Mr Philip Ma

Profession: Practitioner psychologist

Registration Number: PYL15717

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 25/05/2018 End: 11:30 25/05/2018

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

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

The following allegation was considered by a panel of the Conduct and Competence Committee at the substantive hearing on 28-30 November, 1-3 and 5 December 2016:

During the course of your employment as a Practitioner Psychologist with North East London NHS Foundation Trust:

1. On 23 April 2010, you wrote a report on Patient B for Social Services Child Families Case Conference, and

a) you did not ensure a formal risk assessment of the patient was undertaken

b) you did not analyse risk-related matters which came to light during your session with Patient B

c) the report was poorly constructed and lacked structure

2. The matters described in paragraph 1 constitute misconduct and/or lack of competence.

3. By reason of your misconduct and/or lack of competence, your fitness to practise is impaired.

The panel at the substantive hearing found all of the facts proved, that these amounted to misconduct, and that the Registrant’s fitness to practise was impaired. It imposed a Conditions of Practice Order for a period of 18 months.

Finding

Background

1. The Registrant qualified as a Counselling Psychologist in 1997. He commenced employment with the North East London NHS Foundation Trust (“the Trust”) on 3 March 2003. On 8 February 2010, he was transferred to work at the Intake and Brief Intervention Team.

2. The Panel was informed that Patient B was referred to the Trust on 5 January 2010. She was assessed by a psychiatric nurse who later discussed the case with the Registrant, and an appointment was made for Patient B to see the Registrant on 10 March 2010.

3. The Registrant saw Patient B on four occasions: 10 March 2010; 19 March 2010; 1 April 2010; and 9 April 2010.

4. On 21 April 2010, the Registrant was sent a letter inviting him to a multidisciplinary review meeting which was due to take place on 26 April 2010 regarding Patient B. The Registrant was unable to attend, and so he was required to write a report in advance of the meeting to update the team on Patient B’s progress.

5. It was accepted by the HCPC that the Registrant’s intention was to summarise the history that he had obtained from Patient B, together with the social work records that he had accessed, and to summarise the work he had done with Patient B. However, it was alleged, and accepted, that he gave the report a heading that was misleading, namely: “psychology report”. He informed the substantive panel that this was a mistake on his part. He admitted that he had been told previously not to use this heading “because of the connotation of what it means”, but that he had continued to use it; he said that he had not realised that it was inappropriate. He accepted that the heading raised very different expectations. He also accepted that the problem was further compounded by the content of the first sentence of the final paragraph of his report, which stated: “From her presentation it was my impression that Patient B does not pose a risk in the care of her children”.

6. In relation to Sub-Particular 1(a), the substantive panel found that an integral part of preparing a psychological report in relation to Patient B was the carrying out of a formal risk assessment. The Registrant had admitted that he did not undertake such an assessment and the Panel found the Sub-Particular proved.

7. In relation to Sub-Particular 1(b), the substantive panel found that the Registrant did not analyse risk-related matters which had come to light during Patient B’s appointments with the Registrant. The substantive panel accepted expert evidence that the Registrant had made “no attempt to explore highly pertinent and risk laden facts mentioned by the client”.

8. In relation to Sub-Particular 1(c), the substantive panel found that the Registrant’s report was “poorly constructed and lacked structure”. The Registrant admitted that the heading was misleading, that he had not made clear what other documents had been relied on, and that he had reached conclusions that he was not qualified to give, and that were not justified in the circumstances. The substantive panel concluded that the report was “not objectively well constructed. It did not set out what the purpose of the document was and how it was intended to be used. It reached a conclusion that the Registrant was not entitled to find, on the basis of the work he had done, without carrying out an assessment, or having the appropriate experience and knowledge to do so. It was not clear how its conclusions had been reached or the reliance that was intended to be placed upon it”.

9. The substantive panel concluded that the facts found proved amounted to misconduct in that “this was an instance of acting well below the necessary standards that applied to a Practitioner Psychologist. He gave a misleading impression based on his misplaced desire to help Patient B, without any proper regard to the consequences for Patient B or her children. Ultimately such consequences would not have been in the best interests of anyone”.

10. When appearing before the substantive panel, the Registrant accepted that his behaviour had been wrong, and that he had not thought about the impact that his actions would have on the general public. He accepted that “other people would have perceived that I had done a full risk assessment on the client”, and that he was conscious now of what could have happened if someone had been led to believe that he had done a risk assessment. He said that this had not been apparent to him at the time and that he had been acting out of a desire to support Patient B, albeit that he now accepted that that desire could have backfired because “she might use it against others and cause conflict with others in the team” and agreed that it could also have the potential to cause harm to children and that his report would have allowed Patient B to “carry on doing what she was doing”.

11. The substantive panel concluded that the Registrant had provided it with evidence of some insight into his behaviour. He had provided testimonials which dealt with positive attributes of his character. However, the substantive panel concluded that these did not address the core issues in the case. The substantive panel noted that the Registrant showed some remorse but was concerned that he was focusing on the failings of his colleagues rather than on his own failings.

12. The substantive panel took into account a combination of events that were occurring in the Registrant’s professional and personal life at the time. The substantive panel concluded that the Registrant’s actions had been overly sympathetic to his patient and that he had failed to analyse the potential risk to Patient B’s children. The Registrant had provided a document that was misleading and contained opinions that were not justified, were not appropriate and were outside his professional expertise.

13. The substantive panel concluded that the Registrant’s behaviour was remediable but was unable to say that it been fully remedied in light of the limited ways in which he had sought to remedy his behaviour. The substantive panel noted that the Registrant had recognised that his report writing was below par but had not addressed this deficiency, nor sought to increase his skill level. He had recognised that he had become overly involved in focusing on Patient B’s issues to the exclusion of other relevant criteria, but had not attended courses on maintaining professional boundaries and self-care. He had not demonstrated learning about assessment and formulation, the writing up of assessments, or how his learning had been put into practice. He appeared to have reflected on how he might have dealt differently with Patient B but it was not apparent that he had learnt how to apply his learning to other situations.

14. The substantive panel concluded that the Registrant’s fitness to practice was impaired on the basis that he posed a risk to the public, and also on wider public interest grounds, in that there was a need to declare and uphold proper standards and to maintain confidence in the regulatory process.

15. In determining sanction, the substantive panel emphasised the seriousness of the case, and the Registrant’s failure to evidence full insight or to demonstrate appropriate remedial action. The substantive panel concluded that a Conditions of Practise Order would be sufficient to address the risks identified and to protect the wider public interest.

16. The substantive panel imposed the following Conditions:

The Registrar is directed to annotate the Register to show that for 18 months, from the date that this Order comes into effect (“the Operative Date”), you, Mr Philip Ma, must comply with the following conditions of practice:

1. You must inform the following parties that your registration is subject to these conditions:

a. any organisation or person employing or contracting with you to undertake professional work which requires HCPC registration.

b. any agency you are registered with or apply to be registered with (at the time of application) when seeking to undertake professional work which requires HCPC registration.

c. any prospective employer (at the time of your application) when seeking to undertake professional work which requires HCPC registration.

2. When undertaking professional work, which requires HCPC registration, you must place yourself and remain under the supervision of a suitable and appropriately qualified supervisor who is registered with the HCPC and supply details of your supervisor to the HCPC within 21 days of commencing any such professional work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with that supervisor to formulate a Personal and Professional Development Plan within 2 months of commencing supervision. That plan should be designed to address the deficiencies in the following areas of your practice:

- report writing, to the extent they form part of your practice and acting within your scope of practice

- maintaining professional boundaries

- reflective practice and self-care.

4. You must forward a copy of your Personal and Professional Development Plan to the HCPC within one month of it having been formulated.

5. You must meet with your supervisor on at least a monthly basis to reflect on and consider your progress towards achieving the aims set out in your Personal and Professional Development Plan.

6. You must allow your supervisor to provide information to the HCPC concerning your progress towards achieving the aims set out in your Personal and Professional Development Plan.

7. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

17. The substantive panel decided to impose the Order for 18 months.

18. Since the substantive hearing, the Registrant had produced two Supervision Reports, dated 30 August 2017 and 30 April 2018, and a witness statement dated 15 May 2018 from his supervisor. The reviewing Panel took this material into account in reaching its decision.

19. The Panel was informed that, since the imposition of the Conditions of Practice Order, the Registrant had had significant difficulties in obtaining employment as a registered Practitioner Psychologist. He had undertaken a voluntary counsellor role at the Awareness Centre, contracted to NHS Wandsworth, NHS Lambert and HMP Brixton, to provide IAPT services, on 22 July 2017. However, the Registrant was discharged after the clinical manager returned from leave in September 2017. The HCPC was informed that the Registrant now counselled one client on a private basis.

20. The Registrant attended regular supervision in connection with his voluntary work at the Awareness Centre, although technically his work did not require him to do so, and it was the supervisor of these sessions who provided the two reports and the witness statement referred to earlier in this determination.

21. Since the termination of his voluntary work, the Registrant had been unable to secure further work, either paid or voluntary.

22. Mr Lazarus’s sole submission on behalf of the Registrant was that the requirement to notify potential employers of the existence of the Conditions should be removed. He argued that Registrant’s integrity was not in question, that he had self-referred, and that he had been seeing a supervisor on a regular basis in connection with his voluntary work when there had been no requirement on him to do so. In those circumstances, the Panel could be satisfied that he would inform his employers of the existence of the Conditions, and it followed that there was no need to impose that particular Condition.

Decision

23. This Panel considered the issues carefully. It listened to and accepted the advice of the Legal Assessor. It paid attention to the HCPC’s “Indicative Sanctions Policy”.

24. The Panel drew no adverse conclusions from the Registrant’s absence and was satisfied that his interests had been covered by his legal representative.

25. Both parties accepted that the Registrant’s fitness to practise remains impaired. Nevertheless, the Panel was aware that it had a duty to reach its own decision. The Panel agreed with the conclusion reached by the substantive panel, for the reasons set out in its determination as summarised above, that the Registrant’s fitness to practise had been impaired at the time of the substantive hearing. The Panel had been provided with no material to suggest that the Registrant’s fitness to practise no longer remained impaired. The Registrant was not in a position to provide evidence of remediation. He had not managed to obtain employment as a regulated professional. The Panel could only conclude that there remained a likelihood of repetition of the Registrant’s failings if he were to be allowed to practise unrestricted. Accordingly, the Registrant remained a risk to the public if permitted to practice as a Practitioner Psychologist unrestricted.

26. The Panel also found that public confidence in the profession and the declaring of proper standards of conduct and performance demanded a finding of impairment for the same reasons as had been identified by the substantive panel.

27. The Panel considered whether to make no order or to impose a Caution Order but concluded that this would not be sufficient to protect the public or satisfy the public interest.

28. The Panel concluded that a Conditions of Practice Order was the appropriate and proportionate response in the circumstances of the case. The Panel accepted that this had been an isolated incident, but nevertheless it had had the potential to place Patient B’s child at risk of harm and was serious.

29. The Panel then gave consideration to the current Conditions.

30. The Panel did not accept the argument put forward by Mr Lazarus that Condition 1 should be removed. The Panel accepted that the Registrant’s integrity had not been brought into question but questioned why there was a need for removal of this Condition if it was the Registrant’s intention to declare the existence of the Conditions of Practice Order in any event. In those circumstances, it did not consider that it would be disproportionate to maintain it in its current form. Additionally, the Panel was mindful of its duty to protect the public, which included the need to ensure that every registrant declares the existence of a Conditions of Practice Order to his or her regulator.

31. However, the Panel concluded that a number of other Conditions could be amended. It therefore decided to vary the existing Order as follows:

The Registrar is directed to annotate the Register to show that for 12 months, from the expiry of the existing Order, you, Mr Philip Ma, must comply with the following conditions of practice:

1. You must inform the following parties that your registration is subject to these conditions:

a. any organisation or person employing or contracting with you to undertake professional work which requires HCPC registration.

b. any agency you are registered with or apply to be registered with (at the time of application) when seeking to undertake professional work which requires HCPC registration.

c. any prospective employer (at the time of your application) when seeking to undertake professional work which requires HCPC registration.

2. When undertaking professional work, which requires HCPC registration, you must place yourself and remain under the supervision of a suitable workplace supervisor who is a qualified and registered healthcare professional relevant to your clinical practice and supply details of your supervisor to the HCPC within 21 days of commencing any such professional work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with that supervisor to formulate a Personal and Professional Development Plan within 2 months of commencing supervision. That plan should be designed to address the deficiencies in the following areas of your practice:

- report writing, to the extent they form part of your practice and acting within your scope of practice

- maintaining professional boundaries

4. You must forward a copy of your Personal and Professional Development Plan to the HCPC within one month of it having been formulated.

5. You must meet with your supervisor on at least a six weekly basis to reflect on and consider your progress towards achieving the aims set out in your Personal and Professional Development Plan.

6. You must allow your supervisor to provide information to the HCPC concerning your progress towards achieving the aims set out in your Personal and Professional Development Plan.

7. you must write and submit a reflective piece within one month of the next review hearing that demonstrates your understanding and acceptance that you did not adequately manage your professional standards and explaining how you have addressed this with regard to your future practice.

8. Prior to your next hearing you must provide up to date testimonials in respect of any work you have undertaken whether paid or unpaid.

9. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

32. The Panel concluded that it would be appropriate and proportionate to extend the current Order for a further year (12 months) to give the Registrant a further opportunity to remediate his misconduct and to comply with the current Conditions.

Order

That the current Conditions of Practise Order be varied and extended for a further period of 12 months on the expiry of the existing Order.

The Registrar is directed to annotate the Register to show that for 12 months from the expiry of the existing Order, you, Mr Philip Ma, must comply with the following conditions of practice:

1. You must inform the following parties that your registration is subject to these conditions:

a. any organisation or person employing or contracting with you to undertake professional work which requires HCPC registration.

b. any agency you are registered with or apply to be registered with (at the time of application) when seeking to undertake professional work which requires HCPC registration.

c. any prospective employer (at the time of your application) when seeking to undertake professional work which requires HCPC registration.

2. When undertaking professional work, which requires HCPC registration, you must place yourself and remain under the supervision of a suitable workplace supervisor who is a qualified and registered healthcare professional relevant to your clinical practice and supply details of your supervisor to the HCPC within 21 days of commencing any such professional work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with that supervisor to formulate a Personal and Professional Development Plan within 2 months of commencing supervision. That plan should be designed to address the deficiencies in the following areas of your practice:

- report writing, to the extent they form part of your practice and acting within your scope of practice

- maintaining professional boundaries

4. You must forward a copy of your Personal and Professional Development Plan to the HCPC within one month of it having been formulated.

5. You must meet with your supervisor on at least a six weekly basis to reflect on and consider your progress towards achieving the aims set out in your Personal and Professional Development Plan.

6. You must allow your supervisor to provide information to the HCPC concerning your progress towards achieving the aims set out in your Personal and Professional Development Plan.

7. you must write and submit a reflective piece within one month of the next review hearing that demonstrates your understanding and acceptance that you did not adequately manage your professional standards and explaining how you have addressed this with regard to your future practice.

8. Prior to your next hearing you must provide up to date testimonials in respect of any work you have undertaken whether paid or unpaid.

9. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

Notes

The Order imposed today will take effect from the expiry of the current order on 2 July 2018.

The order will be reviewed again before its expiry on 2 July 2019.

Hearing History

History of Hearings for Mr Philip Ma

Date Panel Hearing type Outcomes / Status
25/05/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
28/11/2016 Conduct and Competence Committee Final Hearing Conditions of Practice