Mr Stuart Martyn Hill

Profession: Social worker

Registration Number: SW31671

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 23/04/2018 End: 16:00 25/04/2018

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

During the course of your employment as a Social Worker at Defence

Primary Health Care, between 6 June 2015 and 13 May 2016, you:

1. Did not undertake contact and/or record contact in the cases of:

a) Service User 2;

b) Service User 3;

c) Service User 11;

d) Service User 12;

e) Service User 13;

f) Service User 14;

g) Service User 17;

h) Service User 18 ;

i) Service User 19 ;

j) Service User 26;

k) Service User 27;

l) Service User 28;

m) Service User 31;

n) Service User 32;

o) Service User 33;

p) Service User 34;

q) Service User 38;

r) Service User 39;

s) Service User 40;

2. Did not maintain records and/or maintain records in a appropriate

manner in the cases of:

a) Service User 1;

b) Service User 4;

c) Service User 5;

d) Service User 6;

e) Service User 7;

f) Service User 8;

g) Service User 9 ;

h) Service User 10;

i) Service User 15 ;

j) Service User 16 ;

k) Service User 20 ;

l) Service User 21 ;

m) Service User 22 ;

n) Service User 23;

o) Service User 24;

p) Service User 25;

q) Service User 29 ;

r) Service User 30;

s) Service User 35;

t) Service User 36 ;

u) Service User 37;

3. The matters set out in paragraphs 1 - 2 constitute misconduct and / or

lack of competence.

4. By reason of your misconduct and/or lack of competence your fitness to

practise is impaired.

Finding

Preliminary matters:
Service


1. The Panel heard that notice in respect of this hearing was sent by first class post and email to the Registrant’s registered address on 30 January 2018 in accordance with Rules 3 and 6 of the Conduct and Competence Procedure Rules 2003.


2. The Panel heard and accepted the advice of the Legal Assessor and determined that the notice had been served in accordance with the Rules.

Proceeding in the absence of the Registrant


3. The Presenting Officer invited the Panel to proceed in the absence of the Registrant. She provided the Panel with a bundle of correspondence between the HCPC and the Registrant between September 2017 and 20 April 2018. She informed the Panel that while there has been some communication between the HCPC and the Registrant both prior to and subsequent to the service of the notice of hearing, the Registrant contacted the HCPC on Friday 20 April 2018 to state that he would not be attending this hearing.  

   
4. The Presenting Officer referred the Panel to the guidance contained in the HCPTS Practice Note on ‘Proceeding in the Absence of the Registrant’ and submitted that in the circumstances it was appropriate for the Panel to exercise its discretion to proceed on the basis that the Registrant had chosen not to attend the hearing and had waived the right to appear. She submitted that the public interest in the expeditious disposal of the Allegation outweighed any disadvantage to the Registrant in proceeding in his absence. She noted that the Registrant has not sought an adjournment and submitted that no useful purpose would be served in adjourning the matter

.
5. The Panel heard and accepted the advice of the Legal Assessor who reminded it of the guidance provided in the cases of R v Jones [2002] UKHL5, Adeogba v the General Medical Council [2016] EWCA Civ 162 and Davies v HCPC [2016] EWHC 1593 (Admin).


6. The Panel recognised that the discretion to proceed in the absence of a registrant is one which must be exercised with the utmost care and caution and that its decision should be guided by the overarching objective to protect the public.

7. In reaching its decision, the Panel had regard to the nature and circumstances of the Registrant’s behaviour in absenting himself. It noted that in his email dated 20 April, he had stated “I will regrettably be unable to attend due to combination of poor health and lack of communication”. However, he had provided no details of his poor health or when and if he might be able to attend, and had not requested an adjournment. The Panel was concerned that, despite having been informed of the purpose of today’s hearing, the Registrant appears to regard the event as a meeting rather than as the final hearing of the Allegation that has been made against him.


8. In all the circumstances, the Panel concluded that the Registrant had voluntarily absented himself and had waived his right to be present. The Panel balanced the public interest in the timely disposal of the Allegation with any disadvantage to the Registrant should the hearing proceed in his absence. In respect of disadvantage to the Registrant the Panel noted that the Registrant had previously submitted written representations for the consideration of the Investigating Committee and that these representations would be available for consideration by this Panel should it decide to proceed. Further, the Panel is independent of the HCPC and the Legal Assessor would ensure that proceedings were conducted fairly. The Panel also had in mind that an adjournment may have a deleterious effect on the memory of the witness in attendance, given that some of these events date back to 2015, and also took into account inconvenience to that witness.


9. The Panel had no reason to believe that, if it were to adjourn the hearing, the Registrant would attend on the next occasion.


10. For the reasons set out above, the Panel concluded that it would be fair and in the interests of justice to proceed in the absence of the Registrant.


Application to amend Particulars

11. The Presenting Officer applied to amend the Particulars of Allegation on the basis that the proposed amendments would mean that the Particulars would more clearly set out the case against the Registrant. She said that the amendments would not materially change the case and would not disadvantage the Registrant.


12. The Panel heard that notice of the proposed substantive amendments had been sent to the Registrant by first class post on 24 November 2017. The Registrant had not lodged any objection to those. The Presenting Officer pointed out that there were some minor additional amendments proposed in order to address what would become numbering errors if the substantive amendments were permitted.


13. The Panel heard and accepted the advice of the Legal Assessor.

14. The Panel accepted that the amendments would mean that the Particulars would more accurately reflect the case against the Registrant and would not materially change the case against him. For these reasons, the Panel concluded that there would be no disadvantage or injustice to the Registrant if it allowed the application.


15. The Panel agreed to the amendments.


Background


16. The Registrant began his employment as a locum Senior Worker at the Department of Community Mental Health (DCMH) in the Defence Mental Health Social Service within Defence Primary Health Care, Ministry of Defence in 2007. His role became permanent in 2014 and he continued to work at DCMH. As a senior Social Worker, the Registrant is an experienced practitioner. The service users consisted of Armed Services personnel and eligible veterans, all with serious mental health problems and some with additional health issues. The service provides mental health care and treatment. As a social worker within the DCMH, the Registrant’s role would mainly be to support service users through the medical discharge pathway. Care and treatment is noted in an integrated health record, Defence Medial Information Capability Programme (DMICP).


17. In May 2016, the Registrant was suspended from his role pending investigation into a matter unrelated to the current allegation. At a disciplinary hearing on 20 July 2016 he was dismissed. However, he successfully appealed the decision to dismiss him and was reinstated in January 2017. As a result of the dismissal, his line manager reviewed his caseload after he left and audited his case notes. She identified a number of concerns. These related to cases for which there was no recorded contact made at all with service users following referral to the service and cases where there was no follow up contact made or recorded with service users following initial appointments. A referral was made to the HCPC in respect of these concerns.


Decision on facts


18. In considering the Particulars, the Panel applied the principles that the burden of proving the facts is on HCPC, that the Registrant is not required to prove anything and that any fact alleged is only to be found proved if the Panel is satisfied on the balance of probabilities that it is correct.


19. In reaching its decisions, the Panel had careful regard to all the evidence put before it and to the submissions of the Presenting Officer.

20. The Panel heard oral evidence from Witness 1, a registered Social Worker who, at all material times, was the Registrant’s line manager. The Panel found her to be an open, clear, fair and highly credible witness.


21. Witness 1 told the Panel that she joined DCMH in January 2015. At this time she became the Registrant’s line manager. She said he was away on sick leave from 20-27 January 2015, and then off work while an incident involving his former line manager was investigated. He returned to work on 29 June 2015. He remained at work until May 2016 when he was suspended for a second incident unrelated to the current Allegation. As a result of this incident, the Registrant was dismissed on 20 July 2016. He successfully appealed against this dismissal and was reinstated in January 2017. On his return, Witness 1 informed him that she had referred him to the HCPC in respect of the current Allegation. She told the Panel that the Registrant went on long term sick leave on 29 September 2017 and is still on sick leave.


22. Witness 1 told the Panel that in April 2016, prior to his 20 July 2016 dismissal, the Registrant had agreed to have weekly supervision sessions with her in order to bring his caseload up to date. She said that in a supervision session on 11 April 2016 the Registrant advised her that he knew what he needed to do in respect of each of his service users. She told the Panel that the notes of this supervision made reference to new referrals with whom the Registrant had not made contact, and that she had explicitly asked him to contact these service users as a matter of urgency. She said that during the supervision session the Registrant had given her the impression that he was getting up to date with his work. As a result, she had been left unaware of the scale of the problem.

23. Witness 1 told the Panel that when she reviewed the Registrant’s caseload and audited his case notes after his dismissal on 20 July 2016, she found that there were issues on around 90 per cent of all his cases. She said these related to cases where he had made no contact with Service Users after they had been referred into the service and where he had not recorded follow up actions after conducting initial visits or appointments. She stressed that at no point was there any concern with the content of the notes he did make, which were of good quality.

24. Witness 1 told the Panel that, upon the Registrant’s return to work in January 2017, she discussed the issue of his record keeping with him. She said he acknowledged that there were failings in his record keeping practice but told her that he was unable to offer any explanation for these, and that as his line manager she was partly responsible as there had been a failure in her oversight of him and his work. Witness 1 told the Panel that she accepted that she should have reviewed his case notes before she did. She said however that they had talked about his caseload and he was well up to date with this. It was only after he had been dismissed that she conducted the audit in order to reallocate his work.

25. Witness 1 said that the Registrant never expressed remorse for his failings and that, in her view, he demonstrated no insight into those failings. She told the Panel that he had informed her of personal problems and health issues that might have impacted on his performance. She told the Panel that there were no issues with the Registrant’s training or IT abilities which might explain his failings and that he had never sought additional training.


26. The documentary evidence before the Panel included:

• Witness Statement of Witness 1;
• Review of Registrant’s case, screenshots and comments;
• Registrant’s Supervision Notes;
• Minutes of Return to Work Discussion dated 29 June 2015;
• Introduction to the Clinical Use of DMICP;
• DMICP Assurance Tool for Clinicians;
• DMICP Assurance Tool Guidance Note;
• DMICO Problem Field Guidance;
• DCMH Guidelines for Standards for Record Keeping and Transportation of Notes;
• Surgeon’s General Policy Letter;
• Healthcare Governance Assurance Visit Report dated 24 March 2015;
• Common Assurance Framework;
• DPHC Mandatory Training Policy;
• Minutes of DCMH Social Work Meetings 11 April 2014 and 14 November 2014;
• Timeline of Registrant’s Supervision Meetings with Witness 1;
• The Registrant’s written submissions and representations dated 12 April 2017 for the Investigating Committee Panel.

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

Particular 1 found proved

Did not undertake any contact and/or make any record of contact in the cases of:
a. Service User 2;
b. Service User 3;
c. Service User 11;
d. Service User 12;
e. Service User 13;
f. Service User 14;
g. Service User 17;
h. Service User 18 ;
i. Service User 19 ;
j. Service User 26;
k. Service User 27;
l. Service User 28;
m. Service User 31;
n. Service User 32;
o. Service User 33;
p. Service User 34;
q. Service User 38;
r. Service User 39;
s. Service User 40. 

28. Witness 1 told the Panel that the Registrant was well aware that all new referrals to the service were to be contacted within 15 working days of receipt of referral. However, when she searched the DMICP records for each of the Service Users identified in Particular 1 she found that in some instances no contact had been recorded months after the Registrant had been allocated their case. In some instances she found that other healthcare professionals had recorded being informed of contact having been made by the Registrant, but that no such contact had been recorded by him.
29. Witness 1 told the Panel that the Registrant’s failure to contact Service Users allocated to him raised a significant risk that the care of those service users would be jeopardised. She said that where the Registrant did contact a service user but failed to upload a consultation note, he put such service users at risk because the case notes would not be an accurate reflection of the case, other professionals would not be aware of what action had been taken, what the action plan was or even when the service user had last been visited.


30. The Panel had careful regard to the screenshots of the DMICP records for each of the Service Users listed in Particular 1 and satisfied itself that the Registrant had either not contacted them at all or had made no record of such contact as has taken place.


Particular 2 found proved


2. Did not undertake follow up contact and / or make a record or follow up contact in the cases of:
a) Service User 8
b) Service User 35

31. Witness 1 told the Panel that in the case of Service User 8, it was clear from the DMICP records that the Registrant had made no entry at all on the system. However, the record shows that when the case was followed up by a Social Work colleague during one of the Registrant’s periods of suspension, Service User 8 had informed the colleague that the Registrant had visited him at home and had been due to visit again but had not done so. Service User 8 is recorded as having reported that the Registrant “did a fantastic job and had told him exactly what to get on with.”


32. Witness 1 told the Panel that the team had only a limited amount of time between referral and discharge in which to put in place all the support measures a Service User might require. She said that the Registrant’s failure to record his visit and the detail of what had occurred risked the Service User not being as well prepared for post-service life as they would otherwise have been.


33. In respect of Service User 35, Witness 1 told the Panel that the Service User had been particularly vulnerable and had been placed on the Risk Register. Although it was clear that the Registrant had interacted with the Service User on a number of occasions in 2015 and 2016 there were alarming gaps in the records where it was either not clear whether or not scheduled meetings or visits had taken place, or where there was no record made by the Registrant as to what had transpired in such meetings or visits. Witness 1 told the Panel that the Registrant’s record keeping failures in respect of Service User 35 could have had extremely serious consequences and it was a matter of good fortune that the Service User had apparently not suffered harm.


34. The Panel had careful regard to the DMICP records in respect of both Service Users and concluded that the records confirmed that the Registrant had acted as alleged in Particular 2.


Particular 3 found proved


3. Did not maintain records and / or maintain records in an appropriate manner in the cases of: Service User 1;
a. Service User 4;
b. Service User 5;
c. Service User 6;
d. Service User 7;
f. Service User 9 ;
g. Service User 10;
h. Service User 15 ;
i. Service User 16 ;
j. Service User 20 ;
k. Service User 21 ;
l. Service User 22 ;
m. Service User 23;
n. Service User 24;
o. Service User 25;
p. Service User 29 ;
q. Service User 30;
s. Service User 36 ;
t. Service User 37;

35. Witness 1 told the Panel that in respect of these Service Users, the Registrant had clearly interacted with each. However, there were numerous gaps in the records of the Service Users, making it impossible to determine what might have transpired in terms of information gathered, advice given and/or action taken. Witness 1 told the Panel that she had no doubt that the Registrant was aware of the necessity of not only following up on visits but also of uploading full notes detailing each and every contact with a Service User. She told the Panel that failure to do so put affected Service Users at risk. At best, the risk was that they might not receive the support they needed on time or at all, and at worst they might suffer actual harm.

36. The Panel had careful regard to the DMICP records in respect of all these Service Users and concluded that the records confirmed that the Registrant had acted as alleged in Particular 3.


Decision on grounds


37. Having made its findings on the facts, the Panel went on to consider whether the matters found proved constituted misconduct and / or lack of competence. In this regard, the Panel had careful regard to the submissions of the Presenting Officer and accepted the advice of the Legal Assessor.


38. In relation to Misconduct, the Presenting Officer submitted that the Registrant had fallen seriously below the standards expected of a Registered Social Worker set out in the HCPC ‘Standards of conduct, performance and ethics’.  She submitted that, if found proved, the facts alleged were serious and amounted to Misconduct going to fitness to practise.


39. The Panel found that, in respect of conduct occurring before the publication of the January 2016 edition of the HCPC ‘Standards of conduct, performance and ethics’, the Registrant had breached the following Standards as set out in the August 2012 edition:


 1 You must act in the best interests of service users;
7 You must communicate properly and effectively with… other practitioners;                                       
10 You must keep accurate records;
13 You must…make sure that your behaviour does not damage the public’s confidence in you or your profession.


40. In addition, in respect of conduct occurring after the publication of the January 2016 edition of the HCPC ‘Standards of conduct, performance and ethics’, the Panel found that the Registrant had breached the following Standards set out in the 2016 edition:
2.6 You must share relevant information, where appropriate, with colleagues involved in the care, treatment or other services provided to a service user;
6.2 You must not do anything…which could put the health or safety of a service user…at unacceptable risk;
10.1 You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to;
10.2 You must complete all records promptly and as soon as possible after providing care, treatment or other services.


41.   In relation to lack of competence, the Presenting Officer submitted that the Registrant had breached the HCPC Standards of Proficiency for Social Workers.


42.     The Presenting Officer submitted that the matters alleged demonstrated serious deficiencies in core competencies which are fundamental to the work of a Registered Social Worker. She said these deficiencies had been identified through a fair sample of the Registrant’s work.

43.  In considering the issues of misconduct and lack of competence, the Panel noted that the facts found proved spanned a considerable period of time. The facts also related to a large number of vulnerable Service Users for whom there was only a limited period of time in which their needs could be appropriately provided for before they transitioned out of service. In the Panel’s view, the Registrant had prioritised face-to-face work over his responsibility to make full and timely records of his actions and plans, and that this had been a deliberate choice on his part.

44.     The Panel gave careful regard to the guidance provided in the cases of Roylance v GMC [2001] 1 AC 311 and  Calhaem v GMC [2207] EWHC 2606 (Admin). It recognised that Misconduct and Lack of Competence can both involve a falling short from the professional standards that would be proper in the circumstances. It considered that the Registrant had repeatedly fallen well below the standards to be expected of a Registered Social Worker. In the Panel’s view the matters referred to in Particulars 1-3 represent a fair sample of his record keeping practice. However, in the Panel’s view, the difference between Misconduct and Lack of Competence is that Misconduct involves a deliberate or reckless falling short where the registrant is capable but unwilling to adhere to the proper standard, whereas Lack of Competence involves an involuntary falling short where the Registrant may well be willing to, but is simply not capable of, performing to the required standard. In the Panel’s view this is a case where the Registrant had repeatedly demonstrated his ability to input high quality data on to the record, but had, on numerous occasions, deliberately chosen not to do so.


45. In the circumstances set out above, the Panel had no doubt that the Registrant’s actions and omissions in relation to Particulars 1 - 3  constituted Misconduct going to his fitness to practise.


Decision on impairment


46. The Panel then went on to consider whether the Registrant’s fitness to practise is impaired by reason of his misconduct. It had careful regard to all the evidence before it and to the submissions of the Presenting Officer. It accepted the advice of the Legal Assessor and had particular regard to the HCPC’s Practice Note “Finding that Fitness to Practise is ‘Impaired’.”


47. The Panel noted that the Registrant had fallen seriously short of the standards expected of a registered Social Worker, and had thereby breached fundamental tenets of the profession, put vulnerable patients at unwarranted risk of harm and brought the profession into disrepute. In those circumstances, the Panel had no doubt that the Registrant’s fitness to practise had been impaired by reason of his Misconduct.


48. The Panel then went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of that Misconduct.


49. In addressing the personal component of impairment, the Panel asked itself whether the Registrant is liable, now or in the future, to repeat his Misconduct. In reaching its decision, the Panel had particular regard to the issues of insight, remediation and the Registrant’s history.


50. The Panel has not had the benefit of hearing from the Registrant in person, though it did have regard to the Registrant’s written submissions and representations dated 12 April 2017 for the Investigating Committee Panel.


51. The Panel considered that the Registrant has demonstrated no meaningful insight into his failings. His engagement with the regulatory process has been minimal and he chose not to attend this hearing. While reportedly telling Witness 1 that he accepted there were failings in his record keeping practice, he was apparently unable to provide any explanation for those failings, and told her that she was partly to blame as she had been his line manager.

52. The Panel had careful regard to the Registrant’s written submissions and representations dated 12 April 2017 for the Investigating Committee Panel. This made little reference to the allegations themselves but expressed concerns about the way in which the Registrant felt he had been treated, both at work and by the HCPC. Reference was made to personal issues at the time, including the Registrant’s health, but the Panel read nothing in either regard which impacted on its findings. The Panel noted the Registrant’s view that Witness 1, his line manager, should take some responsibility for not identifying his failures at an earlier stage and his line manager did acknowledge that she should have intervened earlier. Further, the Panel took the view that her supervision of the Registrant had been less structured and systematic than would have been helpful, but that this neither excused nor justified the Registrant’s failings.

53. In the Panel’s view, the Registrant had taken a persistently cavalier attitude to his record keeping responsibilities. While there were no concerns about the quality of his record keeping entries when he chose to make them, he apparently prioritised his field work over his record keeping responsibilities, and on numerous occasions put Service Users at risk by failing to record visits, plans and actions in DMCIP. In the Panel’s view, his actions and omissions not only demonstrated a lack of understanding of the importance of keeping records accurate and up to date, but also an attitudinal problem in deliberately failing to make records when he knew he was required to do so.


54. The Panel recognised that clinical, or in this case practice, failings are usually easier to remedy than those, for example, which involve entrenched attitudinal problems. In the Panel’s view the Registrant’s record keeping failures should by their nature be easy to remedy.  However, the Panel is concerned that the attitudinal problem it has identified may mean that remediation in this case will not be straightforward. The Panel has received no evidence of any steps which the Registrant may have taken to remediate his failings.


55. In light of its views on insight and remediation the Panel considered it likely that the Registrant will repeat failings of the kind found proved. For these reasons, the Panel determined that a finding of impairment is required on the ground of public protection.


56. The Panel then went on to consider whether a finding of impairment is necessary on public interest grounds.  In addressing this component of impairment, the Panel had careful regard to the critically important public policy issues identified by Silber J in the case of Cohen [2008] EWHC 581 (Admin) when he said: “Any approach to the issue of whether .... fitness to practise should be regarded as ‘impaired’ must take account of ‘the need to protect the individual patient, and the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.”


57. The Panel considered that making full, accurate and timely records is a fundamental requirement of the profession of Social Work and that the public would be appalled to learn of the Registrant’s failures in relation to the records of so many Service Users over such a lengthy period of time. Vulnerable members of the military, all of whom had mental health issues and some of whom were also dealing with physical challenges, were entitled to expect that those charged with assisting them in their transition out of service would maintain high standards in ensuring that they received all the assistance they needed and were entitled to. In the Panel’s view, the Registrant’s deliberate failure to adhere to the standards of record keeping expected of him had put Service Users at wholly unwarranted risk. The Panel had no doubt that the need to maintain public confidence in the profession, and to declare and uphold proper standards, would be undermined if a finding of impairment of fitness to practise were not made in the circumstances of this case.


58. For all the reasons set out above, the Panel determined that the Registrant’s fitness to practise is currently impaired, both on the grounds of public protection and in the public interest. 

Decision on sanction


59. The Panel next considered what, if any, sanction to impose on the Registrant’s registration. It had careful regard to all the evidence put before it and to the submissions of the Presenting Officer. It accepted the advice of the Legal Assessor.


60. The Presenting Officer drew the Panel’s attention to the HCPC’s Indicative Sanctions Policy (ISP) and submitted that the question of sanction is a matter for the Panel’s own independent judgment.


61. In reaching its decision the Panel had at the forefront of its thinking the principle of proportionality and the need to balance the interests of the Registrant with the protection of the public and the wider public interest in maintaining confidence in the profession and the HCPC, and in declaring and upholding proper standards of conduct and performance.


62. In reaching its decision, the Panel had regard to all the circumstances, including the following mitigating and aggravating features of the case:


Mitigating factors


• No Service Users suffered harm as a consequence of the Registrant’s actions or omissions;

• There have been no previous regulatory findings made against the Registrant;

• The Registrant’s failings were confined to a discrete but important area of Social Work practice.  The Panel heard evidence that he was safe and effective in other areas of Social Work practice.

Aggravating factors


• The Registrant deliberately failed to adhere to record keeping requirements;

• The Registrant did not accept full responsibility for his actions and omissions;

• Vulnerable Service Users, whose opportunities for effective assistance from the DCMH were time limited, were put at unwarranted risk of harm;

• The Registrant’s failings impacted on colleagues’ ability to perform their roles in a timely and effective manner;

• The Registrant’s failings took place over a substantial period of time and involved a large number of Service Users;

• The Registrant has demonstrated no meaningful insight or remediation;

• The Registrant’s failings are indicative of an attitudinal problem that may hinder or create a bar to the development of appropriate insight and the implementation of effective remediation.

63. The Panel first considered whether it would be appropriate to impose no sanction in this case. It gave careful consideration to Paragraph 8 of the ISP. The Panel noted its findings that the Registrant has demonstrated no meaningful insight or remediation and that there remains a risk of repetition of his serious and long running Misconduct. In those circumstances, the imposition of no sanction would neither protect the public nor serve the wider public interest in maintaining confidence and declaring and upholding proper standards.

64. The Panel then considered whether it would be appropriate to refer the matter for mediation. It had careful regard to Paragraphs 26 and 27 of the Indicative Sanctions Policy. It noted that mediation may only be used if the Panel is satisfied that the only other appropriate course would be to take no further action. This is not such a case.

65. The Panel next considered the imposition of a Caution Order. It gave careful consideration to the factors set out in the ISP. The Panel determined that, in light of its findings that the Registrant has demonstrated no meaningful insight or remediation and that there remains a risk of repetition of his serious and long running Misconduct, the imposition of a Caution Order would be inappropriate as it would neither protect the public nor be sufficient to mark the wider public interest.

66. The Panel then considered the imposition of a Conditions of Practice Order. It gave careful consideration to Paragraphs 30-38 of the ISP. The Panel noted that, while failings of the kind found proved are usually, by their nature easily remediable, it had in this case detected an attitudinal problem that may hinder or create a bar to the development of appropriate insight and the implementation of effective remediation. In the absence of meaningful insight or remediation or engagement with this hearing, the Panel had no confidence that the Registrant would co-operate with a Conditions of Practice Order. Given the seriousness of the matter and the Panel’s finding that there remains a risk of repetition, the Panel determined that a Conditions of Practice Order is neither appropriate nor proportionate at this time.

67. The Panel went on to consider the imposition of a Suspension Order. It gave careful consideration to Paragraphs 39-45 of the ISP. Such an order would both protect the public and send a clear message that the Registrant’s actions and omissions were unacceptable and must not be repeated. It would also provide the Registrant with an opportunity to reflect on his failings and decide whether he wishes to engage with his regulator for the purpose of remediating those failings. The Panel considered that a period of nine months suspension is sufficient, necessary, and proportionate but noted that it would be open to the Registrant to seek an early review if his progress is rapid.

68. The Panel did consider a Striking Off Order. It concluded that if the Registrant satisfactorily addresses his attitudinal problem, there is no reason why he should not be able to fully remediate his failings, thereby facilitating a return to safe and effective practice. In those circumstances, the Panel decided that a Striking Off Order is not necessary, proportionate or appropriate at this time.

69. For all the reasons set out above, the Panel decided to impose a nine month suspension order. That order must be reviewed by another panel prior to its expiry. The reviewing panel may be assisted by the following:

• the Registrant’s engagement with the process and attendance at the hearing;

• evidence of any relevant training activities and/or professional development undertaken by him during the period of suspension;

• a reflective piece from the Registrant, following a recognised model. This should demonstrate the Registrant’s reflection on the gravity of his failings, the importance of maintaining consistent contact with Service Users and of maintaining full and up to date records, and the potential impact of failure to do so on Service Users and colleagues, and on the reputation of the profession and public confidence in the profession.

• testimonials relating to any work undertaken in an employment and/or voluntary capacity after this hearing that evidences the Registrant’s performance in working effectively and consistently with colleagues and/or members of the public.

70. The Registrant should be aware that at the next review hearing the reviewing panel will have the power to make a Striking-Off Order, if appropriate.

71. The Panel heard an application from the Presenting Officer to cover the appeal period by imposing an 18 month Interim Suspension Order on the Registrant’s registration. She submitted that such an order is necessary to protect the public and is otherwise in the public interest.


72. The Panel heard and accepted the advice of the Legal Assessor. It had careful regard to Paragraphs 51-54 of the Indicative Sanctions Policy. The Panel noted that the Registrant had been informed, in the Notice of hearing dated 30 January 2018, that if this Panel found proved the allegation against him and imposed a sanction which removed, suspended or restricted his right to practise, the HCPC may make an application to the Panel to impose an interim order to cover any appeal period. For the reasons set out in its earlier decision to commence the hearing in the absence of the Registrant, the Panel determined that it would also be fair, proportionate and in the interests of justice to consider the Presenting Officer’s application.

73. The Panel recognised that its power to impose an interim order is discretionary and that the imposition of such an order is not an automatic outcome of fitness to practise proceedings in which a Suspension Order has been imposed and that the Panel must take into consideration the impact of such an order on the Registrant. However, the Panel was mindful of its findings in relation to the lack of insight and remediation and that there remains a risk of repetition. In the circumstances, it considered that not to impose an order would be inconsistent with its finding that a substantive Suspension Order is required. Public confidence in the profession and the regulatory process would be seriously harmed if the Registrant were not made subject to an interim order during the appeal period

Order

Order: The Registrar is directed to suspend the registration of Mr Stuart Martyn Hill for a period of nine months from the date this order comes into effect.

Notes

Hearing History

History of Hearings for Mr Stuart Martyn Hill

Date Panel Hearing type Outcomes / Status
23/04/2018 Conduct and Competence Committee Final Hearing Suspended