Mrs Dinusha Arya

Background

1. The Registrant is a registered Physiotherapist and was employed in 2000 by the London North West University Healthcare NHS Trust (“the Trust”). Apart from a short period in about 2001, when the Registrant was employed at other hospitals in the London area, she was based at Ealing Hospital (“the Hospital”).

2. In 2004, the Registrant became the in-patient Therapy Coordinator at the Hospital. Later she took on responsibility for both in-patients and out-patients and as Trauma Rehabilitation Coordinator. Between 01 November 2015 to 25 October 2019, the Registrant was the Senior Physiotherapy Lead (Band 8a). The Registrant also line-managed other physiotherapists at the Hospital.

3. Colleague A was appointed as a Band 7 Physiotherapist by the Trust, starting in May 2018. The Registrant was Colleague A’s line manager. Initially the Registrant also supervised Colleague A.

4. In December 2018, Colleague A made a written complaint to the Trust regarding the Registrant’s conduct towards him. An internal investigation was undertaken and reported to the Trust on 23 July 2019. The matter went no further. By this time, Colleague A had resigned from the Trust, leaving at the end of April 2019. The Registrant had also left the Hospital at the end of March 2019, on secondment to another hospital outside the Trust.

5. The Registrant relocated to Mumbai, India in December 2019 to attend to personal family commitments, and she remains living there. She is currently working as a Hospital Manager.

6. On 22 December 2019, Colleague A referred his concerns regarding the Registrant to the HCPC.

7. On 29 January 2021, a panel of the Investigating Committee found there was a case to answer against the Registrant and referred an Allegation to the Conduct and Competence Committee.

8. The HCPC subsequently completed its own investigation and progressed the concerns to a final substantive hearing.

9. At the conclusion of the substantive hearing on 20 October 2022, the substantive hearing panel found particular 1a, 1b (raised voice and abusive comments), and 1c were proved and found that particular 1b (shouted only) was not proved.

10. The substantive hearing panel made a finding that there had been a breach of the HCPC Standards of Conduct, Performance and Ethics (2016) applicable to all HCPC registrants: namely Standard 2.5 relating to communication and working in partnership with colleagues, sharing skills and knowledge and experience; and Standard 9.1 relating to personal and professional behaviour, making sure that conduct justifies the public’s trust and confidence.

11. It also found that the Registrant had breached the HCPC Standards of Proficiency for Physiotherapists (2013): namely Standard 3.1 in relation to understanding the need to maintain high standards of personal and professional conduct; and Standard 8.1 in relation to demonstrating effective and appropriate verbal and non-verbal skills in communicating advice, instructions, and professional opinion to colleagues.

12. The substantive hearing panel considered that the Registrant had failed to understand the need to maintain high standards in her professional conduct towards Colleague A in the way that she managed him, and that whatever competency issues there had been relating to Colleague A, it was never acceptable to bully or humiliate a colleague. The substantive hearing panel also considered that it was unacceptable to use condescending and belittling or abusive language towards a colleague, especially when in a position of seniority. It found that it was not effective communication to speak over a colleague who was asked to explain their actions, and that the Registrant should have had the skills and ability to communicate with Colleague A in such a way that did not amount to bullying and humiliation. The substantive hearing panel therefore considered that the Registrant failed to maintain high standards in her professional conduct when communicating with Colleague A, and that the facts proven amounted to misconduct.

13. The substantive hearing panel considered that the Registrant’s fitness to practise was impaired on the personal component and noted that:

a. The misconduct was very serious, amounting to bullying and humiliating behaviour towards Colleague A, who was a more junior colleague, and the Registrant’s behaviour had a significant impact upon Colleague A. In addition, there was an impact on both colleagues and patient care, as Colleague A’s confidence was undermined.

b. The misconduct was potentially remediable, and the Registrant had expressed remorse and offered an unconditional apology.

c. Some level of recent developing insight, after having seen Colleague A give evidence about the impact of the Registrant’s behaviour. However, the insight was incomplete at that stage.

d. The Registrant did not demonstrate within her evidence that she understood the seriousness of her behaviour or the full nature of the impact upon Colleague A, and how her behaviour had affected colleagues and the implications for patient care.

e. The Registrant had taken some steps towards remedying her misconduct and noted her passion for high standards of patient care.

f. The Registrant had limited opportunity to take on courses to address her misconduct due to her relocation to India.

g. The misconduct was a one-off episode, directed only towards Colleague A with no similar or subsequent behaviour. However, the length of the behaviour was noted to span over approximately six months, sometimes on a daily or very frequent basis.

h. There was a modest risk of repetition, which was balanced by the initial seriousness of the bullying behaviour as a senior manager, and the only partial insight that had been developed.

14. The substantive hearing panel considered that the Registrant’s fitness to practise was impaired on the public component and noted that:

a. The serious misconduct, bullying behaviour towards a more junior colleague, brought the profession into disrepute.

b. The Registrant had breached a fundamental tenet of the profession.

c. A well-informed member of the public would be shocked to learn that the Registrant had not been found to be impaired, given the findings.

d. There was a need to uphold proper standards of behaviour, and bullying behaviour was not acceptable in the workplace, particularly from senior staff who are expected to uphold high standards of behaviour and set a good example.

e. Confidence in the profession would be undermined if there was no finding of impairment, given the serious nature of the misconduct.

15. The substantive hearing panel subsequently considered the aggravating and mitigating features. It concluded that a Suspension Order for a period of 9 months was appropriate and made recommendations for the Registrant to complete relevant Continuing Professional Development (“CPD”), a reflective piece, and to provide written testimonials regarding her skills as a manager.

Post-substantive hearing

16. On 19 October 2022, the HCPTS provided the Registrant with information regarding the voluntary removal process. The Registrant responded to indicate that she no longer wished to continue her career within the NHS and would wish to pursue Voluntary Removal.

17. On 21 October 2022, the Registrant requested further information about the process to de-register from the HCPC. She noted, “I do not intend to ever work for the NHS or as a physiotherapist in the UK. I have relocated to India”. The Registrant further repeated those indications by email on 31 October 2022.

18. In November 2022, the Registrant followed up her request for further information. On 23 November 2022, the HCPC Case Manager acknowledged receipt of the request and provided further information about the process. The information included the HCPTS Practice Note for “Disposal of Cases by Consent” and a copy of a pro forma response for the Registrant to complete.

19. In February 2023, the HCPC requested from the Registrant a full copy of the completed and signed pro forma documentation.

20. On 1 March 2023, the Registrant provided a completed pro forma response dated 27 February 2023. Although the substantive hearing panel had already made findings on the facts of the Allegation, grounds and impairment, the Registrant admitted the substance of the Allegation. She stated that she did not wish to practise Physiotherapy in the UK, had read the relevant HCPTS Practice Note, and confirmed that she wished for the HCPC to consider Voluntary Removal. She restated that she had relocated to live in India since 2019 for personal reasons and had no intention to resume practice.

21. Following receipt of the information from the Registrant, the HCPC reviewed the case and considered that voluntary removal was appropriate in the circumstances and upon the information provided.

22. On 15 May 2023, the HCPC sent a copy of the Voluntary Removal Agreement for the Registrant’s consideration and, if accepted, her signature. The Registrant signed the Voluntary Removal Agreement dated 18 May 2023.

Decision

23. The Panel had before it a bundle of documents, including a Skeleton Argument on behalf of the HCPC dated 19 May 2023 and a copy of the signed Voluntary Removal Agreement dated 18 May 2023.

24. Ms Welsh, for the HCPC, submitted that the purpose of the hearing was for the Panel to consider the application based on the procedure that allows for disposal of cases by consent. The Panel was invited:

i. To revoke the existing Suspension Order made at the substantive hearing; and

ii. To approve the Voluntary Removal Agreement dated 18 May 2023.

25. Ms Welsh submitted that it was the role of the Panel to determine whether to accept or reject the proposal. Rejection of the proposal would mean the matter would return to the cycle of substantive reviews of the existing Suspension Order.

26. Ms Welsh made submissions based on the contents of the Skeleton Argument on behalf of the HCPC dated 19 May 2023.

27. In summary, she submitted that the appropriate level of public protection was secured by means of the Voluntary Removal Agreement because its effect would be to restrict the Registrant from practising in the UK or from using the protected title of Physiotherapist for a period of five years, and thus was equivalent in its effect to a Striking Off Order. In circumstances where the Registrant had no intention to resume practice, the public was adequately protected.

28. She further submitted that disposal by consent would not be detrimental to the wider public interest because the fitness to practise process had allowed ventilation of the Allegation and had already resulted in a finding of misconduct, impairment, and sanction, so a member of the public would be satisfied that the Allegation had been appropriately and properly considered.

29. Ms Welsh therefore submitted that to revoke the existing Suspension Order and approve the disposal of the case by consent on the basis of the signed Voluntary Removal Agreement was an appropriate, expeditious, and proportionate way to proceed.

30. The Panel then heard submissions from the Registrant. She confirmed that, after a 23-year career in the NHS, she had now relocated to India for personal reasons and had no desire or intention to resume practice as a Physiotherapist in the UK.

31. The Registrant explained that she is currently employed as Chief Operating Officer of a hospital in India and, in the event she were to seek employment in the UK, it would be in the field of health care management and not in professional practice. The Registrant emphasised her clear wish to be removed from the Register without delay.

32. The Panel received advice from the Legal Assessor.

Panel’s Decision

33. The Panel had regard to the documents in the bundle before it, in particular the Skeleton Argument on behalf of the HCPC and the signed Voluntary Removal Agreement dated 18 May 2023. It noted that in that document, the Registrant confirmed her acceptance of the Allegation and the finding of impairment made at the substantive hearing.

34. The Panel also had regard to the HCPTS Practice Note on “Disposal of Cases by Consent” (March 2018). It noted the requirement for the HCPC to provide a Skeleton Argument giving a clear, appropriately detailed, and objectively justified explanation of why the matter is suitable for disposal by consent.

35. The Panel was satisfied that the Skeleton Argument on behalf of the HCPC dated 19 May 2023 provided the necessary explanation.

36. The Panel reminded itself that its overarching statutory objective is the protection of the public, and that a panel should not agree to resolve a case by consent unless it is satisfied that the appropriate level of public protection is being secured and doing so would not be detrimental to the wider public interest.

37. The Panel considered the contents of the Voluntary Removal Agreement and was satisfied that its effect would be to have the Registrant’s name removed from the Register so that she will be prohibited from applying for re-registration as a Physiotherapist or from using the protected title for a period of at least five years. The Panel took note of the fact this restriction would have the equivalent effect of a Striking Off Order. The Panel was satisfied that this provides adequate public protection from any risk of repetition of misconduct in the circumstances of the case.

38. The Panel was also satisfied that disposal of the proceedings by way of Voluntary Removal Agreement would not be detrimental to the wider public interest. It noted there had already been a public substantive hearing at which the Allegation was ventilated and findings of misconduct and impairment were made, and so public interest in allegations of misconduct being appropriately dealt with had already been served. The Panel considered that there was no likely benefit to the public interest, and indeed a potential detriment to public confidence in the regulatory process if the Suspension Order remained in force and was subject to repeated reviews where the Registrant had no intention or desire to continue to practice and had permanently relocated outside of the UK.

39. In those circumstances, the Panel was satisfied that it was an appropriate, expeditious, and proportionate course to:

a. revoke the Suspension Order of 9 months made on 20 October 2022; and

b. approve the disposal of these proceedings by consent, by means of the signed Voluntary Removal Agreement dated 18 May 2023.

The Panel granted the Voluntary Removal application.

No notes available

History of Hearings for Mrs Dinusha Arya