Scott R E Hughes

Allegation (as amended)

As a registered Physiotherapist (PH119653) your fitness to practise is impaired by reason of your misconduct and/or lack of competence. In that:

1. Between 02 November 2020 and 16 June 2021, you did not record complete and/or adequate details of the clinical assessments and/or reasons for the treatment provided, in relation to the Service Users set out in Schedule A.

2. Between January 2021 and June 2021, you did not maintain accurate and complete records for the Service User’s in Schedule B in that:
a) You did not record details of the appointment that took place on or around the dates as set out in Schedule C.

3. On or around 28 May 2021, you kept Service User P’s personal contact details for your own personal use without their consent.

4. On or around 28 June 2021, you accessed confidential information relating to the Service Users set out in Schedule D without authorisation to do so.

5. On or around 28 June 2021, you attempted to remove confidential service user records from Pendulum Physiotherapy (PP) in relation to the Service Users set out in Schedule D.

6. On or around 30 June 2021, you sent an email from your physiotherapy company, to Service User P’s personal email addresses without consent to do so.

7. The matters set out in particular 1 – 2 above constitutes a lack of competence.

8. The matters set out in particular 1 – 6 above constitutes misconduct.

9. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Schedule A

• Service User B – E

• Service User G

• Service User H and - J

• Service User L

• Service User O – R

• Service User U – Z

• Service User 1

• Service User 3

• Service User 5 – 12

• Service User 15

• Service User 17 –18

Schedule B

• Service User B

• Service User D – G

• Service User I

• Service User K

• Service User N

• Service User 2

• Service User 4

• Service User 11

• Service User 13 – 16

• Service User 18

Schedule C

• 4 January 2021

• 18 January 2021

• 25 January 2021

• 1 February 2021

• 16 February 2021

• 22 February 2021

• 01 March 2021

• 02 March 2021

• 08 March 2021

• 15 March 2021

• 16 March 2021

• 23 March 2021

• 29 March 2021

• 12 April 2021

• 16 April 2021

• 20 April 2021

• 23 April 2021

• 30 April 2021

• 3 May 2021

• 14 May 2021

• 19 May 2021

• 21 May 2021

• 24 May 2021

• 26 May 2021

• 28 May 2021

• 8 June 2021

• 9 June 2021

• 14 June 2021

Schedule D

• Service User A – R

 

Preliminary Application

Application to amend the charges

1. Mr Schofield made an application to amend a number of the Particulars as set out above. He submitted that the proposed amendments did not change the substance of the allegation against the Registrant, but merely ensured that the allegation better reflected the evidence available in relation to service users and dates and to correct an inadvertent error when a previous application to amend the allegation was made which included omitting further dates in relation to Particular 2.

2. Mr Hamill did not object to the proposed amendments.

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

a) the proposed amendments do not materially widen the scope of the allegation, but merely seek to better reflect the available evidence,

b) albeit that it is not determinative of the issue, the Registrant does not object to the proposed amendments.

4. The Panel concluded that the proposed amendments of the paragraphs did not materially affect the nature or seriousness of the allegation. In all the circumstances, there was no likelihood of unfairness or injustice to the Registrant. The Panel therefore agreed to the proposed amendments and granted the HCPC’s application.

Background

5. The Registrant is a registered Physiotherapist with registration number PH119653.

6. On 7 July 2021, the HCPC received a referral form pertaining to the Registrant which had been completed by Colleague C, a registered Physiotherapist and the owner of Pendulum Physiotherapy.

7. In this referral form, Colleague C advised that the Registrant had been escorted from the premises on 28 June 2021, after gaining unauthorised access to service user files.

8. Colleague C further advised that patients had complained to the practice that the Registrant had been contacting them in order to promote his ‘new physio clinic’. It is further noted within this form that although some patients recalled giving their contact information to the Registrant, they did not do so with the understanding that the Registrant would use their contact information for his own personal use.

9. At the Investigating Committee stage, the Registrant submitted a written response via email on 3 June 2022. In this document, the Registrant admitted that he had failed to record and/or complete adequate details of clinical assessments and treatments that he had conducted between 2 November 2020 and 16 June 2021.

Live evidence heard

10. The Panel heard live evidence from Colleague C and Colleague B, a former employee at Pendulum Physiotherapy who each gave evidence by video link. The Registrant also gave oral evidence at the impairment stage.

11. The Panel also had sight of a number of documents which included, but were not limited to:

• Statement of Colleague C dated 12 April 2023 together with his exhibits;
• Statement of Colleague B dated 23 January 2023, together with his exhibits;
• The Registrant’s written response to the allegations;
• The Registrant’s bundle which included WhatsApp messages and diary entries and character references; and
• CCTV footage.

12. On health grounds, Service User P was not called by the HCPC to give live evidence. Mr Schofield did not make an application for his statement to be admitted by way of hearsay evidence. This is explored further below in relation to the HCPC’s position to offer no evidence in relation to Particulars 3-6.

Decision on Facts

Panel’s Approach

13. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything, and the individual particulars of the Allegation could only be found proved if the Panel was satisfied that this was the case on the balance of probabilities.

14. In reaching its decision, the Panel took into account the oral evidence of the HCPC witness and the Registrant, together with all of the documentary evidence provided to it, including the Registrant’s written statement and supporting document submitted by him, and the oral submissions made by Mr Schofield on behalf of the HCPC and by the Registrant.

15. The Panel also accepted the advice of the Legal Assessor, which is a matter of record. When considering each Particular of the Allegation, the Panel has borne in mind that the burden of proof rests on the HCPC and that allegations are found proved based on the balance of probabilities. This means that particulars will be proved if the Panel is satisfied that what is alleged is more likely than not to have happened.

16. The Panel accepted the advice of the Legal Assessor regarding whether admissions made by the Registrant could be accepted in line with HCPTS’s Practice Note on Admissions which states:

“13. In considering its approach to admissions, particularly admissions from registrants who are not represented, a panel must ensure that the overall fairness of the proceedings is secured. Panels will therefore want to ensure that, by way of example:
a. a registrant's admission is 'unequivocal' and that they are not making an admission for reasons of expediency or on some other inappropriate basis;”

Particular 1

17. At the outset of this hearing, the Registrant admitted the facts of Particular 1 in its entirety.

18. The Panel was satisfied that the Registrant’s admission was unequivocal, consistent with his written representations, and that it was not made for expediency or for any other inappropriate reason and that, in the circumstances, it could properly be accepted.

19. As such, the Panel found the facts of Particular 1 proved in their entirety by reason of the Registrant’s admission.

20. By way of background, the HCPC principally relied on the evidence of Colleague C who produced copies of the Registrant’s medical records of the relevant service users. Colleague C stated that the Registrant's record keeping was exemplary at the start of his employment at the Practice so he knew that the Registrant was more than capable of good record keeping and following the Subjective Objective Analysis and Plan (SOAP) structure of record keeping. At the start of the Registrant’s time working at the Practice, Colleague C made a habit of frequently checking the Registrant’s clinical records to ensure he was getting on well, and that his records were always good and satisfactory.

21. At Pendulum, Physiotherapists usually have 45 minute appointments and occasionally 30 mins if the physio decides that is best. The patient will usually be with them for 30–40 minutes of this appointment and then the Physiotherapist has a minimum of five minutes to make a record of the appointment. In the NHS they have 30 minute appointments so 45 minutes is more than enough time to ensure record keeping for each patient is up to date and completed properly.

22. Even with the more occasional 30 minute appointments, Colleague C stated that Physios should have plenty of time to complete their notes. In addition to this, there are natural breaks between appointments where physiotherapists can do their record keeping or they can block out extra clerical time in their diaries or do it during appointments, as well as the times when patients have failed to turn up. This has always been the way appointments are run at Pendulum and was still the case so this never changed during the time the Registrant worked there. He stated that their clinical records system was also a cloud based system allowing staff to access clinical records from home so records could have also been made outside of work hours (although he discouraged this).

23. Colleague C stated that Physios have full editing capabilities and control of their own diaries. The diary data report shows that the Registrant saw a total of 217 patients across 603 appointments during the eight month period from November 2020 until June 2021 inclusive.

24. Colleague C stated that the Registrant's poor record keeping compromised their ability as a Practice to provide effective and safe care to service users. By not making records for some appointments and not making complete and accurate records for other appointments, this meant that if the Physiotherapist changed for any reason, they would not know what level the service user was performing at and what their capabilities were. They would therefore not be able to take over care of the service user safely and effectively, which could lead to duplication of work and it could be unsafe as the new Physiotherapist could prescribe an incorrect weight or number of repetitions for the service user because the Registrant's records did not provide them with enough information. He stated that it was bad practice to make no clinical record at all and it was impossible to rely on memory alone to treat service users.

25. Colleague C, who produced copies of the Registrant’s records in respect of each Service User who is the subject of this Particular, identified a number of failings in the Registrant’s record-keeping, which included, but was not limited to, the following concerns:

• There was insufficient information about the symptoms service users were reporting;
• The Registrant did not include sufficient information relating to his findings and observations;
• Insufficient detail of treatment plans was given;
• The Registrant recorded inadequate detail of treatments;
• The Registrant failed to use the required template for his record keeping;
• His notes were unclear and insufficiently detailed, for example in relation to exercises required;
• He failed to record patient assessments, objectives, treatment, problems and plans;
• He failed to include photographs of exercise plans in the notes;
• Insufficient detail of whether a patient had been referred or was due to return for further appointments; and
• He failed to make a record of patients’ drug/medical history.

26. By way illustration of the Registrant’s failings, the Panel noted the following examples:

Service User B

27. Colleague C stated that the clinical records the Registrant made on 15 February 2021 and 24 March 2021 were not complete and were inadequate. On both records, the Registrant had not used the 'SOAP' structure. He stated that there were no other records available anywhere else for this appointment.

28. Colleague C said that the record made on 15 February 2021 did not include any objective information relating to his findings and observations. Colleague C stated that he would also expect to see more information relating to the exercises the Registrant had prescribed for the service user. The Registrant had written 'added ball figure 8's and banded oh press'. He said the Registrant had not included any information about the parameters, for example, the repetitions and amount of sets the service user was to complete, whether the service user felt confident doing the exercise, whether they tolerated it well, or whether they had any pain.

29. Colleague C also said that in the record made on 24 March 2021, the Registrant had written 'added overhead carries and landmine presses', but he had not included information as to what equipment the service user should be using, the weight they should be using or how many repetitions and sets they should be performing. This particular service user had a shoulder dislocation so it was important to know what they were capable of to ensure that the new physiotherapist does not prescribe a weight that is too heavy for them which could dislocate the shoulder again. He concluded that the notes made by the Registrant for this service user are way below the standard expected in any physiotherapy department.

Service User C

30. Colleague C exhibited Service User C's clinical record made by the Registrant on 25 May 2021. He stated that It was clear that it was made by the Registrant as on the top left hand corner of the note says the name of the person who created the note and had the Registrant's name is on it.

31. Colleague C said this clinical record was inadequate. These were all of the available records and there were no other records stored anywhere else, whether electronic or paper. The Registrant had not used the SOAP template. There was no information relating to the Registrant's findings and observations, no analysis of the position the Service User was in at the time of the appointment, and no plan as to how the Service User would be treated.

32. He stated that there was no photograph of an exercise plan or an exercise plan developed through Physiotrack attached to the clinical record.

33. Colleague C stated that he would have expected the Registrant to have used the full SOAP template and included information as to his findings and observations, some insight into what is happening to the service user and a plan as to how the service user would be treated going forward. If another Physiotherapist had to take over care of this service user, it would have been difficult to treat them and could have led to repetition of work. This patient had a disc injury with spinal cord compression which was rarely serious, but it could become serious. He said that the lack of adequate notes was a safety concern and could have resulted in the patient's injury becoming worse.

Service User 1

34. A copy of Service User 1's assessment document was produced to the Panel. There were no other electronic or paper records available anywhere else and this was the only record that was made. The Registrant saw Service User 1 for an appointment on 10 May 2021 and completed an assessment document however, the assessment document is inadequate as he has not recorded anything for objective, analysis, treatment, problem list and plan. He stated he would have expected this information to be included on the record. Service User 1 is a minor and it is therefore even more important to be vigilant and make a thorough assessment as children do not usually have the same aches and pains that adults get so there is more chance that they could have a serious condition.

35. A copy of the 'files' tab from the service user's record showed that there was no photograph of an exercise plan or an exercise plan developed through Physiotrack attached to the clinical record.

Particular 2

36. At the outset of this hearing, the Registrant admitted the facts of Particular 2 in their entirety.

37. The Panel was satisfied that the Registrant’s admission was unequivocal, consistent with his written representations, and that it was not made for expediency or for any other inappropriate reason and that, in the circumstances, it could properly be accepted.

38. As such, the Panel found Particular 2 proved in its entirety by reason of the Registrant’s admission.

39. By way of example to demonstrate the Registrant’s failings, the Panel noted the evidence of Colleague C in relation to this Particular, and noted that:

Service User B

40. Colleague C exhibited a copy of a screenshot of the service user's appointments from their clinical record The Registrant saw Service User B for appointments on 26 January 2021, 15 February 2021, 23 March 2021 and 23 April 2021. Colleague C stated that when he looked at the clinical records that had been recorded in the notes tab on the service user's clinical records, there were only records for the appointments on 15 February 2021 and 24 March 2021. There was also an initial assessment in the assessment tab for the appointment on 26 January 2021. There was no record made for the appointment on 23 April 2021. There are no other clinical records stored anywhere else (electronic or paper) and this is all that is available. He stated that the appointment went ahead as the records showed that the patient had been charged for their appointment.

Service User D

41. A list of the clinical records made for Service User D by the Registrant was produced by Colleague C. These were all of the available records and there were no other records stored anywhere else, whether electronic or paper. There was a number '1' in the bottom left hand corner of the screenshot and this indicates how many pages of notes there are. As there was only 1 page, this screenshot showed all of the available notes on the system. The Registrant had made a clinical record for them on 9 and 27 April 2021 (which must be for the appointment on 26 April 2021) but there was no clinical record made for the appointment on 14 May 2021. The record for their first appointment on 30 March 2021 was stored under the assessment tab so would not be visible in the notes tab. Colleague C stated that he knew that the appointments went ahead as the service user has been charged for their appointment. This was evidenced by looking at the column called 'status' which indicated whether they paid by cash, card or cancelled the appointment.

Particulars 3-6

HCPC’s submissions

42. At the conclusion of the evidence of Colleagues C and B, Mr Schofield indicated that the HCPC did not intend to offer evidence in respect of these Particulars. The basis of the application was as follows:

43. He stated that the HCPC has given further consideration to the information received by Service User P regarding his health and its impact on the ability on the HCPC to prove Particulars 3 and 6 in this case. Furthermore, he submitted that the decision taken regarding Service User P’s evidence may also impact on the other disputed Particulars (4 and 5) in this case.

44. [Redacted].

45. [Redacted].

46. [Redacted].

47. [Redacted].

48. Service User P’s attendance as a witness was not an issue relating to non-engagement. Accordingly, consideration of the HCPC’s powers to compel a witness’s attendance was not further considered in these submissions.

49. Mr Schofield stated that the HCPC has given consideration to the following potential courses of actions:

• Continuing to call Service User P as a witness and providing appropriate special measures;
• Making an application to admit his 2022 statement by way of hearsay evidence;
• To no longer seek to rely on his evidence (and the resulting consequence).

50. [Redacted].

51. [Redacted].

52. Accordingly, the HCPC took the view it is not appropriate to seek to call Service User P as a witness.

53. In light of that, the HCPC has given consideration to seeking to rely on Service User P’s account by applying to adduce his statement as hearsay.

54. Service User P’s evidence is that he did not provide the Registrant with any contact details or give him consent to obtain those details from Pendulum and he still received the advertising email. The Registrant accepted sending him the advertising email, but the factual dispute is that he says Service User P did provide him with his email during the relevant appointment. As is usual with healthcare appointments, only the service user and the Registrant were present in the consultation room at the time and only those two can provide direct evidence on the disputed facts.

55. Mr Schofield reminded the Panel that the admission of hearsay in regulatory proceedings, El-Karout, Ogbonna, Thorneycroft and Bonhoeffer was now well settled and regularly applied in first instance cases. Having considered the guidance from those cases, the HCPC took the view that seeking to adduce Service User P’s statement as hearsay would not be in accordance with that guidance in all the circumstances.

56. Service User P’s evidence was both the sole and decisive evidence on the disputed facts. Crucially, the HCPC took the view that Service User P’s hearsay evidence could not be said with any force to be ‘demonstrably reliable or otherwise capable of being tested’. It was highly likely there will be some remaining doubt of Service User P’s earlier recall by reference to the later diagnosis of a medical condition affecting his memory. This would be further compounded by the guidance of applicable case law on the assessment of a witness’s recall, which must take account of the intrinsic fragility of human memory. Also, in light of the absence of any other evidence of the Registrant’s interactions with Service User P, or other service users, it cannot be said that his evidence can be meaningfully tested against any other evidence.

57. Mr Schofield made reference to the case of Mansaray v NMC [2023] EWHC 730 (Admin), in which the High Court dismissed the appeal by a nursing registrant against the admission of hearsay evidence in his fitness to practise hearing. This was a case where there was also a good reason for the service user not being called (as they had died before the final hearing was heard). Mr Schofield submitted that It was important to note that Mansaray did not make any change to the law on the admission of hearsay. He submitted that there was a significant distinction in that case in that the High Court was satisfied the hearsay evidence was still sufficiently reliable and capable of being tested against other evidence available in that case.

58. Accordingly the HCPC took the view that seeking to admit Service User P’s statement by way of hearsay evidence in these circumstances would be unlikely to be in line with the guidance of the higher courts.

59. In light of those observations, Mr Schofield submitted that the HCPC would simply have no admissible evidence in which to advance Particulars 3 and 6. Therefore, he submitted that there was no realistic prospect of being able to prove those Particulars. As the case is now before the final hearing Panel, the HCPC cannot apply to discontinue these particulars, but it can ‘offer no evidence’, which materially has the same effect as set out in the footnote to paragraph 3 in the HCPTS’s Practice Note on ‘Discontinuance of proceedings’.

60. The HCPC therefore offered no evidence in relation to Particulars 3 and 6.

61. Having drawn that conclusion, the HCPC has considered the impact that would have on the remaining disputed Particulars, 4 and 5, which related to the events on 28 June 2021.

62. Mr Schofield submitted that with the absence of the evidence of Service User P, the HCPC no longer had an evidential basis on which to assert that the Registrant was inappropriately using or removing service user data from Pendulum. The loss of this evidence left the assessment of the Registrant’s actions on 28 June 2021 to be considered on the remaining available evidence. Salient aspects of that evidence include:

• The Registrant was still an approved keyholder to the clinic at the time;
• As a self-employed worker, the Registrant enjoyed a degree of autonomy on how he made his work arrangements (notwithstanding the evidence demonstrated it was unusual for workers to attend the clinic on non-working days);
• No express instruction not to attend the clinic outside of working hours was given to the Registrant;
• The relevant records referred to in Particulars 3 and 6 were intended to be provided to the Registrant in any event;
• The evidence on the movement of those records ceases with them being moved to the treatment room with the Registrant as he attempted to access the computer.

63. On a narrow reading of Particulars 4 and 5, the HCPC considered this remaining evidence as providing no ‘realistic prospect’ of establishing their proof.

64. The HCPC has also paused to consider any possible wider reading of those Particulars (and including potential amendments to capture any underlying public protection / interest concerns) resulting from the Registrant’s actions on that date. The HCPC noted the following evidence provided to the HCPC by the Registrant on 2 May 2025 as materially relevant including:

• The WhatsApp voice note dated 28 June 2021 at 14:11, in which the Registrant expressly asks Colleague C for either his or Colleague B’s Writeup login details;
• The contemporaneous narrative within the video taken by the Registrant in which he explains his intent in recording the video on 28 June.

65. The HCPC has advanced the undisputed evidence of the Registrant contacting Colleague B on 14:34 in attempting to obtain his log in details, as evidence of potentially seeking to surreptitiously access the Writeup system. This position was, Mr Schofield submitted, fundamentally undermined in light of the Registrant’s actions 23 minutes earlier in suggesting such an action to Colleague C.

66. The HCPC was therefore satisfied there was no risk of under-prosecution in not pursuing or seeking to amend the Particulars in relation to the events on 28 June 2021.

67. The HCPC therefore offered no evidence in relation to Particulars 4 and 5.

Submissions on behalf of the Registrant

68. Mr Hamill did not oppose the HCPC’s position. However, he also submitted that, irrespective of the HCPC’s submissions, he would otherwise have made an application that there was no case to answer in relation to Particulars 4 and 5.

Decision

69. The Panel had regard to all of the evidence presented to it including the submissions made by both advocates. The Panel accepted the advice of the Legal Assessor. The Panel has had regard to the HCPTS’s Practice Note on “Discontinuance of proceedings”, noting the relevant footnote that “if the HCPC no longer intends to pursue all or part of an allegation at a substantive hearing, as the matter is already before a Panel, the appropriate course of action is for the HCPC to ‘offer no evidence’ at that hearing rather than make a separate discontinuance application.”

70. The Panel has taken into account:

• The nature of the case and the background to the allegation;
• The nature of the evidence available;
• The explanation provided by the HCPC as to why it no longer considered there to be a reasonable prospect of being able to prove Particulars 3-6 of the Allegation;
• The Registrant’s agreement to no evidence being offered;
• The extent to which the offering of no evidence would be consistent with the HCPC’s overarching objective of public protection.

71. In all the circumstances, the Panel accepted the HCPC’s submission that there was no realistic prospect of proving Particulars 3-6 of the Allegation for the reasons set out by Mr Schofield. The Panel concluded that, taking all the above into account, the HCPC would not be failing in its statutory objective of protecting the public and the public interest, if no evidence was offered where there was no realistic prospect of those parts of the Allegation being proved as was the case here.

72. Accordingly, noting that no evidence was being offered in relation to Particulars 3-6, the Panel dismissed those Particulars of the Allegation.

Decision on Grounds

73. The Registrant gave live evidence. In summary, he accepted that his record-keeping had fallen below the standard expected of him and that he accepted responsibility for that failing.

74. He stated that accurate record-keeping was essential as it was in the best interest of service users that there was a complete and accurate record of care given. He stated that only accurate records would ensure an effective handover of patients or referral to others and provide a justification for any treatment given. A failure to do so could result in an inaccurate diagnosis or inappropriate ongoing care as treatment plans may be impacted as a result. He conceded that his poor record-keeping could have resulted in sub-optimal care for service users.

75. The Registrant referred to his written representations and identified a number of strategies that he has now put in place to ensure that his failings will not be repeated, namely:

• “Immediate Response: 60 minute new patient window, 45 minute follow up, regular breaks + max of 4 patients in a row + max 8 patients per day. I will book challenging cases at the end of clinic day or for longer with no extra charge to allow learning and appropriate documentation.
• Introduced new rehabilitation app that tracks patient loading during rehab including volume, frequency, subjective data from patient and graphics to show trajectory.
• Completed x3 courses that covered medico-legal note keeping as part of assessment ITMMIF L4 (2022), Safe rugby L2 (2023), Safe rugby level 3 (2024)
• Introduced note keeping system to [Redacted] in 2021 alongside medical entrant/exits as formality, locked filing cabinet in locked physio room inside locked building, formalised weekly meetings for medical - football handover with coaching staff, highlighted existing issues to the board regarding player welfare - including note keeping as i inherited x3 cruciate knee injuries on my arrival with no handover - this encouraged me to drive standards going forwards.
• [Redacted].
• [Redacted].
• [Redacted].
• [Redacted].
• Less conflict in the work environment I found my note keeping improved drastically upon my departure from Pendulum.
• I also made a conscious decision to prioritise note-taking whether that is during breaks, immediately post clinic, at home in the evenings, or starting early the following day to pick up any notes from the previous day., i keep a productivity diary and have done for 2+ years now where i have top 3 priority tasks to complete for the day which note-keeping is always included as appropriate.”

76. The Registrant stated that he has undergone courses which included elements on record-keeping but that he had not been on a dedicated record-keeping course. Having said that, he stated that his work with [Redacted] necessitated regular audits and monitoring.

77. In relation to his own private practice which he attended approximately 12 hours a week, he stated that he was still using the same software that he used at Pendulum, but that he had learned from his errors and reviewed his own notes each week. He emphasised that his admitted failings were an anomaly, had not happened before the incidents in questions and have not been repeated since.

78. He stated that he was embarrassed about his record-keeping failures and hoped to continue his work in sports therapy. He stated that the good standards he had witnessed in [Redacted] had been transferred to his private practice and that the risk of him repeating his failings was therefore low.

HCPC submissions

Misconduct

79. Mr Schofield, relying on his submissions made in his case summary, submitted that the Registrant’s conduct marked a serious departure from the standards expected of a registered Physiotherapist, posed a risk to service users and was sufficiently serious to amount to misconduct. He sub mitted that taking into account the nature of the Registrant’s failings, many of which included a complete absence of clinical note taking, the repetitive nature of the failures and the length of time it occurred over, that such record keeping failures crossed the high threshold into misconduct.

80. He invited the Panel to conclude that the Registrant had breached standards 6 and 10 of the HCPC “Standards of Conduct, Performance and Ethics” (2016):

Standard 6.1: You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible

Standard 10.1: You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to.

Lack of competence

81. With reference to the cases of Calhaem v GMC and Holton v GMC, Mr Schofield invited the Panel to consider the following questions:

a. Does the panel have a fair sample of the Registrant’s work by which to assess his level of competence.
b. What would the standards expected of a reasonably competent physiotherapist be?
c. Were the standards attained by the Registrant unacceptably low when measured against the standards of a reasonably competent physiotherapist?

82. He submitted that there was a fair sample of work before the Panel in the evidence. The Allegation related to a period of time over several months in which concerns were identified.

83. When considering the standards that the Registrant was expected to meet, the Panel was invited to conclude that the Registrant had breached standard 10, of the HCPC “Standards of Proficiency for Physiotherapists”:

Standard 10: be able to maintain records appropriately
10.1 be able to keep accurate, comprehensive and comprehensible records in accordance with applicable legislation, protocols and guidelines

10.2 recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines”

84. Accordingly, Mr Schofield submitted a finding of lack of competence was also open to the Panel in this case. However, he conceded that, given Colleague C’s evidence that the Registrant maintained appropriate records when he first started working at Pendulum, it could not fairly be said that the Registrant was not sufficiently competent to be able to produce a satisfactory standard of record-keeping. As such, he submitted that, on reflection, the Registrant’s failings could more properly be characterised as misconduct rather than a lack of competence.

85. In relation to impairment, Mr Schofield submitted in relation to the ‘personal component’ of impairment, that inadequate record-keeping was capable of remediation and that it was a matter for the Panel to decide the extent to which it considered that the Registrant had remediated his failings and the risk of recurrence. The HCPC was not submitting that the Registrant’s failings were attitudinal or so serious that they were incapable of remediation.

86. In relation to the ‘public component’ of impairment, Mr Schofield submitted that there was a need to be robust, fair and transparent, but that the Registrant’s self-assurance that his failings had been remediated, in the absence of demonstrable evidence that it had, was inadequate to conclude that the Registrant’s fitness to practise was not impaired.

87. Mr Schofield reminded the Panel that Colleague C had identified the risk to patients resulting from poor record-keeping, and that the Registrant accepted that risk. He reminded the Panel that in the event of legal proceedings ensuing, reliance might have to be placed on the accuracy of medical records. That, he submitted would be compromised if patient records were incomplete, inaccurate or not completed at all.

88. As a result, Mr Schofield submitted that the Registrant’s fitness to practise was also impaired on the public component.

Registrant’s submissions

89. Mr Hamill submitted that the matters which have been admitted relate to administrative failures in relation to record keeping. They were not matters which are typically viewed as being difficult to remediate, unlike dishonesty or sexual misconduct.

90. He submitted that the Registrant has undergone a period of reflection and improvement in relation to his note taking and record keeping. This was demonstrated in a number of the references provided, for example:

MB: “his notes/record keeping has always been accurate and complete and of the highest standard”.

Dr PM: “he has provided timely, full and accurate notes of his assessment and finding for me to work from and add to. At all times I have found that he provides complete details of clinical assessments and reasons for treatment provided or investigations needed or what his clinical question is of me in reviewing the player”.

CS: “His note keeping practices were diligent and forward thinking; indeed, it was Mr Hughes who took the initiative to introduce structured medical documentation procedures at the club, where previously none had been formally established. He implemented record keeping systems, established thorough medical histories for players, initiated emergency action planning and ensured that all medical information was stored securely and in accordance with GDPR requirements”.

91. Mr Hamill accepted that the Panel may have some concerns about the underlying evidence of remediation, but it should have regard to the totality of the evidence before it to include the documentary and oral evidence and in particular the character evidence highlighted above.

92. In relation to the risk of repetition, Mr Hamill invited the Panel to take into account that the facts giving rise to these proceedings arose in a particular context which no longer applied. It was clear that there were unhappy differences in the working relationship between Colleague C and the Registrant. There was some evidence to support the contention that whilst the Registrant was ultimately responsible for the admitted failures, the workplace was a stressful environment with significant time pressures to complete notes and some difficulties with IT equipment. Colleague B, who had no axe to grind in these proceedings, gave helpful and supportive evidence in relation to those matters.

93. Mr Hamill further submitted that the allegations were of considerable vintage dating back to the period 2020 - 2021 and there have been no further concerns about the Registrant in the intervening period. His work was scrutinised by others in the sports medicine field but his private clinic notes are also regularly shared with other practitioners with no issues of concerns being raised. The Registrant does review his own notes, albeit this done in a very informal way.

94. It was also very noteworthy that the Registrant was a relatively inexperienced practitioner at the time. Since leaving Pendulum, the Registrant has developed an impressive CV, and he has a lot to give to the profession. He submitted that the Registrant has a bright future ahead of him.

95. Mr Hamill said that the experience of going through a regulatory investigation and hearing has been traumatic for the Registrant. The mere involvement in this process was, in itself, a salutary lesson to the Registrant who will have no wish to ever find himself involved with his regulator again.

96. Mr Hamill also said that it was very much an atypical case. The matters proved by the admissions made by the Registrant did not reflect who he is, his overall ability and his approach to his work.

97. The Registrant, he submitted, was clearly extremely well thought of by colleagues and clients alike. The Panel had the references that have been produced for the hearing. A number of the referees made themselves available to give evidence, if necessary, which in itself is a significant vote of confidence in the Registrant as a person and a practitioner.

98. In respect of those references, he submitted that the Panel can have regard to the manner in which at least some of them have been produced. The referees’ details were provided to the Registrant’s solicitors. The Registrant had no hand or part in the content of same.

99. Mr Hamill reminded the Panel that the Registrant was a person of good character. In his career to date, he has had no other disciplinary or regulatory incidents. The matters under consideration are the only blot on his copybook. Since starting in his various new roles, he has practised safely without incident. He is doing very well in those roles. Again, he was hugely respected by his colleagues as evidenced by the testimonial evidence.

100. The Registrant has demonstrated good insight into his failings. The Registrant has reflected at length on the matter. He understands the impact on the public, colleagues and the reputation of the profession.

101. In all those circumstances, it was submitted that the risk of repetition of the behaviours giving rise to these proceedings was so remote that the Panel can safely discount it.

102. Whilst in no way diminishing the seriousness of what happened, the difficult working environment and working relationships provided relevant context which the Panel should have regard to when considering the question of impairment.

103. The Registrant has made admissions and cooperated with the Council in the course of its investigations.

104. It is therefore submitted that the Panel could properly find that the personal component of fitness to practise was not engaged in this case.

105. Mr Hamill accepted that the Panel also needed to consider whether the public component of impairment was engaged by the proven facts. It should address the question of whether, given the nature of the facts found proved, public confidence in the profession be undermined if there were to be no finding of impairment?

106. It was submitted that whilst these findings are of course serious, the Panel should consider the extent of the Registrant’s culpability and the personal and professional pressure the Registrant was under to form a view about what the public might think. His inexperience and working environment were, he submitted, relevant factors.

107. Mr Hamill said that a finding of misconduct would be a powerful marker in itself sending out a clear message to the Registrant, fellow registrants and the wider public as to the view the Panel took of these failures. He submitted that an ordinary, well-informed member of the public who was aware of the circumstances may well in fact have some sympathy for the Registrant. They would be likely to view the conduct being considered as an aberration when set against the rest of the Registrant’s career. It therefore followed that there would be no loss of confidence in the profession or regulator if impairment was not found.

108. It was accepted that the Panel may feel that there was a risk of harm from the incomplete record keeping. However, there was no evidence of any actual harm and it appeared the issues were detected as a result of an investigation of the other parts of the case which have fallen away rather than as a result of an incident or complaint involving a service user of Pendulum.

109. It was therefore submitted that the events under consideration, taking into account all of the features of the case, were not such as to ground a finding of current impairment.

110. Alternatively, Mr Hamill submitted that if the Panel considered a finding of impairment was necessary, it could safely find impairment on the public component only.

Decision on misconduct / lack of competence

111. On the basis of the facts found proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct and/or a lack of competence. It took into account all the evidence, including the documentation received which included details of courses undertaken, together with the submissions made by Mr Schofield on behalf of the HCPC and those made by Mr Hamill on behalf of the Registrant.

112. In considering this matter, the Panel exercised its own judgement. The Panel also took into account the public interest, which includes protection of the public, maintenance of public confidence in the profession, and the declaring and upholding of proper standards of conduct and behaviour.

113. When considering whether the facts found proved amounted to misconduct, the Panel noted that not all breaches of the HCPC’s “Standards of Performance, Conduct and Ethics” need amount to a finding of misconduct.

114. The Panel heard and accepted the advice of the Legal Assessor which is a matter of record. He reminded the Panel of the meaning prescribed to misconduct in the case of Roylance v General Medical Council (No 2) [2000] 1 A.C. 311, in which it was said:

“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.”

115. In Nandi v GMC [2004] EWHC 2317 (Admin) the Court referred to Roylance where the Court described misconduct as “a falling short by omission or commission of the standards of conduct expected among medical practitioners, and such falling short must be serious” such that it would be “regarded as deplorable by fellow practitioners”.

116. The Panel adopted a two-step process in its consideration. Firstly, the Panel considered whether the facts found proved amounted to misconduct or a lack of competence. Secondly, and only if the facts proved were found to amount to misconduct or a lack of competence, the Panel would go on to consider whether the Registrant’s fitness to practise is currently impaired as a result of that misconduct or lack of competence.

117. Given the Panel’s findings in relation to the facts found proved, it concluded that the Registrant, by failing to keep accurate records which posed a risk to patient care, breached standards 6 and 10 of the HCPC’s “Standards of Conduct, Performance and Ethics”, and Standard 10 of the HCPC “Standards of Proficiency for Physiotherapists.

118. However, the Panel was mindful that a finding of misconduct / lack of competence did not necessarily follow as a result.

119. The Panel carefully considered the seriousness of the Registrant’s failings. In doing so, it identified that the Registrant’s poor record-keeping was repeated over a period of several months and, as identified by Colleague C and accepted by the Registrant, posed a significant risk to service users, even though there was no evidence of actual harm having been caused. The Registrant’s failings also included repeated examples of failing to make any notes of a number of appointments carried out by him.

120. The Panel was mindful that it cannot make a finding of both misconduct and a lack of competence in respect of the same Particular. It has had regard to the fact that Colleague C stated that initially, after joining Pendulum, there were no concerns regarding the Registrant’s record-keeping. It therefore concluded that this was not a case where the Registrant could be said to be incapable of keeping accurate records. In the circumstances, the Panel concluded that the Registrant’s failings could more properly be characterised as misconduct rather than a lack of competence.

121. For the reasons set out above, the Panel concluded that the matters found proved and subsequent breaches of the HCPC’s “Standards of Conduct, Performance and Ethics”, were sufficiently serious departures from the standards expected of a Physiotherapist as to amount to misconduct.

122. Having carefully considered the advice received from the Legal Assessor, the Panel therefore found that the Registrant’s conduct in relation to Particulars 1 and 2, both individually and collectively, amounted to misconduct.

Decision on Impairment

123. The Panel went on to decide whether, as a result of his misconduct, the Registrant’s fitness to practise is currently impaired.

124. The Panel had regard to all of the evidence presented in this case, including the submissions of Mr Schofield and those of Mr Hamill. The Panel also heard and accepted the advice of the Legal Assessor and took into account the HCPTS’s Practice Note on “Fitness to Practise ‘Impairment’”.

125. Physiotherapists are expected at all times ensure that their conduct justifies both service users’ and the public’s trust in the profession. Omitting to make patient records, or to make incomplete and inadequate records, unquestionably undermines the trust the public can have, both in the Registrant and in the profession generally. In this regard, the Panel considered the judgement of Mrs Justice Cox in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) in reaching its decision. In paragraph 74, she said:

“In determining whether a practitioner’s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances.”

126. Mrs Justice Cox went on to say in Paragraph 76:

“Do our findings of fact in respect of the doctor’s misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he:

a. 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

b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or

c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or

d. has in the past acted dishonestly and/or is liable to act dishonestly in the future”.

127. Given its findings regarding the risk the Registrant’s conduct posed to service users, and the extent of his failings repeated over a period of several months, the Panel considered that limbs a, b and c were all engaged by the Registrant’s conduct.

128. In relation to the Registrant’s record-keeping, in assessing future risk the Panel noted that the Registrant displayed some insight in that he had reflected on the importance of accurate record-keeping. It concluded that in relation to the Registrant’s work with [Redacted], robust governance and procedures were in place to ensure there was proper oversight of the Registrant’s work, and that it was being effectively monitored.

129. However, in relation to the Registrant’s private practice, the Panel concluded that the Registrant was unable to sufficiently demonstrate or evidence that adequate oversight procedures were in place to prevent a repeat of the Registrant’s misconduct. The Panel was not satisfied that the Registrant’s review of his own record-keeping, albeit on a weekly basis, was a sufficient safeguard in place such that it could be satisfied that his misconduct was highly unlikely to be repeated, notwithstanding that no further complaints have been made against him.

130. The Panel noted that the Registrant had not undertaken dedicated record-keeping CPD courses and had not sufficiently evidenced what further education or training he had received with particular reference to record-keeping.

131. The Panel was therefore not satisfied that the Registrant had, in practice, remediated his failings. In the circumstances, it concluded that there remained an ongoing risk of repetition of his misconduct.

132. As such, the Panel determined that the Registrant’s fitness to practise is impaired on the personal component.

133. The Panel also took into account the overarching objectives of the HCPC to protect, promote, and maintain the health, safety, and wellbeing of the public and patients, and to uphold and protect the wider public interest, which includes promoting and maintaining public confidence in the Physiotherapy profession and upholding proper professional standards for members of the profession. The Panel therefore considered that, given the ongoing risks identified, and failings that had had yet to be fully remediated, public confidence in the profession would be undermined if a finding of impairment were not made in all the circumstances.

134. Having regard to all of the above, the Panel found that by reason of his misconduct, the Registrant’s fitness to practise is also currently impaired on the public component of impairment.

Sanction

HCPC’s submissions

135. Mr Schofield did not make any specific submission that any particular sanction should be imposed. He reminded the Panel that sanction was a matter for the Panel’s judgment.

136. He identified a number of mitigating factors, recognising the Registrant’s remorse, apology and insight into his failings, noting that he admitted his record-keeping failings in response to the Investigating Committee from the outset.

137. He referred the Panel to the HCPC’s Sanctions Policy (“SP”) and identified each of the available sanctions and the circumstances in which each might be appropriate.

138. Mr Schofield submitted that the Registrant had yet to fully remediate his failings and that the Panel had identified an ongoing risk of harm to the public. However, he suggested that there was nothing about the Registrant to suggest that remediation would not be possible, particularly given that the Registrant’s misconduct did not relate to the type of conduct characterised as ‘Serious cases’ in the HCPC’s Sanctions Guidance.

139. Mr Schofield submitted that this was not a case where taking no action or mediation would be appropriate, and questioned whether a caution order would be sufficient to ensure that the ongoing risk of patient harm would be addressed by such an outcome.

140. He submitted that a Conditions of Practice Order, imposing training, supervision and audit requirements, however, might address those ongoing risks.

141. Finally, Mr Schofield accepted that imposing a period of suspension or a striking-off order would be disproportionate in all the circumstances.

Registrant’s submissions

142. Mr Hamill referred the Panel to the SP and identified the factors that would demonstrate when any particular sanction was appropriate.

143. He submitted that it was of significance that the risk of repetition was low and therefore the risk of damage to public confidence in the profession was reduced. He reminded the Panel of its earlier finding that record-keeping failings are remediable and that the Registrant has gone some way to addressing his failings.

144. Mr Hamill recognised that the Panel had identified a risk of harm from the Registrant’s conduct, even though no actual harm was caused. However, he asked the Panel to bear in mind the following relevant features of this case, namely:

• The misconduct was an aberration in an otherwise unblemished career;
• These were a series of failures which occurred in 2020-2021 so a considerable amount of time had passed;
• The failures arose in a difficult working environment. There was significant pressure on the Registrant (and his colleagues);
• The Registrant had developed as a person and a health practitioner in the intervening years despite, the stress of this case hanging over him;
• The Registrant was quite inexperienced at the time of the misconduct;
• He was clearly a skilled and now more experienced practitioner who, other than this matter, has been, and is a credit to the profession;
• He works in various roles both in private practice and in elite sport with a high level of responsibility. He referred the Panel to the Registrant’s evidence and the references submitted on his behalf;
• The Panel has the benefit of a range of character evidence who all speak of the Registrant in very positive terms. They were aware of the nature of the allegations made in these proceedings;
• The Registrant was remorseful and has learnt from this experience
• The Registrant has always accepted responsibility for the failings identified;
• He has cooperated with and engaged with the regulatory process;
• It was submitted the Registrant has a significant degree of insight. He was able to articulate the impact his actions had not only on service users but also his colleagues and the profession at large and the reputation of the profession; and
• It was submitted that whilst not negligible, the risk of repetition was low.

145. In terms of sanction, Mr Hamill conceded that the Panel was unlikely to take no action.

146. He submitted that a caution order was appropriate. He referred the Panel to paragraphs 100 onwards of the SP which indicated that a caution order might be appropriate where:

• The issue was isolated, limited or relatively minor in nature;
• There was a low risk of repetition;
• The Registrant has shown good insight, and
• The Registrant has undertaken appropriate remediation.

147. Mr Hamill accepted that there was a mixed picture in relation these factors. However, he submitted that the Panel could have regard to the context of the misconduct which was limited to a period of time with a particular employer in which there were certain difficulties which compounded matters in terms of the time pressures and IT issues. The issues had not manifested themselves beforehand and have not been repeated since. He invited the Panel to consider the question of sanction “in the round” rather than by way of a “checklist” approach.

148. He then submitted that if the Panel was not minded to impose a Caution Order, then this case met the ‘test’ for the imposition of a Conditions of Practice Order. He submitted that conditions can be drafted in such a way as to address the finding of impairment. The Registrant could be required to undertake CPD training which is tailored specifically to record keeping issues, and could have a more formal audit carried out on his record keeping within his private practice. Conditions going beyond that were, he submitted, likely to represent a disproportionate interference with the Registrant’s right to practise in as unrestricted a way as possible.

149. Finally, Mr Hamill submitted that either a striking-off order or suspension would be entirely disproportionate and would in fact be a disservice to the profession and to the public at large.

150. In relation to the length of any proposed Conditions of Practice Order, Mr Hamill submitted that a 6 month order would give the Registrant sufficient time to adequately address his misconduct.

Decision on Sanction

151. The Panel accepted the advice of the Legal Assessor who referred it to the SP. He reminded the Panel that it should consider any sanction in ascending order, and to apply the least restrictive sanction necessary to protect the public and the public interest. It should also consider any aggravating and mitigating factors and bear in mind the principle of proportionality. He reminded the Panel that the primary purpose of imposing a sanction was protection of the public and the public interest and that there was a need to balance those interests with the interests of the Registrant.

152. In reaching its decision on whether to impose a sanction, and if so, which one, the Panel has reminded itself of its conclusions in relation to the seriousness of the Registrant’s misconduct as set out in its determination on impairment. The Panel had concluded that the Registrant continued to pose an ongoing risk to the public, and that there remained a risk of repetition of his misconduct until such time as the Registrant could demonstrate that his failings had been fully remediated. As such, any sanction should reflect the need to uphold the public interest and mark the seriousness of the misconduct found proved.

153. The Panel considered all the information before it. In doing so, the Panel identified the following aggravating factors:

• That the Registrant’s record-keeping failures were repeated over several months; and
• Even though no actual harm was caused, the potential for patient harm was significant.

154. The Panel identified the following mitigating factors:

• The Registrant’s misconduct represented an isolated incident that has not been repeated.;
• The Registrant does not have any previous regulatory findings recorded against him;
• He admitted his failings at the outset of this hearing and made early admissions to the Investigating Committee;
• There has been a significant expression of remorse, regret and apology;
• There was no evidence that the Registrant had an entrenched attitudinal issue, and he had engaged positively with the regulatory process and had expressed a willingness to engage with the process of addressing his failings;
• As corroborated by Colleague B, the Registrant at the time was working in a challenging and difficult working environment; and
• The Registrant has produced a number of positive references attesting to his character and professionalism.

155. The Panel approached the issue of sanction starting with the least restrictive first, bearing in mind the need for proportionality and to take into account the Registrant’s interests. Having done so, it concluded that taking no further action would not reflect the nature and gravity of the misconduct. The Panel concluded that taking no action would not be adequate to protect the public or the wider public interest of maintaining confidence in both the profession and the regulatory process given the ongoing risks identified. Such an outcome was therefore neither appropriate nor proportionate in the circumstances.

156. The Panel next considered mediation, but having had due regard to the circumstances of this case, such an outcome was inappropriate to address the issue of poor record-keeping. It therefore concluded that this was not an appropriate outcome.

157. The Panel then considered whether to impose a Caution Order and had regard to paragraphs 99-102 of the SP. Noting that many of the relevant factors that would justify such an outcome were present, the Panel nevertheless concluded that this was also not an appropriate outcome because the Panel considered that there remained an ongoing risk of repetition given the Registrant’s incomplete remediation.

158. The Panel next considered whether a Conditions of Practice Order was appropriate. It had regard to paragraphs 105-109 of the SP. Having done so, it has concluded that such a sanction would be appropriate and proportionate to specifically address the public protection and public interest concerns identified. The Panel concluded that workable and appropriate conditions could be formulated that would meaningfully address the Registrant’s misconduct.

159. In the circumstances, the Panel concluded that imposing a Conditions of Practice Order was the appropriate sanction to impose.

160. To satisfy itself that a Conditions of Practice Order was the appropriate and proportionate sanction to impose, the Panel considered whether a Suspension Order was justified. It had regard to paragraph 121 of the SP which states that a Suspension Order may be appropriate where “there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register”. The Panel had regard to the substantial mitigating factors identified in this case, noting that the Registrant’s misconduct related to a specific failing that was remediable, and where the Registrant was willing and potentially able to address his failings. The Panel noted that the Registrant was an otherwise competent and respected practitioner. In the circumstances, the Panel concluded that imposing a Suspension Order would be disproportionate.

161. The Panel therefore imposed a Conditions of Practice Order for a period of 6 months. The Panel concluded that that was an appropriate and proportionate period of time to enable the Registrant to allow him an adequate period of time to fully remediate his failings.

162. So far as any future review is concerned, the Panel considered a future reviewing panel would be assisted by:

• His attendance at any review hearing; and
• Any other evidence the Registrant considered would assist him to demonstrate that he is suitable to return to unrestricted practice.

163. The Panel accordingly determined to impose a Conditions of Practice Order for a period of 6 months.

ORDER: The Registrar is directed to annotate the Register to show that, for a period of 6 months from the date that this Order comes into effect (“the Operative Date”), you, Scott R E Hughes, must comply with the following conditions of practice:

1. Within three months of the Operative Date you must:

A. satisfactorily complete a course on record-keeping; and

B. forward a copy of your results to the HCPC within seven days of receiving them.

2. In respect of any work undertaken in your independent sports injury clinic, you must place yourself and remain under the indirect supervision of a workplace supervisor, registered by the HCPC of Band 7 or equivalent or other appropriate statutory regulator and supply details of your supervisor to the HCPC within 1 month of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations. Such supervision may not be carried out online.

3. You must arrange for an audit of the following areas of your practice in your independent sports injury clinic by your supervisor every month: Record-keeping. You must send the HCPC a copy of the results of each audit within seven days of receipt.

4. You must inform the HCPC within seven days if you cease to be employed by your current employer.

5. You must inform the HCPC within seven days if you take up any other or further professional work.

6. You must inform the HCPC within seven days if you take up work requiring registration with a professional body outside the United Kingdom

7. You must inform the HCPC within seven days of returning to practice in the United Kingdom.

8. You must inform the HCPC within seven days of becoming aware of:

A. any patient safety incident you are involved in;

B. any investigation started against you; and

C. any disciplinary proceedings taken against you.

9. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work;

B. any agency you are registered with or apply to be registered with to undertake professional work (at the time of application);

C. any prospective employer for professional work (at the time of your application);

D. any organisation through which you are undertaking professional training;

10. You must allow the HCPC to share, as necessary, details about your performance, compliance with, and/or progress under these conditions with:

A. any organisation or person employing or contracting with you to undertake professional work;

B. any agency you are registered with or apply to be registered with to undertake professional work (at the time of application);

C. any prospective employer for professional work (at the time of your application);

D. any organisation through which you are undertaking professional training.

Interim Order

1. Mr Schofield applied for an Interim Conditions of Practice Order in light of the Panel’s determination on sanction, on the grounds that it was necessary for the protection of the public, and was otherwise in the public interest to cover the appeal period. He referred to the SP with particular reference to paragraphs 133 onwards with reference to interim orders and the HCPTS’s Practice Note on Interim Orders. He applied for an Interim Conditions of Practice Order for a period of 18 months to cover the length of time it may take for any appeal to be considered.

2. Mr Hamill on behalf of the Registrant did not specifically oppose the application. He said it was a matter for the Panel to consider in light of the fact that the Registrant had continued to practise without any further concerns being raised. As such, he submitted that there was little risk to guard against but submitted that it was a matter for the Panel to determine.

3. The Panel was mindful that when a substantive sanction is imposed, a Registrant’s entitlement to practise is unrestricted whilst their appeal rights against the substantive sanction remain outstanding. The Panel concluded that in view of its determination that a Conditions of Practice Order should be imposed, it would not be appropriate for the Registrant to return to unrestricted practice given the Registrant’s lack of complete remediation and the ongoing risk of repetition of his misconduct.

4. The Panel therefore decided to impose an interim order under Article 31(2) of the Health Professions Order 2001, it being necessary to protect members of the public and being otherwise in the public interest, which outweighed the Registrant’s personal and professional interests.

5. It first considered whether to impose an Interim Conditions of Practice Order. The Panel concluded that such an interim order would be appropriate given its rationale for its earlier determination on sanction. It considered that in light of that determination, an Interim Conditions of Practice Order is necessary for protection of the public and is also in the public interest. It would be wholly incompatible with the Panel’s findings and its decision as to sanction not to impose an Interim Conditions of Practice Order with the same conditions.

6. The Panel concluded that the appropriate length of the Interim Conditions of Practice Order should be 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event that the Registrant submits a Notice of Appeal within the 28-day period. This Interim Conditions of Practice 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) on the final determination of that appeal, subject to a maximum period of 18 months.
Decision

The Panel makes an Interim Conditions of Practice 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.

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 Scott R E Hughes

Date	Panel	Hearing type	Outcomes / Status
06/05/2025	Conduct and Competence Committee	Final Hearing	Conditions of Practice