Suzanne Boyce

Profession: Hearing aid dispenser

Registration Number: HAD02264

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 20/09/2018 End: 11:30 20/09/2018

Location: The Holiday Inn, 132 Corstorphine Road, Edinburgh, EH12 6UA

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

Allegation (facts found proved at the final hearing)

During the course of your employment as a Hearing Aid Dispenser with Amplifon between 12 November 2012 and 14 October 2014, you:

1. Were not registered with the HCPC whilst practising as a Hearing Aid Dispenser between 20 August 2013 and 01 June 2014.

2. Regarding your assessment of Client A for a hearing aid on 20 August 2014 you:

a) did not fully complete Client A's paper record card;

b) did not undertake and/or record the Bone Conduction readings on:

i) the GOAL audiogram; and/or

ii) onto the paper record card;

3. Regarding your assessment of Client B for a hearing aid on 15 September 2014 you:

a) Duplicated a previous Bone Conduction and Uncomfortable Loudness Level readings onto Client B's GOAL audiogram;

b) recorded the Uncomfortable Loudness Levels at greater than the acceptable level to record, namely above 110 dB HL;

c) did not apply and/or record that you had applied the Rule 2 and/or Rule 3 masking;

d) did not produce and/or complete a confidential paper record card.

4. Regarding your prescription of a replacement hearing aid for Client C in approximately July 2014 you:

a) did not re-test and/or record a re-test of Client C's hearing for the replacement aid, and/or programmed the hearing aid using the out of date audiometric readings;

b) did not produce and/or complete a new confidential paper record card;

c) did not record a detailed account of the appointments that took place on 30 July 2014 and/or 15 September on the GOAL recording system;

d) did not create a GOAL record of the fitting appointment that took place on 28 August 2014

5. Regarding your assessment of Client D for a hearing aid on or around 17 September 2014 you:

a) did not perform an Audiometry test;

b) duplicated the audiogram from April 2014;

6. Regarding your assessment of Client E for a hearing aid on 27 August 2014 you:

a) duplicated Bone Conduction results onto Client E's GOAL audiogram;

b) did not apply and/or record that you had applied the Rule 2 and/or Rule 3 masking;

c) did not carry out and/or record  a NOAH session and/or configuration when fitting the hearing aid on 18 September 2014;

d) did not produce and/or complete a paper record card.

7. Regarding your assessment of Client F for a hearing aid on or around 14 August 2014 you:

a) did not record Bone Conduction readings:

i) on the GOAL audiogram; and/or

ii) onto the paper record card.

 b) did not record the bilateral fitting that took place on 21 August 2014 onto GOAL recording system, and/or did not record any details about this bilateral fitting onto GOAL;

c) upon receipt of medical information provided by Client F, did not refer Client F to a medical practitioners as required;

d) did not ensure that Client F signed a disclaimer confirming the client’s wish not to be referred to a medical practitioner.

8. Regarding your assessment of Client G for a hearing aid on or around 5 August 2014 you:

a) did not record your assessment of Client G onto GOAL recording system and/or onto a paper record card;

b) did not record the reason why you did not test Bone Conduction on GOAL recording system, and/or did not take Bone Conduction readings;

c) did not carry out a NOAH session or configuration when fitting the hearing aid on 28 August 2014;

d) did not complete and/or produce a confidential paper record card for the assessment appointment on 5 August 2014.

Particular 1 was not found to be misconduct.

Finding

Preliminary matters:

Proceeding in Private

1. During the course of the Hearing the Registrant provided information which related to her personal life and resulted in the Presenting Officer suggesting that it was necessary for the hearing to proceed in private in respect of those matters.

2. The Panel received advice from the Legal Assessor, which they accepted. It had regard to the guidance note issued by the HCPTS entitled “Proceeding in Private”.  Whilst conscious that there is a presumption that hearings will be conducted in public, the Panel was obliged to ensure that the interests of justice were served and the private life of the Registrant protected. It concluded that it would be inappropriate to refer to the health and private life of the Registrant in a public hearing. Accordingly, evidence in relation to the Registrant’s health and private life would be heard in private to protect her privacy, but all other matters would be heard in public.

Background

3. The Registrant was employed at Amplifon between 12 November 2012 and 14 October 2014. When she first joined Amplifon, she was not qualified as a Hearing Aid Dispenser and was employed as a student practitioner. She completed her university course on 22 August 2013 and qualified as a Hearing Aid Dispenser. She should have registered as a Hearing Aid Dispenser with the HCPC at this time but no application was received by the HCPC.

4. In September 2013 a clinical audit of the Registrant’s cases was conducted. This was a standard audit conducted in line with Amplifon’s policy. The Registrant failed this audit and was provided with additional training. A second follow up audit of the Registrant’s caseload was undertaken in September 2014 because of the failure of the first audit. The Registrant also failed this audit and an internal investigation meeting was held on 25 September 2014 with the Registrant.

5. In June 2014 the Human Resources department of Amplifon noted that the Registrant had failed to register with the HCPC despite being a fully qualified Hearing Aid Dispenser. Their concerns about the Registrant were forwarded to the HCPC. At a substantive hearing between 25 and 27 September 2017, the allegation against the Registrant, as set out above, was found proved. The Panel hearing the allegation imposed a Suspension Order for a period of twelve months, having determined that the allegation amounted to the statutory ground of misconduct and that the Registrant’s practice was impaired.

Decision

6. The Panel noted that it was required to firstly determine whether the practice of the Registrant remained impaired, and if so, what, if any, order was necessary.  It had regard to the submissions of the Presenting Officer and also the information provided by the Registrant under affirmation and the documents she provided in relation to her continued professional development and reflection on her failings. It also noted that she had submitted a reference to the Panel.

7. In considering the question of impairment the Panel took note of and considered the submissions of the Registrant that her fitness to practice is not impaired. The Registrant stated that she had been working as a technical advisor in relation to hearing aid software and accessories and has engaged in continuing professional development by completing online courses and reading relevant professional publications. She has had regular contact with Hearing Aid Dispensers in the course of her employment and has been expected to make and maintain adequate records. She believed that she had matured and developed and that she would, with support, be able to return to practice without restriction. However, she indicated that she would be prepared to engage with any conditions of practice the Panel considered appropriate as she just wanted to get back to work as a Hearing Aid Dispenser as quickly as possible.

8. The Panel also had regard to the submissions of the Presenting Officer on behalf of HCPC, who indicated that, notwithstanding the steps taken by the Registrant since the Suspension Order was imposed in 2017, the HCPC remained concerned. She submitted that, given the Registrant’s engagement in the hearing, and the information provided, the HCPC was prepared to concede that a Suspension Order may no longer be appropriate, however it would not be appropriate for the Registrant to return to practice on an unrestricted basis. It was her submission that a Conditions of Practice Order would be appropriate and proportionate in the circumstances for the benefit of the Registrant and the public, and that such an Order would be in the public interest.

9. The Panel considered the two elements of impairment - the ‘personal component’ and the ‘public component’. The personal component addresses whether the conduct is remediable, whether it has been remedied and whether the conduct was likely to be repeated. It noted the issues raised in Cohen v GMC [2008] EWHC 581 (Admin) in relation to the remediation of identified shortcomings and the risk of repetition. In the Panel’s view the Registrant’s failings are readily remediable, and she has taken steps to remedy this but not while practicing as a Hearing Aid Dispenser and not while supervised by a suitable qualified professional. It also noted that the Registrant’s level of insight into the impact of her conduct, and her personal responsibility for the same, appeared to be developing.

10. It was of some concern to the Panel that the Registrant considered that, despite having not practiced as a Hearing Aid Dispenser for four years, and having only worked for a limited time post qualification, she believed she was fit to return to unrestricted practice.   The Panel were conscious that she was working in a related field, which may explain her confidence, but it did not believe that her experience of working in that related field was sufficient evidence that her conduct would not be repeated, especially given the Registrant’s acknowledgement that she would need time to learn processes and procedures pertinent to a post as a Hearing Aid Dispenser.

11. The Panel found that, notwithstanding the steps taken by the Registrant to date, which were to be commended, the Registrant’s fitness to practice remains impaired with regard to the ‘personal component’.

12. With regard to the ‘public component’, the Panel was of the opinion that a reasonable and fully informed member of the public would be concerned if a finding of impairment was not made in the circumstances. Further, a failure to make such a finding would undermine public confidence in the profession and the regulatory process. The Panel was also mindful of the need to uphold and maintain standards within the profession. It therefore determined that the Registrant’s fitness to practice is also impaired on the ‘public component’.

13. Having found that the Registrant’s fitness to practice remains impaired, the Panel went on to consider whether a Suspension Order remained the appropriate sanction. It noted the submissions of the Presenting Officer and the evidence given by the Registrant under affirmation. It also had regard to the documentation provided by the Registrant in respect of her reflection and continued professional development.

14. Whilst appreciative that the Registrant had provided a reference, the Panel did not attach substantial weight to this document given that it did not provide information in relation to her professional practice and was provided by a relative. In future, it would assist a reviewing panel to be provided with a reference from a suitably qualified professional who could comment upon the current practice of the Registrant, particularly in relation to the concerns previously expressed. However, the Panel acknowledged the particular personal circumstances of the Registrant over the last few months and accepted her explanation as to why she had not sought a reference from her current employer for this hearing.

15. The Panel considered the HCPTS Indicative Sanctions Policy and accepted the advice of the Legal Assessor. It accepted and adopted in the main the aggravating and mitigating factors identified by the Panel at the substantive hearing, noting however that there was no longer a failure by the Registrant to accept responsibility for her failings. Rather, the steps she had taken since the substantive hearing should be considered a mitigating factor, as should her attendance before them today. The Panel considered the Registrant to be open and credible in giving evidence to them.

16. The Panel was required to assess whether the order imposed by the panel at the substantive hearing remained necessary and proportionate in the circumstances, having regard to the sanctions available to them.

17. The Registrant recognised throughout her evidence to the Panel that she had failed while practicing as a Hearing Aid Dispenser, and whilst she would prefer to return to unrestricted practice, she would cooperate with any Conditions of Practice Order imposed upon her. In response to questions from the Panel she confirmed that there were suitably qualified professionals that she could approach to mentor her, and she considered she would be well placed to return to practice, even though having restrictions on her practice may make securing employment in that role challenging. The Registrant also demonstrated to the Panel a level of insight into her failings and expressed remorse for them, which had not been expressed to the Panel conducting the substantive hearing.

18. The Panel was conscious that it must balance the interests of the Registrant with that of the public. It was satisfied that, given the insight shown by the Registrant, and the development she has undertaken voluntarily during her suspension from practice, a Conditions of Practice Order would now be a more appropriate sanction to impose and that it was no longer appropriate for the Registrant to be suspended from practice. Imposing a Conditions of Practice Order would allow her to return to the profession but protect the public from the risk of repetition of failings.

19. The Panel were mindful that a Conditions of Practice Order can be imposed for a maximum period of three years. Given that the Registrant would need to secure employment and then demonstrate that she had addressed all of the concerns previously expressed, the Panel was of the view that a Condition of Practice Order should be imposed for a period of eighteen months.

20. The conditions imposed by the Panel were drawn from the sample conditions bank referred to in the document entitled “Drafting Fitness to Practice Decisions”, issued by HCPC, amended to reflect the circumstances of the Registrant.

Order

Order: That the Registrar is directed to reinstate the registration of Miss Suzanne Boyce subject to the conditions of practice set out below for a period of eighteen months from the date this order comes into effect.

Supervision

1. You must place yourself, and remain under, the supervision of a workplace supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within fourteen days of commencing employment as a Hearing Aid Dispenser.  You must attend upon that supervisor as required and follow their advice and recommendations.

Informing HCPC and Others

2. You must promptly inform the HCPC when you commence employment as a Hearing Aid Dispenser, or if you cease to be employed as a Hearing Aid Dispenser. 

3. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer in relation to employment as a Hearing Aid Dispenser.

4. You must inform the following parties that your registration is subject to conditions, and the nature of the conditions:

 i) any organisation or person employing or contracting with you to undertake professional work;  

 ii) any agency you are registered with for the purposes of professional work, or that you apply to be registered with at the time of application; and

iii) any prospective employer (at the time of your application to work as a   Hearing Aid Dispenser).  

Personal Development

5. You must work with your workplace supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

i) Record keeping

ii) Any other areas of concern identified by your supervisor

a) Within three months of attaining employment as a Hearing Aid Dispenser you must forward a copy of your Personal Development Plan to the HCPC. 

b) You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

c) You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.
     

Notes

 

The order imposed today will apply from 25 October 2018.

This order will be reviewed again before its expiry on 25 April 2020 

 

 

 

 

 

 

Hearing History

History of Hearings for Suzanne Boyce

Date Panel Hearing type Outcomes / Status
20/09/2018 Conduct and Competence Committee Review Hearing Conditions of Practice