Alice Langley

Preliminary Matters:

Privacy

1. At the beginning of the hearing, the Panel considered an application on behalf of the Registrant made by Ms Khorrasani, Presenting Officer from the HCPC. Ms Khorrasani applied for parts of the hearing to be conducted in private as reference may be made to the Registrant’s health and private life.

2. Having received advice from the Legal Assessor, the Panel granted that application in view of the principles set out in the HCPTS Practice Note, Conducting Hearings in Private. The Panel determined that those parts of the hearing that concern the Registrant’s health and private life should be conducted in private.

Background:

3. The Registrant is a registered Speech and Language Therapist (SLT) who was employed by the Royal Wolverhampton NHS Trust (the Trust) as a Band 5 SLT from 2 February 2009 to 20 January 2017.

4. In June 2015, the Trust carried out an audit of the Registrant’s caseload which revealed a number of concerns regarding her record-keeping. The concerns included:

• issues with the quality of reports produced;
• a lack of reports produced;
• a lack of treatment plans;
• a lack of Identification of Need Tool (INT) documentation; and
• the recording of inaccurate information.

5. The Trust then carried out seven months of informal monitoring of the Registrant’s practice, during which the Registrant met weekly with her Line Manager to review her progress.

6. In February 2016, as there had been no significant improvement in the Registrant’s record-keeping, the Trust commenced Stage One of its Capability Process. During a meeting in May 2016, the Trust’s ongoing concerns were raised with the Registrant with a view to escalating the matter to a Stage Two Capability Meeting. Subsequently, the Registrant was re-deployed to non-clinical duties from May 2016 to June 2016.

7. During the period covered by the Allegation, the Registrant had three periods of sick leave: 30 July 2015 to 7 August 2015 (9 days); 14 August 2015 to 11 September 2015 (29 days), and 2 April 2016 to 29 April 2016 (18 days). The Registrant was referred to Occupational Health on a number of occasions in 2015 and 2016. At a meeting on 24 May 2016 held as part of Stage 1 of the formal Capability Process, the Registrant made further, more detailed disclosures about on-going health issues. Between February and September 2016, the Registrant’s health and capability issues were managed under the Trust’s Capability and Sickness and Absence Policies.

8. On 2 September 2016, a Stage Two Capability Meeting was held. From 2 September 2016 to January 2017, the Registrant was redeployed to a clerical role within the Orthopaedics department. The Registrant left the Trust on 20 January 2017.

9. On 28 June 2017 the Trust referred the Registrant to the HCPC, and, on 12 March 2021, a panel of the Investigating Committee found that there was a case for the Registrant to answer and referred an Allegation to the Conduct and Competence Committee.

10. The Final hearing in relation to this matter took place in 2023 and concluded in 2024. The Registrant did not attend the hearing and was not represented at it.

11. A panel of the Conduct and Competence Committee found that the failings identified in the Registrant’s professional practice were wide ranging and that her deficiencies constituted a lack of competence in relation to the following areas: not completing the Identification of Need tool form for service users; not completing reports for service users in a timely manner; not closing service user records on the Trust’s case management system; not completing and/or saving service user records onto the Trust’s drives; not ensuring that service users were reviewed regularly; not completing case notes; not completing records to the required standard; not following up with service users; not discharging service users; and not completing treatment plans to the required standard.

12. In coming to its decision on impairment at the Final hearing, the panel commented as follows: “The Panel is satisfied that the Registrant’s lack of competence is remediable. The Trust’s capability process which the Registrant was required to undertake, was intended to allow her to achieve and maintain the relevant standards of practice as a Band 5 SLT. However, as the Registrant has not engaged with these proceedings, there is no evidence before the Panel to show that she has taken any steps since leaving the Trust to remedy her lack of competence. The Panel notes that the Registrant was able to make some progress in some areas of her practice during the capability process, but that she was not always able to maintain this. The Registrant has not shown that she has insight into her lack of competence and its effect on the Service Users concerned, on her colleagues, or on her profession. There is no evidence that the Registrant has properly reflected on her lack of competence. The Panel also notes that while the Registrant’s state of health at the relevant time may have been a factor contributing to her lack of competence, it has no evidence of the current state of her health and how she is managing this. The Panel has concluded that, in the absence of any information to show that the Registrant has taken steps to remedy her shortcomings, there is a real risk of repetition in this case.”

13. The panel found that the Registrant’s fitness to practise was impaired both on the grounds of public protection and from the point of view of the public interest.

14. That panel imposed a Suspension Order for a period of 12 months and considered that a reviewing panel may be assisted by the attendance of the Registrant; a reflective piece from her, evidencing her insight into the consequences of her shortcomings on not only the service users in her care, but also on her colleagues, her profession, and the wider public; information about what the Registrant has been doing by way of employment, since she left the Trust; up to date references and testimonials; evidence of Continuing Professional Development (CPD) and evidence of keeping her knowledge and skills up to date; and evidence from the Registrant’s GP as to the current state of her health and how the Registrant is managing this.

15. The Substantive order was first reviewed 16 September 2024. The panel determined that the Registrant’s fitness to practise was currently impaired, noting that the Registrant’s case had not moved on factually since the Final hearing. The Registrant submitted that she was committed to regaining her good health and confidence in the workplace in a non-registered role, outside of the healthcare setting, and as such she did not wish to return to practice.

16. The panel noted that it did not have the power to impose a sanction of strike off as the matters were lack of competence concerns and the Registrant had not been subject to a substantive order for two years or more.

17. The panel imposed a sanction of a further 12 months suspension. The panel noted that a future panel would be assisted by the following;

• The Registrant’s attendance at the next review hearing, either in person or remotely;

• A written statement or declaration/signed undertaking from the Registrant setting out her future intentions in relation to her professional practice as an SLT.

• If the Registrant on reflection wished to re-establish her career as an SLT then evidence of acting on the suggestions made by the final hearing panel would assist a future panel.

Evidence

18. The Registrant attended today’s hearing and represented herself. She gave oral evidence to the Panel. The Registrant referred the Panel to her written submissions in which she stated she wished to make unequivocally clear that she has not practised a speech and language therapist for approximately 9 years. The Registrant stated that she had no intention of returning to the profession and the last time she practised was in 2016. The Registrant noted that since then she has been pursued a different career path entirely and is now working as a training officer in the local council. The Registrant stated she has a professional life which is firmly established outside of the healthcare sector.

19. The Registrant noted that she has not undertaken any CPD refresher courses or clinical work relating to speech language therapy. She stated that this was her intention because she wishes to continue a career outside of the profession. She stated that she has fully complied with the order and has not sought work in a speech and language role.

20. The Registrant noted that she carefully reviewed the suggestions of the panel on the previous occasions but has no intention to return to the profession and as such she has not gathered any such evidence. She stated her intentions were to formally depart from the register.

21. The Registrant submitted that there is no continuing risk to the public arising from her past practice. She stated she will not be practising in the future, and her preferred outcome would be for the Panel to conclude that her fitness practise is no longer impaired and to allow the suspension order to lapse. The Registrant stated that the option of voluntary removal from the register was never discussed with her.

22. The Registrant stated that it was very clear that her career has ended and she wished to “move on”. The Registrant noted that the proceedings have had a huge impact on her and she needs to be able to put an end to matters.

Submissions:

23. Ms Khorrasani referred the Panel to the background and history of this matter. Ms Khorrasani submitted that the Registrant’s fitness to practise continues to be impaired and that an order striking off the Registrant from the register would be appropriate in this case. Ms Khorrasani submitted that the Registrant has not provided evidence of compliance with the suggestions made to her by the previous substantive order review panel and has provided no evidence of any remediation. She submitted that, in light of the Registrant’s stated intention not to work in a registered role as a Speech and Language Therapist, neither a conditions of practice order, nor a suspension order would be appropriate. She referred the Panel to the judgment in Abrahaem v GMC [2008] EWHC 183 (Admin) and noted that the Registrant had not discharged the persuasive burden upon her to demonstrate she was no longer impaired. She further submitted that allowing the current Order to lapse upon its expiry would not sufficiently protect the public. She noted that the Registrant is of working age, able to work, and could decide to re-register in the future.

24. The Registrant confirmed to the Panel that she had no further submissions to make.

Decision:

25. This Panel accepted the advice it received from the Legal Assessor as to the proper approach that it should adopt and had regard to the HCPTS Practice Notes entitled “Review of Article 30 Sanction Orders” and “Fitness to Practise Impairment”. The Panel is carrying out a comprehensive reconsideration of the Suspension Order in light of the current circumstances. The Legal Assessor advised that, in practical terms, there was a persuasive burden on the Registrant to show that her fitness to practise is no longer impaired and that all the shortcomings which led to the original finding of impairment have now been overcome. The Panel was referred to the case of Abrahaem v GMC [2008] EWHC 183 (Admin) and the principle that it is for a registrant to fully acknowledge why past performance was deficient and demonstrate that they have, “through insight, application, education, supervision and other achievement … sufficiently addressed the past impairments”.

26. The Panel bore in mind that it must first decide if a finding of current impairment is necessary to protect the public from any risk of harm (assessing the extent of any current or future risk), to maintain public confidence in the profession, or to declare and uphold the proper standards of conduct or behaviour. This is a matter for the Panel’s independent judgment. The Panel bore in mind that any approach to the issue of whether a Registrant’s fitness to practise should be regarded as impaired must take account of the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.

27. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. When undertaking this review, the Panel took into account all of the documentation before it and the new evidence provided by the Registrant by way of her oral evidence. It also considered the submissions of both parties.

28. The Panel considered that there had been no material change in circumstances since the last review. The Registrant has clearly and repeatedly stated her intention is not to continue practising within the profession. The Registrant has made clear that in acting on this intention she has not followed any of the steps highlighted by previous panels, as helpful should she wish to return to the profession.

29. The Panel considered that while the Registrant had provided a statement in respect of these matters, it solely addressed that impact of the matters upon herself. Further, the Panel noted the summary record of the Registrant’s evidence at the previous review hearing contained in its Decision document, where it is noted that she stated, “She has struggled to recover from the trauma of having to leave her career as an SLT, having worked so hard to achieve her registration.” The Panel considered that it had no evidence before it that the Registrant has reflected on the impact that her deficiencies may have had on service users, her colleagues, the public or the wider profession. The Panel considered that the Registrant has not expressed remorse in respect of the deficiencies found in respect of her practice and has not demonstrated insight into the issues which have led previous panels to find impairment.

30. The Panel considered that the Registrant has not taken any steps to remediate the deficiencies found proved at the Final hearing and, as such, it determined that the Registrant’s fitness to practise continues to be impaired.

31. In the absence of any evidence of insight, reflection focused upon others or remediation, the Panel considered there was a clear risk of repetition of the failings identified. The Panel therefore concluded that the Registrant remained liable to put service users at risk of harm in the future and that the Registrant remained impaired on the personal component.

32. The Panel then considered the public component and the wider public interest in the case. The Panel was of the view that, in the absence of insight, remediation and remorse, members of the public would be concerned if such a registrant were able to practise without restriction. In those circumstances, the Panel was of the view that the need to protect the public, and to uphold confidence in the profession and the regulator would be undermined if a finding of impairment were not made.

33. The Panel next considered the issue of sanction and had in mind the HCPC’s Sanctions Policy. The Panel was aware that sanction is a matter for its own professional judgement. It has borne in mind that any sanction must be proportionate and that the primary purpose of sanction is protection of the public. Any sanction it imposes must protect the public but must be the least restrictive sanction that achieves that aim.

34. The Panel first considered taking no action in this case and allowing the current Suspension order to lapse upon its expiry. It was mindful of the Registrant’s evidence that she is no longer paying her professional fees and was of the view that her registration as an SLT is only active by virtue of this regulatory hearing process. On the other hand, the Panel was mindful of the HCPC’s submission that the Registrant is of working age and able to work as an SLT and that her stated intentions not to work as an SLT could change. The Panel was of the view that there is a continuing risk to the public and that the public would not be suitably protected and the public interest would not be suitably upheld by allowing the current Order to lapse.

35. The Panel next considered a caution order and decided that this would not be appropriate, because it would not place any actual restriction on the Registrant’s practice to address the public protection concerns.

36. The Panel then considered whether a period of conditions of practice would be appropriate. The Panel noted that the imposition of a conditions of practice order requires a registrant to engage fully with the fitness to practise process to protect the public and improve her professional practice, with a view to returning her to safe and unrestricted practice. The Panel took into account the Registrant’s clearly stated intention not to return to professional practice and, as such, determined that a conditions of practice order would not be workable, appropriate or practicable in these circumstances.

37. In relation to a suspension order the Panel took into account the guidance within section 121 of the HCPTS Sanctions policy which states that such an order would be appropriate in the following situations:

• the concerns represent a serious breach of the Standards of conduct, performance and ethics;
• the registrant has insight;
• the issues are unlikely to be repeated; and
• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings

38. The Panel considered that the Registrant had shown no insight and there was nothing to support findings that the risk of repetition had been addressed. Further, there was nothing to demonstrate that the Registrant would resolve those failings, given the Registrant’s expressed intention not to return to practice.

39. The Registrant has clearly stated that she no longer wishes to practise, she has stated she wants to move on, therefore the Panel considered that imposing a Suspension Order for a further period of time would not be in the Registrant’s own interests. Additionally, to continue with this Article 30 review process would incur more expense to the public and it is not in the public's interest.

40. In relation to the imposition of a Striking-Off Order the Panel took into account the terms of paragraph 131 of that guidance which states that it is appropriate in situations where the Registrant lacks insight and there is no willingness to resolve the issues. In the Panel’s view this is the position in this case.

41. The Panel therefore concurred with the HCPC’s position that the appropriate and proportionate sanction in this instance was the imposition of a striking-off Order. Such an Order will permanently remove the Registrant’s name from the HCPC Register with effect from 12 October 2025.

42. Finally, the Panel wished to record that whilst its decision today reflects the Registrant’s current views, there may come a day when those views change. The Registrant should therefore be aware that if in five years’ time she is able to provide the HCPC with evidence that she has addressed the deficiencies in her practice and reflected upon the impact these deficiencies had on others, she may wish to produce evidence that she is, subject to further training, fit to return to the profession.

The Registrar is directed to strike the name of Ms Alice Langley from the Register.

The Order imposed will apply from 12 October 2025.

History of Hearings for Alice Langley