Mrs Helen J Stokes

Preliminary Matter

Private Hearing

1. Ms Sampson made an unopposed application for those parts of the hearing that touch upon the private life, in particular the health, of the Registrant should be heard in private. In accordance with the provisions of Rule 10(1) of the Procedure Rules, the Panel granted this application.

Background

2. At the material time, the Registrant, who started work as a Physiotherapist in 2005, was working as a specialist Physiotherapist in the Falls Team at the North Somerset Community Partnership (NSCP). In about January 2017 the Registrant was seriously injured in an accident which involved a vehicle that ran her over. Amongst other matters, her mobility was seriously affected. The Registrant’s daughter, in clearing out the Registrant’s home after this accident, discovered notes and records relating to service users and colleagues that the Registrant had been keeping in her home. Some of the records dated back to a period in excess of 10 years.

3. The Registrant’s daughter returned the notes to the NSCP and, by a process of cross referral, it was discovered that they related to a total of 277 patients and the names of 418 patients that appeared within the documentation which also included the names of staff. There was no suggestion, however, that any patient had suffered harm.

4. On 6 October 2017, the NSCP referred the Registrant to the HCPC.

5. The Final Hearing of this case took place on 18-19 December 2019 in the absence of the Registrant. She had previously emailed the HCPC to state that she was suffering from health issues caused by her dismissal from work. She added in that same email that she had no desire to return to practice and wanted her name removed from the Register.

6. During the course of the investigation conducted by the NSCP the Registrant had admitted that she should not have kept the documents in her home. This acceptance formed part of the panel’s reasons in finding the factual particular (particular 1) proved.

7. In further finding misconduct that panel took the view that the failure of the Registrant to maintain confidentiality and keep the records safe betrayed a fundamental tenet of the role of a Physiotherapist.

8. Other reasons given for finding misconduct included the sheer volume of notes stored at the Registrant’s home and the extended time period over which they had accumulated.

9. A finding of impairment followed in relation both to the personal and public components. The Registrant had never, in the view of the panel, fully appreciated the gravity of the situation and the serious implications for service users and her employer as a result of these failures.

10. In dealing with the topic of impairment, although that panel determined that the Registrant’s actions were remediable, there was no actual evidence of any action taken by the Registrant to demonstrate that she had achieved remediation. Nor, the panel found, was there evidence that the Registrant had kept up to date with statutory, mandatory, annual training in relation to information governance since 2015. As such, the panel found that the Registrant’s insight, at best, was limited, that her failings had not been remediated and that the risk of repetition remained high. In respect of the public component, the panel’s view was that the volume of material recovered and the period of time involved was so significant that the Registrant’s misconduct was such that a finding of impairment was necessary in order to uphold professional standards and public confidence in the profession.

11. On 24 November 2020 the Registrant emailed to the HCPC a reflective piece in which she accepted that her fitness to practise had been impaired at the material time. She stated her belief that all the issues that affected her then had now been resolved. She catalogued them and blamed her failure to return some of the documents to the workplace on the near fatal car accident that she had suffered. She complained of being bullied at work and claimed a lack of support from her line manager. To this she added details of health problems that afflicted her at the time. In requesting the revocation of the current order, she emphasised that all her problems now had been resolved. Furthermore, she provided information about her employment as a domiciliary care worker for Blue Sky Enabling (BSE) and as a live-in carer for Flexicare UK. Within this same document she declared that she had completed her care certificate and nearly finished a City and Guilds Level 3 qualification in Adult Social Care. Attached to this email was a BSE self-appraisal dated 29 January 2020.

12. Today the Registrant emailed a second reflective piece in which she expressed remorse for her failings. She also amended her original proposal not to return to her profession and emphasised a newfound desire to work as a Disability Assessor.

13. In amplification of these observations, the Registrant today gave evidence on her oath. She repeated details of the health problems she had been suffering from, but said these were now matters in the past. She expressed deep remorse and shame for her misconduct. She added that since she herself had been suffering the experiences of a patient she now possessed greater insight. She further told the Panel that she is now well aware of the importance of confidentiality and that she was blessed with a very supportive husband and a number of close friends. She did accept that she had done no Physiotherapy related CPD over the past 12 months, although she had read up on a number of topics.

Decision

14. Ms Sampson submitted to the Panel that little had in fact changed over the past 12 months. The recommendations, she said, of the previous Panel had not been fully taken account of. Ms Sampson went on to contend that the Registrant could have done more to demonstrate insight and remediation. She contended that the fitness to practise of the Registrant was still impaired in relation to both the private and personal components and that the appropriate course for the Panel now to adopt would be to extend the current order of Suspension for another 12 months.

15. The Registrant submitted that the time is now right for her to return to the profession that she loves and that the course to be adopted should be revocation of the current order. Failing that, she suggested, she would be prepared to abide by an appropriate order of conditions.

16. The Panel took into account all the material in this case and the submissions made by both parties. 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 took into account all of the mitigating factors identified by the previous panel and added to them its acceptance that the Registrant is genuinely remorseful and ashamed of what she did. As against that, however the Panel could not ignore the aggravating factors that persist in this case. In dealing with the personal component the Panel shares the views of those of the previous panel in concluding that the Registrant has not demonstrated full insight yet and the risk of repetition continues to exist. Any plans she may have for her work future are unformulated. No outside references have been produced to the Panel. In relation to the public component, again this Panel agrees with what was previously said about the seriousness of the sheer volume of breaches of confidentiality that this case has exposed. Many of the documents wrongly stored at the Registrant’s home were mixed with other personal papers and the sheer number of years that this took place over was a pertinent factor to take into account in this context. Thus, the Panel found that the Registrant’s fitness to practise was still impaired.

17. The Panel considered what, if any, sanction to impose and referred to the HCPTS Sanction Policy. The taking of no further action, mediation or a caution order were not appropriate due to the serious nature of the findings.

18. In considering whether to impose a Conditions of Practice Order the Panel’s view was that this would not be appropriate, workable or measurable. Not least amongst its reasons for this was the fact that the Registrant’s future work commitments were uncertain.

19. The only appropriate and proportionate course to adopt, in the view of the Panel, is to extend the current order of suspension for a further 12 months. This period of time should give the Registrant opportunities to show that she can develop real insight and remediate her failings. In coming to this conclusion, the Panel recommends that any future Panel would be assisted by:

(i) References and/or testimonials by third parties to attest to the fact that the Registrant fully understands the issues identified in this case.
(ii) Evidence that the Registrant has joined a special interest group to assist her return to work as a physiotherapist and/or the appointment of a mentor to help her to focus upon her failings.
(iii) A Personal Development Plan to inform her learning in relation to the requirements of standards 1,2,3 and 4 contained within the document entitled ‘Continuing Professional Development and your Registration’.
(iv) Evidence/certificates of any relevant continuing professional development relating to confidentiality and information governance.
(v) A reflective piece demonstrating what she has learnt from CPD and her experience of these proceedings.

ORDER: The Registrar is directed to confirm the existing suspension order for a further period of 12 months.

The Order imposed today will apply from 16 January 2021.

This Order will be reviewed again before its expiry on 16 January 2022.

History of Hearings for Mrs Helen J Stokes