Dr Rajshree Weston

Profession: Practitioner psychologist

Registration Number: PYL22289

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 28/09/2018 End: 16:00 28/09/2018

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

Panel: Conduct and Competence Committee
Outcome: Suspended

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.

 

Allegation

 

Allegation (as amended at the Final Hearing commencing 3 September 2018)

 

Whilst registered as a Practitioner Psychologist:

 

1. In relation to Service User A:


a) Between approximately 2014 and March 2017 you maintained contact with Service User A after Service User A had ceased to be under your clinical care.


b) On or around 5 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:


i. Requested confidential information regarding Service User A including:


a. Details of Service User A’s Section 17 leave; and


b. Details of her prescribed medication.


ii. Stated that Service User A did not require escorts


iii. Requested that Service User A's Section 17 leave be reviewed that day;


iv. Requested that there be no escorts during your visit.


c) On or around 6 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:


i. Stated that “If observing staff are going to be present, I will not attend” or words to that effect;


ii. Requested confidential information regarding Service User A’s Section 17 leave;


iii. Stated “This is not a standard friendship I am an ongoing supporting professional previously involved in [Service User A]’s care” or words to that effect.


d) On or around 9th May 2016 you visited Service User A and you:


i. Suggested that Service User A's care team should "make allowances" for you or words to that effect;


ii. Did not acknowledge the care team’s concerns about Service User A’s perception of your relationship with Service User A;


iii. Requested confidential information about Service User A from Service User A's care team;


iv. Expressed dissatisfaction at having to comply with the hospital’s policies around visit times and protected meal times;


v. When advised that it would not be appropriate to bring your boyfriend to a visit you stated "it wouldn’t be a problem because of who I am" or words to that effect;


vi. Told Service User A that the Psychologist and Ward Doctor said [Service User A] would "freak out" if you [the Registrant] brought your boyfriend with you, or words to that effect;


vii. Asked Service User A why Service User A didn’t want to meet your boyfriend and suggested that you would bring him next time "just to see how it goes" or words to that effect;


viii. Told Service User A that you would not be able to talk properly with Service User A whilst the observing staff were present, or words to that effect;


ix. Suggested that it might be possible for Service User A to move to your practice area or words to that effect;


x. Encouraged Service User A to request unescorted Section 17 leave;


xi. Asked Service User A if your "weekly sessions were helping" or words to that effect.


e) On or around 23 May 2016 you informed Service User A that your boyfriend had committed suicide.


f) In June 2016, during a weekly telephone conversation you told Service User A that you missed your boyfriend.


g) During a weekly telephone conversation, you became upset whilst talking to Service User A about your boyfriend.


h) On or around 5 November 2016 you attended Service User A’s family home during Service User A's Section 17 leave:


i. Without prior discussion or agreement from Service User A's treating hospital;


ii. Suggested during the visit that Service User A should move to Cambridge after Service User A is discharged;


iii. Suggested Service User A could attend your son’s football matches with you after Service User A is discharged;
[HCPC offered no evidence]


iv. iv. Asked Service User A if one of the escorting staff members was the reason Service User A didn’t want to come to Cambridge or words to that effect.


i) On an unknown date told Service User A that you didn’t think Service User A had Autism Spectrum Disorder ("ASD") despite that fact that Service User A had recently been assessed and diagnosed. [HCPC offered no evidence]


j) On or around 25th November 2016 you told Service User A that you wanted to be present at an assessment for a specialist ASD service and / or you wanted to be part of the deciding panel, or words to that effect.


k) In approximately March 2017 you told Service User A that if Service User A doesn’t believe in God Service User A will "burn in hellfire" or words to that effect


2. The matters set out 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.

 

Finding

Preliminary Matters:

Application to Amend the Allegation

1. At the outset of the hearing Ms Eales, on behalf of the HCPC, made an application to make the following amendments:

• Paragraph 1(b)(i) – deleting, ‘…’s Section 17 leaving…’ and replacing these words with:

‘Including:

a. Details of Service User A’s Section 17 leave; and

b. Details of her prescribed medication.’

• Paragraph 1(e) – deleting, ‘killed himself’ and replacing these words with ‘committed suicide.’

• Inserting a new Paragraph 1(g) - ‘During a weekly telephone conversation, you became upset whilst talking to Service User A about your boyfriend.’

• and re-numbering the remaining paragraphs.

2. Mr Saad did not oppose the application to amend.

3. The Panel noted that the Registrant had been put on notice of the proposed amendments in a letter dated 23 January 2018. The Panel was satisfied, having accepted the advice of the Legal Assessor, that the Allegation should be amended as requested as the proposed amendments:

• provided helpful clarification;

• avoided ambiguity;

• did not alter the substance or meaning of the Allegation as originally drafted and did not widen the scope of the HCPC’s case.

4. The Panel was also satisfied that the amendments would cause no injustice to the Registrant as they were minor in nature and more accurately reflected the HCPC’s case.

Application to exclude hearsay evidence

5. Mr Saad made an application for the hearsay evidence of CM1 to be excluded. He submitted that as the HCPC was not intending to call CM1 as a witness it would be unfair for the Panel to rely on her statement as the statement was made 10 months after the alleged event and is the sole evidence in support of particular 1(h)(iv).

6. Ms Eales, on behalf of the HCPC, opposed the application. She submitted that the evidence should not be excluded as the Panel will be able to afford it as much weight as it deemed to be appropriate.

7. Although the Panel acknowledged that the evidence of CM1 was relevant to particular 1(h)(iv) it determined that her evidence should be excluded. The Panel concluded that it would be unfair to the Registrant to place any reliance on CM1’s statement for the following reasons:

(i) As CM1 would not be called as a witness there would be no opportunity for her evidence to be tested by way of cross examination.

(ii) CM1’s evidence was the sole evidence in support of particular 1(h)(iv).

(iii) The contents of CM1’s statement related to an alleged event that took place 10 months prior to the date of the statement.

Background

8. The Registrant is a Practitioner Psychologist. The HCPC Allegation concerns the Registrant’s relationship with Service User A.

9. Based on the HCPC’s opening statement the background circumstances were as follows:

i. The Registrant was Service User A’s case manager during her role at Cambridgeshire & Peterborough Foundation Trust as part of the complex cases team. Service User A had a diagnosis of Personality Disorder and Autism. Due to her Autism, Service User A had difficulty with interacting and expressing her thoughts and feelings. She would become intolerant of people entering her personal space. Due to her personality disorder she experienced impulsive behaviour and problems controlling her emotions which placed her at risk to herself and others. She had issues surrounding abandonment and struggled to form appropriate relationships. In addition, Service User A had a high risk of absconding and when she did abscond historically she would engage in self-harming or suicidal behaviour.

ii. In April 2016 Service User A was a patient on the Bowling Ward, a Specialist Female Personality Disorder Ward at Cygnet Hospital. On 21 April 2016, Witness BW, a Preceptorship Nurse at the hospital, took Service User A on Section 17 leave. Section 17 leave refers to Section 17 of the Mental Health Act 1983 and allows for a patient to be absent from the hospital subject to certain conditions. During this leave, Service User A informed Witness BW, that she had been in contact with a professional who had been formerly involved in her care – the Registrant. Service User A explained that she had telephone contact with the Registrant every Tuesday to discuss ‘thoughts and feelings’. Service User A explained that the Registrant was ‘working private’ but would ‘never charge’ her as she was a friend. Service User A went on to explain that she was aware of personal details regarding Dr Weston’s relationships.

iii. On 5 May 2016 Witness BW spoke with the Registrant on the telephone. It was alleged by the HCPC that during the telephone discussion the Registrant requested details of Service User A’s medication and also asked why Service User A required two members of staff during her Section 17 leave. The Registrant went on to state that she wished to take Service User A on leave by herself and that she was unable to understand the importance of the requirement for two escorts to be present. The Registrant also allegedly stated, ‘if observing staff are going to be present, I will not attend’.

iv. On 6 May 2016 witness BW received a telephone call from the Registrant. The telephone call was in relation to Service User A’s leave on 9 May 2016. During the telephone conversation that took place the Registrant was informed that the Service User A would be able to have one hour with her in the visitor’s room accompanied by one member of staff and then one and half hours escorted local leave with two members of staff. In response the Registrant allegedly stated, ‘if observing staff are going to be present, I will not attend.’ The Registrant went on to ask for the rationale for the decision and stated that Service User A did not need to be escorted by two members of staff. Witness BW stated that she was unable to discuss Service User A’s care with the Registrant but the Registrant continued to ask about Service user A’s risk on the basis that she was a professional.

v. On 9 May 2016, the Registrant visited Service User A. Dr RN, a Clinical Psychologist met the Registrant on 9 May 2016 to discuss concerns regarding the visit she was about to have with Service User A. Dr RN explained in her witness statement that the Registrant suggested the care team should ‘make allowances’ for her in relation to the visit and disregarded Service User A’s protected mealtime. It was explained to the Registrant that the care team had a duty to encourage Service User A’s healthy lifestyle and ensure she had an opportunity to eat, particularly given Service User A had historical issues with an eating disorder. The HCPC alleged that during that visit, the Registrant did not acknowledge the care team’s concerns about Service User A’s perception of the Registrant’s relationship with her and how it may impact upon her recovery. The Registrant suggested that she had planned to bring her male partner to visit Service User A. The Registrant did not accept the care team’s perspective on this and allegedly stated ‘it would not be a problem’ because of who she was. Dr RN explained that this was not in the best interests of Service User A. Service User A had difficulties in interacting with men in particular, and could become highly anxious around men such that the care team had to manage her contact with male staff as part of risk assessment and care planning.

vi. The Registrant went on to tell Service User A that Service User A’s doctor and psychologist thought she would ‘freak out’ if the Registrant brought her partner to meet her. She went on to state that she would bring him along to the next visit ‘just to see what happens’. During the visit the Registrant told Service User A that they would not be able to talk properly in front of the observing staff. It later transpired that the Registrant had suggested to Service User A that it might be possible for her to move to the Registrant’s practice area and encouraged her to ask for unescorted Section 17 leave.

vii. On 23 May 2016, Witness CM, a nursing assistant at Cygnet Hospital, walked in on a conversation Service User A was having with another patient. Service User A explained that the Registrant had told her during a telephone call that she would not be meeting her partner as he had committed suicide. A month later on 23 June Dr RN had a weekly psychology session with Service User A. Service User A reported that the Registrant had told her she missed her boyfriend and had been upset. She explained that she thought about the Registrant a lot after her telephone conversations with her and worried about her. Service User A explained that she thought more about death and suicide after these conversations. It was around this time that Service User A herself had attempted suicide.

viii. On 5 November 2016, Service User A was on Section 17 leave and at her family home when the Registrant attended. The care team had not been informed that the Registrant was going to attend. During this visit the Registrant suggested to Service User A that she move to Cambridgeshire when she was released from hospital and went on to question Service User A whether the reason Service User A did not want to move was due to the relationship between her and the escorting staff members.

ix. Later that month, on 25 November 2016, Service User A informed Dr RN that the Registrant told her that she wanted to be present at an assessment for a specialist Autism Spectrum Disorder Service that Service User A had been referred to. Service User A reported that the Registrant had told her she wanted to be part of the team making the decision regarding this potential move.

x. On 13 March, during a psychology session, Service User A reported to Dr RN that the Registrant had said to her ‘if you don’t believe in god you’ll burn in hellfire’ or words to that effect. Service User A went on to express her anxiety about going to hell and had been ruminating on this since their conversation.

Assessment of Witnesses

Witness BW – Mental Health Nurse

10. Witness BW was credible and honest and candid when asked questions regarding areas of her evidence which she could not clearly recollect.

Witness CM – Nursing Assistant

11. Witness CM was credible and honest and candid when asked questions regarding areas of her evidence which she could not clearly recollect.

Dr RN – Psychologist for Service User A

12. Dr RN was credible and honest and candid when asked questions regarding areas of her evidence which she could not clearly recollect.

Witness LS – Healthcare Support Worker

13. Witness LS was credible and honest and candid when asked questions regarding areas of her evidence which she could not clearly recollect.

The Registrant

14. The Registrant chose to give evidence. The Panel found the Registrant to be honest when giving her evidence. She was open and candid when unable to recall details. The Panel was informed by Mr Saad that the Registrant has an unblemished record in terms of her regulator and has worked for many years.

Decision on Facts

Panel’s Approach

15. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the Allegation could only be found proved, if the Panel was satisfied, on the balance of probabilities.

16. The Panel accepted the advice from the Legal Assessor. In reaching its decision the Panel took into account the oral evidence of the HCPC witnesses, the Registrant’s oral evidence, the written and documentary evidence as well as the oral submissions made on behalf of both parties.

17. The Panel noted that the Registrant admitted 20 particulars at the outset and took these admissions into account when determining the facts of the case.

Particular 1(a) – Found Proved

 ‘Between approximately 2014 and March 2017 you maintained contact with Service User A after Service User A had ceased to be under your clinical care.’

18. Witness BW informed the Panel in her witness statement that she was informed by Service User A that she had initiated contact with the Registrant. Service User A stated that the Registrant had previously been involved in her care. Service User A confirmed to BW that she was in regular phone contact with the Registrant. Witness BW explained that it was unusual for a Psychologist to have such a relationship with a service user after their professional relationship had ceased and she had not seen this happen with anyone else.

19. The evidence of Witness BW was corroborated by the evidence of Dr RN, who informed the Panel in her witness statement that she was aware that the Registrant had been employed by the NHS Trust in Service User A’s home area a number of years before and had provided community services to Service User A. Dr RN stated that Service User A made reference to telephone calls and visits from the Registrant.

20. The Registrant admitted that she had maintained contact with Service User A between approximately 2014 and March 2017 after she had ceased to be under her clinical care. She stated during her oral evidence that Service User A had been allocated to her at the Cambridgeshire and Peterborough Foundation Trust in August 2009 and that the therapeutic relationship ended in December 2010. The Registrant informed the Panel that she was contacted by Service User A by email in November 2014. The email stated, ‘I need you’. The Registrant confirmed that she visited Service User A at a hospital in Peterborough where she was an inpatient and took her out on two unescorted visits. The Registrant informed the Panel that Service User A subsequently moved to Cygnet Hospital in Bradford and she had regular telephone contact and three visits with Service User A up until the period ending March 2017.

21. Accordingly, particular 1(a) was found proved.

Particular 1(b)(i)(a) – Found Proved

‘On or around 5 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:
Requested confidential information regarding Service User A including:
Details of Service User A’s Section 17 leave;…’


22. Witness BW informed the Panel in her witness statement that she had a telephone conversation with the Registrant on 5 May 2016. She stated that the Registrant was ‘very hostile and adamant’ that she wanted to speak to Service User A’s Responsible Clinician and demanded to know why Service User A required two members of staff during her Section 17 leave. Dr RN spoke with Witness BW following the telephone discussion. Dr RN confirmed in her witness statement that it was her understanding that the Registrant had requested confidential information regarding the specific risks which required two escorts to accompany Service User A whilst on Section 17 leave.

23. The Registrant admitted this particular. She explained, during her oral evidence, that she was trying to obtain information about Service User A’s Section 17 leave as she had made arrangements for Service User A to meet her partner. She stated that there was a significant difference between a 4 hour break, which she had anticipated, and a 1 hour escorted visit. The Registrant informed the Panel that she was seeking clarification because she did not want to let Service User A down.

24. The Panel was satisfied that the details of the Section 17 leave were confidential and that such information would only be given out on a ‘need to know’ basis. The Panel accepted that friends and family would not usually given be given this information unless there were particular circumstances.

25. Accordingly, particular 1(b)(i)(a) was found proved.

Particular 1(b)(i)(b) – Found Proved

‘On or around 5 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:
Requested confidential information regarding Service User A including:
details of her prescribed medication.’

26. Witness BW stated in her witness statement that during the telephone conversation that she had with the Registrant on 5 May 2016, the Registrant requested further details of Service User A’s prescribed medication, in particular her fortnightly depot medication. When she was cross-examined, Witness BW accepted that she had not referred to the conversation about medication within her statement of 24 March 2017, however, she went on to state that she was ‘quite sure’ it was discussed on the phone and recalled ‘multiple’ conversations about the medication, the depot and Section 17 leave.

27. The Panel noted that the Registrant denied this particular. However, she accepted under cross examination that she could not clearly recall and confirmed that the conversation ‘could have happened’. She added that if it had happened, it would have been because she wanted to confirm whether or not what Service User A had told her on the telephone was accurate.

28. The Panel preferred the evidence of Witness BW on this issue and concluded that the Registrant did request details of Service User A’s prescribed medication during that telephone call.

29. The Panel was satisfied that Service User A’s medication was confidential information and that such information would only be given out on a ‘need to know’ basis. The Panel accepted that friends and family would not usually given be given this information unless there were particular circumstances.

30. Accordingly, particular 1(b)(i)(b) was found proved.

Particulars 1(b)(ii), (iii) and (iv) – Found Proved

‘On or around 5 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:
Stated that Service User A did not require escorts;
Requested that Service User A's Section 17 leave be reviewed that day;
Requested that there be no escorts during your visit.’

31. Witness BW informed the Panel that during the telephone conversation the Registrant stated that she was a professional and that she would be able to take Service User A out on Section 17 leave on her own. Witness BW expressed surprise that the Registrant did not respect the view of the Multi-Disciplinary Team (MDT) who were responsible for Service User A’s care. Witness BW also expressed concern that the Registrant appeared to disregard the view of the MDT in their decision regarding Service User A’s risk and safety. She stated that although she explained that Section 17 leave was a legal document authorised by the Responsible Clinician, discussed and agreed with the whole MDT, the Registrant requested the leave was reviewed again by the Responsible Clinician on that day.

32. The Registrant admitted these particulars.

33. Accordingly, particulars 1(b)(ii), (iii) and (iv) were found proved.


Particular 1(c)(i) – Found Proved

‘On or around 6 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:
Stated that “If observing staff are going to be present, I will not attend” or words to that effect;’

34. Witness BW informed the Panel in her witness statement that she told the Registrant during the telephone conversation on 6 May 2016, that she would be able to see service user A for one hour in the visitor’s room on 9 May 2016. She stated that she explained that the visit would be for one hour accompanied by a member of staff and that the escorted local leave would be for one and a half hours with two members of staff. The Panel was provided with a note of this conversation made from reading Service User A’s records. Witness BW explained that she was sure the Registrant stated, ‘If observing staff are going to be present, I will not attend” or words to that effect;’ as she recalled thinking that it should not matter whether she (Witness BW) was there or not. When cross-examined Witness BW explained that the Registrant ‘definitely’ made the comment.

35. The Registrant denied this particular at the outset of the hearing but accepted that her recollection was vague. In oral evidence, she conceded that she ‘might have questioned it’ and that she ‘wasn’t thinking’. She said it was an attempt to have a conversation about the quality of the interaction and how important it was for Service User A that she did not let her down or disappoint her.

36. The Panel preferred the clear and consistent evidence of Witness BW and concluded that the Registrant had used the words as set out above or words to that effect.

37. Accordingly, particular 1(c)(i) was found proved.

Particulars 1(c)(ii) and 1(c)(iii) - Found Proved

‘On or around 6 May 2016 you had a telephone conversation with a member of Service User A’s treatment team regarding your scheduled visit on 9 May 2016 and you:
Requested confidential information regarding Service User A’s Section 17 leave;
Stated “This is not a standard friendship I am an ongoing supporting professional previously involved in [Service User A]’s care” or words to that effect.

38. Witness BW informed the Panel in her witness statement that during the telephone conversation with the Registrant on 6 May 2016, the Registrant asked for the rationale behind the decision with regard to escorts and expressed the view that this was not necessary. Witness BW stated that she informed the Registrant that she would not be able to discuss Service User A’s care with her.

39. Witness BW had another conversation with the Registrant during which the nature of the Registrant’s relationship with Service User A was discussed. Witness BW was unsure of the exact date and time of the telephone conversation. She informed the Panel in her witness statement that when she asked the Registrant what her role was the Registrant responded, ‘This is not a standard friendship I am an ongoing supporting professional previously involved in [Service User A]’s care’, or words to that effect. During her oral evidence Witness BW stated that it was unclear to her what the relationship between the Registrant and Service User A was. In her view as the Registrant had previously been involved in Service User A’s care, the relationship should have ceased once Service User A was no longer under her care.

40. Dr RN explained during her evidence that the concern was that because of Service User A’s previous experiences, she had very little experience of healthy relationships. Service User A had experienced exploitation and abuse by professionals and people in power in terms of the care she received and any further negative experiences would have a lasting effect on her ability to form relationships, understand what to expect from these relationships and who to trust. She informed the Panel that it may also have had an impact on Service User A’s ability to form appropriate relationships in the future and manage endings of professional relationships.

41. The Registrant accepted these particulars.

42. Accordingly, particulars 1(c)(ii) and (iii) were found proved.

Particular 1(d)(i) – Found Proved

On or around 9th May 2016 you visited Service User A and you:
Suggested that Service User A's care team should "make allowances" for you or words to that effect;

43. Dr RN confirmed in her witness statement that the Registrant visited Service User A on 9 May 2016. She explained that the hospital policy was that service users had ‘protected meal times’ between 12.00 and 13.00 which meant that no visits would be scheduled during this time period. Dr RN stated that the Registrant attended early for her visit with Service User A and due to concerns regarding the Registrant’s telephone conversation with Witness BW on 6 May 2016, Dr RN met with the Registrant prior to the visit. During the meeting, Dr RN formed the view that the Registrant was not happy that she could not meet Service User A when she arrived and was not happy about the ‘protected meal times’ rule. Dr RN stated that the Registrant suggested that the care team should make allowances for her because of the distance that she had travelled to attend the visit. During her oral evidence Dr RN explained that she believed that the Registrant had used the words ‘make allowances’ as she had noted these words in quotation marks (in the same way as she had with other phrases used by the Registrant) in her email the following day.

44. The Registrant denied this particular at the outset of the hearing. However, under cross-examination she stated that while she ‘didn’t think’ she had used these words it was fair to say she ‘couldn’t recall’.

45. The Panel preferred the clear and consistent evidence of Dr RN and concluded that the Registrant had used the words as set out above or words to that effect.

46. Accordingly, particular 1(d)(i) was found proved.

Particular 1d(ii) – Found Proved

On or around 9th May 2016 you visited Service User A and you:
Did not acknowledge the care team’s concerns about Service User A’s perception of your relationship with Service User A;

47. Dr RN informed the Panel that in addition to the suggestion that the care team ‘make allowances’ the Registrant expressed dissatisfaction that she was not able to take Service User A to Bradford and commented that, given the distance that she had travelled, it was not worth a visit on the hospital site. Dr RN stated in her witness statement that she explained Service User A’s Section 17 leave and the concerns that the care team had with regard to the relationship between the Registrant and Service User A. She informed the Panel that she also explained that there was a concern about Service User A’s understanding of the relationship and how this fitted in with her therapeutic treatment. Dr RN stated that she informed the Registrant that Service User A had difficulties in dealing with uncertainty and unclear boundaries and there was a risk that she would receive conflicting advice in relation to her mental health which could impact on her recovery. Dr RN stated that the Registrant did not acknowledge these concerns. During her oral evidence Dr RN stated ‘there was no expression of acknowledging or understanding’ from the Registrant.

48. The Registrant denied this particular at the outset of the hearing. In questioning from the Panel she stated that on reflection she failed to explain her approach compared with theirs. She said she understood their view but she wanted them to understand her view. The Panel preferred the clear and consistent evidence of Dr RN and concluded that the Registrant had not demonstrated in that meeting that she acknowledged or understood the care team’s concerns whether she agreed with it or not.

49. Accordingly, particular 1(d)(ii) was found proved.

Particular 1(d)(iii) and (iv) – Found Proved

On or around 9th May 2016 you visited Service User A and you:
Requested confidential information about Service User A from Service User A's care team;
Expressed dissatisfaction at having to comply with the hospital’s policies around visit times and protected meal times;

50. Dr RN informed the Panel in her witness statement that the Registrant was unhappy that the leave would be escorted and observed by hospital staff. It was explained to the Registrant that this was in accordance with hospital policy based on their assessment of risk. Dr RN stated that the Registrant went on to enquire what those risks were. Dr RN explained that the team did not feel comfortable sharing that information with the Registrant as it was confidential.

51. The Panel took into account its factual findings in relation to particular 1(d)(i) and was satisfied that the Registrant ‘s comments with regard to the ‘protected meal times’ amounted to an expression of dissatisfaction at having to comply with the hospital policies with regard to visits and mealtimes.

52. The Registrant admitted these particulars at the outset of the hearing.

53. Accordingly, particulars 1(d)(iii) and (iv) were found proved.

Particular 1(d)(v) – Found Proved

‘On or around 9th May 2016 you visited Service User A and you:
When advised that it would not be appropriate to bring your boyfriend to a visit you stated "it wouldn’t be a problem because of who I am" or words to that effect;’

54. Dr RN informed the Panel that she was quite sure that the Registrant had used the words as set out in the particular as she had documented it in the notes after the meeting. The Panel noted that reference to this comment was within the email sent by Dr RN the day after the visit. Dr RN explained that the team had observed Service User A become highly anxious with men, even when she was familiar with them and that managing contact with male staff formed part of Service User A’s risk assessments and care planning.

55. The Registrant denied this particular. During her oral evidence she explained that she wanted Service User A to have experience of a ‘kind and gentle’ man. However, the Panel preferred the clear and consistent evidence of Dr RN and concluded that the Registrant had used the words as set out in the particular. In reaching this conclusion the Panel noted that the comment was consistent with the Registrant’s view that Service User A had a strong attachment to her and her own view that she would be able to contain Service User A because of their long-term relationship.

56. Accordingly, particular 1(d)(iii) was found proved.

Particular 1(d)(vi) and (vii) – Found Proved

‘‘On or around 9th May 2016 you visited Service User A and you:
Told Service User A that the Psychologist and Ward Doctor said [Service User A] would "freak out" if you [the Registrant] brought your boyfriend with you, or words to that effect;
Asked Service User A why Service User A didn’t want to meet your boyfriend and suggested that you would bring him next time "just to see how it goes" or words to that effect;

57. Dr RN explained in her witness statement that the ‘freak out’ comment was inappropriate as it was an inflammatory comment and undermined the care team and minimised their concerns and the importance of the meeting with the Registrant. In relation to ‘seeing how it goes’, Dr RN explained her concern that the comment highlighted the power imbalance between Service User A and the Registrant. She informed the Panel that it suggested that the Registrant was not considering what would be in Service User A’s best interests. She explained that she found it difficult to understand that the Registrant asked her why she did not want to meet the male partner and that this may have put a pressure on Service User A to agree to something that made her uncomfortable in order to please the Registrant. The Panel noted that this was within the context of Service User A’s difficulties around males.

58. The Registrant admitted these particulars at the outset of the hearing.

59. Accordingly, particulars 1(d)(vi) and (vii) were found proved.

Particular 1(d)(viii) – Found Proved

‘‘On or around 9th May 2016 you visited Service User A and you:
Told Service User A that you would not be able to talk properly with Service User A whilst the observing staff were present, or words to that effect;

60. Witness BW informed the Panel in her witness statement that she was present during the visit and heard the registrant make the comment as set out in the particular. She explained she was sure that was what was said and remembered the incident and the comment because she felt uncomfortable due to the Registrant’s behaviour. She said she felt as though she should not be there. When Witness BW was cross-examined she explained that she remembered the Registrant making the comment and recalled thinking ‘Oh thanks!’ in response.

61. The Registrant denied the particular. She stated during her oral evidence that she did not make the comment but that both her and Service User A ‘felt it’.
62. The Panel preferred the clear and consistent evidence of Witness BW and concluded that the Registrant had made the comment as alleged.

63. Accordingly, particular 1(d)(viii) was found proved.

Particulars 1(d)(ix), (x) and (xi) – Found Proved

‘On or around 9th May 2016 you visited Service User A and you:
Suggested that it might be possible for Service User A to move to your practice area or words to that effect;’
Encouraged Service User A to request unescorted Section 17 leave;
Asked Service User A if your "weekly sessions were helping" or words to that effect.’

64. Dr RN explained in her witness statement that she was concerned by the Registrant’s conduct. She explained that the comment about moving to the Registrant’s practice area highlighted the power dynamic between the Registrant and Service User A and the concern that Service User A would do anything to please the Registrant. In addition, she informed the Panel that the suggestion may not have been in the best interests of Service User A. Dr RN stated in her witness statement that Service User A had had negative experiences in Cambridgeshire and had previously stated she did not wish to return there. During her oral evidence Dr RN explained that the care team had discussed the possibility of Service User A moving back home and this was a possibility, however she explained that whether it was in Service User A’s best interests depended on a number of factors. Service User A later reported that the Registrant had stated that she herself was ‘bored and lonely’ when suggesting Service User A return to Cambridge. Dr RN explained this was not a reason for Service User A to move back.

65. In relation to the Registrant encouraging unescorted leave, Dr RN explained that this was an example of the Registrant suggesting something that may not have been facilitated and could have resulted in Service User A becoming upset and undermining her relationship with her current care team. Dr RN explained that the team had already explained to the Registrant that the request was unlikely to be granted due to the risks posed and that the Registrant was setting Service User A up for failure. Further, Dr RN explained that it was in Service User A’s best interests to have escorted leave due to the risks regarding self-harm and suicide.

66. Dr RN explained that the Registrant in asking Service User A if the “weekly sessions” were helping was at risk of causing confusion over the nature of the relationship as there would not be “sessions” within a friendship. She explained that it suggested that the boundaries were unclear and confusing for Service User A. In addition, Dr RN explained that the care team would not be aware of what went on in these sessions and they would not have been recorded or regulated in any way which may have consequences in terms of risk management for Service User A or others.

67. The Registrant accepted these particulars. However, she explained during her oral evidence that she was trying to give Service User A ‘a voice’ and for her to state what she wanted.

68. Accordingly, particulars 1(d)(ix), (x) and (xi) were found proved.

Particulars 1(e) and 1(f) – Found Proved

‘On or around 23 May 2016 you informed Service User A that your boyfriend had committed suicide.
In June 2016, during a weekly telephone conversation you told Service User A that you missed your boyfriend.’

69. Dr RN explained that the Registrant’s contact with Service User A on or around 23 May 2016 was less than a week after Service User A had stated she had taken an overdose. Dr RN explained that there was an ongoing risk of suicide for Service User A and the discussion with the Registrant could have caused further distress to Service User A and potentially increased her risk of suicide. In a session soon after the 23 May 2016, Dr RN explained that Service User A stated she was worrying about the Registrant and that she may kill herself. Dr RN, in her witness statement described Service User A as ‘clearly struggling’.

70. The Registrant explained during her oral evidence that she told Service User A about her boyfriend’s suicide because she asked how her boyfriend was.

71. The Registrant admitted these particulars at the outset of the hearing.

72. Accordingly, particulars 1(e) and 1(f) were found proved.

Particular 1(g) – Found Not Proved

‘During a weekly telephone conversation, you became upset whilst talking to Service User A about your boyfriend.’

73. Witness LS stated in her witness statement that she spoke with Service User A following the disclosure by the Registrant about her boyfriend. She informed the Panel that Service User A stated that the Registrant had been crying on the telephone. Witness LS stated that Service User A had explained that she was supporting Dr RN and that this did not feel right because as a Psychologist, the Registrant should not have needed support from Service User A. Witness LS explained that the Registrant should not have looked to Service User A for support given her vulnerabilities. The Panel noted that this evidence was supported by Dr RN who had a weekly session with Service User A, who told her that the Registrant had been talking about missing her boyfriend and had been upset. Both witnesses stated in oral evidence that Service User A was very upset and worried about the Registrant.

74. The Registrant denied this particular at the outset of the hearing.

75. Although the Panel had no reason to doubt the accuracy of the information Witness LS and Dr RN stated that they had received from Service User A, the Panel was not satisfied that the underlying basis of that information was reliable. The Panel noted that due to Service User A’s vulnerabilities there was considerable scope for her account of the conversation with the Registrant to become distorted because of her own distress. The Panel took the view that it would be unfair to place much weight on the hearsay evidence of Service User A, and in the absence of any other evidence, concluded that insufficient evidence had been adduced.

76. Accordingly, particular 1(g) was found not proved.

Particular 1(h(i) and (ii) – Found Proved

‘On or around 5 November 2016 you attended Service User A’s family home during Service User A's Section 17 leave:
Without prior discussion or agreement from Service User A's treating hospital;
Suggested during the visit that Service User A should move to Cambridge after Service User A is discharged;’

77. Dr RN explained in her witness statement that as part of the agreement to permit Section 17 leave the care team take into account which family members are going to be present. She explained that if any additional people were going to be present, they would want to know this, in the same way they would if a visit was going to take place at the hospital, they would need to know who was attending. She explained they have a duty of care to maintain the safety of service users and visitors, due to the significant vulnerability of many of their service users. She also explained that Section 17 leave is a legal requirement and can state whether certain individuals can be present during leave. Dr RN went on to inform the Panel that the comments regarding Service User A moving to Cambridge were of concern as they highlighted the power imbalance between the two and the influence the Registrant may have on Service User A’s decision making. She stated it also highlighted the unclear boundaries. The Panel noted that ten days later during a weekly psychology session with Dr RN, Service User A explained that the Registrant had asked her to move to Cambridge because the Registrant was ‘lonely and bored’. Dr RN explained that this seemed to concern the Registrant’s needs rather than the needs of Service User A. The Panel noted that the Registrant had already conducted the visit in May and had heard the concerns from the care team, yet she still chose to attend the home visit in November 2014, without informing anyone from the hospital team in advance that she was intending to attend.

78. The Registrant admitted these particulars at the outset of the hearing.

79. Accordingly, particulars h(i) and (ii) were found proved.

Particular h(iii) – Found Not Proved

‘On or around 5 November 2016 you attended Service User A’s family home during Service User A's Section 17 leave:
Suggested Service User A could attend your son’s football matches with you after Service User A is discharged’

80. The HCPC offered no evidence in relation to this particular.

81. Accordingly, particular h(iii) was found not proved.

Particular 1(h)(iv) – Found Not Proved

‘Asked Service User A if one of the escorting staff members was the reason Service User A didn’t want to come to Cambridge or words to that effect.’

82. The Panel excluded the hearsay evidence of Witness CM and as there was no other evidence particular h(iv) was found not proved.

Particular 1(i) – Found Not Proved

‘On an unknown date told Service User A that you didn’t think Service User A had Autism Spectrum Disorder ("ASD") despite that fact that Service User A had recently been assessed and diagnosed

83. The HCPC offered no evidence in relation to this particular.

84. Accordingly, particular h(iv) was found not proved.

Particular 1(j) – Found Proved

On or around 25th November 2016 you told Service User A that you wanted to be present at an assessment for a specialist ASD service and / or you wanted to be part of the deciding panel, or words to that effect.

85. Dr RN stated in her witness statement that Service User A informed her during a session that the Registrant had told her she wanted to be part of the team taking the decision. Dr RN explained that given that the Registrant was not involved in the care of Service User A and was not a family member, it would not be appropriate for her to be present and it was Service User A’s choice who should be there, not the Registrant’s.

86. The Registrant accepted that she told Service User A she wanted to be present at the assessment but denied that she stated she wanted to be part of the deciding panel.

87. The Panel found that the Registrant did tell Service User A that she wanted to be present at the assessment but the Panel did not consider it safe to rely on the hearsay evidence of Service User A as to her having said that she wanted to be part of the deciding Panel. The Panel considered that the Registrant would have known that she would not have been in a position to do so. The Panel preferred the Registrant’s evidence on this point.

88. Accordingly, particular 1(i) was found proved on the basis that the Registrant stated that she wanted to be present. It was not found proved on the basis that she wanted to be part of the deciding panel.

Particular 1(k) – Found Not Proved

k) In approximately March 2017 you told Service User A that if Service User A doesn’t believe in God Service User A will "burn in hellfire" or words to that effect

89. Dr RN stated in her witness statement that Service User A, during a psychology session, became anxious and was not sure whether she believed in God and expressed worry that her family members were ‘going to hell’. Dr RN informed the Panel that Service User A stated she had been ruminating about the issue since she had had the conversation with the Registrant. Dr RN explained that the Registrant should have been aware, because of her knowledge of the psychological process, of the impact that this statement would have on a person who was not sure of their own beliefs. In addition, she explained that the Registrant should have been aware that Service User A may have taken the statement literally because of her diagnoses of Autism Spectrum Disorder. The impact on Service User A was that it affected her mental health.

90. The Registrant vehemently denied saying this and stressed that it was something she would never say. She referred to her own religious and spiritual beliefs. She told the Panel that she had informed Service User A that these matters were “unknowable”.

91. The Panel noted that the Registrant had a close relationship with Service User A and held her in high regard (on the Registrant’s own admission). It considered that Service User A therefore could be influenced by the Registrant’s opinion on spiritual matters. However, the Panel was not satisfied that there was sufficient evidence to find the particular proved. For the reasons stated above regarding the weight that the Panel is able to give to Service User A’s hearsay evidence, the Panel preferred the evidence of the Registrant in regards to this particular.

92. Accordingly, particular 1(k) was found not proved.

Decision on Grounds

93. Having found all of the particulars proved save for particulars 1(g),1h iii, iv, 1(i), and 1 (k) the Panel went on to consider whether the Registrant’s conduct amounted to lack of competence and/or misconduct. The particulars that were found not proved did not form any further part of the Panel’s consideration.

Panel’s Approach

94. In considering lack of competence the Panel bore in mind that it indicates a standard of work that is unacceptably low and is usually demonstrated by a fair sample of the Registrant’s work.

95. The Panel bore in mind that the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 defined misconduct in the following terms:

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession ... Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

96. The Panel took into account the oral submissions of both parties and followed the advice of the Legal Assessor.

Decision - Lack of competence

97. The Panel noted that the concerns raised relate to a single service user and a particular set of circumstances. The Registrant had 18 years’ experience at the time of the Allegation and confirmed that she was aware of the ‘guidance’ and standards relating to maintaining boundaries. The Panel was satisfied that the Registrant was aware of the standards expected of her as a registered practitioner but chose to maintain contact with Service User A in the interests, she said, of responding as a ‘human being’ rather than as a professional. The Panel concluded that the issues that arose from this decision are more appropriately considered within the context of misconduct and in any event do not represent a fair sample upon which the Panel could make a judgment as to the Registrant’s overall competence. The Panel concluded that the Registrant’s acts and omissions did not establish a lack of competence.

Decision - Misconduct

98. The Panel noted that the Registrant’s therapeutic relationship with Service User A ended in 2010. The Panel noted that it is rarely appropriate for professionals to continue or resume contact with former service users after the end of a professional relationship. The Panel was aware that each case has to be assessed on its own merits and requires the Registrant to exercise their own professional judgement as to whether re-establishing and maintaining contact in a different capacity would be appropriate. Mr Saad, on behalf of the Registrant, invited the Panel to assess the issue of misconduct from the point of view that maintaining contact with Service User A was not inappropriate from the outset, but issues arose when the relationship was viewed through a ‘cynical lens’. The Panel did not accept this submission.

99. In assessing the context, the Panel noted that Service User A had complex mental health needs and at the time that she made contact with the Registrant was in a hospital setting in Peterborough. The Registrant informed the Panel through Mr Saad that she did not know if Service User A was being detained under the Mental Health Act at that time. The Panel took the view that Service User A’s status at that time was highly relevant in considering whether it was appropriate to re-establish and maintain contact with her. However, even without that information, by the Registrant’s own admission, the Service User’s initial contact by email stated, ‘I need you’ which clearly indicated that all was not well. The Registrant stated that she was aware that re-establishing contact on a personal level with a former service user was not generally advisable. She also stated that she had discussed the issue with a psychotherapist friend and had been advised ‘do not to go there, but if you have to, set clear boundaries’. The Registrant informed the Panel that Service User A’s contact presented her with a dilemma, in that her “professional integrity” and her “personal integrity” were in conflict. She stated that she “went in as a human being” but was being judged “as a clinical psychologist”.

100. The Registrant informed the Panel that she was a ‘supportive friend’ and had made it quite clear to Service User A where the boundaries of their relationship lay. However, by her own admission, the Registrant stated that she found it difficult at times to separate her personal life from her professional life. The Panel took the view that given that the Registrant found that difficult, there was no clear indication as to how she expected a vulnerable service user to be able to identify the boundaries of that relationship.

101. The Panel took the view that if the Registrant had properly considered the risks that were evident and foreseeable from the outset, and indeed which had been highlighted to her by her psychotherapist friend it is unlikely that she would have agreed to become Service User A’s ‘supportive friend.’

102. In light of the above, although there were some aspects of the Registrant’s conduct and interactions with the care team at the Cygnet Hospital that would have been acceptable, if she had been a carer or a family member, they were not acceptable in the context of a registered professional who was in that position because of a failure to maintain professional boundaries. With that context in mind the Panel concluded that the Registrant’s actions had to be viewed as a course of conduct.

103. The Panel was aware that breach of the standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that the Registrant’s conduct and behaviour fell far below the standards expected of a Registered Practitioner Psychologist. The risks associated with embarking on a personal friendship with Service User A and of that relationship breaking down were obvious from the outset and the Registrant as an experienced professional ought to have been able to recognise that any potential benefit was likely to be outweighed by the risk of harm. There was clearly a power imbalance between the Registrant and her former patient, and there was no indication that the Registrant had fully taken this into account. She told the Panel that she did not get involved in Service User A’s treatment but was empowering her to become involved in her own care plan. She did not acknowledge the risk that her involvement, however well intentioned, might unduly influence Service User A and affect the success of her current care plan, given the fact that she had been Service User A’s case manager some years earlier. The Registrant’s behaviour cannot be described as a momentary failure or a temporary lapse of judgement as it formed part of a pattern of behaviour and even when concerns were raised with her by the care team at the Cygnet Hospital, the Registrant did not acknowledge the concerns.

104. The Panel acknowledged that the Registrant’s involvement was driven by her belief that she was acting in Service User A’s best interest. However, the blurring of the professional boundaries was serious and collectively amounted to misconduct. For example, the Registrant considered it appropriate to involve her own partner in the relationship with Service User A; also, after concerns had been raised by the clinical team, about her planning for her visit of 9 May 2016 she nevertheless omitted to inform them in advance that she was intending to visit Service User A whilst on Section 17 home leave in November 2016.

Decision on Impairment 

Panel’s Approach

105. Having found misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the HCPC Practice Note: “Finding that Fitness to Practise is Impaired” and accepted the advice of the Legal Assessor.

106. In determining current impairment the Panel had regard to the following aspects of the public interest:

• The ‘personal’ component: the current competence, insight, behaviour etc. of the individual registrant; and

• The ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

Decision

107. The Panel took the view that the factual findings raise significant concerns as the Registrant demonstrated a persistent lack of judgment which had the potential to cause harm to Service User A.

108. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

109. The Panel noted that the key events took place between May 2016 and March 2017 and in the intervening period the Registrant had continued to work as a Registered Psychologist in private practice. The Panel also noted that the Registrant had attended various training courses which included mandatory training on safeguarding adults and had read articles on professional boundaries. The Panel was provided with a record of the training and copies of the articles. The Registrant also provided the Panel with five references. The Panel noted that the references were positive but there was no indication that they were prepared specifically for this hearing as there was no acknowledgement that the author was aware of the fitness to practise concerns raised by the Registrant’s previous conduct.

110. Overall, there was some indication that the Registrant had reflected on her behaviour and had taken some steps to address the underlying concerns. However, there were no clear expressions of remorse for the impact the Registrant’s behaviour had on others, and, although she made substantial admissions, she attempted to deflect responsibility rather than accept it. For example, the Registrant asserted that any harm caused to Service User A occurred during the course of breaking off the connection. Furthermore, although the Panel had no reason to doubt that the Registrant had read literature on the issue of professional boundaries, no evidence was provided of any personal reflection and learning in connection with the Registrant’s relationship with Service User A, which is of critical importance. The Panel was not satisfied that the Registrant fully appreciated the gravity of her misconduct, despite her assurances that she would behave differently in the future and that the misconduct would not be repeated. The commitment to avoiding this in future appeared to be based on the personal consequences for the Registrant not because she had learnt meaningful lessons about where she had gone wrong. In the absence of any evidence of meaningful insight, the Panel concluded that there is a real risk of repetition, as boundary issues are likely to arise in many different guises and the ability to identify the risks is an integral part of maintaining high professional standards at all times. There did not appear to be any appreciation that her belief that her relationship with Service User A would be permanent was naïve and unrealistic. The Panel was particularly concerned that the pattern of behaviour, in blurring the lines between her professional status and her supportive friend role, continued for a significant period of time despite concerns being raised. As a consequence of the Registrant’s lack of insight the Panel has determined that there is a current and ongoing risk of harm to service users.

111. The Panel recognised that demonstrating remediation in a case involving a failure to maintain professional boundaries is particularly difficult, as the concerns relate to an attitudinal failing. However, the Panel recognised that the Registrant’s misconduct has the potential to be remediated, provided that there is evidence of sincere and meaningful reflection that demonstrates that the flawed thinking that led to the blurring of professional boundaries is firmly in the past and is not a deep-seated attitudinal trait.

112. The Panel concluded that these concerns have not yet been fully addressed and for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.

113. In considering the public component the Panel had regard to the important wider public interest issues which include the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.

114. Members of the public would be extremely concerned to learn that a Practitioner Psychologist had consented to enter into a personal friendship with a vulnerable service user with profound and complex mental health problems, given the potential for such a relationship to compromise service users’ safety and well-being. The public would also be concerned that the concerns raised by the care team responsible for the well-being of Service User A were disregarded.

115. A significant aspect of the public component is upholding proper standards of behaviour. The Registrant’s conduct fell far below the standard expected of a registered practitioner. The Panel took the view that the Registrant has brought the profession into disrepute and has breached a fundamental tenet of the profession by failing to act in the best interests of Service User A. In all the circumstances the Panel determined that public trust and confidence would be undermined if a finding of impairment is not made.

116. The Panel concludes that the Registrant’s current fitness to practise is impaired on the basis of both the personal component and the wider public interest and therefore the HCPC’s case is well-founded.

Decision on Sanction

117. The Panel was mindful that the purpose of any sanction was not to punish the Registrant but to protect the public and maintain public confidence in the profession and the HCPC as its regulator, by the maintenance of proper standards of conduct and behaviour.

118. The Panel had regard to the Indicative Sanctions Policy. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of seriousness.

119. In deciding whether to impose any sanction, the Panel had regard to paragraph 13 of the Indicative Sanctions Policy which states,

"The degree of insight displayed by a registrant is central to a proper determination of whether fitness to practise is impaired and, if so, what sanction (if any) is required. The issues which the Panel need to consider include whether the registrant:

• has admitted or recognised any wrongdoing;

• has genuinely recognised his or her failings;

• has taken or is taking any appropriate remedial action;

• is likely to repeat or compound that wrongdoing.”

120. Having carefully considered the above paragraphs of the Indicative Sanctions Policy, the Panel concluded that given the seriousness of the misconduct and that the Registrant’s fitness to practise is currently impaired, a sanction was required to protect the public and was in the public interest, to mark the seriousness of the matter.

121. The Panel considered as aggravating features the fact of the clear power imbalance between the Registrant and her former service user and the service user’s obvious vulnerability. The Panel also considered that the Registrant’s course of conduct over a two and a half year period was an aggravating feature.

122. The Panel however, accepted as mitigating factors, the fact that the Registrant’s actions were initially well intentioned, she has engaged with this process and has made substantial factual admissions. The Registrant has no previous HCPC disciplinary record. She has provided positive testimonials, however, these do not specifically address the misconduct that has been found in this case. The Panel took account of the reflective statement produced by the Registrant since this case was adjourned following a finding of current impairment. The Panel recognised that this statement, which was provided at a very late stage, shows some evidence of insight and remorse as a result of the Panel’s findings.

123. The Panel considered the available sanctions in ascending order of seriousness and concluded that taking no action or imposing a Caution Order would be not be appropriate to mark the seriousness of the matters for which the Registrant’s fitness to practise is found to be impaired. The nature of the misconduct was not of a limited or minor nature. Whilst the allegations concerned a single service user, the Registrant embarked on course of conduct which persisted over a significant period of time and caused actual harm to her former service user.

124. The Panel next considered conditions of practice. Paragraph 33 of the Indicative Sanctions Policy makes it clear that conditions of practice will rarely be effective unless the Registrant is genuinely committed to resolving the issues they seek to redress and can be trusted to make a determined effort to do so.

125. The Panel had regard to the fact that since the events in question, the Registrant has continued to practice alone and unsupervised. Following questioning from the Panel, the Registrant’s representative stated that she would like to find a local peer supervisory group to join. The Panel was concerned however, that the Registrant had not earlier recognised her need for proper professional clinical supervision in order to maintain her own professional standards in routine clinical practice. This was of particular concern to the Panel, given the failings identified by this case. In the Panel’s view the fact that the Registrant had not to date embarked on regular clinical supervision demonstrated that she had not fully developed her insight into her former failings nor fully remediated them at this stage. With regard to the question of training, whilst the Registrant has shown willingness to undertake further training, her failure to demonstrate any specific reflective learning from the reading and training she had previously undertaken, evidence of which she had supplied to the Panel, has led the Panel to take the view that further training courses on their own would not be sufficient at this stage to remedy the impairment found. The Panel considered therefore that no working or practicable conditions could be formulated at this stage which would adequately resolve the issues in this case. Whilst Conditions of Practice can be used to remedy clinical deficiencies they are rarely appropriate as a means for developing insight and understanding or for changing attitudinal problems.

126. The Panel also considered that conditions of practice would not be sufficient to uphold the reputation of the profession. Serious failings were identified in this case and the imposition of a Conditions of Practice Order would not be proportionate to mark them.

127. In considering whether a Suspension Order would be appropriate and proportionate, the Panel had regard to Paragraph 39 of the Indicative Sanctions Policy, which indicates that suspension should be considered where the Panel considers that a caution or conditions of practice would provide insufficient public protection or where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited.

128. The Panel considered the guidance in relation to both a Suspension Order and a Striking Off order in deciding whether a Suspension Order would be sufficient and proportionate. The Panel has already found that the misconduct in this case is remediable.

129. The Panel considered that a striking off order would be disproportionate at this stage, given that remediation could be achieved after a further period of reflection and the development of full insight. The Panel further considered that the public would expect the Regulator to respond to this level of misconduct with very firm action. Accordingly, the Panel concluded that a suspension order was the least restrictive sanction which was appropriate and proportionate in the circumstances.

130. In deciding the period of 12 months, the Panel had regard to the length of time it considered was necessary for the Registrant to develop and demonstrate full insight. The Panel was also mindful that a suspension order is subject to review prior to its expiry. The Panel concluded that any period of time shorter than 12 months would not be practicable or sufficient.

131. A future reviewing panel may be assisted by evidence that the Registrant has engaged with a HCPC registered Clinical Psychologist with whom she had undertaken mentored sessions focussed on lessons she has learned from this case. A report from any such mentor would be of assistance. The future reviewing panel would also be assisted by a reflective statement from the Registrant which outlines in detail the lessons she has learned from the sessions undertaken. Finally, any appropriate references about the Registrant’s understanding of professional boundaries and how she has adhered to them, from employers or supervisors with whom the Registrant has undertaken either paid or unpaid work would be of assistance.

Order

ORDER: The Registrar is directed to suspend the registration of Dr Rajshree Weston for a period of 12 months from the date this order comes into effect.

Notes

No notes available

Hearing History

History of Hearings for Dr Rajshree Weston

Date Panel Hearing type Outcomes / Status
13/03/2019 Conduct and Competence Committee Review Hearing Struck off
28/09/2018 Conduct and Competence Committee Final Hearing Suspended
03/09/2018 Conduct and Competence Committee Final Hearing Adjourned part heard