Mrs Rachel Bruce

Profession: Speech and language therapist

Registration Number: SL28772

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 07/06/2018 End: 11:30 07/06/2018

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

Panel: Health Committee
Outcome: Voluntary Removal agreed

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Allegation

Your fitness to practise is impaired by reason of your health.

Finding

Preliminary matters:


Service:


1. The Panel saw a Notice of today’s hearing, originally listed as a substantive order review, dated 10 May 2018, which was sent to the Registrant’s registered address by first class post on the same date. Following this, the purpose of today’s hearing was altered so that a Voluntary Removal Agreement (“VRA”) could be considered by the Panel. To this effect, an amended Notice of today’s hearing, listed as a VRA hearing and dated 5 June 2018 was sent by first class post to the Registrant’s address. The Panel noted that the Registrant’s husband, who represents the Registrant, has waived the statutory notice period in respect of the latter Notice. The Panel was therefore satisfied that notice had been properly served as required by Rules 3 and 5 of the Health and Care Professions Council (Health Committee) (Procedure) Rules 2003 (“the Rules”).


Proceeding in absence:


2. Miss Wills, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence. The Panel took into account the HCPTS Practice Note entitled “Proceeding in the Absence of the Registrant”, and accepted the advice of the Legal Assessor who advised that the Panel’s discretion to proceed in the Registrant’s absence should only be exercised with the utmost care and caution.
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3. The Registrant is  represented by her husband who was not present. The Panel had regard to a file note of a telephone conversation between the Case Manager and the Registrant’s husband dated 6 June 2018.  The Registrant is reported as being happy for the hearing to proceed in a manner in which if the Panel had any questions for him or the Registrant before they retired to make their decision, he could be telephoned. The Registrant’s husband is also reported to have stated in that file note that in the event that the VRA is not approved, he would provide a document for the Panel to read solely for reviewing the existing order. On the basis of this information, the Panel was of the view that it could be inferred from this that the Registrant had voluntarily waived her right to attend. The purpose of this hearing is to consider the terms of a VRA agreed between the HCPC and the Registrant which has been signed by her. From this, it can also be inferred that the Registrant expects that the hearing will proceed in her absence. The Panel was of the view, in light of the manner in which she agreed that the hearing should proceed, that there was little if any prejudice to the Registrant in proceeding today. The Panel considered that it was in the public interest and in the Registrant’s interests that the agreement should be considered expeditiously. Accordingly, the Panel decided to proceed in the Registrant’s absence. 



Hearing in Private


4. Miss Wills applied for the entirety of the hearing to proceed in private on the basis that the original allegation was founded upon the Registrant’s health condition, and that there will be references during the hearing to her health. The Panel took into account the HCPTS Practice Note entitled “Conducting Hearings in Private” and accepted the advice of the Legal Assessor. The Panel was satisfied that the hearing should be in private in order to protect the Registrant’s private life, pursuant to Rule 10(1)(a) of the Rules.

 

Background


5. The Registrant is a registered Speech and Language Therapist.

6. On 11 October 2012, the Registrant made a self-referral to the HCPC. The Registrant advised that she had resigned from Surrey Community Health, where she had been employed for eleven and a half months. She stated that, since February 2012, she had been subject to a capability process relating to difficulties she had with aspects of dysphagia work. The Registrant indicated that these difficulties were primarily due to a health condition that she suffers from,. She advised that the capability process had not been completed and outlined the lack of training and support she had received from her employer.

7. On 18 March 2013, a Panel of the Investigating Committee determined that there was a case to answer in respect of the allegation against the Registrant, which related to her competence in the area of practice of dysphagia. Subsequently, on 21 October 2013, a Panel of the Conduct and Competence Committee accepted an application made jointly by the HCPC and the Registrant for the case to be transferred to the Health Committee.

8. On 14 April 2014, a Panel of the Health Committee considered a fitness to practise allegation against the Registrant at a consent hearing.


9. At the consent hearing, the Panel considered an application made jointly by the HCPC and the Registrant for a Conditions of Practice Order to be imposed, the Registrant having admitted to the above allegation. The Panel was of the view that the proposed consent order provided an appropriate level of public protection and did not identify any wider public interest considerations which required a full hearing rather than a disposal by consent. The Panel therefore imposed the proposed Conditions of Practice Order for a period of three years.

10. The first Substantive Review hearing for this matter was held on 10 March 2017. The Panel noted that it had not been provided with any medical evidence as to the Registrant’s health condition and therefore it could not be satisfied that difficulties in relation to the management of it were unlikely to recur. It also noted that the Registrant was no longer working as a Speech and Language Therapist and had not maintained her knowledge and skills. The Panel therefore concluded that the Registrant’s fitness to practise remained impaired by reason of her health and imposed a Suspension Order for a period of twelve months.

11. The second Substantive Review Hearing for this matter was held on 20 February 2018. The Panel concluded that the Registrant’s fitness to practise was still impaired, reiterating the concerns identified by the previous Panel. The Panel noted the intention of the parties to explore the possibility of a VRA and imposed a further Suspension Order for a period of four months to allow this to be canvassed.

12. Following this hearing, the HCPC Case Manager met with the Registrant on 28 February 2018 to discuss the option of voluntary removal. The Registrant requested a number of changes to the standard wording of the VRA, in particular noting that she would like to have the option to practise as a Speech and Language Therapist in the future. The Registrant reiterated these concerns by email on 5 March 2018.

13. On 12 March 2018, the HCPC emailed the Registrant advising her that the HCPC had determined this matter was no longer suitable for a VRA due to the Registrant’s desire to have the option of returning to practice in the future.

14. On 18 March 2018, the Registrant advised the HCPC by email that, due to the impact the HCPC process was having on her health, her husband would now be representing her in this matter.

15. The Registrant’s husband advised the HCPC by email on 22 March 2018 that, if the standard terms could not be varied, the Registrant would still be interested in entering into a VRA as this would be preferable to the alternative paths open to her. Further correspondence received from the Registrant’s husband confirmed this position. However, he reiterated that, whilst the Registrant did not have plans to practise as a Speech and Language Therapist in the future, she would prefer to have this option available to her in the event that her circumstances change.

16. On 2 May 2018, the Registrant’s husband met with the HCPC Case Manager and an Operations Manager to discuss the matter. He again outlined the Registrant’s position and enquired as to the possibility of varying the standard wording of the agreement.

17. On 29 May 2018, the HCPC Case Manager wrote to the Registrant’s husband advising him that the Director of Fitness to Practise had agreed to pursue the VRA but had not agreed to the variation of the terms of the agreement.

18. Following this, however, the Director of Fitness to Practise agreed to remove clause 3.2.3 from the agreement, thus removing the clause which prohibits the Registrant from seeking re-admission to the Register.


Decision


19. The Panel heard submissions from Miss Wills that the HCPC was satisfied that voluntary removal from the Register was an appropriate disposal of this case and would not compromise public protection or the wider public interest. Miss Wills reminded the Panel that the effect of a VRA is the same as a strike-off from the Register following a finding of impairment of fitness to practise. The Panel had regard to Miss Wills’ skeleton argument dated 5 June 2018 as well as all the documentation before it.

20. The Panel received and accepted the advice of the Legal Assessor. 


21. The Panel reminded itself of the guidance offered in the HCPC Practice Note entitled “Disposal of Cases by Consent”.

22. The Panel carefully considered the removal of the usual clause in the VRA which would have prevented the Registrant seeking re-admission to the Register. The Panel was of the view that this did not undermine public protection or the wider public interest. The Registrant may overcome her health condition, and therefore it is fair and proportionate to allow her to engage in the restoration process which has its own safeguards. The state of her health, and the steps she has taken to address her health, and how this impacts on public safety is a matter which will be fully considered at a hearing if she were to apply for future restoration to the Register. The Panel was of the view that the public interest, which  includes maintaining confidence in the profession and in the regulator, and upholding proper professional standards of conduct and performance, would be maintained in these circumstances.


23. In all the circumstances, the Panel was therefore satisfied that the public would be protected by the removal of the  Registrant from the Register. The public interest will also be served by the VRA. In coming to this decision, the Panel took into account the Registrant’s intention not to practise in the near future, the fact that she admitted the allegation and the findings of impairment and the sanctions which have been imposed throughout the regulatory process. All these factors are relevant to maintaining public confidence in the profession and the regulatory process.

24. The Panel notes from the Practice Note on Disposal of Cases by Consent that where an order such as a suspension order is in place, a VRA cannot take effect unless those proceedings are withdrawn or a Panel revokes the order. For the reasons set out above, the Panel concluded that it would not undermine public protection, or the wider public interest if the current Suspension Order is revoked.


25. For all these reasons, the Panel revokes the current Suspension Order and approves the signed VRA dated 30 May 2018.

Order

Order: The current Suspension Order is revoked and the Voluntary Removal Agreement is approved.

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
14/04/2014 Health Committee Final Hearing Conditions of Practice