Ms Sarah Sikpa
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Between 20 March 2014 and 4 August 2014, while working as a
Practitioner Psychologist at Cambridgeshire and Peterborough NHS
Foundation Trust on behalf of the Cambrian Group, you:
1. Did not appropriately record any clinical contact and/or record case notes with the required timescales for:
a. Service User A
b. Service User B
c. Service User C
d. Service User D
e. Service User E
f. Service User F
g. Service User G
h. Service User H
i. Service User I.
2. The matters described in paragraph 1 constitute misconduct and / or a lack of competence.
3. By reason of your misconduct and/or lack of competence, your fitness to practise is impaired."
Service of Notice
1. The notice of this hearing was sent to the Registrant at her address as it appeared in the register on 15 February 2018. The notice contained the date, time and venue of today’s hearing.
2. The Panel accepted the advice of the Legal Assessor, and is satisfied that notice of today’s hearing has been served in accordance with Rule 6(1) of the Conduct and Competence Rules 2003 (the “Rules”).
Proceeding in the absence of the Registrant
3. The Panel then went on to consider whether to proceed in the absence of the Registrant pursuant to Rule 11 of the Rules. In doing so, it considered the submissions of Ms Wills on behalf of the HCPC.
4. Ms Wills submitted that the HCPC has taken all reasonable steps to serve the notice on the Registrant. Ms Wills further submitted that the Registrant has voluntarily absented herself. Her last telephone contact with the HCPC was on 13 February 2018, when she was encouraged to attend this hearing. Ms Wills reminded the Panel that there was a public interest in this matter being dealt with expeditiously.
5. The Panel accepted the advice of the Legal Assessor. He advised that, if the Panel was satisfied that all reasonable efforts have been made to notify the Registrant of the hearing, then the Panel had the discretion to proceed in the absence of the Registrant.
6. The Legal Assessor also referred the Panel to the case of GMC v Adeogba and Visvardis  EWCA Civ 162. It was clear, from the principles derived from case law, that the Panel was required to ensure that fairness and justice were maintained when deciding whether or not to proceed in a Registrant’s absence.
7. The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of the hearing. It was also satisfied that the Registrant was aware of the hearing.
8. In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPTS Practice Note entitled ‘Proceeding in the Absence of a Registrant’. The Panel weighed its responsibility for public protection and the expeditious disposal of the case with the Registrant’s right to a fair hearing.
9. In reaching its decision the Panel took into account the following:
• The Registrant had not made an application to adjourn today’s hearing;
• The Registrant has had some engagement with the process, and since the last contact, has submitted further documentation for the attention of the Panel;
• There is a public interest that this substantive order is reviewed before it expires.
10. The Panel was satisfied that the Registrant had voluntarily absented herself from the hearing. There is a distinction between a case where the Registrant was clearly aware of the hearing date, and one where there had been no response from the Registrant. The Panel is able to take into account the documentation submitted by the Registrant since having been sent notification of the hearing date. Having weighed the public interest against the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.
11. The Registrant was employed by the Cambian Group as a Senior Psychologist in the Child Exploitation Service from March 2014 to May 2014 as a locum for three days a week before moving to a permanent, full time contract with the company in May 2014, until her resignation in August 2014.
12. The service contains a number of residential homes which each look after up to five LAC female children who have experienced child exploitation or child trafficking. As the Senior Psychologist, the Registrant was responsible for overseeing the clinical care of service users in two of the homes. She was expected to work autonomously and provide consultation and training to care home staff. She undertook individual work with the service users, including assessments and intervention when required, and was responsible for liaising with all parties involved, such as the Local Authority, Health Care etc, in order to coordinate the clinical care of the service users. She was also the supervisor of a Psychology Assistant.
13. At the end of July 2014 a service user absconded and her whereabouts were unknown. The Registrant was the allocated psychologist for the missing child. Witness 1 called the Registrant on 31 July 2014, requesting her to meet at the Residential Home to urgently review the clinical input. Although the Registrant initially said that she was unavailable, when pressed she later agreed and met Witness 1 at the home. Witness 1 requested that she and the Registrant review the service user’s file whereupon it became apparent that the Registrant had not made any clinical notes or entries. That prompted Witness 1 to review all the clinical files pertaining to the Registrant’s clinical case load and it became clear that the Registrant had not recorded any clinical notes or entries for any of the Service Users in her care (A – I) since the start of her employment. At that stage the Registrant was suspended and subsequently resigned.
14. All the factual particulars were proved at the substantive hearing and found to be sufficiently serious so as to amount misconduct. That panel also determined that the Registrant’s fitness to practise was impaired and imposed a Condition of Practice Order for a period of 18 months.
15. Ms Wills, on behalf of the HCPC accepted that the Registrant had been, to some degree, complying with the conditions placed upon her practice, although she accepted that there was evidence to the contrary. She said the that the Council’s position on this review was neutral.
16. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if she is fit to return to unrestricted practice. Its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment.
17. The Legal Assessor advised that the Panel might find the questions formulated in the case of CHRE v NMC and Grant (2011) EWHC 927 (Admin) of some assistance, albeit slightly modified for these proceedings:
‘Does the evidence before the Panel today show that the Registrant’s fitness to practice remains impaired by reason of her misconduct in the sense that she:
a) is liable in the future to act so as to put a service user at unwarranted risk of harm; and/or
b) is liable in the future to bring the profession into disrepute; and/or
c) is liable in the future to breach one of the fundamental tenets of the profession”
18. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired then the Panel consider what sanction, if any, should be imposed. The Legal Assessor advised the Panel that it could exercise all the options under Article 30 of the 2001 Order, if it determined that the Registrant’s fitness to practise remained impaired. He also advised the Panel that it should bear in mind the principle of fairness and proportionality, and have regard to the Indicative Sanctions Policy document issued by the HCPTS. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.
Panel’s considerations and decision
19. The Panel accepted the advice of the Legal Assessor. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Ms Wills. In particular it noted the following factors:
(a) This is a case of misconduct and there was no suggestion that the Registrant lacked the requisite competence to carry out the role of a Practitioner Psychologist;
(b) The documentation provided by the Registrant was lacking in the following areas:
(i) there were no reflective practice logs for the period of August 2017 to date;
(ii) The reflective logs did not provide evidence of reflection of the two areas of initial concern: record keeping, and professional and ethical standards.
(iii) there were no clinical logs provided for the period October 2017 to December 2017, and there was no indication that the Registrant was not seeing clients during that time;
(iv) there were several clients who were listed as having attended in the clinical logs but who did not have corresponding reflective practice logs for those appointments;
(v) whilst there was an initial action plan regarding supervision, the Registrant had not provided evidence that she had consistently remained under supervision and although, there was evidence that her supervisor had changed at least once in the past 18 months, this had not been notified to the HCPC as required;
(vi) whilst an action plan had been developed with the supervisor to meet the condition requirement of a Personal Development Plan, the Registrant has not provided evidence of compliance with that plan, nor whether the actions that were stipulated therein were followed or successful;
(vii) the Personal Development Plan did not contain any actions to be undertaken that were related to professional and ethical standards. This was the stated purpose of the Condition requiring such a Personal Development Plan;
(viii) there was evidence that the Registrant had been seeing clients from August 2017 to date (a third of the duration of the current order). However, there was no evidence that the Registrant actually recorded or maintained her reflective log during that period; and
(ix) the courses undertaken by the Registrant do not have any correlation to the issues the substantive panel found in the Registrant’s practice.
20. The Panel was mindful that there was no requirement contained within the Conditions of Practice Order that the Registrant was to supply full documentation, or any at all, to demonstrate full compliance with the Order. However, the Registrant should have realised that it was for her to demonstrate full compliance with the order, and that such compliance goes a long way to demonstrating insight and remediation.
21. In the light of all the above, the Panel determined that there was insufficient evidence for it to be satisfied that the Registrant’s fitness to practise was no longer impaired. On the contrary, the evidence before the Panel demonstrated that there remained a real risk of repetition of the original concerns. The Panel also determined that the evidence demonstrated a lack of appreciation, on the part of the Registrant, of the seriousness of the original concerns and her role in addressing those concerns.
22. The Panel then went on to consider what the appropriate and proportionate sanction should be. It had regard to the Indicative Sanctions Guide issued by the HCPC and considered the available sanctions in order of severity, starting with the least restrictive. In the light of the Panel’s earlier determination that the Registrant had not demonstrated sufficient insight into her misconduct and that there was a real risk of repetition of the original misconduct, the Panel determined that it was not appropriate to allow the order to lapse. Nor was it appropriate to impose a Caution Order. Neither would protect the public nor satisfy the public interest in these circumstances.
23. The Panel considered extending the current Conditions of Practice Order, but determined that this would not be appropriate. This is because there was evidence that the Registrant had not complied with the previous conditions imposed.
24. The Panel determined that a period of suspension was the least restrictive sanction that would protect the public and the public interest. The Panel determined that the shortest period of suspension appropriate in these circumstances would be six months. This would allow the Registrant sufficient time to reflect on her practice and to gain insight into her misconduct.
25. A future Panel reviewing this order would be assisted by the following, if possible:
a) The attendance of the Registrant at the Hearing;
b) A reflective piece by the Registrant, concentrating on:
i) her insight relating to her misconduct;
ii) how her actions impacted, or could have impacted, on clients and her colleagues;
iii) the importance of the regulatory process and how it relates to public protection and confidence in the profession;
iv) the importance of proper case file recording, in particular the risks of inadequate recording and how that affects the safeguarding of clients; and
v) her understanding of what is required of a good clinical record.
c) Information about any employment, paid or unpaid, since these events;
d) An indication as to her future plans and whether she wishes to remain in the profession;
e) Reading, other self-directed learning, undertaking training relating to the following:
i) Professional and ethical standards;
ii) Safeguarding issues in relation to vulnerable adults and children; and
f) Evidence of the Registrant keeping her practice and skills up to date or being employed in any capacity including a voluntary capacity in any allied and relevant roles;
g) Up to date testimonials from colleagues and/or persons who are aware of these proceedings.
26. Essentially, the Registrant will need to demonstrate her recognition of her wrong-doing and its impact upon the reputation of the profession, confidence in the profession, and on clients.
History of Hearings for Ms Sarah Sikpa
|Date||Panel||Hearing type||Outcomes / Status|
|06/01/2020||Investigating Committee||Interim Order Application||Interim Conditions of Practice|
|21/03/2018||Conduct and Competence Committee||Review Hearing||Suspended|
|19/09/2016||Conduct and Competence Committee||Final Hearing||Conditions of Practice|