Miss Suzanne Boyce

Profession: Hearing aid dispenser

Registration Number: HAD02264

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 16/04/2020 End: 17:00 16/04/2020

Location:

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing which took place on 25-27 September 2017.

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and/or record a re-test of Client C's hearing for the replacement aid, and/or programmed the hearing aid using the out of date audiometric readings;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.

9. The matters set out in paragraphs 1 - 8 constitute misconduct and/or lack of competence.

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

The Panel found the facts proved, that these amounted to misconduct (save for Particular 1), and that the Registrant’s fitness to practise was currently impaired. The Panel imposed a Suspension Order for a period of 12 months, which was subsequently replaced with a Conditions of Practice Order at the first substantive review hearing.

Finding

Preliminary Matters

Service and Proceeding in Absence

1. On 24 February 2020, Notice of Hearing was originally sent to the Registrant by post in relation to the hearing which was due to take place on 23 March 2020.

2. On 13 March 2020, the HCPC wrote to the Registrant cancelling the hearing listed on 23 March 2020, owing to the limited availability of panel members.

3. Around 23 March 2020, in line with the Government’s recommendations in relation to the Covid-19 pandemic, the HCPC made the decision to suspend all public hearings. Accordingly, the Registrant was served, by email, with a fresh Notice of Hearing on 26 March 2020. This Notice contained details of the change of hearing date to 16 April 2020 and the fact that the hearing would be taking place ‘on the papers’, as well as inviting the Registrant to make any written representations. The email address to which this notification was sent to the registered email address of the Registrant and was used by her in her recent communications with the HCPC.

4. The Panel accepted the advice of the Legal Assessor, namely that ordinarily Notice should be served by post. The Legal Assessor alerted the Panel to the current practice of the HCPTS, namely that, since 23 March 2020, following the Government’s advice in relation to Covid-19, the HCPC has been sending all notices to the registered email address of registrants. The Legal Assessor suggested that, given the current exceptional circumstances, the Panel could deem that service had been effected by email, as an appropriate form of substituted service.

5. The Panel accepted that these were unprecedented times and that it was reasonable to serve notice to the Registrant by email, given the Government guidance. The Panel noted that there was proof that the email had been sent to the registered email address provided by the Registrant to the HCPC and, most importantly, the Registrant had recently sent the HCPC her written submissions by email on 8 April 2020, and is clearly aware of this hearing taking place ‘on the papers’.

6. In all the circumstances, the Panel was satisfied that Notice of today’s hearing had been properly served on the Registrant.

7. The HCPC applied to have this matter heard in the Registrant’s absence, on the basis that the HCPC has decided to conduct all such hearings ‘on the papers’ in view of the Covid-19 pandemic.

8. The Panel accepted the advice of the Legal Assessor, and particularly its duty to proceed in the absence of a Registrant with the utmost care and caution. Rule 11 of the Conduct and Competence Committee Procedure Rules (the Rules) permits the Panel to proceed in the absence of a registrant if they are satisfied that all reasonable steps have been taken to serve the Notice of Hearing on the Registrant.

9. In view of the Covid-19 pandemic, the Panel was satisfied that it was reasonable to conduct this mandatory review ‘on the papers’. The Panel noted that the Conditions of Practice Order is due to expire on 25 April 2020 and considered there to be a pressing public interest to review the Order. The Panel balanced this with the Registrant’s interests, but noted that the Registrant had not objected to this review being conducted ‘on the papers’ and has engaged with this process by sending her written representations to the Panel for consideration, to which the Panel has had careful regard.

10. The Panel determined to proceed in the Registrant’s absence and consider the matter ‘on the papers’ with the benefit of written submissions from the HCPC and the Registrant.

Background

11. 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. After completing her university course on 22 August 2013, she qualified as a Hearing Aid Dispenser. She should have registered as a Hearing Aid Dispenser with the HCPC at this time, but there was evidence that the Registrant had sent in an application which had not been received by the HCPC.

12. 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.

13. 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.

14. 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 12 months, having determined that the allegation amounted to the statutory ground of misconduct and that the Registrant’s fitness to practise was impaired.

15. The first substantive review hearing took place on 20 September 2018, when the Registrant attended. The Suspension Order was replaced with a Conditions of Practice Order for a period of 18 months, including requirements to work under a workplace supervisor and create a Personal Development Plan. That Order expires on 25 April 2020.

Decision

16. The Panel has considered both the original and updated written submissions of the HCPC and the written submissions of the Registrant dated 8 April 2020.

17. The HCPC submits that the Registrant’s fitness to practise remains impaired on both the personal and public components. The Registrant has not provided any evidence to the Panel of insight or remediation, nor evidence that she has complied with the Conditions of Practice Order. In view of this, the HCPC submits that there remains a risk of repetition. It is further suggested that a finding that the Registrant is not impaired would be seriously detrimental to the public interest, and that professional standards and the reputation of the profession would be seriously undermined.

18. In her written submissions, the Registrant indicated that she has not made any progress with the Conditions of Practice imposed on 20 September 2018, owing to health-related concerns and family issues. She indicated that she has not returned to work as a Hearing Aid Dispenser. She said that she would wish to look for work in the coming months (subject to the Coronavirus situation) and would have discussed this with the Panel at the original hearing on 23 March 2020. She also stated that she was a member of the British Society of Hearing Aid Dispensers (BSHAA) and had been carrying out Continuing Professional Development (CPD) training, although she did not provide any evidence of her CPD training to the Panel. The Registrant invited the Panel to extend the Order to, “give me time to get back on my feet and get practising again (with a supervisor) as soon as I can.”

19. Although the HCPC invited the Panel to consider a six-month Suspension Order to allow the Registrant to re-engage, it submitted that, since the Registrant didn’t have an opportunity to attend a hearing in person and make oral representations, it was “most fair and proportionate” for the Panel to impose a further period of conditions, in the same form, for 12 months.

20. The Panel accepted the advice of the Legal Assessor and reminded itself that it was required to consider whether the Registrant’s fitness to practise remained impaired, and if so, what, if any, Order was necessary.

21. The Panel considered the two elements of impairment – the ‘personal component’ and the ‘public component’.

22. The Panel first considered the personal component, which includes whether the conduct is remediable, whether it has been remedied, and whether it is likely to be repeated, as well as whether the Registrant has developed insight. The Panel agreed with the previous panels’ views that the conduct complained of is remediable. However, the Conditions of Practice Order imposed on 20 September 2018 has not been complied with by the Registrant. The reasons given for this relate to the Registrant’s health and family issues. Given that the Panel has clear evidence that the Registrant has not sought to remediate her conduct, the Panel concluded that there remains a risk of repetition.

23. With respect to the public component, the Panel concluded that a reasonably and fully informed member of the public would be concerned if a finding of impairment were not made in circumstances where a Registrant had not complied with conditions imposed over 18 months ago. 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 Hearing Aid Dispenser profession. It therefore determined that the Registrant’s fitness to practise is also impaired on the ‘public component’.

24. Having found the Registrant’s fitness to practise impaired, the Panel considered what sanction, if any, was appropriate and necessary. The Panel noted that the Registrant is currently subject to a Conditions of Practice Order, which is due to expire on 25 April 2020.

25. The Panel reminded itself of the HCPC Sanctions Policy (last updated in March 2019) as well as its powers under Article 30(1) of the Health Professions Order 2001 (‘the 2001 Order’). The Panel has the power to:

• extend, or further extend, the period for which the Order has effect;
• make an Order which could have been made when the Order being reviewed was made;
• replace a Suspension Order with a Conditions of Practice Order.

26. In terms of the length of any extension for such Orders, Article 30(5) of the 2001 Order permits the Panel to extend a Conditions of Practice Order by no more than three years at a time or a Suspension Order by no more than one year at a time.

27. The Panel accepted the previous substantive panels’ analysis of the mitigating and aggravating features of this case, with the caveat noted by the reviewing Panel, namely that the Registrant had since accepted responsibility for her failings, demonstrating some insight into the misconduct found.

28. Given the Panel’s conclusion that the Registrant’s fitness to practise is currently impaired, based on non-compliance with conditions, the Panel considered that there had been no material change of circumstances since the last Order was made. The Panel therefore determined that an Order remained both proportionate and necessary.

29. As for the type of Order, the Panel considered each sanction in turn. The Panel considered that taking no action and/or imposing a Caution Order was inappropriate in this case given its finding in relation to impairment, based on a lack of compliance with conditions, little remediation, and a consequent risk of repetition.

30. The Panel next considered a Conditions of Practice Order. It accepted the agreed submissions of the HCPC and the Registrant, namely that the current Conditions of Practice Order should continue. In reaching this decision the Panel placed reliance on the written submissions of the Registrant, namely that health and family reasons have impeded her ability to comply with the conditions imposed. Further, the Panel noted that the Registrant considers that she is now in a better position to look for work in the coming months. The Registrant has also indicated that she has been carrying out CPD training. The Panel considered that despite the Registrant’s previous non-compliance with conditions, a further opportunity for the Registrant to engage with her Conditions of Practice Order was a proportionate response given that the Registrant has expressed a willingness to comply and a desire to return to practice.

31. In view of the reasons above, the Panel did not consider that a Suspension Order was either necessary or proportionate.

32. The Panel next considered the length of time for a Conditions of Practice Order. The Panel concluded that 18 months was an appropriate period for the Registrant to engage with the conditions imposed, take meaningful steps to address them, and provide evidence to the HCPC that she had done so. The Panel was also mindful that the current Covid-19 pandemic may create some obstacles to obtaining employment and/or complying with conditions. A longer period for the Conditions of Practice Order to run was warranted.

33. Accordingly, the Panel imposed a further Conditions of Practice Order for 18 months, commencing from the expiry of the existing Order.

34. The Panel considered that the conditions imposed by the previous panel on 20 September 2018 remained appropriate to address the concerns identified at the substantive hearing.

35. The Panel reminds the Registrant that, since she has not worked as a Hearing Aid Dispenser for two years, she will need to comply with the HCPC’s requirements as laid out in their guidance entitled ‘Returning to Practice’.

Order


The Registrar is directed to extend the Conditions of Practice Order against the registration of Miss Suzanne Boyce for a further period of 18 months on the expiry of the existing Order.

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 April 2020.

This Order will be reviewed again before its expiry on 25 October 2021.

Hearing History

History of Hearings for Miss Suzanne Boyce

Date Panel Hearing type Outcomes / Status
16/04/2020 Conduct and Competence Committee Review Hearing Conditions of Practice
25/09/2017 Conduct and Competence Committee Final Hearing Suspended