Miss Sutapa Halder

Preliminary matters:

Notice of Hearing and Proceeding in Absence

1. The Panel was satisfied that the Registrant had been sent notice on 5 December 2019 of the date and location of this review hearing by email and by post to her registered address. 

2. The Registrant did not appear nor was she represented. She sent an email to the HCPC on 5 January 2020 in which she confirmed that she would not attend the hearing. On behalf of the HCPC, Ms Thilagarajan applied for the hearing to be conducted in the absence of the Registrant on the basis that she had been notified of the date, time and location of the hearing at her registered address. Ms Thilagarajan submitted that this was a mandatory review and it was in the public interest for the hearing to proceed expeditiously.

3. Having considered the revised HCPTS Practice Note on proceeding in absence and the advice of the Legal Assessor on the case of GMC v Adeogba [2016] EWCA Civ 162 (“the fair, economical, expeditious and efficient disposal of allegations against medical practitioners is of real importance”), the Panel was satisfied that the Registrant had received reasonable notice of today’s hearing. The panel took account of her email to the HCPC dated 5 January 2020 in which she confirmed she would not be attending the hearing. The Panel concluded that she had in effect waived her right to appear by confirming that she did not intend to attend the hearing.

4. The Registrant had not applied for an adjournment.  There was no indication that she would attend at a later date if today’s hearing were to be adjourned. The Panel noted the overriding public interest in dealing with mandatory reviews in a timely manner. In balancing the Registrant’s interest and the public interest, the Panel decided that the matter should be heard in the absence of the Registrant.

Background

5. The Registrant was employed as a Band 5 Speech and Language Therapist by the East London NHS Foundation Trust (the Trust) from 1 October 2014 to 22 July 2016 when she resigned. She was responsible for providing speech and language therapy to children between the ages of 4 and 11 with speech, language and communication needs.

6. During the course of the Registrant’s employment, concerns were raised about her clinical documentation and record keeping. Her employer provided joint supervision arrangements and additional support and she was placed on a performance improvement plan. The problems however continued, so the Trust referred the case to the HCPC.

7. A panel of the Investigating Committee of the HCPC determined that the Registrant had a case to answer in relation to failures to carry out and/or record appointments, failures to complete or record contemporaneous clinical progress notes, and/or failures to complete and/or record review reports and programmes reports in relation to three children (A, B and E) between October 2014 and September 2016.  There were similar allegations in relation to two other children (C and D).

8. In a formal response to the allegation dated 27 September 2017, the Registrant accepted that her fitness to practise was impaired and that she was not yet ready to return to practice. She requested voluntary removal from the register until she was well enough to return. She set out mitigating circumstances in relation to her health and personal life and identified support mechanisms and coping strategies that would enable her to return to the profession. She had since worked as a Learning Support Assistant and Special Needs Assistant.

9. A panel of the Conduct and Competence Committee of the HCPC considered the case at a substantive hearing on 4 February 2019. The Registrant had signed a proposed Consent Order on 24 November 2018 in which she consented to the panel making a Suspension Order of 12 months on the basis that she had demonstrated insight and engagement. The then panel accepted the HCPC’s submission that this was a suitable case for disposal by consent in view of the Registrant’s level of engagement, co-operation and insight at that stage. A Conditions of Practice Order would not be workable or verifiable in the circumstances. The panel determined that a Suspension Order of 12 months would be the proportionate sanction to protect the public and to uphold and declare proper standards. 

This Review Hearing

10. The Panel considered the Registrant’s written statement dated 3 January 2020, in which she gave details of her recent employment as an agency Learning Assistant, Special Needs Assistant and Teaching Assistant. She worked at one school from November 2018 to July 2019.  She took a counselling course in September-October 2019 and obtained a short term position at a London museum in November 2019.

11. The Registrant has also sought voluntary work with an organisation that uses theatre and drama to help children with speech, language and communication difficulties. She stated that she would like to return to her profession, but that she was uncertain how to proceed until she knows the outcome of this review hearing. She recognised that she would have to undertake a longer period of retraining before she can do so.

12. Ms Thilagarajan for the HCPC outlined the history of the case, including the findings of the previous panel, and reminded the Panel of its powers of extending, continuing, varying or revoking the order or imposing another order. She referred the Panel to the factors to be taken into account in the Practice Note on Article 30 Reviews. She submitted that the Registrant’s fitness to practise remained impaired. The Registrant had engaged with the HCPC by producing a written statement, but she had not produced any evidence to address the original concerns in relation to her shortcomings in record keeping. There was no evidence of insight or remediation that would enable the Panel to find her fit to return to unrestricted practice.

Decision

Decision on Impairment

13. A substantive review is a two-stage process. The first task of the Panel is to decide whether the Registrant’s fitness to practise is currently impaired and if so, to then consider what sanction to impose, if any. In reaching its decision, the Panel has considered all the relevant material and had regard to the HCPTS Practice Notes on Impairment and Article 30 Reviews. The Panel accepted the advice of the Legal Assessor on the principles of proportionality and fairness in considering impairment.

14. The Panel had firmly in mind that the purpose of this hearing was to conduct a thorough appraisal of the Registrant’s current fitness to practise, including changes of circumstances and an assessment of future risk, and that this was not a rehearing of the original case. The Panel considered the two components relating to impairment; the personal component and the public component. It first considered the personal component: whether the conduct was remediable, whether it had been remedied and whether it was likely to be repeated.

15. In considering the issue of personal impairment, the Panel noted that the Registrant had not addressed or referred to the original concerns, namely her record keeping failures in 2014-2016, that had led to her suspension from professional practice by means of a Consent Order in 2019. She had provided evidence of her employment, but she had not provided the Panel with any references or testimonials. She had not undertaken any proactive work in relation to CPD or retraining for her profession. She had not, for example, approached the Royal College of Speech and Language Therapists with a view to undertaking their return to practice course. The Panel therefore determined that the Registrant had neither demonstrated sufficient insight nor provided evidence of remediation of her misconduct, and that there was a continuing risk of repetition of her record keeping deficiencies. The Registrant’s fitness to practise was therefore impaired on personal grounds.

16. In considering the wider public interest, the Panel reminded itself of the public component in Cohen v GMC [2008] EWHC 581: “the need to protect the individual and the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour which the public expect…and that the public interest includes, amongst other things, the protection of service users and the maintenance of public confidence in the profession.”

17. The Panel concluded that a finding that the Registrant was not currently impaired would undermine public confidence in the profession. The nature of her original failings was such as to damage the reputation of her profession if not remedied.  The Registrant’s fitness to practise therefore remained impaired on public interest grounds.

Decision on Sanction

18. The nature of the original impairment was too serious to make no order. The Panel considered whether to impose a Caution Order, but decided that it was inappropriate, because it was not an isolated instance and it would not provide sufficient public protection where the original concerns have not been addressed.

19. The Panel considered that a Conditions of Practice Order would not be workable or verifiable because the Registrant has not worked as a Speech and Language Therapist since 2016 and such an order would serve little practical purpose in the absence of current evidence of remediation or re-engagement with her profession.

20. The Panel considered that there was an arguable case for a Striking Off Order at this stage in view of the absence of evidence of remediation or insight, and considered paragraph 48 of the Indicative Sanctions Policy: ‘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.  A registrant’s inability or unwillingness to resolve matters will suggest that a lower sanction may not be appropriate.’

21. However, the Panel determined that the Registrant should be afforded a further opportunity to engage with the HCPC. The Panel therefore concluded that an extension of the current Suspension Order for a further period of 12 months was the necessary and proportionate measure to ensure there was no repetition of her failings and to maintain public confidence in the profession.

22. The Panel noted that the Registrant had not been given any specific guidance at the last hearing as to what a future review panel might expect of her in relation to demonstrating insight and remediation. It appeared from her statement that the Registrant was uncertain as to how to proceed or re-engage with her profession whilst she remained subject to a Suspension Order.

23. It may therefore help the Registrant to know that the next reviewing panel may be assisted by the following from the Registrant:

• References or testimonials for any paid or unpaid work.
• Evidence of record keeping in any paid or unpaid work
• Evidence that the Registrant has taken steps to maintain her professional knowledge by undertaking CPD and/or courses
• Evidence that she has engaged with the Royal College of Speech and Language Therapists, for example by commencing their return to work course
• Evidence in relation to managing her health
• The Registrant’s attendance at the next hearing.

24. The Registrant should be in no doubt that the next review panel may have grounds to consider striking her name from the register if she fails to take a more proactive approach in the way that is outlined above.

The Registrar is directed to suspend the registration of Miss Sutapa Halder for a further period of 12 months on the expiry of the existing order.

This Order will be reviewed again before its expiry on 4 February 2021.

History of Hearings for Miss Sutapa Halder