Dr Rajshree Weston

Profession: Practitioner psychologist

Registration Number: PYL22289

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 13/03/2019 End: 17:00 13/03/2019

Location: Health and Care Professions Tribunal Service

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

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) Not proved.

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. Not proved.

iv Not proved.

i) Not proved.

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) Not proved.

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

Service of Notice

1. The Panel had information before it that notice of today’s hearing dated 12 February 2019 was sent to the Registrant’s address on the Register on the same date by first class post. The notice contained details of when and where the hearing was to take place and the power of the Panel to proceed in the absence of the Registrant in the event that she did not attend. The Panel was satisfied that service had been effected in accordance with Rules 3 and 6 of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the Rules).

Proceeding in the Registrant’s Absence

2. Ms Iskander, on behalf of the HCPC, applied for the Panel to proceed today in the absence of the Registrant.

3. Good service having been found, the Panel took note of the fact that the Registrant had indicated, in an email to the HCPC dated 19 February 2019, she would not be able to attend today’s hearing. On 22 February 2019, in another email to the Case Manager, the Registrant said that she had decided not to take up an offer of attending the hearing by telephone.

4. It is plain to the Panel that the Registrant has voluntarily absented herself from today’s hearing.

5.  Although there is mention in the papers submitted by the Registrant of the possibility of an adjournment, the Registrant ignored the advice given to her by the Case Manager that, if she wished to pursue this course, she should put her application in writing, with reasons. The Registrant has not done this and the Panel’s consequent view is that there is no formal application by her to adjourn these proceedings.

6. It is in the public interest that this case should be heard expeditiously and the Panel’s view is that it is in the public interest for Ms Iskander’s application to be granted.
 

Background

7. At the material time, the Registrant, a practitioner of 18 years’ experience, was working for the Cambridgeshire and Peterborough Foundation Trust (the Trust) as part of the complex cases team. In this role, the Registrant was the care manager of Service User A, who had a diagnosis of Personality Disorder and Autism. Additionally, Service User A had a high risk of absconding and, when she did so, she had in the past engaged in self-harming or suicidal behaviour.

8. Service User A ceased to be under the Registrant’s clinical care in 2010.

9. On 21 April 2016, contact was re-established between the Registrant and Service User A and regular discussions took place between them.

10. On 5 May 2016, the Registrant requested details of Service User A’s medication and added that she wished to take Service User A on leave by herself and without the requirement for the presence of two escorts.

11. On 6 May 2016, the Registrant telephoned a member of Service User A’s treatment team, having a disruptive effect on her care.

12. On 9 May 2016, the Registrant paid a visit to Service User A and, again, interfered with the efforts being made by Service User A’s care team to treat her professionally, in the way that is detailed in Particular 1(d) of the Allegation. Amongst other matters, the Registrant had suggested to Service User A that it might be possible to move her to the Registrant’s practice area and the Registrant encouraged her to ask for unescorted Section 17 leave. 

13. On 23 May 2016, the Registrant informed Service User A that her boyfriend had committed suicide and later, in June, the Registrant became upset during a telephone conversation to Service User A about her boyfriend. Service User A explained that these conversations precipitated her own thoughts about death and suicide and, around this time, Service User A herself attempted to take her own life.

14. On 5 November 2016, the Registrant, without informing the care team, visited Service User A at her family home when she was on Section 17 leave. During this visit, the Registrant suggested to Service User A that she should move to Cambridgeshire on her release from hospital.

15. On 25 November 2016, the Registrant told Service User A that she wanted to be present at an assessment that Service User A had been referred to for a specialist Autism Spectrum Disorder Service. The Registrant added that she wished to be part of the decision making team.

16. On 28 September 2018, the Final Hearing panel determined that the Registrant’s fitness to practise was impaired and that the appropriate sanction was a Suspension Order for 12 months. 

17. Throughout these proceedings, which lasted a total of six days, the Registrant was represented by counsel who, after a nine minute adjournment to have a private consultation with his client, told the panel that an Interim Suspension Order Application for 18 months to cover the appeal period was not opposed. This application was granted.

18. On 5 October 2018, the Hearings Officer emailed the Registrant to remind her that the order imposed upon her registration was one of suspension for 12 months. She added these words “you are not permitted to work in the profession while this order is in place”.

19. On 8 October 2018, the Case Manager emailed the Registrant to confirm the nature of the order and added these words “in terms of your private caseload, you are unable to treat, assess or advise any service users”.

20. On 28 January 2019, the Registrant emailed the Case Manager and sought to explain that she thought she was able, nevertheless, to work for 28 days after the conclusion of the Final Hearing. She wrote “I ceased practising on 26 October 2018”.

21. It later came to the notice of the HCPC that the Registrant provided three therapy sessions to a male service user on 2, 9 and 16 October 2018. The Registrant later confirmed that she had performed these treatments and added that she had seen ten other service users for treatment on another nineteen occasions. The dates ranged from 1 – 19 October 2018.

22. On 18 February 2019, in a written statement she made for the HCPC, the Registrant repeated her contention that she thought that her period of suspension did not start until the expiry of 28 days from the determination at the Final Hearing.
23. On 22 February 2019, in an email to the Case Manager of the HCPC, the Registrant said that the work she did in October 2018 amounted to “honest mistakes on my part and I was acting in good faith. It has never been my intention to breach the order”. She said that she had not fully taken in what was being decided on her behalf due to the emotional nature of the proceedings.


Submissions

24. Ms Iskander submitted that the Registrant had blatantly disregarded the terms of the Suspension Order. Even if there was any truth in the Registrant’s contention that she was confused at the Final Hearing, the later correspondence from the HCPC made it plain that she was not entitled to work during the period of the Suspension Order.

25. Ms Iskander drew the Panel’s attention to some of the remarks of the previous panel contained within its determination such as “she [the Registrant] attempted to deflect responsibility rather than accept it”. In the view of that panel there was an absence of any meaningful insight and it concluded that there was a real risk of repetition of her misconduct.

26. The Registrant, in her various written submissions to the HCPC, expressed a desire to return to her chosen profession. She said that she was rehabilitated and had reflected for almost six months over her misconduct, in which she said it was clear that she had acted irresponsibly.


Decision

27. The Panel took into account all of the material in this case and paid close attention to the competing submissions. It accepted the advice of the Legal Assessor and paid due regard to the HCPTS Practice Note ‘Finding that Fitness to Practise is Impaired’. The Panel’s view is that the Registrant has deliberately ignored the terms of the Suspension Order imposed in September and provided treatment for which she received payment. It was clear to the Panel that from receipt of the HCPC email dated 8 October 2018, if not before, the Registrant was in no doubt that she should not be treating service users. As such, the judgment of the Panel is that the fitness to practise of the Registrant remains impaired.
 
28. As far as the personal component is concerned, the Registrant has shown, again, a lack of insight and there remains a high risk of repetition of misconduct.

29. 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.

30. Members of the public would be extremely concerned to learn that a practitioner psychologist had ignored the terms of the sanction imposed upon her by her regulatory tribunal. The Panel noted, as an aggravating factor, the view of the Provider Investigations Manager of the insurance company AXA that the Registrant’s decision to treat one of the company’s “customers post suspension caused emotional distress and inconvenience…because he had to restart his treatment with another practitioner”.

31. In deciding upon the appropriate sanction, the Panel reminded itself of the contents of the HCPC Indicative Sanctions Policy. It paid particular attention to paragraph 48 which states “striking off should be used where there is no other way to protect the public, for example, where there is a lack of insight, continuing problems or denial”.

32. The Registrant has continued to fail to take responsibility for her actions, a trait noted by the previous panel. She has acted in an unprofessional manner and has been rude in some of her contact with the officers of the HCPC. She still suffers from the attitudinal problems identified by the previous panel.

33. In all the circumstances, the Panel has determined that a continuation of the Suspension Order would be inadequate. It would fail to address the gravity of the misconduct in this case. The only appropriate and proportionate sanction to impose is that of a Striking Off Order with immediate effect, on the grounds of public protection and the wider public interest. In coming to this decision, the Panel is aware that the Registrant will suffer financially, but its view is that the public interest outweighs that of the Registrant.

Order

That the Registrar is directed to strike the name of Rajshree Weston from the Register on the date this order comes into effect.

Notes

The order imposed today will apply with immediate effect.

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