Mrs Rachel Bruce

Profession: Speech and language therapist

Registration Number: SL28772

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 20/02/2018 End: 17:00 20/02/2018

Location: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

Panel: Health Committee
Outcome: Suspended

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Allegation

(The following allegation was considered by a Panel of the Health Committee at the substantive hearing on 14 April 2014)

Your fitness to practise is impaired by reason of your physical and/or mental health

Finding

Preliminary Matters:
Proceeding in Private
1. Mr Byrne on behalf of the HCPC submitted that the entirety of this hearing should be conducted in private. This is to protect the private life of the Registrant and to ensure that matters relating to her health are kept confidential. The Registrant supported this application. Having taken the advice of the Legal Assessor the Panel directed that the entire hearing should be conducted in private.
Background:
2. On 18 March 2013 a Panel of the Investigating Committee of the HCPC determined that there was a case to answer in respect of an allegation against the Registrant which related to her competence in the area of practice of dysphagia.
3. On 23 October 2013 that allegation was considered by a panel of the Conduct and Competence Committee and transferred to be considered by a Health Committee of the HCPC. Following correspondence between the parties and a hearing of the Health Committee of the HCPC on 14 April 2014 a Consent Order imposing agreed conditions of practice on the Registrant’s registration for a period of three years was made.
Hearing on 10 March 2017
4. On 10 March 2017 the 3 years Conditions of Practice Order was reviewed. The Registrant did not attend but was represented by her husband Mr Stephen Bruce.  Having considered the submissions made to it, the Panel concluded that there had not been any significant change in the circumstances since the Conditions of Practice Order made in April 2014. The Panel noted that that it had not received any updated medical evidence as to the Registrant’s health. It also noted that as the Registrant was not working as a Speech and Language Therapist, she had not maintained her knowledge and skills relating to her practice as a Speech and Language Therapist. The Panel concluded that in all the circumstances it was bound to conclude that the Registrant’s fitness to practise remained impaired by reason of her health condition.
5. The Panel then considered the order that it should make. It concluded that a Caution Order was not appropriate. It considered next the existing Conditions of Practice Order. Its conclusion was that no Conditions of Practice Order could be formulated, which would provide the public with the degree of protection that was necessary in the circumstances of this case. Accordingly, it determined that a Suspension Order for a period of 12 months was appropriate. It commented that “An order of 12 month’s duration with enable the Registrant to reconsider what, if any steps are available to her in respect of her continued registration with the HCPC”.
Decision (of this Panel):
6. Mr Byrne made submissions to this Panel. He informed the Panel that prior to this hearing there had been discussions and correspondence between the Registrant and the HCPC. This had resulted in an agreement  between the HCPC and the Registrant that subject to the approval of the relevant Panel, this matter would be disposed of by a Voluntary Removal Agreement [VRA]. With regard to this hearing it was agreed between the HCPC and the Registrant that the Panel would be asked to extend the existing Suspension Order for a period of 3 months to allow the HCPC to arrange the VRA.  Mr Byrne further said that subject to the agreement set out above, there had been no change in the circumstances since the previous hearing and in particular no updated medical evidence to show that her health problems had been resolved; consequently the Registrant’s fitness to practise remained impaired. He submitted that the appropriate order was a Suspension Order for a period of 3 months so as to allow the HCPC to arrange an appropriate VRA which when completed would be put before a Panel for its consideration.
7. The Registrant put forward to the Panel a written statement dated 19 February 2018 to which a number of documents were attached. In that statement she stated that she supported the HCPC’s request for the Panel to extend the existing order for a period of 3 months to allow enough time for a VRA to be put in place between the HCPC and herself. The statement also set out the Registrant’s plans for the future and made comments on the circumstances which have given rise to this hearing. By an email dated 31 January 2018 and addressed to the HCPC the Registrant had admitted the allegation “in full”. In that email the Registrant emphasised that the admission was confined to the allegation that it “affected me in the practice of Dysphagia but not in other areas of her practice”. The Registrant in a brief oral submission confirmed and amplified her position as stated in the written statement. Mr Bruce did likewise.
8. The Panel considered the submissions that it had received and the material that it had seen. The Panel also heard and accepted the advice of the Legal Assessor.
9. The Panel is aware that it has all the powers that are set out in Article 30 [1] of the Health and Social Work Professions Order 2001 [The Order] and which are summarised in the letter 16 January 2018 addressed to the Registrant and giving notice of this hearing.
10. The Panel is aware that the process under Article 30 [1] of the Order is one of review and not one of appeal and that its function is to determine whether the Registrant’s fitness to practise is still impaired and if so whether the Suspension Order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other order.
Decision on Impairment:
11. The Panel has concluded that the Registrant’s fitness to practise is still impaired. In coming to this conclusion the Panel noted that there was no updated medical evidence to show whether there had been any change in the Registrant’s health since the previous hearings in April 2014 and March 2017. Moreover, the Registrant has not been working as a Speech and Language Therapist since before April 2014 and therefore has not been able to maintain her relevant skills and expertise in her profession. The Panel noted the Registrant’s admission as set out in her email dated 31 January 2018. In these circumstances, the Panel has concluded that it has no alternative but to conclude that the Registrant’s fitness to practise remains impaired. The Panel considered that public confidence in the profession of Speech and Language Therapy and in the HCPC as its regulator would be undermined, if in the circumstances that presently exist, the Panel has decided that the Registrant’s fitness to practise was not impaired.
Decision on Sanction:
12. Having decided that the Registrant’s fitness to practise is still impaired, the Panel proceeded to consider what order is appropriate, proportionate, sufficient and necessary to protect the public and to safeguard the public interest.
13. The Panel took into account the principles of proportionality balancing the interests of the Registrant with the public interest.
14. The Panel has had regard to the contents of the Indicative Sanctions Policy published by the HCPTS and is aware that sanctions should be considered in ascending order of severity. The Panel is aware that the purpose of sanctions is not punitive but to protect members of the public and to safeguard the public interest. The latter objective includes maintaining standards within the profession, together with public confidence in the profession and in its regulatory processes.
15. The Panel has concluded that to take no action, thus allowing the present Order to lapse, making a Mediation Order or imposing a Caution Order would be inappropriate having regard to the circumstances of this case. Such outcomes would not sufficiently protect the public or the public interest.
16. The Panel further concluded that a Conditions of Practice Order could not be formulated which would provide the appropriate degree of protection to members of the public. Its reasons were the same as those identified by the reviewing Panel on 10 March 2017. In coming to this conclusion, the Panel noted in particular that the Registrant was not working as a Speech and Language Therapist and had no present intention of doing so; consequently no viable or workable conditions could be identified which would protect the public or safeguard the public interest.
17. The Panel has had regard to the correspondence between the HCPC and the Registrant. It has noted that both the Registrant and the HCPC are content that the Panel should make a Suspension Order for a period of 3 months and that during that period the HCPC should make the necessary arrangements to dispose of this matter by way of a VRA. The Panel had further noted that that the Registrant has stated in correspondence with the HCPC that she admits the allegation that has been made in this case. In all the circumstances, the Panel determines that the Suspension Order should be extended for a further period of four months. The Panel determined that a four month extension was preferable to a three month extension in that it reduced the risk that the VRA will not have been completed before the expiry of the Order. The Panel did not want the Registrant to face a further review hearing if that could be avoided. The extension of the suspension order will enable the HCPC to make the necessary arrangements to dispose of this matter by way of a VRA. Such an arrangement, if agreed between the Registrant and the HCPC, will come before another Panel for consideration and if deemed appropriate, approval. In the interim the public will be safeguarded and the public interest satisfied.

Order

The Registrar is directed to suspend the name of Mrs Rachel Bruce from the register for a further period of four months.

Notes

No notes available

Hearing History

History of Hearings for Mrs Rachel Bruce

Date Panel Hearing type Outcomes / Status
07/06/2018 Health Committee Review Hearing Voluntary Removal agreed
20/02/2018 Health Committee Review Hearing Suspended
10/03/2017 Health Committee Review Hearing Suspended