Mr Jason Keers

Preliminary matters

Application for private hearing

1. At the outset of the proceedings, Mr Hamill made an application for the entirety of the review hearing to be conducted in private. He told the Panel that it would have to consider matters that were relevant to his private life and that other matters concerning the Registrant’s health were also likely to be raised. Ms Ktisti did not object to the application.
2. The Panel accepted the advice of the Legal Assessor and had regard the HCPTS Practice Note on “Conducting Hearings in Private”. The Panel agreed to grant Mr Hamill’s application to convene the entirety of the hearing in private.

Background

3. On 18 July 2016 the Registrant commenced employment as the sole Musculoskeletal Physiotherapist for “Rebound Physiotherapy” (“the Company”), a company wholly owned by a local charity supporting children and adults with acquired brain injury, “Brain Injury Matters NI”.

4. In November 2016, the Company’s management team noticed that a number of the Registrant’s patients did not appear to have received follow-up appointments. An audit was conducted which suggested that some service users had in fact received follow-up appointments, but in some cases the follow-up appointments had not been recorded by the Registrant. In other cases, there were notes on the system showing that appointments had been held, but there was no record that these appointments had been paid for. In all these cases, cash paid to the Registrant by service users had not been handed over by him to the Company.

5. On the morning of 24 November 2016, FM (the Company’s Chief Executive) held a meeting with the Registrant regarding these concerns. The Registrant claimed that either no follow-up appointment had in fact been carried out, or that an appointment had taken place, but the patient had not paid for it.

6. Following this, FM made further enquiries, which included phoning some of the service users and a care home.

7. As a result of the information received, FM held a further meeting with the Registrant on 24 November 2016. The Registrant then admitted that he had carried out appointments with two patients in a care home and had taken cash payments from them. He had not handed on to his employer one of those payments (Service User A’s money) but had kept it for his own personal gain. He stated that he had only acted in this way on two occasions, having also taken money from Service User B on a separate occasion but not entered it onto the system.

8. On 25 November 2016, the Registrant asked to speak with FM again, and told her that, in addition to the difficulties that he had been experiencing with debt, he had also been suffering from health issues at the time. He also admitted that there had been more cases than previously disclosed when he had taken cash for his own personal gain.

9. Following this further disclosure, the Registrant was suspended on full pay until further notice. He was invited to attend a disciplinary meeting on 1 December 2016. He resigned before the meeting could take place.

10. The amount that the Registrant was alleged to have kept for his own gain was in the region of £160 and four service users were identified. In advance of the hearing, the Registrant sent an email to the HCPC, dated 1 December 2016, in which he admitted that on five occasions he had received cash from clients which he had not recorded as receiving and which he had kept for his own benefit.

11. At the outset of the substantive hearing, the Registrant admitted the facts of the Allegation which were accordingly found proved against him. The Registrant also indicated, while accepting it was a matter for the independent judgment of the Panel, that his actions amounted to misconduct and that his fitness to practise was impaired as a consequence. The Registrant gave evidence to the Panel, at both the impairment and sanction stage of the proceedings. The Panel determined that the Registrant’s fitness to practise was impaired and imposed a 12-month suspension order. In light of the mitigation advanced at the hearing, the Panel concluded that a striking-off order would be disproportionate.

12. Ms Ktisti, on behalf of the HCPC, submitted that there was no new information before the Panel at this review. She further submitted that, in light of this, the only appropriate outcome would be for the Panel to find that the Registrant remained currently impaired and that a further suspension order remained necessary and proportionate.

13. Mr Hamill, on behalf of the Registrant, was in agreement that there was no basis on which to alter a finding of current impairment. The Registrant is also currently taking steps to secure employment.  Mr Hamill invited the Panel to impose a further suspension order. In that time, Mr Hamill stated, the Registrant could expect to receive appropriate therapeutic intervention for his ongoing health problems. Mr Hamill submitted that a suspension order would provide the necessary degree of public protection while the Registrant availed of medical treatment and that the public interest would also be upheld in that regard.

Decision 

14. The Panel accepted the advice of the Legal Assessor. As part of his advice, he advised the panel of its powers at review under Article 30(2) of the Health and Social Work Professions Order 2001. He further advised that the Panel was required to undertake a comprehensive review of all the evidence presented at the review hearing.

15. The Panel reminded itself of the observations of the previous Panel on the question of impairment. On the personal component of impairment, it was stated:

“29. The Panel concluded that the nature of the Registrant’s misconduct, namely dishonesty, was difficult to remediate. The Panel noted that, at the time of committing the thefts, the Registrant had concealed his dishonesty by failing to record either the follow-up appointment that he had provided, and/or the cash that he had received. His admission to his dishonesty was piecemeal. He did not initially admit the full extent of what he had done when first questioned by his employer. He then made fuller admissions in the course of the second meeting with his employer, but the Panel concluded that by then he must have been aware that enquiries had been made and evidence obtained. Even then he only admitted to stealing on two occasions, whereas he subsequently admitted five occasions.

30. Whilst he expressed genuine remorse, the Panel was not satisfied that he had shown genuine insight into the seriousness of his actions…The Panel did not accept that the Registrant could have acted spontaneously in relation to all the cases. Furthermore, it appeared that the Registrant had given no prior thought to the impact that an absence of follow-up appointment records may have had on the future care of service users until he was asked about this in Panel questioning.

31. The Panel wished to make it clear that it regarded the Registrant’s honesty in relation to his personal difficulties, and his recent attempts to address those difficulties, as admirable. Nevertheless, the Registrant himself did not claim to have fully remediated the health issues and personal difficulties that lay behind his misconduct, and the Panel agreed with the accepted stance taken by the Registrant that, for so long as these issues remained unresolved, his fitness to practise was impaired.

32. For those reasons the Panel concluded that there is a risk that the Registrant will repeat his misconduct and that his fitness to practise is impaired on the personal component.”

16. The Panel also had regard to the comments of the previous Panel on the question of impairment on the public component. It was stated:

“33. It was also the firm judgement of the Panel that the Registrant’s fitness to practise is impaired by reason of the public component. The Registrant’s misconduct consisted of dishonest behaviour carried out in relation to a number of service users in the course of his profession, for his own personal gain, and at the expense of a charitable institution. His behaviour had breached the trust that service users had placed in him and amounted to a breach of a fundamental tenet of the profession. It was clear that his behaviour undermined confidence in the profession and brought the profession into disrepute.”

17. In the Panel’s judgment, there was no proper basis on which to depart from the findings of the previous Panel. There was no new information provided by the Registrant at the review which would entitle the Panel to conclude that the Registrant was no longer currently impaired. There was an acceptance by the Registrant that he remained impaired. This concession, in the Panel’s view, had been properly made. The Panel considered that the reasons advanced for a finding of current impairment by the previous Panel on the personal and public components remained valid.

18. Having determined that the Registrant’s fitness to practise remained impaired, the Panel next considered the appropriate sanction to impose. It had careful regard to the Indicative Sanctions Policy published by the HCPC and to the need to act proportionately.

19. The Panel had been provided with no new information by the Registrant that would permit the current order to lapse or the imposition of a Caution Order. Such an outcome was undesirable as it would permit the Registrant to return to unrestricted practice. In addition, having regard to the facts and the impairment identified, the Panel could not devise workable, enforceable or verifiable conditions that would adequately protect the public.

20. Accordingly, the Panel decided that it was appropriate and proportionate to impose a further suspension order for a period of 12 months. The Registrant’s misconduct was serious. It was satisfied that a risk of recurrence remained. There was no evidence that the Registrant had developed insight, to the degree required, into his actions. He awaited therapeutic intervention and had not demonstrated any evidence of action to remedy his previous dishonest conduct. The Panel concluded that a further suspension order would enable the Registrant to engage positively with medical treatment. The Registrant could also use the intervening time during which he would be suspended to provide the necessary evidence of remediation and insight to a future reviewing Panel.

21. The Panel considered whether a striking off order was appropriate and concluded that in these circumstances it was not. A suspension order would provide protection to the public and uphold the public interest.

22. The Panel noted that the Registrant had failed to take up the opportunity to provide the materials suggested to him by the previous Panel which would be of assistance at that review. It was a matter of regret to the Panel that the Registrant had not taken up that opportunity. On this occasion, however, the Panel was persuaded that, on balance, there was a sustainable explanation for the Registrant not doing so. The Panel wished to make it clear to the Registrant that another reviewing Panel might not take a similar approach in the future, if faced with a paucity of information on the Registrant’s progress during his suspension,

23. Accordingly, the Panel concluded that a future reviewing Panel would benefit from:

• Third party evidence of continuing engagement with any specialist organisation that assists the Registrant with the personal issues underlying his misconduct…

• References, particularly from an employer or potential employer, which attests to the Registrant’s honesty and trustworthiness;

• Evidence of CPD activities which meet HCPC standards, with particular emphasis on Standard 3 (“A registrant must seek to ensure that their CPD has contributed to the quality of their practice and service delivery”) and Standard 4 (“A registrant must seek to ensure that their CPD benefits the service user”), to be served 1 month in advance of the next review, evidencing how the Registrant has reflected on, and learnt from, his misconduct.

The Registrar is directed that Mr Jason Keers be suspended from the register for a further period of twelve months.  

The Order will apply from 4 July 2019.

History of Hearings for Mr Jason Keers