Darren Adamson

Preliminary Matters

Proof of Service

1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent by email on 06 December 2022, to the address shown for the Registrant on the HCPC register.

2. The Panel accepted the advice of the Legal Assessor and was satisfied that notice had been properly served in accordance with the Conduct and Competence Committee Rules 2003 (as amended) (hereafter ‘the Rules’).

Proceeding in absence of the Registrant

3. Mr Greany, on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence, as permitted by Rule 11 of the Rules.

4. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPC Practice Note “Proceeding in Absence”.

5. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:

a) the Panel noted that the Registrant sent an email to HCPC, dated 01 February 2023 which stated the following:
“… I will not be attending the hearing but would like to ensure that all evidence provided by me is made available to the panel. I have attached all of the relevant documentation to this email and would like a written confirmation that these have been received and will be made available to the panel prior to the hearing taking place…”
The Panel was satisfied that it was reasonable to conclude from this email, that the Registrant’s non-attendance was voluntary and therefore a deliberate waiver of his right to attend and participate in person;

b) there has been no application to adjourn and no indication from the Registrant that he would be willing or able to attend on an alternative date and therefore re-listing this final hearing would serve no useful purpose;

c) the HCPC has made arrangements for two witnesses to give evidence during the hearing. In the absence of any reason to re-schedule the hearing, the Panel was satisfied that the witnesses should not be inconvenienced by an unnecessary delay and should give evidence as soon as practicable;

d) the Panel recognised that there may be some disadvantage to the Registrant in not being able to give evidence or make oral submissions. However, the Panel noted that he had provided written submissions which are included within the documents before the Panel and which went some way to mitigate any potential disadvantage to the Registrant; and

e) as this is a substantive hearing there is a strong public interest in ensuring that it is considered expeditiously. It is also in the Registrant’s own interest that the Allegation is heard as soon as possible.

Application to amend the particulars

6. At the outset of the hearing Mr Greany made an application to amend the Allegation. The Registrant had been put on notice of the proposed amendments, save for one made at the start of the hearing, in a letter dated 14 February 2022.

7. Mr Greany also made an application for an additional amendment to the stem of the proposed Allegation, further to those proposed in the aforementioned letter. He submitted that the amendment to the stem would remove the duplication contained within the Allegation.

8. The proposed amendments were therefore as follows:

i. Stem – deletion of the words ‘your fitness to practise is impaired by reason of misconduct and/or lack of competence. In that’
ii. Particular 2 – deletion of the letter ‘a’ and ‘D’;
iii. Particular 3 – deletion of the letter ‘a’ and insertion of the words ‘and Patient Q’;
iv. Schedule C – deletion of the letter ‘D’ and insertion of the letter ‘C’; and
v. Moving Patient 0 up the list of patients so that they appeared in alphabetical order.

9. The Panel accepted the advice of the Legal Assessor and carefully considered the HCPC application to amend the Particulars. The Panel concluded, after reviewing each of the proposed amendments, that they would agree to the Particulars being amended for the following reasons:

i. the Registrant had been provided with significant notice of the HCPC’s intention to amend the Allegation, having been put on notice in February 2022, over twelve months before the commencement of the substantive hearing;
ii. the Registrant had not provided any objection to the proposed amendments;
iii. on the whole, the proposed amendments were to correct typographical errors and to provide further clarification of the Allegation; and
iv. the proposed amendments did not seek to widen the scope of the Allegation.

10. The Panel therefore concluded that the proposed amendments to the Allegation did not heighten the seriousness of the Allegation and therefore there was no likelihood of injustice to the Registrant.

Background

11. The Registrant was employed by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (“the Trust”) as a Band 7 Counselling Psychologist from November 2018.

12. In April 2019, concerns surrounding the Registrant’s practice were identified by the Registrant’s supervisors and colleagues. These concerns came about as a result of numerous complaints raised by patients and focused on the frequency of appointment cancellations. Following receipt of these complaints, an investigation into the Registrant’s caseload was conducted which led to the discovery of poor patient care and record keeping across the Registrant’s caseload.

13. Although the Registrant received continued supervisory support, a further complaint was received by the Trust in September 2019 raising concerns that were similar in nature to those raised earlier in the same year. A meeting was conducted between the Trust and the Registrant and it was agreed between the parties that the Registrant would leave the Trust’s employment in October 2019. A referral was made to the HCPC on 30 October 2019 by the Trust.

14. At its meeting on 13 May 2021, a panel of the HCPC’s Investigating Committee determined that there was a case to answer in relation to an allegation of impairment of the Registrant’s fitness to practise.

Decision on Facts

Summary of Evidence

15. The HCPC relied upon the oral and written evidence of two witnesses, as follows:

i. Witness Dr CA – Band 8b Principal Counselling Psychologist; and
ii. Witness Dr CM – Band 8d Consultant Clinical Psychologist.

16. The HCPC also relied upon the following documentation which the Panel labelled as follows:

i. Final hearing bundle – 750 pages (B1);
ii. Service and Supplementary bundle – 14 pages (B2); and
iii. Email correspondence with the Registrant – 14 pages (B4).

17. The Panel was also provided with a Registrant’s bundle, consisting of 76 pages, which the Panel labelled B3.

18. The accounts below are provided as a summary of each of the witnesses’ oral and written evidence to the panel and are not a verbatim account of the evidence provided.

Witness Dr CA:

19. Witness CA told the Panel that she is currently, and was at the relevant times, employed by the Trust in the role of Principal Counselling Psychologist. She told the Panel that she has been in this role since she qualified in 2006. Witness CA also told the Panel that she became a band 8b in March 2018 and this meant that she was responsible for supervising more junior members of the team, alongside peers who were of a similar banding.

20. Witness CA informed the Panel that her current role is within the Older Adults Clinical Psychology Department (‘the Service’) and her role involves assessment and intervention with people over the age of 65 years presenting with mental health and neurodegenerative issues. CA also told the Panel that she also provided assessment and intervention for people under the age of 65 years old with neurodegenerative conditions.

21. CA told the Panel that she was the external supervisor for the Registrant when he was on the doctorate for Counselling Psychology course between 2013 and 2014. CA also stated that she was the Registrant’s supervisor when he went on the training placement to the department within the Trust between February 2016 and May 2017. CA also informed the Panel that when the Registrant joined the Trust as a locum, she was his clinical supervisor between December 2018 and September 2019.

22. CA told the Panel that the Registrant joined the Trust as a Band 7 locum Counselling Psychologist in December 2018 and that he worked within the Older Adult Clinical Psychology Service. She told the Panel that he was responsible for patients presenting with mental health issues over 65 years and also individuals under 65 years with neurodegenerative conditions including stroke.

23. CA also told the Panel that as his clinical supervisor, she provided the Registrant with clinical supervision once a fortnight, initially when he first started and that this then moved to a once a month session when the Registrant had settled in. CA also informed the Panel that ad hoc supervision was also available to the Registrant should he have required it.

24. CA confirmed that prior to the supervisory role she was the Registrant’s supervisor while he was training on the Counselling Psychology Doctorate at Teesside University. CA told the Panel that in this role she was clinically responsible for the trainee’s cases and she would review their clinical notes and letters and further, that the trainee’s caseload would be considered as an extension of her own.

25. CA indicated to the Panel that during her first supervision session with the Registrant in his locum role, she differentiated between trainee supervision and qualified supervision now he was an autonomous practitioner and that she reiterated the function of clinical supervision to the Registrant. CA told the Panel that as an autonomous practitioner, the Registrant was responsible for his own caseload and she would not be checking his patient notes or records and that this conversation was documented in a supervision record exhibited to her witness statement.

26. CA also informed the Panel during her oral evidence that during supervision sessions the Registrant did not raise any concerns with her regarding his caseload. CA stated that when the Registrant had worked at the Trust as a trainee, the Trust had been utilising paper patient records but when the Registrant joined as a locum practitioner, the Trust had migrated to using an Electronic Medical Information System (‘EMIS’). CA informed the Panel that every member of staff attended training on EMIS. CA also told the Panel that she offered the Registrant the opportunity to observe and review her EMIS records and notes so that he could familiarise himself with them and that she invited the Registrant to let her know should he require additional training on the EMIS system, which CA told the Panel he did not do. CA also told the Panel that all clinicians were expected to use EMIS in accordance with the record keeping policy and professional standards. In that, she stated that there should be substantial detail in the notes so that the notes can be used by other clinicians when they are picking up handover cases and provide a sense of continuity for patients. CA also told the Panel that the records should contain the core information concerning a patient.

27. CA also told the Panel in her oral evidence that during her time supervising the Registrant between December 2018 and September 2019 she did not have any concerns about the Registrant’s work, including his clinical work or the service that he was providing to patients. However, on 03 April 2019 she became aware that Patient D had made a complaint about the Registrant cancelling appointments and that Patient D requested an alternative clinician to treat him. CA informed the Panel that, at this point, she spoke to the Registrant and the Registrant stated that he had encountered issues with accessing Patient D’s property and that this was the reason for the missed appointments. CA told the Panel that the fact that the Patient had requested another clinician did not concern her and she took over responsibility for Patient D in order to ensure continuity of care for him.

28. CA told the Panel that she subsequently received a telephone call from one of the Parkinson’s nurses, on 16 October 2019, who advised that she had been contacted separately by Patients F and G to express their frustration with the Registrant cancelling appointments. CA stated that this struck her as very unusual because it was not common for her department to receive concerns regarding the number of appointments having been cancelled. CA told the Panel that when she spoke to Patients F and G neither wanted to pursue a formal complaint and each continued their treatment with her. CA told the Panel that following on from this, she raised the matter with the Registrant’s line manager (CM) and that she understood that CM and the Registrant had a meeting to discuss the concerns raised on 18 October 2019, whereby it was mutually agreed that the Registrant’s contract would be terminated.

29. CA told the Panel that following this decision an in-depth review was undertaken to consider the Registrant’s cases. CA told the Panel that she was “shocked” by the number of cancellations, given that the Registrant had not alluded to her during their supervision sessions that the level of cancellations had been so high. CA stated that she would have expected this to have been raised as part of supervision.

30. CA also told the Panel that following the Registrant leaving the Trust, and each of the Patients being contacted, the Trust did not receive any formal complaints regarding the Registrant. CA also told the Panel that it was very difficult to determine what the potential consequences could have been as a result of the Registrant’s conduct as it is very subjective to each patient’s circumstances.

31. CA also told the Panel that the Registrant only worked as a locum two days a week, Wednesday’s and Friday’s and would not be present during the Tuesday meeting whereby work was allocated across the team. However, CA also informed the Panel that her understanding was that the Registrant was required to provide his capacity prior to the Tuesday allocation meeting so that the team could allocate him new work in his absence. CA also gave oral evidence to the Panel that in addition to this, she would also discuss capacity with the Registrant during his supervision sessions with her and he never once raised a concern regarding his workload to her.

32. Additionally, when referring to cancelled appointments, CA also told the Panel that it was her understanding that the department did not have a cancellation policy however, she stated that it would have been apparent and familiar to the Registrant in maintaining his own diary, that if an appointment was cancelled that it would need to be rebooked. She also stated that when cancelling an appointment, the Registrant should have endeavoured to give sufficient notice to the patient. CA stated to the Panel that she would have expected the Registrant to have had the foresight to not cancel appointments with patients at the last minute. CA also told the Panel that the consequence of last-minute cancellations was that it could potentially disrupt the patient’s therapeutic treatment resulting in a loss of trust in the department and not wanting to continue with their care. CA informed the Panel that she understands, following the review of the Registrant’s patients that there were no clinical consequences for any of them but there was a general sense of frustration among the patients which was unusual for the department.

Application to recall the witness:

33. After the conclusion of CA’s evidence, Mr Greany made an application on the morning of the second day to recall CA to give evidence. This was following an email from CA to the HCPC whereby CA stated that she wished to clarify one aspect of her oral evidence to the Panel.

34. The Panel accepted the advice of the Legal Assessor and determined to grant the application. In the Panel’s view, as CA had not made it clear in her email to the HCPC which aspect of her evidence that she wished to clarify, the Panel considered that it was in the interests of justice and fair to both parties that the witness be permitted to clarify her evidence. In forming this view, the Panel considered that it was important that it received CA’s best and most accurate evidence, to ensure the Panel could make informed decisions in respect of the facts before it. The Panel therefore granted Mr Greany’s application.

35. [redacted]

Witness Dr CM:

36. Witness CM told the Panel that she is currently, and was at the relevant times, employed by the Trust as a Consultant Clinical Psychologist and is the Head of Department for the Service and has been in this role since 2018.

37. CM told the Panel that as part of her role she manages a team of four Clinical Psychologists and one Counselling Psychologist. CM also told the Panel that she was the Registrant’s manager for a period of 11 months, from November 2018 until October 2019. CM stated that the Registrant entered the department as a Band 7 Counselling Psychologist and was employed as a “bank” member of staff; meaning, that he was employed via an agency. CM told the Panel that he worked two days per week (Wednesday and Friday) and that he was responsible for psychological assessment and treatment of older adults on his caseload, referred for functional and cognitive mental health assessment, formulation and intervention. CM also told the Panel that whilst she was the Registrant’s line manager, she did not work with him on a daily basis as he was an autonomous practitioner and many of the Registrant’s appointments were home visits to patients and the Registrant therefore saw the patients in their own homes.

38. CM gave oral evidence to the Panel that in addition to management supervision, she also made herself available to the Registrant for ad hoc supervision and the Registrant knew that he could approach her at any point should he require assistance. CM told the Panel that she was aware of this because she reminded the Registrant each time they met for supervision.

39. CM also told the Panel that the Registrant had been a trainee within the department prior to his qualification, but that she did not have contact with him during this time as the Registrant worked as a trainee on one of CM’s days off. CM also stated that the Registrant did not have any supervisory duties as part of his role as a Band 7 Psychologist.

40. CM gave evidence to the Panel that once she became aware of the issues surrounding the Registrant’s practice, she made a referral to the HCPC and as part of that referral provided it with a detailed report and an audit of patients’ care, which she produced alongside a number of other exhibits.

41. CM told the Panel that she was first made aware of issues regarding the Registrant’s practice in early 2019. CM stated that she received contact from two patients, In April and July, (Patient D and Patient O) regarding their concerns surrounding the Registrant cancelling appointments. CM told the Panel that Patient D requested another Psychologist and Patient O was discharged from the service. CM gave evidence to the Panel that she raised these concerns with the Registrant at the time and the Registrant informed her that he was having issues accessing Patient D’s home and could not attend the appointments due to access issues. Following this conversation, CM told the Panel that she accepted the Registrant’s explanation for the cancellation of appointments and was happy to give the Registrant the benefit of the doubt. CM told the Panel that from this point she reminded the Registrant of the need to provide reasons and provide those reasons for cancellations as this would avoid the need for conversations like the one, she had with the Registrant, in the future. When questioned by the Panel in respect of the reason provided by the Registrant in respect of Patient O, CM stated that she was unable to recall the exact reason provided for cancelling the appointments but she had afforded him with the same benefit of the doubt at the time.

42. CM told the Panel that on 27 September 2019, she received a message from the administrative team to say that Patient I had contacted the Service to cancel any future appointments with the Registrant as the Registrant had cancelled three appointments in a row. CM told the Panel that she spoke to the Registrant about this and he informed her that the patient’s son had been hostile towards him during his visit to the property. CM told the Panel that she understood that CA was instructed to follow up on these issues with the Registrant at his next supervision meeting.

43. CM then told the Panel that on 16 October 2019, she received a message from CA to say that a referrer had contacted her as two further patients had raised concerns about the Registrant and it was at this point that she decided to “look into” the Registrant’s practice. CM gave evidence to the Panel that on 16 October 2019, she emailed the Registrant and asked him for a meeting with him to talk about the concerns that had been raised. CM stated that a meeting was set for 18 October 2019 and in between these dates she considered the notes for Patients G and F and she also contacted the Trusts team responsible for EMIS system.

44. CM told the Panel that on the morning of the meeting, the Registrant approached her in her office to ask what the meeting was concerning [redacted]. CM told the Panel that she outlined to the Registrant, during this conversation, that the meeting had been convened following concerns raised from patients and referrers regarding his cancellation of appointments.

45. CM stated that during the course of her meeting with the Registrant, she presented the Registrant with the issues that had been raised and noted that there were specific issues with both Patient F and Patient G’s records. CM informed the Panel that the Registrant told her that he was aware that his record keeping was not sufficient and informed her that his workload had been overwhelming him to the point where he could not record keep sufficiently. CM also told the Panel that the Registrant had not raised this issue with either her or CA prior to this meeting.

46. CM also told the Panel that during the course of the meeting the Registrant could not account for the cancelled appointments and told her that he was not able to cope under the current workload [redacted]. CM stated that the Registrant also told her that he was not able to manage his diary. CM told the Panel that after this meeting, along with two colleagues (CA and Dr AH) she conducted a full review of all of the Registrant’s patients records and they contacted each of the Registrant’s patients to establish if they had any concerns to raise regarding the Registrant’s practice. CM stated that in light of this review, she compiled the aforementioned audit report which was provided to the HCPC as part of its fitness to practise investigation.

Decisions on Facts

47. At the outset of its deliberations, the Panel noted that there was a further typographical error contained within the Allegation at Particular 2, in that the word ‘appoint’ should have read ‘appointment’. Given that it was clear to the Panel that this was a typographical error and did not alter the substance or nature of the Allegation in any way, the Panel determined to further amend the Allegation to rectify this mistake and did not invite representations from the HCPC prior to doing so.

Stem: Proved
As a registered Practitioner Psychologist (PYL35470):

48. The Panel had regard to the certificate, produced by a member of HCPC staff, contained within the HCPC service bundle and noted that it confirmed that the Registrant is a registered Practitioner Psychologist with the registration number PYL35470.

49. Consequently, the Panel was satisfied that the Registrant is a registered Practitioner Psychologist and that the stem had been satisfied.

Particular 1a: PROVED (save for in respect of Patient O which is NOT PROVED)
1. Between around November 2018 and 18 October 2019, you did not provide safe and efficient care in that you:

a. Did not see the Patients set out in Schedule A in a timely manner and/or within 28 working days of their referral to the Older People’s Psychology Service.

Schedule A
Patient D
Patient E
Patient F
Patient G
Patient J
Patient K
Patient O

50. The Panel had regard to both witnesses’ evidence and noted that they both stated that the Registrant was employed by the Trust between 2018 and 2019. The Panel also noted that witness CM’s evidence to it was that the Registrant was employed between November 2018 and October 2019 as a Band 7 Counselling Psychologist. Further, the Panel also noted that the Registrant did not dispute in his written representations to the Panel, that he was employed by the Trust between November 2018 and October 2019. Additionally, the Panel also had regard to the entries contained within the patient notes exhibited and was satisfied that the Registrant was employed by the Trust between November 2018 and October 2019.

51. The Panel next considered the term “safe and efficient care” within the wording of the Particular. The Panel considered that the words should be given their ordinary natural meaning. The Panel had regard to the witnesses’ evidence and noted that both witnesses stated that the Registrant worked within the Service and was responsible for patients presenting with mental health issues over 65 years of age and also individuals under 65 years old with neurodegenerative conditions including stroke. The Panel accepted both witnesses’ evidence to it, that in treating patients with such conditions, continuity of care was vital to their ongoing recovery. Further, the Panel also noted that both witnesses stated that it was important that appointments were kept with patients because the disruption of treatment could have an impact on a patient and also on their trust and confidence in the service provided by the Trust. Additionally, both witnesses also told the Panel that the consequence of not seeing a patient within the specified time lines could lead, at worst, to a serious untoward incident such as the suicide of a patient. Further, the Panel also had regard to the Registrant’s job description, produced as part of the bundle of exhibits, and determined that the Registrant was under an obligation to provide each of the duties outlined within his job description and that he was also under an obligation to make and keep appointments with patients in order to deliver his obligation of “safe and efficient” care.

52. The Panel next considered whether the Registrant was under an obligation to see patients in a timely manner and/or within 28 working days of their referral to the Service. In forming the view that the Registrant was under an obligation to see patients within 28 working days of referral, the Panel had regard to the witnesses evidence. Both witnesses informed the Panel that the Registrant was under an obligation to see patients within 28 days of referral and CM also told the Panel that she expressly informed the Registrant of this when he re-joined the team in November 2018.

53. Further, witness CM also told the Panel that after having cause to speak to the Registrant in early 2019, regarding the patients who raised concern about cancelled appointments, that she reminded the Registrant of this requirement and she also stated that it was something that was discussed amongst practitioners working within the department because it was at the time, the only Key Performance Indicator (‘KPI’) required of the team. CM also told the Panel that there was an Operational Policy in existence and in force between November 2018 and October 2019 which highlighted that the Registrant (and all staff) were under an obligation to meet the KPI of 28 working days. CA also stated that the Registrant was very “aware” of the KPI and would have had access to the Operational Policy on the shared electronic EMIS drive. CA told the Panel that the Registrant knew where the electronic folder was because he had to access it to draft letters to send to patients.

54. The Panel considered the Registrant’s written representation’s that he was not aware of the 28-working day KPI. However, the Panel rejected the Registrant’s submission in this regard preferring the evidence presented by both witnesses and having regard to the Operational Policy before it and the fact that the Registrant did comply with this KPI in respect of some patients that he treated.

55. Having regard to the aforementioned, the Panel was satisfied that there was an obligation on the Registrant to see patients referred to the Service within 28 working days and that this time period was considered to be a ‘timely manner’ by those working within the Service.

56. Having determined that the Registrant was under an obligation to see patients within 28 working days, the Panel went on to consider whether each of the patients listed within Schedule A had been seen within this timescale by the Registrant. In undertaking this exercise, the Panel scrutinised the witnesses’ evidence, the patient notes and the audit report exhibited by CM. The Panel also had regard to the Registrant’s submission that ‘As far as I was aware, all patients were seen within this time scale but I had no information as to when the referral was originally received and processed by the team as he [sic] was not present at allocation meetings’.

57. Having scrutinised and compared each of these documents and considered the totality of the evidence before it, the Panel rejected the Registrant’s submission that all patients were seen within 28 working days and was satisfied that the Registrant failed to see Patients D, E, F, G, J and K within the 28-working days of their referral to the Service. The Panel was also satisfied that by failing to do doing so, the Registrant did not provide safe and efficient care to each of those patients.

58. In respect of Patient ‘O’, when undertaking its review of the documentation, the Panel noted that the patient was first referred to the Service on 21 November 2018, and the Registrant had his first appointment with the Patient, according to CM, on 07 December 2018 (within 7 working days). Further, having regard to the audit report, the Panel further noted that Registrant had attended the patients home on 07 December 2018, but was unaware at that time, that the patient had been admitted to hospital. Having regard to the evidence before it, the Panel was not satisfied that it could be said that the Registrant had failed to see the patient within 28 working days because when it considered the oral evidence from CA, that when a patient is admitted to hospital the Registrant would not have been expected to have seen them as the Service was community based, the Registrant had made attempts to see Patient O within the 28 working days.

59. The Panel therefore considered that in respect of Patient O, the Particular was not proved.

Particular 1b: PROVED (save for in respect of Patients D and K which are NOT PROVED)
a. Repeatedly cancelled multiple appointments and/or did not attend appointments as scheduled for the Patients set out in Schedule B.

Schedule B
Patient A
Patient B
Patient C
Patient D
Patient F
Patient G
Patient I
Patient K
Patient L
Patient P
Patient Q
Patient R

60. The Panel next considered whether the Registrant had repeatedly cancelled appointments or not attended appointments in respect of each of the patients listed within Schedule B. Again, in undertaking this exercise, the Panel scrutinised the witnesses’ evidence, the patient notes and the audit report exhibited by CM. The Panel also had regard to the Registrant’s submission that ‘Appointments were cancelled when deemed necessary due to illness or they were cancelled by the patient or on the patient’s behalf. As far as I am aware, all appointments that were scheduled were attended by me. There were several times when patients would fail to answer the door and this was recorded on EMIS. The trust does not have a cancellation policy in place in order to ascertain appropriate/inappropriate levels of cancellation.’.

61. Having carefully reviewed and compared each of these documents and considered the evidence before it, the Panel was satisfied that the Registrant repeatedly cancelled or failed to attend appointments in respect of Patients A, B, C, F, G, I, L, P, Q and R and that by doing so, he did not provide safe and efficient care to each of those patients.

62. In respect of Patient ‘D’, when undertaking its review of the documentation, the Panel noted that the audit report, compiled by CM, stated that the Registrant had not cancelled any appointments and that in the comments section of the report it stated “Patient seen once. Two further visits documented as unable to access communal residence”. Further, the Panel also had regard to CA’s evidence that she was also aware of the difficulties in accessing Patient D’s property as there was a communal entry system before you could access the patient’s individual property and that the communal area was not always staffed. Having regard to the aforementioned, the Panel was not persuaded on the evidence before it that the Registrant cancelled, or failed to attend, appointments with Patient D. The Panel therefore considered that in respect of Patient D, the Particular was not proved.

63. In respect of Patient K, also when undertaking its review of the documentation, the Panel noted that the audit report, compiled by CM, stated that the Registrant had 2 cancelled or missed appointments by the Registrant and that he had seen the Patient on two occasions. However, when the Panel compared this evidence to that contained within the patient record the Panel noted that the Registrant saw Patient K on three occasions (20 September 2019, 09 October 2019 and 18 October 2019). Further, the Panel also noted from the patient record, that it was only a single appointment which was moved or cancelled from the 04 October 2019 to the 09 October 2019. In considering whether this amounted to a cancellation or failure to attend, the Panel considered that it was also not outside the realms of possibility that the patient had cancelled and/or moved the appointment themselves, rather than the Registrant and had regard to CA’s oral evidence to it when formulating this view. Additionally, whilst the Panel accepted that there should have been a record in respect of why the appointment was cancelled or moved, the Panel noted that the Registrant saw the patient within 3 working days of the original appointment (04 October to 09 October 2019) and determined that it could not be said that this would amount to a derogation in his duty to provide safe and efficient care. Consequently, having regard to the aforementioned, the Panel was not satisfied, in respect of Patient K, that the Particular was proved.

Particular 2: PROVED
Between November 2018 and 18 October 2019, you did not maintain complete and accurate records in that you did not document appointment dates and/or reasons for appointment changes and or delays and/or missed appointments within Outlook and/or the electronic patient system, EMIS, in relation to the Patients set out in Schedule C.

Schedule C
Patient B
Patient C
Patient E
Patient F
Patient G
Patient H
Patient I
Patient J
Patient K
Patient L
Patient O
Patient P
Patient Q
Patient R

64. The Panel first considered the date range of November 2018 to October 2019 and was satisfied that these dates spanned the time when the Registrant was employed by the Trust.

65. The Panel next considered whether the Registrant was under a duty to maintain complete and accurate notes and considered that he was. In forming this view, the Panel had regard to the evidence of both witnesses, but in particular to the evidence of CM who stated that it should be routine for all clinicians, not just psychologists, to document all consultations, cancelled or rearranged appointments and contact with patients. CM told the Panel that this was important because it is the formal NHS record of care offered to that patient and the record enables other clinicians involved with the patient to understand the care being provided to the patient and enables others to provide continuity of care to the patient should the allocated clinician be unexpectedly unavailable.

66. The Panel next considered whether the Registrant did not maintain complete and accurate records in that he did not document in respect of each of the patients outlined in Schedule C: appointment dates; reasons for appointment changes; delays; and missed appointments within Outlook and/or EMIS.

67. Again, in undertaking this exercise, the Panel scrutinised the witnesses’ evidence, the patient notes and the audit report exhibited by CM. The Panel also had regard to the Registrant’s submission that ‘As far as I am aware, all appointments/ cancellations were noted on EMIS as well as being captured on Outlook.’. In respect of this submission, the Panel noted that this was at odds with the Registrant’s earlier submission to the HCPC, dated 31 October 2019, whereby he stated:
“…I take full responsibility for the errors in my electronic schedule and in cancelling a number of appointments [redacted]… I agreed with everything [CM] said and felt as though it was a good decision [to leave the Service]…’

68. Having carefully reviewed and compared each of these documents and considered the evidence before it, the Panel was satisfied that the Registrant did fail to do the following in respect of each patient:

i. Patient B’s records did not include any recorded reasons for cancelling or moving six appointments and the moved / cancelled appointments were not recorded with reasons on EMIS;
ii. Patient C’s appointments which were cancelled and or moved did not have attached reasons on EMIS and only one of the cancellations had been recorded on EMIS and the others were not recorded at all;
iii. Patient E’s records did not outline why there was a delay between the Patient being referred to the Service on 18 February 2019 and their first appointment on 05 April 2019 and there was no reason provided on EMIS;
iv. Patient F’s did not document why two of their appointments were cancelled and three appointments were missed and no entries included on EMIS;
v. Patient G’s records did not outline why four appointments were missed or cancelled and three of the changes were not reported on EMIS;
vi. Patient H’s records did not document why his appointment on one occasion was not kept and there was no reason provided on EMIS;
vii. Patient I’s records did not record that Patient I had requested to be seen two weeks after their initial assessment and there was no record on EMIS that the second appointment had been made, missed or cancelled;
viii. Patient J’s records did not provide a reason for the delay between his referral and the Registrant’s first appointment with Patient J – a delay of 66 working days. Further, an appointment made for 04 October 2019 was not kept and no reason provided as to why cancelled or moved on EMIS;
ix. Patient K’s records did not outline why appointments were moved or cancelled on EMIS;
x. Patient L’s record did not document why four appointments had been moved or cancelled and no record was made on EMIS;
xi. Patient O’s records did not document why three separate appointments were cancelled or moved and no record was made on EMIS;
xii. Patient P’s records did not document why fourteen of their appointments were cancelled or missed and no reasons provided on EMIS;
xiii. Patient Q’s records did not outline why two of their appointments had been missed or cancelled and no reasons provided on EMIS. Further, in respect of this patient the discharge letter which was uploaded to EMIS had no reasons for the patient’s discharge outlined within it; and
xiv. Patient R’s records did not outline why ten appointments were cancelled or missed and no reasons were outlined on EMIS.

69. Having identified and verified each of the aforementioned failings on the evidence presented to it, the Panel rejected the Registrant’s assertion that all appointments and/or cancellations were noted on EMIS as well as Microsoft Outlook (the Registrant’s own diary) and found Particular 2 proved in respect of the aforementioned patients.

Particular 3 – PROVED in respect of Patient S, NOT PROVED in respect of Patient Q.
3. Between around November 2018 and 18 October 2019, you did not provide adequate care in that you did not conduct a cognitive assessment for Patient S and Patient Q and/or ensure it was saved in the appropriate location.

70. The Panel first considered whether the Registrant was under an obligation to perform a cognitive assessment and then if so, whether he was under an obligation to save it to an appropriate location.

71. The Panel had regard to the evidence of the witnesses and noted that CA stated that a cognitive assessment is an assessment of a patient’s cognitive function and that in the Service they utilised a number of cognitive assessments including the Addenbrookes Cognitive Examination (ACE-iii). CA stated that this assessment was used if there was an indication of a patient having issues with their memory or cognitive function. She further informed the Panel that the test was widely used for a number of cognitive domains and is widely used as a screening tool.

72. CA also told the Panel that the Registrant was versed in undertaking these tests and that he intended to perform a test on each of these patients (S and Q). CA stated that in respect of Patient S, Patient S’s husband had indicated that he was worried about Patient S’s cognitive decline and the Registrant arranged with Patient S and her husband that a cognitive test would be administered on 28 November 2018. CA told the Panel that upon review of Patient S’ records, the test was never administered by the Registrant and he did not arrange an appointment to administer the test. The Panel also noted that CA, in her evidence, drew its attention to supervision notes between the Registrant and CA whereby Patient S was discussed and the need for an assessment was also discussed.

73. On the basis of the evidence before it, the Panel was satisfied that a cognitive assessment was required for Patient S and that the Registrant did not conduct such an assessment and in failing to do so, the Registrant also failed to provide adequate care to Patient S. Consequently, this Particular in respect of Patient S, is proved.

74. The Panel next considered Patient Q and the evidence before it. The Panel noted that in respect of this patient the Registrant had provided the following submission: ‘As far as I am aware, the ACE III (Addenbroke’s Cognitve Assessment) letter was saved in his own folder on the Bensham Psychology server as well as being uploaded to EMIS.’

75. The Panel noted that CA stated in her evidence to the Panel that the Registrant did complete an ACE-111 cognitive assessment on this patient on 05 December 2018 and the results of the assessment were noted in the comments section of the patient’s record on EMIS. The Panel also noted that CA’s criticism of the Registrant was that there was no scanned copy of the original completed assessment sheet uploaded to the same record and that it was also not located on the patient’s record.

76. Having regard to the wording of the Particular, the Panel was satisfied on the evidence before it that the Registrant did conduct a cognitive assessment for Patient Q. The Panel next considered whether the Registrant had saved the results from the assessment in the requisite place and determined that he had. In the Panel’s view, the outcome of the assessment was contained within Patient Q’s record and whilst this may not have included the original paper document upon which the assessment was undertaken, in the Panel’s view there was sufficient information saved within the patient’s record to outline to any other clinician who reviewed the patients notes, what the outcome of the assessment was and that the outcome could be used as a barometer for future assessments. Consequently, it was also the Panel’s view that the Registrant did not fail in his duty to provide adequate care to Patient Q and therefore this Particular, in respect of Patient Q, is not proved.

Decision on Grounds

77. Having found Particulars proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct and/or a lack of competence.
Panels Approach

78. The Panel took into account Mr Greany’s oral submissions, made on behalf of the HCPC, and the written submissions provided by the Registrant.

79. The Panel accepted the advice of the Legal Assessor.

Lack of Competence:

80. The Panel had regard to the fact that competence describes knowledge and skills, i.e., what a registrant ‘can-do’ and that the appropriate standard to be applied is that applicable to the post to which the practitioner had been appointed and the work he was carrying out; Holton v GMC [2006] EWHC 2960.

81. The Panel also had regard to the fact that competence of a registrant is generally to be decided by reference to a fair sample of their work; R (on the application of Calhaem) v GMC [2007] EWHC2606 admin.

82. The Panel considered that the matters charged in the Particulars of the Allegation did represent a fair sample of the Registrant’s work. However, in considering whether the facts found proved amounted to a lack of competence, the Panel had regard to the evidence of both CA and CM that the Registrant had, in a number of other cases not cited within the Particulars of the Allegation: provided safe and efficient care; seen patients within the 28 working days of their referral; and maintained appropriate records. The Panel therefore considered that the facts found proved did not amount to the Registrant having a lack of competence in performing the role of a band 7 Psychologist, rather the Panel considered that he had simply elected not to. Consequently, the Panel was satisfied that this case did not amount to a lack of competence on the Registrant’s part.

Misconduct

83. The Panel next considered whether any of the facts found proved amounted to misconduct.

84. In considering the issue of misconduct, the Panel bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession ... Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

85. The Panel considered the HCPC’s Standards of Conduct, Performance and Ethics (dated January 2016) and was satisfied that the Registrant’s conduct had breached the following standards:

⦁ 1 - Promote and protect the interests of service users and carers;
⦁ 1.1 - You must treat service users and carers as individuals, respecting their privacy and dignity;
⦁ 1.2 – You must work in partnership with service users and carers, involving them, where appropriate, in decisions about the care, treatment or other services to be provided;
⦁ 1.3 - You must encourage and help service users, where appropriate, to maintain their own health and well-being, and support them so they can make informed decisions.
⦁ 2 - Communicate appropriately and effectively;
⦁ 2.1 - You must be polite and considerate;
⦁ 2.2 - You must listen to service users and carers and take account of their needs and wishes;
⦁ 2.3 - You must give service users and carers the information they want or need, in a way they can understand;
⦁ 2.5 - You must work in partnership with colleagues, sharing your skills, knowledge and experience where appropriate, for the benefit of service users and carers;
⦁ 2.6 - You must share relevant information, where appropriate, with colleagues involved in the care, treatment or other services provided to a service user;
⦁ 6 - Manage risk;
⦁ 6.1 - You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible;
⦁ 6.2 - You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk;
⦁ 8 - Be open when things go wrong;
⦁ 8.1 – You must be open and honest when something has gone wrong with the care, treatment or other services that you provide by:
– informing service users or, where appropriate, their carers, that something has gone wrong;
– apologising;
– taking action to put matters right if possible; and
– making sure that service users or, where appropriate, their carers, receive a full and prompt explanation of what has happened and any likely effects.
⦁ 10 – Keep records of your work
⦁ 10.1 – You must keep, full, clear, and accurate records for everyone you care for, treat, or provide other services to; and
⦁ 10.2 - You must complete all records promptly and as soon as possible after providing care, treatment or other services.

86. The Panel next considered whether there were breaches of the HCPC’s Standards of Proficiency for Practitioner Psychologist’s in England (dated 01 March 2013). As outlined, in the Panel’s view this was not a case concerning the Registrant’s proficiency to perform his role, rather a case where he had simply not performed the tasks required of him. The Panel therefore did not consider that the Standards of Proficiency were relevant in this case.

87. The Panel was aware that a breach of the standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that the Registrant’s conduct in respect of Particulars 1a), 1b), 2 and 3 fell far below the standards expected of a registered Practitioner Psychologist and was satisfied that each of the aforementioned Particulars, individually and when taken together, amount to misconduct.

88. In forming this view, the Panel had regard to the fact that the Registrant was responsible for seeing patients allocated to him within 28 working days and that in respect of a large number of patients (identified within Schedule A) he had failed to do so. Further, he had also not provided sufficient explanation as to why there was a delay in seeing the majority of these patients. Whilst the Panel noted that both witnesses indicated that there were no known consequences for the patients identified, the Panel considered that harm could have been caused to very vulnerable patients by the Registrant unnecessarily delaying their treatment and by the Registrant not seeing patients within the 28 working day referral window. The Panel considered, this to be a serious failure on the Registrant’s part.

89. The Panel was also satisfied that the Registrant’s actions in repeatedly cancelling and/or moving appointments with patients was also very serious. In the Panel’s view, repeatedly moving patients’ appointments without sufficient notice, or any notice in some cases and/or without providing adequate reason or explanation for doing so, would be considered deplorable by fellow practitioners. Patients rely on practitioners to build trust with them, especially when they may go on to divulge personal matters to them during the course of their treatment. Repeatedly cancelling and/or moving appointments, for a large number of patients would have, in the Panel’s view, inevitably damaged trust in the service being provided to them. The Panel considered that this conclusion was borne out by the fact that some patients requested to see an alternative Psychologist and at least one patient (Patient I) left the care of the Service altogether. In the Panel’s view, the Registrant’s actions had a direct impact upon the level of trust placed in the Service and could, in this regard, be said to have caused harm to patients.

90. Further, the Panel considered that the Registrant’s actions in not maintaining accurate patient records was also very serious and would also be considered as deplorable by fellow practitioners. In reaching this conclusion, the Panel noted that both witnesses had given oral evidence to it which stated that accurate and up-to-date patient records are vital when clinicians are reviewing handover cases, or when other practitioners need to understand the stage at which a patients’ treatment had reached. The Panel also noted that both witnesses also stated that up-to-date records provide a sense of continuity for patients as well as providing core information in respect of the patients ongoing care or treatment. For these reasons therefore, the Panel considered that the Registrant’s failure to keep up-to-date records amounted to misconduct.

91. Lastly, the Panel also considered that the Registrant’s failure to undertake a cognitive assessment for Patient S was also deplorable and also amounted to misconduct. In the Panel’s view, Patient S and her husband, who had raised concerns about Patient S’s cognitive deterioration, had both been given an expectation that the Registrant would undertake an assessment of Patient S. The Panel considered that by not performing that assessment, the Registrant potentially placed Patient S at risk of harm because there was not a clinical snapshot, from that point in time, which demonstrated what the patient’s cognitive function was. This inaction on the Registrant’s part would, in the Panel’s view, have resulted in the patient not having any issues of potential cognitive decline being identified and/or recorded. This, in turn, would have meant that there was no outcome recorded to be used as a benchmark for a future test to determine whether her mental acuity was indeed declining or not. Cognitive decline could present risks to the patient which could have been missed due to the cognitive assessment not taking place as planned.

Finding and reasons on current impairment

92. Having found that Particulars 1a), 1b), 2 and 3 amounted to the statutory ground of misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired.

93. The Panel took into account all of the evidence that it had heard during the course of the proceedings, the oral submissions made by Mr Greany on behalf of the HCPC and the written submissions of the Registrant. The Panel also considered the evidence of Continuing Professional Development provided by the Registrant and the testimonial reference, dated 09 April 2022.

94. The Panel took into account the practice note titled ‘Fitness to Practise Impairment’ published by the HCPC and in particular the factors to be taken into account when determining impairment.

95. The Panel also accepted the advice of the Legal Assessor. The Legal Assessor advised the Panel to consider the first three criteria set out in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Paula Grant [2011] EWHC 927, namely whether the Registrant:
• Has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or
• Has in the past and/or is liable in the future to bring the profession into disrepute; and/or
• Has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the profession.
96. The Legal Assessor also reminded the Panel, in accordance with the case of Cohen v General Medical Council [2008] EWHC 581, that it was relevant to ask whether the Registrant’s conduct is easily remediable, whether it has been remedied and whether it is highly unlikely to be repeated. In so doing, the Panel would examine whether or not the Registrant has demonstrated insight into his past behaviour. The Legal Assessor also advised the Panel to consider the public interest in accordance with the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Paula Grant [2011] EWHC 927 and Yeong v GMC [2009] EWHC 1923.

97. She also reminded the Panel when determining current impairment, the Panel should have regard to the following aspects of the public interest:

i) the ‘personal’ component: the current behaviour of the individual Registrant; and

ii) the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

98. The Panel first turned its mind to the ‘personal’ component of current impairment.

99. The Panel considered whether the Registrant’s conduct was remediable and if so, whether he had remediated his conduct. The Panel determined that the Registrant’s conduct was remediable. In the Panel’s view, whilst the Registrant’s conduct did fall far below that expected of him, the Panel noted that it related mainly to his record keeping and communication with patients and that both CA and CM had given evidence to the Panel that the Registrant was capable of performing his role as a Band 7 Psychologist but had failed to do so in respect of the patients outlined within the Allegation.

100. The Panel next considered whether the Registrant had remediated his misconduct and determined that he had not. In the Panel’s view, the Registrant had demonstrated very limited insight into his failings. In forming this view, the Panel noted that when the Registrant first engaged with the HCPC, in October 2019, he stated “I take full responsibility for the errors in my electronic schedule and in cancelling a number of appointments [redacted]”. The Panel further noted that in his most recent submissions to the Panel he refuted the entire Allegation, which the Panel considered was a significant shift and inconsistency in terms of his responses and approach to the concerns raised.

101. [redacted]

102. Further, the Panel also noted that both sets of the Registrant’s submissions focused predominantly on how he had been impacted by the situation arising at the Trust, rather than considering the impact on his patients, his colleagues and the wider Psychologist profession. Additionally, the Panel also considered that the Registrant had failed to engage, in any meaningful way, with the regulatory hearing; had failed to provide any evidence of meaningful remorse for his actions; and had failed to provide the Panel with any evidence of his attempts to remediate his conduct, save for completion of a single course relating to record keeping. In respect of the course completed, the Panel formed the view that the five-hour course did not address the wider communication failings identified in this case, when the Registrant had cancelled multiple appointments, for multiple patients, without explanation or record being made as to the reasons why. Whilst the Panel noted that the Registrant had also provided a document from the Information Commissioners Officer (‘ICO’), the Panel noted that there was no detail or explanation as to what training the Registrant had undertaken in order to achieve it. In the absence of an explanation as to its relevance, the Panel considered this document related the Registrant’s handling of data under The General Data Protection Rights (‘GDPR’) and determined that this document also did not demonstrate any remediation towards the identified failings.

103. Consequently, in the absence of full insight, any meaningful reflection, remorse or remediation, the Panel concluded that there was a real risk of repetition of the Registrant’s conduct. In forming this view, the Panel also determined that the Registrant’s conduct could not be said to be an isolated incident. It had occurred over a significant period of time (9 months), when he was only working two days a week and with a caseload which both witnesses described as ‘manageable’. Further, his failings concerned a large proportion of his patients. Therefore, having regard to all of these factors, the Panel considered there is a real risk of the Registrant repeating the identified failings.

104. For all of these reasons, the Panel concluded that the Registrant’s fitness to practise is currently impaired based on the personal component.

105. The Panel next considered whether this was a case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and in the regulator. In considering the public component the Panel had regard to the public interest, which included the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.

106. Having considered the matter, the Panel was satisfied that an informed member of the public, who was aware of the full facts in this case, would have their confidence in the profession and the regulator undermined if a finding of impairment were not made given the failings identified and the lack of insight, remorse and remediation shown by the Registrant. In the Panel’s view, the Registrant’s cavalier conduct demonstrated a blatant disregard of his professional obligations and members of the public would be extremely concerned to learn that a registered Psychologist had not attended appointments with vulnerable patients when scheduled; had not undertaken assessments of patients; and had not completed accurate records. The Panel considered it was critically important for the profession to have integrity and for the public to be able to trust the actions of a Psychologist and a significant aspect of the public component is upholding proper standards of behaviour. The Registrant’s conduct fell far below those expectations. The Panel concluded that public confidence in the profession would be undermined if a finding of fitness to practise was not made, given the seriousness of the Registrant’s conduct and behaviour.

107. The Panel therefore concluded that the Registrant’s current fitness to practise is impaired on the personal component and the wider public interest.

Decision on Sanction

108. Mr Greany submitted that the Panel’s role, when determining sanction, was not to punish the Registrant but to protect the public and he reminded the panel to have regard to the Sanctions Guidance, published by the HCPC.

109. [redacted]

110. [redacted]

Panel Decision

111. In reaching its decision on sanction, the Panel took into account the submissions made by Mr Greany on behalf of the HCPC and it again also had regard to the Registrant’s written submissions.

112. The Panel also referred to the ‘Sanctions Guidance’ issued by HCPC and accepted the Legal Adviser’s advice.

113. The Panel had in mind that the purpose of sanction was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of conduct and performance. The Panel was also cognisant of the need to ensure that any sanction imposed was proportionate.

114. To assist it in assessing the relevant level of sanction, the Panel identified the following mitigating and aggravating factors.

Aggravating factors:
(i) breach of trust of vulnerable service users, colleagues and the wider public in not performing his role as required;
(ii) repetition of concerns and a clear pattern of behaviour;
(iii) no patient or colleague focussed remorse;
(iv) no apology;
(v) very limited remediation;
(vi) failure to work in partnership with colleagues for the benefit of service users; and
(vii) [redacted]

Mitigating factors:
(i) the Registrant was relatively new to practice and this was his first qualified role as an autonomous practitioner; and
(ii) some very limited insight demonstrated by the Registrant in his reflective piece dated April 2022.

115. As advised by the Legal Adviser, the Panel started its consideration of this matter from the bottom of the scale of possible sanctions. It considered that mediation was not appropriate or relevant in this case. The Panel also considered that taking no action would not be appropriate in this case given its findings.

116. The Panel moved on to consider issuing a caution. The Panel noted that these were serious matters and had regard to its findings in respect of the risk posed to the public by the Registrant. The Panel was of the view that a caution would be insufficient in this case, to protect the public and to mark the seriousness of the matters and the Panel’s findings.

117. The Panel next considered a Conditions of Practice Order. The Panel determined that a Conditions of Practice Order was not the appropriate sanction in this case. In forming this view, the Panel had particular regard to paragraphs 105 to 109 of the guidance. The Panel noted that paragraph 107 states:

‘Conditions will only be effective in cases where the registrant is genuinely committed to resolving the concerns raised and the panel is confident they will do so. Therefore, conditions of practice are unlikely to be suitable in cases in which the registrant has failed to engage with the fitness to practise process or where there are serious or persistent failings.’

118. The Panel noted that this was a case in which the Registrant had failed to engage in any meaningful way. The Panel had regard to its earlier findings that the Registrant was capable of remediating his failings however, it also noted that the Registrant had also failed to provide any evidence of remorse and very limited evidence of remediation and further, that the Registrant had not indicated to the Panel that he would be willing or able to comply with a conditions of practice order. Having regard to the lack of meaningful engagement by the Registrant, the Panel considered that it did not have sufficient information before it to determine appropriate, workable or proportionate conditions of practice in this case at the current time. Additionally, having regard to the case as a whole, the Panel was also not satisfied that a conditions of practice order was the appropriate sanction having regard to the seriousness of the facts found proved.

119. The Panel next considered whether to make a suspension order. Such an order would, in the Panel’s view, provide the necessary degree of protection for the public, whilst leaving open the possibility of remediation. The Panel noted that the Registrant was at the beginning of his Psychologist career when the matters arose and the Panel had nothing before it to suggest why the Registrant cannot address his conduct and concluded that he can remediate his conduct. In the Panel’s view, a suspension order would provide the Registrant with an opportunity to demonstrate further remediation and meaningful insight. The Panel also considered that a Suspension Order would also reflect the seriousness of the Registrant’s conduct and the Panel’s findings and would send a clear message that such conduct was not acceptable to the Registrant and also to the wider profession.

120. In light of all of the aforementioned matters, the Panel considered that this was a suitable case for a period of suspension. The Panel also determined that to strike the Registrant from the Register, which is a sanction of last resort, would be disproportionate at this stage and that a lesser sanction was therefore appropriate in this case.

121. Accordingly, the Panel make an order directing the Registrar to suspend the registration of the Registrant for a period of twelve months.

122. The Panel recognised that there was a risk of de-skilling, by imposing a suspension order for a period of twelve months. However, the Panel was of the view that a twelve-month period of suspension is appropriate, as this will allow the Registrant sufficient time to demonstrate sufficient remorse, insight and remediation. The Panel was also of the view that this period of suspension would satisfy the public interest, in terms of maintaining public confidence in the profession and regulatory process and that this outweighed any detriment that the Registrant may suffer as a result of not being able to practise as a Psychologist.

123. The Panel considered that a reviewing panel would be assisted by the following:

(i) the Registrant’s attendance at a future review hearing;
(ii) a reflective piece;
(iii) evidence of on-going and continuous professional development (‘CPD’) and/or evidence of self-directed learning and/or training;
(iv) testimonials from any training providers in respect of the aforementioned; and
(v) up to date testimonials or references from: any employer, whether paid or unpaid, specifically addressing the issues identified in the Panel’s determination.

ORDER: That the Registrar is directed to suspend the registration of Mr Darren Adamson for a period of 12 months from the date this order comes into effect.

This Order will come into effect on 10 April 2023 if no appeal is made.

Interim Order

Application

1. In light of its findings on sanction, the Panel next considered an application by Mr Greany for an interim suspension order to cover the appeal period before the sanction becomes operative.

2. The Panel next considered whether to impose an interim order.  It was mindful of its earlier findings and decided that it would be wholly incompatible with those earlier findings and the imposition of a suspension order to conclude that an interim suspension order was not necessary for the protection of the public or otherwise in the public interest for the appeal period.

3. Accordingly, the Panel concluded that an interim suspension order should be imposed on public protection and public interest grounds. It determined that it is appropriate that the interim suspension order be imposed for a period of 18 months to cover the appeal period. When the appeal period expires the interim order will come to an end unless there has been an application to appeal. If there is no appeal the suspension order shall apply when the appeal period expires.

Decision

4. The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. 

5. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Darren Adamson