearing aid dispenser was alleged to have failed tocommunicate effectively with service users.

It was alleged that a speech and language therapisthad committed misconduct by dishonestly displayingincorrect qualifications on a professional profile page.The allegation had been made anonymously.

The Panel found there was a realistic prospect of establishing both the facts and the grounds ofmisconduct and / or lack of competence based on the registrant admitting part of the allegation,which covered a number of service users over a prolonged period of time.

In considering whether there was a realistic prospect of proving the registrant’s fitness to practise tobe impaired the Panel took account of a detailed response to the allegation submitted by theregistrant. This showed the registrant’s insight and demonstrated they had made appropriatechanges to their clinical practice aimed at improving communication with service users. In concludingthat the realistic prospect test was not met in relation to impairment the Panel took the view that itshould issue the registrant with a learning point on the importance of appropriate and effectivecommunication, specifically highlighting standard 2.7 of the HCPC’s Standards of conduct,performance and ethics.

The Panel considered there was a realistic prospect of proving one of the facts of the allegation,namely that the registrant’s qualifications had been listed incorrectly. The Panel did not consider,however, that there was a realistic prospect of proving that this had been done through a deliberateact of dishonesty on the part of the registrant. This was because the panel saw evidence that theregistrant had acted in good faith on advice provided by their university. The Panel went on toconsider whether the incorrect listing alone was sufficient to amount to misconduct and concludedthat it was not. In reaching this decision the Panel noted that the registrant had taken immediatesteps to rectify the issue and was able to provide several very positive and supportive testimonials.Because there was no realistic prospect of proving misconduct it followed that there could be nopossibility of proving that the registrant’s fitness to practise was impaired.


Section 2:



The allegations arose following an employer’s audit ofa social worker’s record keeping and report writing,including not maintaining up to date information.

The allegations related to concerns about a registrant’shealth, specifically their alleged dependency onalcohol.

A registrant self-referred to the HCPC that they hadbeen convicted of drink driving.

The Panel concluded that there was no realistic prospect of proving the facts of the allegation.Alongside the employer’s investigation of the matter the Panel also had the benefit of a very detailedresponse to the allegation from the registrant. This response demonstrated to the Panel’s satisfactionthat the registrant was able to refute the particulars of the allegation where these related to specificservice user records.

The Panel found there to be a realistic prospect of proving the facts of the allegation on the basis thatthere was documented medical evidence confirming the registrant’s alcohol dependency. Health is astatutory ground for an allegation. In determining whether there was a realistic prospect of provingthat the registrant’s fitness to practise was impaired by reason of their health, the Panel noted thesteps the registrant had taken. The Panel had evidence that the registrant had abstained fromalcohol for some time and was now back at work practising their profession without giving theiremployer any further cause for concern. In these circumstances the Panel concluded that therecould be no realistic prospect of proving the registrant’s fitness to practise was currently impaired.

Given that the registrant had of their own volition self-referred the matter to the HCPC, there could beno difficulty in the Panel being satisfied that there was a realistic prospect of proving the fact of theconviction. In addition, though, the Panel also had the benefit of documentary evidence of theconviction which had been obtained from the relevant court by the HCPC as part of its investigation.


Section 2:



An operating department practitioner was alleged tohave acted dishonestly by taking on other paidemployment for a two–day period while absent throughsickness from their permanent employment.

A conviction is a statutory ground for an allegation. Going on to consider whether there was arealistic prospect of proving fitness to practise impairment, the Panel considered that the wider publicinterest, including public protection, would not be served by referring the matter to a final hearingpanel. In reaching this conclusion the panel had regard to the fact that this was a one-off incidentunconnected to the registrant’s employment, that the registrant had practised their profession formany years with an otherwise unblemished record and that they had demonstrated considerableremorse for their behaviour and shown insight into how they had allowed the incident to occur.

In their written response to the Panel the registrant had denied the allegations, stating they had infact requested annual leave from their permanent employer and did not understand why this hadinstead been recorded as sickness absence. In comparing the documentation submitted by theregistrant alongside the material provided by their employer the Panel found some apparentconfusion and misunderstanding with regard to the registrant’s agreed working arrangements. ThePanel noted that it was not part of its role to attempt to resolve this apparent conflict in the evidence.Such conflicts could only be resolved by a panel at final hearing, which would have the benefit of oralevidence from the witnesses. Accordingly the Panel concluded that there was a realistic prospect ofproving the facts of the allegation.

Having reached this conclusion the Panel also went on to conclude there was a realistic prospect ofproving that the facts amounted to misconduct. The Panel noted that, if proved, the allegeddishonesty would certainly be sufficient to constitute misconduct. Considering the case as a whole,however, the Panel determined that there was not a realistic prospect of proving current fitness to


Section 2:



practise impairment. In reaching this determination the Panel attached due weight to the registrant’sdetailed response to the allegation. The Panel found persuasive the written evidence it received ofthe registrant’s reflection on the allegation and the learning the registrant had demonstrated throughtheir experience of the fitness to practise process. The Panel noted the actions the registrant hadalready taken to ensure there could be no misunderstandings or miscommunication in future. ThePanel noted too that there had been no previous concerns regarding the registrant’s conductthroughout their employment.


Section 2:


Case to answer decisions by complainanttype Table 8 shows the number of ‘case to answer’decisions by complainant type. There continue tobe differences in the case to answer rate,depending on the source of the complaint.

Fitness to practise allegations received from thePolice had the highest percentage (88 per cent) ofcase to answer decisions, although this is a smallcomplainant group. The largest complaint groupwas Employers and a case to answer decisionwas made in a significant proportion of thosecases (78 per cent). A high proportion (83 percent) of cases referred anonymously, or by article22(6), also have a case to answer decision.

This does represent a change from 2015–16,where the highest proportion of case to answerdecisions were made in cases from the otherregistrant / professionals. This group had thelowest proportion of case to answer decisions in2016–17.

Table 8

Case to answer by complainant

Complainant

Article 22(6) / anonEmployerOtherOther registrant / professionalPoliceProfessional bodyPublicSelf-referral

Total

% case toanswer

8378623688504766

71

Total

63562911168

51149

626

Number ofno case to

answer

18011724

2751

183

Number ofcase toanswer

5276184

144

2498

443


Section 2:


Case to answer decisions and route toregistration Table 9 shows the case to answer decisions forthe different routes to registration.

Time taken from point of meeting theStandard of Acceptance to InvestigatingCommittee PanelTable 10 shows the length of time taken forallegations to be put before an ICP in 2016–17.The table shows that 80 per cent of allegationswere considered by an ICP within seven monthsof the point of meeting the Standard ofAcceptance.

The mean length of time taken for a matter to beconsidered by an ICP was six months frommeeting the Standard of Acceptance and themedian length of time was four months. This isconsistent with the time taken in 2015–16.

Table 9

Case to answer and route to registration

Table 10

Length of time from point of meeting Standard of Acceptance to Investigating Committee Panel

% ofallegations

0.97

92.1

100

Number ofcase toanswer

431

408

443

Route to registration

GrandparentingInternationalUK

Total

Number of months


Total

% ofallegations

0.86.07

93.13

100

Totalallegations

538

583

626

% ofallegations

0.553.83

95.63

100

Number ofno case to

answer

17

175

183

Cummulative% cases

18.5361.3480.0389.6292.6596.3397.76

100

% of cases

18.5342.8118.699.583.043.671.442.24

100

Cumulativenumber of cases

116384501561580603612626

1162681176019239

14

626


Section 2:


Case to answer decisions andrepresentationsGraph 5 provides information on ‘case to answer’and ‘no case to answer’ decisions andrepresentations received in response toallegations. In 2016–17, there was a decrease inrepresentations being made to the ICP by eitherthe registrant or their representative withrepresentations being made in 74 per cent of thecases considered compared to 77 per cent in2015–16.

A total of 183 cases considered by an ICPresulted in a ‘no case to answer’ decision. Of thisnumber, 90 per cent were cases whererepresentations were provided. By contrast, caseswhere there were no representations madeconstituted 32 per cent of the case to answerdecisions.

Graph 5

Representations provided to Investigating Committee Panel

100

150

50

0

200

250

300

Registrant Representative None

Case to answer No case to answer


Section 3:

Interim orders

In certain circumstances, panels of our PracticeCommittees may impose an ‘interim suspensionorder’ or an ‘interim conditions of practice order’on registrants subject to a fitness to practiseinvestigation. These interim orders prevent theregistrant from practising or places limits on theirpractice, while the investigation is ongoing. Thispower is used when the nature and severity of theallegation is such that, if the registrant remainsfree to practise without restraint, they may pose arisk to the public, to themselves, or is otherwise inthe public interest. Panels will only impose aninterim order if they are satisfied that the public orthe registrant involved require immediateprotection. Panels will also consider the potentialimpact on public confidence in the regulatoryprocess should a registrant be allowed tocontinue to practise without restriction whilstsubject to an allegation and may then impose aninterim order in the public interest.

An interim order takes effect immediately and willremain until the case is heard or the order is liftedon review. The duration of an interim order is setby the panel however it cannot last for more than18 months. If a case has not concluded beforethe expiry of the interim order, the HCPC mustapply to the relevant court to have the order

extended. In 2016–17 we applied to the HighCourt for an extension of an interim order in 26cases. This is an increase from 19 cases in 2015–16.

A Practice Committee panel may make an interimorder to take effect either before a final decision ismade in relation to an allegation or pending anappeal against such a final decision. Casemanagers from the Fitness to PractiseDepartment acting in their capacity of presentingofficers present the majority of applications forinterim orders and reviews of interim orders. Thisis to ensure resources are used to their besteffect.

Table 11 shows the number of interim orders byprofession and the number of cases where aninterim order has been granted, reviewed orrevoked. These interim orders are those soughtby the HCPC during the management of the caseprocessing. It does not include interim orders thatare imposed at final hearings to cover theregistrant’s appeal period.

In 2016–17, 142 applications for interim orderswere made, accounting for over six per cent ofthe cases received. 128 (90%) of those

applications were granted and fourteen (10%)were not. In 2015–16, 89 applications were madeand 88 per cent of those applications weregranted. Although there was an increase in thenumber of applications made in 2016–17compared to the previous year, the proportion ofapplications granted has remained broadly thesame.

Social workers in England and paramedics hadthe highest number of applications considered.These professions also had the highest number ofapplications considered in 2015–16.

Our governing legislation provides that we have toreview an interim order six months after it is firstimposed and every three months thereafter. Theregular review mechanism is particularly importantgiven that an interim order will restrict or prevent aregistrant from practising pending a final hearingdecision. Applications for interim orders areusually made at the initial stage of theinvestigation; but a registrant may ask for an orderto be reviewed at any time if, for example, theircircumstances change or new evidence becomesavailable. In some cases an interim suspensionorder may be replaced with an interim conditionsof practice order if the Panel consider this will


Section 3:

Interim orders

adequately protect the public, or either order maybe revoked. In 2016–17 there were eight caseswhere an interim order was revoked by a reviewpanel.

We risk assess all complaints on receipt to helpdetermine whether to apply for an interim order. In2016–17, the median time from receipt of acomplaint to a panel considering whether aninterim order was necessary was 18.8 weeks. In2015–16, this was 15.2 weeks.

Not all interim order applications are madeimmediately on receipt of the complaint. It may bethat we receive insufficient information with theinitial complaint or that during the course of theinvestigation the circumstances of the casechange. We also risk assess new material as it isreceived during the lifetime of a case to decide if itindicates that an interim order application in thecase is necessary.

In 2016–17, the average time from the riskassessment of the relevant information indicatingan interim order may be necessary, to a panelhearing the application was 21 days. In 2015–16,this was 17 days.

Ninety six out of the 142 (68%) interim orderapplications made in 2016–17 were in caseswhere the complainant was the employer. Themedian time for these cases, from receipt ofcomplaint to a panel considering whether aninterim order was necessary, was 14.5 weeks.

In 2016 we introduced a further checkingmechanism on cases where an Interim order islikely to be requested but we still require furtherinformation. An operational manager is tasked toreview a case in these circumstances to ensurethat the case is being progressed and the risk isbeing prioritised.


Section 3:

Interim orders

Table 11

Number of interim orders by profession

Profession


Total

Ordersrevoked on

review

0100000001010050

8

Ordersreviewed

31260613

390

5641110

28118

0

324

Applicationsnot granted

0120001002010160

14

Applicationsgranted

0240025

120

221431

11520

128

Applicationsconsidered

0360026

120

241441

12580

142


Section 4:

Public hearings

445 final hearing cases were concluded in 2016–17. This is 125 more cases than the previousyear.

Hearings where allegations were well foundedconcerned only 0.09 per cent of registrants on theHCPC Register.

Hearings can be adjourned in advanceadministratively by the Head of Adjudication if anapplication is made more than 14 days before thehearing. If the application is made less than 14days before the hearing, the decision onadjournment is made by a panel. Hearings thatcommence but do not conclude in the timeallocated are classed as part heard. In 2016–17,108 cases which were listed for a hearing wereeither adjourned or concluded part heard.

Panels have the power to hold preliminaryhearings in private with the parties for the purposeof case management. Such hearings allow forsubstantive evidential or procedural issues, suchas the use of expert evidence or the needs of avulnerable witness, to be resolved (by a paneldirection) prior to the final hearing taking place.This assists in final hearings taking place asplanned. In 2016–17, 89 cases had a preliminary

hearing, compared to 66 in 2015–16. Thisrepresents a proportionate increase given theincreased number of final hearings.

Most hearings are held in public, as required byour governing legislation, the Health and SocialWork Professions Order 2001. Occasionally ahearing, or part of it, may be heard in private incertain circumstances.

The HCPC is obliged to hold hearings in the UKcountry of the registrant concerned. The majorityof hearings take place in London at the HCPC’soffices. Where appropriate, proceedings are heldin locations other than capitals or regional centres,for example, to accommodate attendees withrestricted mobility. In January 2016 we acquired anew building which now provides a dedicatedhearings centre for fitness to practise hearings.We use this building flexibly to schedule hearingswhilst maintaining a professional and comfortableenvironment. In 2016–17, we had a roomoccupancy for our hearing space of 92%.

Table 12 illustrates the number of public hearingsthat were held from 2012–13 to 2016–17. Itdetails the number of public hearings heard inrelation to interim orders, final hearings and

reviews of substantive decisions. Some cases willhave been considered at more than one hearingin the same year, for example, if a case was partheard and a new date had to be arranged.


Section 4:

Public hearings

Time taken from point of meeting theStandard of Acceptance to final hearingTable 13 shows the length of time it took for casesto conclude, measured from the point of meetingthe Standard of Acceptance. The table also showsthe number and percentage of allegationscumulatively as the length of time increases.

The length of time taken for cases that werereferred for a hearing to conclude was a mean of20 months and a median of 18 months from thedate the Standard of Acceptance was met. Thishas reduced from 22 and 21 months in theprevious year.

When measured from the receipt of the initialcomplaint to the conclusion of the final hearing,the mean was 25 months, and the median was22 months.

The length of time for a hearing to conclude canbe extended for a number of reasons. Theseinclude protracted investigations, legal argument,availability of parties and requests foradjournments, which can all delay proceedings.Where criminal investigations have begun, theHCPC will usually wait for the conclusion of anyrelated court proceedings. Criminal cases are

Table 12

Number of concluded public hearings

Year

2012–132013–142014–152015–162016–17

Total

565689929846

1,135

Article 30(7)hearing

11010

Restorationhearing

11588

Reviewhearing

141155236171216

Final hearing

228267351320445

Interim orderand review

194265337346466


Section 4:

Public hearings

often lengthy in nature and can extend the time ittakes for a case to reach a hearing. We havefocussed efforts on complex cases in the lasttwelve months, which has resulted in changes inthe length of time from the previous year.

The complexity of cases is reflected in thecontinuing requirement for preliminary hearingsbefore a final hearing can take place. In 2016–17there were 89 preliminary hearings. Thiscompares to 66 in 2015–16. Although there weremore preliminary hearings this year, given thenumber of increased hearing activity, theproportion of preliminary hearings remainedsimilar and constituted 20 per cent of concludedhearings compared to 20.6 per cent last year.

In 2016–17, there were 115 cases that tooklonger than 24 months to conclude from theStandard of Acceptance being met. Thisaccounted for 26 per cent of the final hearingsclosed. As illustrated in table 14, this year wehave noted a decrease in the length of time for acase to conclude at a final hearing from the pointof meeting the Standard of Acceptance. This yearthe mean was 20 months, a decrease from 22last year and the median was 18 months, adecrease from 21 months last year.

Table 13

Length of time from point of meeting the Standard of Acceptance to final hearing

Number of months


Total


0.20.2

219.339.661.874.2100

% of cases

0.20

1.817.320.222.212.425.8

100

Cumulativenumber of

cases

119

86176275330445

Number ofcases

108

77909955

115

445


Section 4:

Public hearings

Table 15

Length of time to close all cases from receipt of complaint, including thosethat did not meet the Standard of Acceptance, those where no case toanswer is found and those concluded at final hearing

Table 14

Time taken to conclude cases at final hearing from 2012–13 to 2016–17

Table 15 sets out the total length of time to close all cases from the point theconcern was received to case closure at different points in the fitness topractise process. In 2016–17, the total length of time for this combinedgroup was a mean of 20 months and a median average of 18 months.

Year

2012–132013–142014–152015–162016–17

Median time from pointof meeting Standard of

Acceptance toconclusion (months)

1414142118

Mean time from pointof meeting Standard

of Acceptance toconclusion (months)

1617162220

Number ofconcluded

cases

228267351320445

Number of months


Total


23.745

64.676.781.187.590.9100

% of cases

23.721.319.612.14.46.43.49.1

100.0

Cumulativenumber of

cases

5871,1161,6021,9032,0122,1702,2542,481

Number ofcases

58752948630110915884

227

2,481


Section 4:

Public hearings

Days of hearing activity Panels of the Investigating Committee, Conductand Competence Committee and HealthCommittee met on 2,336 days in 2016–17 acrossthe range of public and private decision makingactivities. Final hearings are usually held in publicand are open to members of the public and otherinterested parties including the press. In certaincircumstances, such as to protect confidentialhealth issues of either the registrant or witnesses,an application can be made to hold some or all ofthe hearing in private. Table 16 sets out the typesof hearing activity in 2016–17.

Of these, 1,709 hearing days were held toconsider final hearing cases. This includes wheremore than one hearing takes place on the sameday. This number includes cases that were partheard or adjourned. This is a 43 per cent increasefrom 1,194 hearing days in 2015–16.

Panels of the Investigating Committee hear finalhearing cases concerning fraudulent or incorrectentry to the Register only. There were no casesfalling within this category this year.

Panels may hear more than one case on somedays to make the best use of the time available.

Of the 445 final hearing cases that concluded in2016–17, it took an average of 3.1 days toconclude cases. This is a slight decreasecompared to 2015–16, when it took an averageof 3.7 days to conclude cases. Despite theincrease in the number of concluded cases, theaverage duration of days per hearing is at thelowest since 2012–13.


Section 4:

Public hearings

What powers do panels have? The purpose of fitness to practise proceedings isto protect the public, not to punish registrants.Panels carefully consider all the individualcircumstances of each case and take intoaccount what has been said by all parties involvedbefore making any decision.

Panels must first consider whether the facts of anyallegations against a registrant are proven. Theythen have to decide whether, based upon theproven facts, the ‘ground’ set out in the allegation(for example misconduct or lack of competence)has been established and if, as a result, theregistrant’s fitness to practise is currently impaired.If the panel decide a registrant’s fitness to practiseis impaired they will then go on to considerwhether to impose a sanction.

In cases where the ground of the allegationssolely concerns health or lack of competence, thepanel hearing the case does not have the optionto make a striking off order in the first instance. Itis recognised that in cases where ill health hasimpaired fitness to practise or where competencehas fallen below expected standards, that it maybe possible for the registrant to remedy thesituation over time. The registrant may be

Table 16

Breakdown of public and private committee activity in 2016–17

Private meetings Public hearings

Activity Activity

Investigating Committee Final hearingsPreliminary meetings Review of substantive sanctions

Interim orders

Total

Number ofdays

1,709145277

2,131

Number ofdays

11194

205


Section 4:

Public hearings

provided the opportunity to seek treatment ortraining and may be able to return to practice if apanel is satisfied that it is a safe option.

If a panel decides there are still concerns aboutthe registrant being fit to practise, they can:

− take no further action or order mediation (aprocess where an independent person helpsthe registrant and the other people involvedagree on a solution to issues);

− caution the registrant (place a warning on theirregistration details for between one to fiveyears);

− make conditions of practice that the registrantmust work under;

− suspend the registrant from practising; or− strike the registrant’s name from the Register,

which means they cannot practise.

These are the sanctions available to a panel if thegrounds of the allegation include misconduct.

In cases of incorrect or fraudulent entry to theRegister, the options available to the panel are totake no action, to amend the entry on theRegister or to remove the person from theRegister.

In certain circumstances, the HCPC may enterinto an agreement allowing a registrant to removetheir name from the Register, this is known asvoluntary removal agreement. The registrant mustadmit the substance of the allegation and bysigning they agree to cease practising theirprofession. The agreement also provides that, ifthe person applies for restoration to the Register,their application will be considered as if they hadbeen struck off. Agreements are approved by apanel at a public, but not contested, hearing.

Suspension or conditions of practice orders mustbe reviewed before they expire. At the review apanel can continue or vary the original order. Forhealth and competency cases, registration musthave been suspended, or had conditions, or acombination of both, for at least two years beforethe panel can make a striking off order.Registrants can also request early reviews of anyorder if circumstances have changed and they areable to demonstrate this to the panel.

Outcomes at final hearings Table 17 is a summary of the outcomes ofhearings that concluded in 2016–17. It does notinclude cases that were adjourned or part heard.Decisions from all public hearings where fitness to

practise is considered to be impaired arepublished on our website at www.hcpc-uk.org.Details of cases that are considered to be not wellfounded are not published on the HCPC websiteunless specifically requested by the registrantconcerned.

An analysis of the impact on the registrant’sregistration status shows that:

− 26 per cent were not well found; − 53 per cent had a sanction that prevented them

from practising (including voluntary removal); − Nine per cent had a sanction that restricted

their practice; and− Nine per cent had a caution entry on the

Register.


Section 4:

Public hearings

Table 17

Outcome by type of committee

Outcome by professionTable 18 shows what sanctions were made in relation to the different professions theHCPC regulates. In some cases there was more than one allegation against the sameregistrant. The table sets out the sanctions imposed per case, rather than by registrant.

Committee

Conduct and Competence CommitteeHealth CommitteeInvestigating Committee (fraudulent and incorrect entry)

Total

432130

Well-founded

30 0

Suspension

11050

Struck off

9200

Removed byconsent

2650

Not wellfounded /

discontinued

11520

No furtheraction

800

Conditions ofpractice

3910

Caution

3900


Section 4:

Public hearings

Table 18

Sanctions imposed by profession

NB: the sanctions of caution, conditions of practice and suspension above contain those where the registrant consented to the sanction. The table below shows thebreakdown of the sanctions by profession. These are included within the totals in the table above.

Profession


Total 16/17 FYE

Total

11813054

22290

6633201

21208

4

445

Consent –removed

00303051024201

100

31

Suspended

0840016

100

1310317

511

115

Struck off

1710000

110

205105

410

92

Removed(fraudulent/

incorrect)

0000000000000000

0

Registerentry

amended

0000000000100020

3

Wellfounded

038010120

116003

303

68

Not wellfounded

005012430

1711903

602

117

No furtheraction / not

impaired

0000000002000060

8

Conditionsof practice

01000031052501

211

40

Caution

02001143070004

170

39


Section 4:

Public hearings

Table 18

Sanctions imposed by profession

Outcome and representation of registrantsAll registrants have the right to attend their finalhearing. Some attend and represent themselves,whilst others bring a union or professional bodyrepresentative or have professionalrepresentation, for example a solicitor or counsel.Some registrants choose not to attend, but theycan submit written representations for the panelto consider in their absence.

The HCPC encourages registrants to participatein their hearings where possible. We makeinformation about hearings and our proceduresaccessible and transparent in order to maximiseparticipation, and to ensure any issues that mayaffect the organisation, timing or adjustments canbe identified as early as possible. Ourcorrespondence sets out the relevant parts of ourprocess and includes guidance. We also producepractice notes, which are available online,detailing the process and how panels makedecisions. This allows all parties to understandwhat is possible at each stage of the process.

Profession


Total

Total

0000000001000050

6

Consent –suspension

0000000000000000

0

Consent –conditions

0000000000000020

2

Consent –caution

0000000001000030

4


Section 4:

Public hearings

Panels may proceed in a registrant’s absence ifthey are satisfied that the HCPC has properlyserved notice of the hearing and that it is just todo so. Panels cannot draw any adverseinferences from the fact that a registrant has failedto attend the hearing. They will receiveindependent legal advice from the legal assessorin relation to choosing whether or not to proceedin the absence of the registrant.

The panel must be satisfied that in all thecircumstances, it would be appropriate toproceed in the registrant’s absence. The practicenote Proceeding in the absence of the registrantprovides further information and is available in fullat www.hcpts-uk.org

In 2016–17, 14 per cent of registrantsrepresented themselves, with a further 36 percent choosing to be represented by aprofessional. Of those who were represented by aprofessional, most attended with thatrepresentative.

Final hearings where the registrant did not attend,or was not represented account for 49 per cent ofactivity in 2016–17. This is the same level of non-attendance as in 2015–16.

Graph 6

Representation at final hearings

Registrant (14%)

Registrant attended and

had representative (34%)

Registrant did not attend

but had representative (3%)

None (49%)

14%

34%

3%

49%


Section 4:

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Table 19

Outcome and representation at final hearings

We meet with the various registrant representativebodies, and share this data with them. We alsoencourage the seeking of representation early inthe process, as part of our regularcommunication relating to the investigation andscheduling of a hearing.

Table 19 details outcomes of final hearings andwhether the registrant attended alone, with arepresentative or was absent from proceedings.In cases where there is representation (either byself or by a representative), sanctions that preventthe registrant from working are less frequentlyapplied. This also applies to removal by consent,but for a different reason, as registrants havesigned a legal agreement with the HCPC to beremoved from the Register, and so rarely attendthe hearing.

CautionConditionsNo further actionWell founded Not well foundRegister entry amendedStruck offSuspendedConsent - removedConsent - cautionConsent - suspensionConsent - conditions

Total

Total

353883

1170

9211531402

445

Norepresentation

3621

280

707627301

217

Registrant didnot attend

but hadrepresentative

120040213001

14

Registrantattended and had

representative

222631

630

14200100

150

Representedself

9431

2206

181000

64


Section 4:

Public hearings

Table 20

Outcome and route to registration

Outcome and route to registration Table 20 shows the relationship between routesto registration and the outcomes of final hearings.As with case to answer decisions at ICP, thepercentage of hearings where fitness to practiseis found to be impaired broadly correlates with thepercentage of registrants on the Register and theirroute to registration. The number of hearingsconcerning registrants who entered the Registervia the UK approved route remained around 95per cent, which is similar to 2015–16.

Table 21 shows the source of the originalcomplaint for cases that concluded at a finalhearing in 2016–17 and the outcome of that finalhearing.

Employers were the complainant in 63 per cent ofthe cases heard. The highest category ofoutcome was not well founded or discontinuedcases and employers were the complainant in 61per cent of these case. Members of the publicwere the complainant in 14 per cent.

Suspensions represent the second highestoutcome (at 115 cases) and employers were thecomplainant in 67 per cent of these cases.Registrants who self-referred represented 20 percent of the cases that resulted in a suspensionand members of the public constituted five percent.

GrandparentingInternationalUK

Total

% ofregistrants

on theRegister

1.26.5

92.3

100

% of cases

0.94.7

94.4

100

Total cases

421

420

445

Removedby consent

00

31

31

Suspension

04

111

115

Struck off

06

86

92

Removed

000

0

Not wellfounded

35

109

117

Wellfounded

012

3

No furtheraction

008

8


11

38

40

Caution

04

35

39


Section 4:

Public hearings

Table 21

Outcome and source of complaint

Outcome

CautionConditions of practiceNo further actionNot well founded / discontinuedRemovedConsent – removedStruck offSuspensionWell-foundedNot impaired

Total

Total

39408

1170

3192

11530

445

Self-referred

1571

1505

152310

82

Public

130

16011600

28

Professionalbody

1000000000

1

Police

1104005010

12

Otherregistrant

1125001300

13

Other

1402034200

16

Employer

18225

720

21647710

280

Article 22(6)/ anon

1203012400

13


Section 4:

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Table 22

Cases not well founded

Year

2012–132013–142014–152015–162016–17

% of cases notwell founded

23.722.321.426.326.3

Total number ofconcluded cases

228269351320445

Number of notwell founded and

discontinued in full cases

54607584

117

Not well foundedOnce a panel of the Investigating Committee hasdetermined there is a case to answer in relation tothe allegation made, the HCPC is obliged toproceed with the case. Final hearings that are ‘notwell founded’ involve cases where, at the hearing,the panel does not find the facts have beenproved to the required standard or concludesthat, even if those facts are proved, they do notamount to the statutory ground (eg misconduct)or show that fitness to practise is impaired. In thatevent, the hearing concludes and no furtheraction is taken. In 2016–17 the panel concludedthat 83 cases were not well founded at finalhearing.

We continue to monitor these cases to ensure wemaintain the quality of allegations andinvestigations. Investigating Committee Panellistsreceive regular refresher training on the ‘case toanswer’ stage in order to ensure that only casesthat meet the realistic prospect test as outlined onpage 20 are referred to a final hearing.

Table 22 sets out the number of not well foundedcases between 2012–13 and 2016–17.


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In 45 per cent of the cases (37 cases) which werenot well founded, registrants demonstrated thattheir fitness to practise was not impaired. The testis that current fitness to practise is impaired andso is based on a registrant’s circumstances at thetime of the hearing. If registrants are able todemonstrate insight and can show that anyshortcomings have been remedied, panels maynot find fitness to practise currently impaired.

In some cases, even though the facts may bejudged to amount to the ground of the allegation(eg misconduct, lack of competence), a panelmay determine that the ground does not amountto an impairment of current fitness to practise. Forexample, if an allegation was minor in nature or anisolated incident, and where reoccurrence isunlikely.

In 43 per cent of the cases (36 cases) which werenot well founded, the grounds of misconduct, lackof competence or health were not found by thepanel.

In other cases the facts of an allegation may notbe proved to the required standard (the balanceof probabilities). This may be due to the standardor nature of the evidence before the panel.

In 2016–17, 12 per cent of cases (ten cases)which were not well founded, did not have thefacts proved. We review any cases that are notwell founded on facts to explore if an alternativeform of disposal would have been appropriate.We continue to monitor the levels of not wellfounded cases to ensure that we are utilising ourresources appropriately, and that we minimise theimpact of public hearings on the parties involved.

Not well founded case study A panel of the Conduct and CompetenceCommittee considered an allegation that anoccupational therapist had accessed the personalrecords of a service user on multiple occasionswithout a work-related reason for doing so.

The registrant, who was represented, attendedthe hearing and admitted to accessing therecords without a work-related reason. The Panelheard evidence from one witness, who was ableto confirm that the employer’s policy was clearand only those with a work-related reason fordoing so should access a service user’s records.The registrant did not dispute this evidence.

The same witness was also able to providepositive evidence in favour of the registrant.

The witness confirmed that the registrant’s workhad been of a very high standard and that theywere an extremely conscientious employee whowould not knowingly breach a policy. When theregistrant gave his own evidence, the Panel foundhim to be open, honest, consistent and credible.

Having found the facts proved, the Panelconsidered whether they amounted tomisconduct. It concluded that the registrant had,by their actions, breached a service user’sconfidentiality and risked undermining publicconfidence in the security of service user recordsand the trustworthiness of the profession. It was,therefore, sufficiently serious to amount tomisconduct.

The Panel had heard oral evidence from theregistrant, who had explained that they had firstknown the service user in a personal capacity andhad accessed the records because they had lostcontact and were worried about the service user.The registrant accepted that, after several yearsand after becoming the service user’s NamedPerson (attending hearings and tribunals for himand advocating on his behalf), this still did notjustify accessing the service user’s records. Theregistrant acknowledged that he had blurred his


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role as a friend with his role as an occupationaltherapist, even if he had thought this was in hisfriend’s best interests. He accepted he shouldhave gone to his line manager for advice. Theregistrant was honest that if he had not beencaught he would have continued to access therecords, but that in being caught, he had learnt alesson and now fully accepted and realised theimportance of data protection.

Whilst considering that the registrant had made aserious error of judgement clouded by personalmotivation, the Panel noted that the registrant hadonly accessed one specific set of records andhad shown full insight and understanding into whyhis actions had been inappropriate andunjustified. He demonstrated genuine remorseand had already remediated the failings identified,making the behaviour highly unlikely to berepeated. Having found that he was not impairedon the personal component, the Panel alsoconsidered that, although a member of the publicwould not condone the registrant’s actions, in lightof his long and otherwise unblemished career, hisremorse, his insight, and the remediation of themisconduct, a finding of no current impairmentwould not undermine public confidence in theprofession.

Disposal of cases by consent The HCPC’s consent process is a means by whichthe HCPC and the registrant concerned may seekto conclude a case without the need for acontested hearing. In such cases, the HCPC andthe registrant consent to conclude the case byagreeing an order of the nature of which the panelwould have been likely to make had the matterproceeded to a fully contested hearing. The HCPCand the registrant may also agree to enter into aVoluntary Removal Agreement, whereby the HCPCallows the registrant to remove themselves fromthe HCPC Register on the basis that they no longerwish to practise their profession and admit thesubstance of the allegation that has been madeagainst them. Voluntary Removal Agreements havethe effect of treating the registrant as if they weresubject to a striking off order.

Cases can only be disposed of in this manner withthe authorisation of a panel of a Practice Committee.

In order to ensure the HCPC fulfils its obligation toprotect the public, neither the HCPC nor a panelwould agree to resolve a case by consent unlessthey are satisfied that:

− the appropriate level of public protection is

being secured; and − doing so would not be detrimental to the wider

public interest.

The HCPC will only consider resolving a case byconsent:

− after an Investigating Committee Panel hasfound that there is a ‘case to answer’, so that aproper assessment has been made of thenature, extent and viability of the allegation;

− where the registrant is willing to admit thesubstance of the allegation (a registrant’s insightinto, and willingness to address failings are keyelements in the fitness to practise process andit would be inappropriate to dispose of a caseby consent where the registrant denies liability);and

− where any remedial action agreed between theregistrant and the HCPC is consistent with theexpected outcome if the case was to proceedto a contested hearing.

The process may also be used when existingconditions of practice orders or suspensionorders are reviewed. This enables orders to bevaried, replaced or revoked without the need for acontested hearing.


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In 2016–17, 37 cases were concluded via theHCPC’s consent arrangements at final hearing.This is the same number as the previous year.

Further information on the process can be foundin the Practice Note Disposal of cases by consentat www.hcpts-uk.org

Consent case study 1Consent to a one year Caution Order was grantedin relation to a social worker who was found tohave failed in their duty to supervise a youngperson on their case load. The social workerworked for a youth offending service and wasgiven a final written warning by their employer.The registrant fully admitted the allegation.

The matter had not previously been considered ata substantive hearing of a panel of the Conductand Competence Committee. The Panel wassatisfied that granting the consent order ratherthan having a contested hearing would not bedetrimental to the public interest in this case.

The allegations made against the registrant wereprimarily conduct matters relating to one serviceuser. The Panel was satisfied that by agreeing toconclude the case by way of a one year Caution

Order, it was providing the appropriate level ofpublic protection and represented a properdisposal of the case. The Panel noted that sincethe registrant’s return to work on an agreed returnto work schedule, they had made excellentprogress, their performance had improved and itwas confirmed that there were no concerns abouttheir fitness to practise. The Panel alsorecognised that the registrant had never deniedthe errors made and recognised the need to dealwith the matters that contributed to their failings.

The information provided by the registrant and hisemployer was sufficient to demonstrate that thiswas a serious, one-off incident and there was alimited risk of repetition. The application was grantedby the Conduct and Competence Committee.

Consent case study 2Consent to a Voluntary Removal Agreement wasgranted in a case relating to a radiographer. Theregistrant had been convicted for drink drivingand was alleged to have taken an amount ofunauthorised leave from work.

The registrant informed the HCPC that they fullyadmitted the allegation and no longer wished topractise as a radiographer.

The Panel considering the application to disposeof this case by way of a Voluntary RemovalAgreement was satisfied that voluntary removalwas not disproportionate in this case andafforded the appropriate level of publicprotection. The Panel took into account that theregistrant had confirmed that they no longer hadthe desire or physical capacity to return to theirprofession in the future.

The Panel considered that, whilst the allegation was serious, the case did not raisewider public interest questions which requiredthe matter to be considered at a contestedhearing. The Panel granted the application andthe registrant was voluntarily removed from theHCPC Register.

Discontinuance Following the referral of a case for hearing by theInvestigating Committee, it may becomenecessary for the HCPC to apply to a panel todiscontinue all or part of the case. This may occurwhen new evidence becomes available orbecause of emerging concerns about the qualityor viability of the evidence that was considered bythe Investigating Committee.


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In 2016–17, allegations were discontinued in full in32 cases. This is an increase of six cases from2015–16.

Discontinuance case study The HCPC applied to discontinue proceedings infull in relation to a practitioner psychologist whowas alleged to have inappropriately advised aformer NHS Trust patient to attend their privatepractice for treatment. It was also alleged that thepsychologist gave the patient their email addressso that the patient could remain in contact andarrange to receive private treatment with them,instead of through the NHS.

The matter was considered by the InvestigatingCommittee who determined there was a case forthe registrant to answer and referred the case fora hearing. However, further evidence gathered bythe HCPC following the referral indicated thatthere was no longer a realistic prospect of theHCPC proving the allegation. The new evidenceand further information obtained from the patientdid not support the allegation, but supported theregistrant’s account of events.

The Panel agreed it was not in the public interestto continue proceedings against the registrant.

This was because of emerging concerns aboutthe viability of the evidence considered by theInvestigating Committee, in light of the furtherwitness evidence obtained by the HCPC. Thisshowed that the patient had raised the subject ofprivate treatment (not the psychologist), thepsychologist had considered the patient’s needsand / or vulnerabilities and had referred the matterto professional colleagues who were able to makedecisions about the patient’s treatment. Thefurther evidence also clarified that the registranthad provided their email address at an early stagein the therapeutic relationship to aid a particulartype of therapy they were providing.

The application was granted by the Conduct andCompetence Committee and the case wasdiscontinued.

Conduct and Competence CommitteePanelsPanels of the Conduct and CompetenceCommittee consider allegations that a registrant’sfitness to practise is impaired by reason ofmisconduct, lack of competence, a conviction orcaution for a criminal offence, or a determinationby another regulator responsible for health orsocial care. Some cases may have a combination

of these reasons for impairment in theirallegations.

Misconduct Consistent with previous years, in 2016–17, themajority of cases heard at a final hearing relatedto allegations that the registrant’s fitness topractise was impaired by reason of theirmisconduct. Some cases also concerned othertypes of allegations concerning lack ofcompetence or a conviction. Some of themisconduct allegations that were consideredincluded:

− attending work under the influence of alcohol;− bullying and harassment of colleagues;− breach of professional boundaries with service

users or service user family members; − breach of confidentiality;− misrepresentation of qualifications and / or

previous employment;− failure to communicate properly and effectively

with service users and / or colleagues;− posting inappropriate comments on social

media;− acting outside scope of practise;− falsifying service user records; and− failure to provide adequate service user care.


Section 4:

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The case studies below give an illustration of thetypes of issues that are considered whereallegations relate to matters of misconduct. Theyhave been based on real cases that have beenanonymised.

More details about the decisions made by theConduct and Competence Committee can befound at www.hcpts-uk.org

Misconduct case study 1 A Panel of the Conduct and CompetenceCommittee found that a practitioner psychologist(the registrant), during their practice as a forensicpsychologist, had conducted assessments on achild which were not age appropriate and had notexplained the limitations of these assessments intheir report.

The Panel imposed a Conditions of PracticeOrder for a period of 12 months.

The registrant had attended the hearing and wasrepresented.

The Panel heard live evidence from the registrantand an expert witness instructed by the HCPC.The registrant made a number of admissions

during the course of their evidence. The Panelaccepted the evidence of the expert witness asreliable and found all but two of the factualparticulars set out in the allegation proved.

The Panel then went on to consider whether thefacts found proved amounted to misconduct orlack of competence. Having regard to only onesample of substandard work undertaken by theregistrant, the Panel concluded that this did notrepresent a fair sample upon which the Panelcould make a judgment as to the registrant’soverall competence. However, the Paneldetermined that the registrant had failed to applyan age appropriate test on a child as a result ofomitting to check the child’s age, and failed toundertake corrective action when they realisedtheir error. The Panel determined that theregistrant’s actions breached the standardsexpected of him and amounted to misconduct.

When considering the registrant’s current fitnessto practise the Panel were of the view that theregistrant’s conduct had the potential to harm thechild who had been assessed by the registrant.Furthermore, the Panel considered that theRegistrant had demonstrated little insight, limitedremorse and no evidence of reflection. The Panel

also considered that a finding of impairment wasnecessary to mark the misconduct and upholdproper standards of behaviour and conduct ofpractitioner psychologists, and to maintain publicconfidence in the profession.

Accordingly, the Panel found that the registrant’sfitness to practise was impaired on both thepersonal and public component.

When considering sanction, the Panel determinedthat taking no further action or imposing aCaution Order would not adequately reflect theseriousness of the registrant’s misconduct norprovide a means by which the registrant coulddemonstrate remediation of their misconduct.However, the Panel noted that the registrant hada previous unblemished career of some 20 years,and that the single serious lapse in conduct wasnot indicative of a deep seated deficiency on theregistrant’s part. The Panel considered that aConditions of Practice Order would afford theregistrant the opportunity to demonstrate insightand professional development. The Paneldetermined that a Suspension Order would havea disproportionate and punitive effect. The Panelconcluded that the appropriate sanction,therefore, to protect the public and to satisfy the


Section 4:

Public hearings

wider public interest was a Conditions of PracticeOrder, which it imposed for a period of 12months.

Misconduct case study 2 A Panel of the Conduct and CompetenceCommittee found that an operating departmentpractitioner (the registrant) had posted a series ofinappropriate comments on a social media site.

The registrant was suspended from the Registerfor a period of 12 months.

The registrant attended the hearing and wasrepresented.

The employer’s investigating officer and theregistrant provided evidence at the hearing. ThePanel found the registrant to be honest in theirevidence, but that they sometimes struggled togive clear and succinct answers to some of thequestions asked. The Panel found theinvestigating officer to be impartial, consistent andcredible in their evidence.

Having heard all of the evidence, the Panel foundall of the facts proved. It concluded that thecomments that the registrant had made were

inappropriate in all circumstances and threateningin some. The Panel was especially concerned thata member of the public, particularly a patient, mightlose confidence in the Trust if they saw theregistrant’s comments. The Panel determined thatthe registrant’s conduct did amount to misconduct.

The Panel considered whether the registrant’sfitness to practise was currently impaired byreason of his misconduct.

The Panel considered that the registrant haddemonstrated some insight. They had apologisedand acknowledged that they were at fault andhad also removed themselves from the socialnetwork site and attended a series of counsellingsessions. The registrant was not, however, able tofully explain the coping strategies that he hadlearnt and they had focused primarily on thepersonal impact of their failings and not the widerimplications of their actions.

The Panel determined that the registrant’s fitnessto practise was currently impaired. It found thatthe registrant’s actions would have impacted onthe public confidence in the profession and that afinding of impairment was also required in order tomaintain professional standards.

When determining sanction, the Panel determinedthat the nature of the misconduct was too seriousto make no order. It considered that a cautionorder was inappropriate because it was not anisolated incident and the Panel was concernedabout the registrant’s level of insight. The Panelalso considered that a Conditions of PracticeOrder was neither verifiable nor workable and thatit would not meet the gravity of the misconduct.

The Panel therefore concluded that a SuspensionOrder, for a period of 12 months, was theappropriate and proportionate sanction thatreflected the gravity of the misconduct. The Panelwas satisfied that this Order would protect thepublic and maintain the confidence of the publicin the regulator and the profession.

Lack of competence In 2016–17, lack of competence allegations weremost frequently cited as the reason for aregistrant’s fitness to practise being impaired afterallegations of misconduct. This is consistent withprevious years.

Some of the lack of competence allegationsconsidered included:


Section 4:

Public hearings

− failure to provide adequate service user care;− inadequate professional knowledge; and− poor record-keeping.

The case studies below give an illustration of thetypes of issues that are considered whereallegations relate to a lack of competence. Theyhave been based on real cases that have beenanonymised.


Lack of competence A Panel of the Conduct and CompetenceCommittee found that a biomedical scientist (theregistrant) had failed to adequately perform basiclaboratory techniques and work unsupervised.

The Panel imposed a Conditions of PracticeOrder for a period of 12 months.

The registrant had attended the hearing and wasrepresented. They admitted all of the alleged factsand that these amounted to a lack ofcompetence. The Panel heard live evidence fromfour witnesses who had previously worked with

the registrant. They also heard from the registrant.

Having heard all of the evidence, the Paneldetermined that all of the factual particulars werefound proved, and that they amounted to a lackof competence. Furthermore, the registrant hadbeen afforded training and support by theirprevious employer to address the deficienciesidentified in her practice, but her performance hadnot improved to the requisite standard.

When considering the registrant’s current fitnessto practise, the Panel determined that althoughthe registrant’s lack of competence wasremediable, in light of documentation provided bythe registrant’s current employer, the deficienciesidentified in the registrant’s practice had not yetbeen remedied. Accordingly, the Panel found thatthe registrant’s fitness to practise was impaired onboth the personal and public component.

In determining the appropriate sanction, the Panelconsidered the aggravating and mitigatingfeatures of the case. The mitigating featuresincluded the registrant’s engagement with fitnessto practise proceedings, demonstration of someinsight and remorse and that no actual harm was

inflicted upon patients. The aggravating featuresincluded the registrant’s deficiencies in theirpractice being repeated on a number ofoccasions, and that attempts to remediate theirrepeated failings had only limited success to date.

The Panel determined that taking no further actionwould be wholly inappropriate. Given that the lackof competence demonstrated by the registrantwas not isolated in nature, the Panel determinedthat a Caution Order would not be sufficient toprotect the public. The Panel considered that aConditions of Practice Order would afford theregistrant the opportunity to remedy their lack ofcompetence. It also concluded that a SuspensionOrder would have a disproportionate and punitiveeffect. In all the circumstances, the Panelconcluded that the appropriate sanction toprotect the public and to satisfy the wider publicinterest was that of a Conditions of Practice Orderfor a period of 12 months.

Convictions / cautionsCriminal convictions or cautions were the thirdmost frequent ground of allegation considered byPanels of the Conduct and CompetenceCommittee in 2016–17. The allegation either solelyrelated to the registrants conviction(s) or caution(s)


Section 4:

Public hearings

or they also included other matters amounting toanother ground, for example, misconduct.

Some of the criminal offences consideredincluded:

− theft;− fraud;− shoplifting;− possession of drugs and / or possession of

drugs with the intent to supply;− receiving a restraining order and breach of a

restraining order;− driving under the influence of alcohol;− failure to provide a specimen;− assault (common or by beating);− possession of pornographic images; and− sexual offences.


Conviction case study A Panel of the Conduct and CompetenceCommittee considered an allegation that aparamedic had been convicted of fraud, havinggiven false information to obtain a prescription.

The Registrant did not attend the hearing, norwere they represented.

The Panel had before it the relevant Certificate ofConviction, which was sufficient to prove that theregistrant had been convicted of the offence. ThePanel went on to consider whether the registrant’sfitness to practise was currently impaired.

The events leading to the conviction involved theregistrant abusing their position of trust on twooccasions. They had used a false name to obtaina prescription. The registrant had admitted theoffence upon arrest and had been open andhonest with both the police and his employersduring their investigations. The registrant hadaccepted that they had been dishonest and thatthis was an abuse of trust. The Panel took theview that the registrant had not provided sufficientevidence of remediation or any steps taken thatwould lower the risk of a repetition. Theregistrant’s action would bring the profession intodisrepute and as there was not sufficient evidencethat the registrant had adequately remediatedtheir behaviour, the Panel concluded that theregistrant’s fitness to practise was currentlyimpaired.

Having considered each of the available sanctionsin ascending order of severity, the Panel decidedthat a Striking Off Order was the most appropriatesanction in this case. It considered that a StrikingOff Order was applicable in cases where therewas a serious, deliberate or reckless act involvingan abuse of trust, including dishonesty. Theregistrant had provided little evidence ofremediation, their current practice or intentions.There was also very limited engagement with theHCPC or the hearing. The registrant had providedno testimonials and no evidence that they hadreflected on their behaviour and that thispresented a real risk of harm. The registrant’sdeliberate and reckless behaviour, his lack ofremediation, reflection, and engagement with theHCPC, and his breach of trust and dishonestywere so serious as to necessitate a Striking OffOrder.

Health Committee PanelsPanels of the Health Committee considerallegations that registrants’ fitness to practise isimpaired by reason of their physical and / ormental health. Many registrants manage a healthcondition effectively and work within anylimitations their condition may present. Howeverthe HCPC can take action when the health of a


Section 4:

Public hearings

registrant is considered to be affecting their abilityto practise safely and effectively.

The HCPC presenting officer at a HealthCommittee hearing will often make an applicationfor proceedings to be heard in private. Oftensensitive matters regarding registrants’ ill-healthare discussed and it may not be appropriate forthat information to be discussed in a publicsession.

The Health Committee considered thirteen casesin 2016–17, this is slightly less than the eighteencases in 2015–16. Of those cases one resulted ina conditions of practice, two were not wellfounded at the impairment stage, five weresuspended, and five were removed using ourconsent processes.


Section 5:

Suspension and conditions of practice review hearings

All suspension and conditions of practice ordersmust be reviewed by a panel before they expire. Areview may also take place at any time at therequest of the registrant concerned or the HCPC.

Registrants may request reviews if, for example,they are experiencing difficulties complying withconditions imposed or if new evidence relating tothe original order comes to light.

The HCPC can also request a review of an orderif, for example, it has evidence that the registrantconcerned has breached any condition imposedby a panel.

In reviewing a suspension order, the panel willlook for evidence to satisfy it that the issues thatled to the original order have been addressed andthat the registrant concerned no longer poses arisk to the public.

If a review panel is not satisfied that the registrantconcerned is fit to practise, it may:

− extend the existing order or− replace it with another order.

In 2016–17, 222 review hearings were held. Table23 shows the decisions that were made by reviewpanels in 2016–17. Similar to the final hearingstage, the HCPC and the registrant concernedmay seek to conclude a review case without theneed for a contested review hearing. In 2016–17,none of the review cases were disposed of usingvoluntary removal agreements. We have reviewedour consent processes this year, but therequirement remains for the registrant to engagein the process prior to the review hearing inagreeing a sanction.


Section 5:


Table 23

Review hearing decisions

Profession


Total

1242003

12150

219

120

16100

7

Consent –suspension

0000000000000000

Consent –conditions

0000000000000000

Consent –caution

0000000000000000

Consent –removed

0000000000000000

Suspension

04100027061606

342

Struck off

06100027032004

241

Orderrevoked

19000240065402

222


05000130051202

162

Caution

0000000000000030

Article30(7)

0000000000000000

Adjourned/ partheard

0000001101000210


Section 5:


Tables 24 and 25 set out the outcomes of thereviews of the suspension and conditions ofpractice orders in the period 2016–17

Three suspension order review and threeconditions of practice review hearings wereadjourned, part heard and therefore do notappear in Tables 24 and 25. In addition to thereview hearings that appear in tables 24 and 25,three reviews resulted in Cautions in 2016–17,which do not require a further review.

Table 24

Suspension orders

Review activity

Suspension reviewed, suspension confirmedSuspension reviewed, replaced with conditions of practiceSuspension reviewed, struck offSuspension reviewed, caution imposedSuspension reviewed, removed by consentSuspension reviewed, no further action

Total

%

42.26.3321.6

018

100

Number

548

4120

23

128

Table 25

Conditions of practice orders

Review activity

Conditions reviewed, replaced with suspensionConditions reviewed, struck offConditions reviewed, conditions confirmedConditions reviewed, conditions variedConditions reviewed, no further actionConditions replaced, removed by consent

Total

%

13.310.818.114.543.4

0

100

Number

119

1512380

128


Section 6:

Restoration hearings

A person who has been struck off the HCPCRegister and wishes to be restored to the Register,can apply for restoration under Article 33(1) of theHealth and Social Work Professions Order 2001.

A restoration application cannot be made until fiveyears have elapsed since the striking off ordercame into force. In cases where the striking offdecision was made by the General Social CareCouncil that period is reduced to three years. Inaddition, if a restoration application is refused, aperson may not make more than one applicationfor restoration in any twelve-month period.

In applying for restoration, the burden of proof isupon the applicant. This means it is for theapplicant to prove that he or she should berestored to the Register and not for the HCPC toprove the contrary. The procedure is generally thesame as other fitness to practise proceedings,however in accordance with the relevantprocedural rules, the applicant presents his or hercase first and then it is for the HCPC presentingofficer to make submissions after that.

If a panel grants an application for restoration, itmay do so unconditionally or subject to theapplicant:

− meeting the HCPC’s ‘return to practice’requirements; or

− complying with a conditions of practice orderimposed by the Panel.

In 2016–17, ten applications for restoration wereheard. Of these, seven were restored (four withconditions of practice orders), one was notrestored and two cases were adjourned to allowthe registrant to collect further evidence todemonstrate their fitness to practise.


Section 7:

The role of the Professional Standards Authority

and High Court cases

The Professional Standards Authority for Healthand Social Care (PSA) is an independent bodythat oversees the work of the nine health and careregulatory bodies in the UK. The PSA reviews ourperformance and audits and scrutinises ourfitness to practise cases and decisions.

The PSA can refer any regulator’s final decision ina fitness to practise case to the High Court (or inScotland, the Court of Session), if it considers thatthe decision is not sufficient for public protection.Consideration of whether a decision is sufficientfor the protection of the public involvesconsideration of whether it is sufficient to protectthe health, safety and well-being of the public,whether it is sufficient to maintain publicconfidence in the profession concerned, andwhether it is sufficient to maintain properprofessional standards and conduct for membersof that profession.

In 2016–17, two HCPC cases were referred to theHigh Court by the PSA. One of these was laterwithdrawn and one was concluded by the partiesconsenting to the original Suspension Order beingsubstituted with a Striking Off Order.

Three registrants appealed the decisions made bythe Conduct and Competence Committee. Eachof these appeals were dismissed by the HighCourt.

Five judicial review applications were made in2016–17. Permission was granted in only one ofthese and that judicial review was dismissed.

The information set out above in relation to thestatus of the cases was correct at the time ofwriting this report in April 2017.


Section 8:

How to raise a concern

If you would like to raise a concern about aprofessional registered by the HCPC, please writeto us at the following address.

Fitness to Practise DepartmentHealth and Care Professions CouncilPark House184 Kennington Park RoadLondon SE11 4BU

If you need advice, or feel your concerns shouldbe taken over the telephone, you can also contacta member of the Fitness to Practise Departmenton:

tel +44 (0)20 7840 9814freephone 0800 328 4218 (UK only)fax +44 (0)20 7582 4874

You may also find our Reporting a concern formuseful, available at www.hcpc-uk.org


Appendix:

Historical statistics

Table 1

Total number of cases received 2002–03 to 2016–17

Year

2002–032003–042004–052005–062006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

% ofregistrantssubject to

complaints

0.050.090.110.190.180.240.260.380.350.420.520.640.660.620.64

Totalnumber ofregistrants

144,141144,834160,513169,366177,230178,289185,554205,311215,083219,162310,942322,021330,887341,745350,330

Number ofcases

70134172316322424483772759925

1,6532,0692,1702,1272,259

Type of complaint

Article 22(6) / anonymousEmployerOtherOther Registrant / professionalPoliceProfessional bodyPublicSelf referral

Total


Appendix:


Table 2

Who raised concerns 2010–11 to 2016–17

% ofcases

2.926.44.5

31.40.4

40.920.5

100

2016–17cases

65596102683110

924463

2,259

% ofcases

2.725.25.42.40.90.5

42.820.2

100

2015–16cases

57535115512010

910429

2,127

% ofcases

325.54.73.30.7

145.516.3

100

2014–15cases

65554103711521

988353

2,170

% ofcases

3.728.73.93.81.80.7

38.319.1

100

2013–14cases

7759381783714

793396

2,069

% ofcases

3.526.35.3

61.61.3

38.317.7

100

2012–13cases

5843587992721

634292

1,653

% ofcases

30.731.1

55.6

3N/A24.6N/A

100

2011–12cases

284288465227

N/A228N/A

925

% ofcases

21.928.62.79.93.3N/A33.6N/A

100

2010–11cases

166217217525

N/A255N/A

759


Appendix:


Table 3

Cases by profession 2005–06 to 2016–17

Profession


Total

2016–17

1132695

192684571

295183143

275

1,22631

2,259

2015–16

847567

171893551

239139146

487

1,17436

2,127

2014–15

1136566

151897602

231133157

280

125115

2,170

2013–14

450713

2122

105632

266134157

259

108525

2,069

2012–13

737539

122574452

262122180

156

73434

1,653

2011–12

466559

121995632

252119138

258

N/A25

919

2010–11

43778109

4462390

188104118

140

N/A25

759

2009–10

539764

120

78382

163126149

747

N/A26

772

2008–09

84662810

55550

9995

N/A6

34N/A14

483

2007–08

1626406

140

45383

9485

N/A3

32N/A22

424

2006–07

41838260

40221

8152

N/A3

44N/A11

322

2005–06

22162370

38190

4379

N/A3

27N/A12

316

Route to registration

GrandparentingInternationalUKNot known

Total


Appendix:


Table 4

Cases by route to registration 2010–11 to 2016–17

% ofcases

1.34.3

94.40

100

2016–17cases

2998

2,1320

2,259

% ofcases

0.83.7

95.50

100

2015–16cases

1779

2,0310

2,127

% ofcases

03

970

100

2014–15cases

066

2,1040

2,170

% ofcases

03

970

100

2013–14cases

062

2,0070

2,069

% ofcases

0.43

96.60

100

2012–13cases

650

1,5970

1,653

% ofcases

27

910

100

2011–12cases

2057

8480

925

% ofcases

45

910

100

2010–11cases

3240

6870

759


Appendix:


Investigating Committee

Table 5

Allegations where a case to answer decision was reached 2004–05 to 2016–17

Year

2004–052005–062006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

% of allegations withcase to answer decision

44586562575857515853536371


Appendix:


Table 6

Percentage case to answer, comparison of 2005–06 to 2016–17

* These are cases that were transferred from the British Psychological Society to the HPC.

22(6) / anonBPS transfer cases*EmployerOtherOther registrant / professionalPoliceProfessional bodyPublicSelf-referral

2016–17

830

78623688504766

2015–16

790

73579367733355

2014–15

530

683852630

2445

2013–14

640

68823167891646

2012–13

770

73702747501941

2011–12

500

69635038

N/A17

N/A

2010–11

720

82572954

N/A22

N/A

2009–10

697

80796250

N/A22

N/A

2008–09

490

81346737

N/A22

N/A

2007–08

610

84567731

N/A29

N/A

2006–07

860

840

4628

N/A33

N/A

2005–06

580

810

6026

N/A18

N/A


Appendix:


Table 7

Representations provided to Investigating Committee Panel by profession 2006–07 to 2016–17

Case to answer No case to answer

Year

2006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

No response

4059617084498699

136131143

Response fromregistrant

7985

131200185182186218256279242

Response fromrepresentative

289

142125212943405758

Total case toanswer

147153206291294252301360433467443

No response

317211410281835283619

Response fromregistrant

6668

115177195197176256301201142

Response fromrepresentative

46

137

13212831483522

Total case toanswer

7391

149198218246222322377272183

Total cases

220244355489512498523682810739626


Appendix:


Interim orders

Table 8

Interim order hearings 2004–05 to 2016–17

Year

2004–052005–062006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

% of allegationswhere interim

order wasimposed

8.74.75.34.55.66.35.85.32.44.64.03.65.7

Number of cases

172316322424483772759925

1,6532,0692,1702,1272,259

Orders revokedon review

0113166483978

Orders reviewed

01238525586

123142151166367260324

Applicationsgranted

151517192749444939858776

128


Appendix:


Final hearings

Table 9

Number of hearings 2004–05 to 2016–17

Table 10

Representation at final hearings 2006–07 to 2016–17

Year

2004–052005–062006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

Year Type of representation

2006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

Total

103140222324396567677732565697854846

1,135

Article30(7)

0000001111010

Restorationhearing

1000002314588

None

43598098

1139495

109166164217

Representative

468074

114160155102119114100164

Registrant

1317214441383139715664

Reviewhearing

11264266929599

126141160166171216

Finalhearing

6686

125187219331404405228267351320445

Interimorder and

review

2528557185

141171197194265332346466


Appendix:



Table 11

Number of review hearings 2004–05 to 2016–17

Year

2004–052005–062006–072007–082008–092009–102010–112011–122012–132013–142014–152015–162016–17

Number of reviewhearings

11264266929599

126141160236202222

© Health and Care Professions Council 2017Publication code: 20171012F2PPUB (published November 2017)

To request this document in Welsh or an alternative format, email [email protected]

Park House184 Kennington Park RoadLondon SE11 4BU

tel +44 (0)300 500 6184fax +44 (0)20 7820 9684www.hcpc-uk.org

fitness to practise annual report 2017 · 2018-11-22 · health and care professions council...

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