Dr Claire V M Evans-Williams

Profession: Practitioner psychologist

Registration Number: PYL32776

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 13/07/2020 End: 17:00 17/07/2020

Location: This is a virtual hearing

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Whilst registered with the HCPC as a Practitioner Psychologist, you;

1. Did not obtain and/or record the informed consent of Service User A;

a. To carry out a diagnostic assessment on him on or around 3 July 2017, and/or

b. To write a report about him on or around 6 July 2017, and/or

c. To carry out a forensic assessment on him on or around 3 July 2017, and/or

d. To write a report about him on or around 9 July 2017

2. Acted outside of your scope of practice in that you;

a. Accepted instructions to complete a Clinical Forensic Assessment Report in respect of Service User A

b. Carried out a Clinical Forensic Assessment of Service User A on or around 3 July 2017

c. Completed a Clinical Forensic Assessment Report dated 9 July 2017 in respect of Service User A

d. Made specific recommendations regarding medication for Service User A

3. Did not carry out an adequate risk assessment of Service User A in that you;

a. Did not obtain and/or seek to obtain any;

i. documents relating to the court proceedings

ii. medical records

b. Did not utilise any and/or an appropriate risk assessment too

c. Advised that Service User A was at low risk of re-offending, despite any or each of the failures at 3 above

d. Used the title ‘Consultant Clinical Psychologist’ in the following documents when you were not entitled to do so;

a. Autism Spectrum Disorders Diagnostic Assessment Report relating to Service User A dated 6 July 2017

b. Clinical Forensic Assessment Report relating to Service User A dated 9 July 2017

c. Letter relating to ‘Re: Psychological reports pertaining to Service User A’ dated 11 July 2017

d. Therapy Progress Report dated 27 July 2017

e. Curriculum Vitae dated 9 July 2017

6. In your Curriculum Vitae dated 9 July 2017 you incorrectly stated that;

a. You were the Lead Clinical Psychologist, Forfar Mental Health Service between August 2016 and March 2017

b. You provided clinical supervision to all CBT-trained health and social care staff across Angus between 2015 and 2017

c. You were the CPD co-ordinator for NHS Tayside, Psychological Services from 2015

7. Your actions at paragraphs 5 and/or 6 were;

a. Misleading

b. Dishonest

8. The matters set out in paragraphs 1 to 7 constitute misconduct.

9. By reason of your misconduct your fitness to practise is impaired.

 

Finding

Preliminary Matters

1. On day one of the Hearing, the Panel received substantial documentation in the form of the main defence bundle. The HCPC submitted its bundle in advance of the Hearing. The Panel decided that in order to familiarise itself with the Registrant’s documentation, it was appropriate to spend a substantial part of the first day in reading the documentation before reconvening the hearing.

2. A list of the documents received on the first day of the Hearing is included with Annex A.

3. The Parties sought and were granted an adjournment prior to the commencement of the Hearing to allow their experts to prepare and submit a Joint Expert Report. This was received as an exhibit.

4. The Panel asked Mr Fortune, Counsel on behalf of the Registrant, if any adjustments were required in respect of the Registrant’s health condition. Counsel submitted that if the Registrant required a ‘break’ in the proceedings she would bring that to his attention.


Amendment

5. Mr Foxsmith, Counsel instructed on behalf of the HCPC, sought to amend Particular 6.a of the Allegation by adding the word ‘Community’ after the word ‘Forfar’. Mr Fortune, Counsel for the Registrant, agreed to this amendment. The Panel accepted the legal advice of the Legal Assessor and allowed the amendment as follows:

6. In your Curriculum Vitae dated 9 July 2017 you incorrectly stated that;

a. You were the Lead Clinical Psychologist, Forfar Community Mental Health Service between August 2016 and March 2017.

Admissibility of Evidence

6. The HCPC objected to the admissibility of part of the written testimonial from the Registrant’s witness, WC.

7. The HCPC submitted that WC was a witness of ‘good character’, not an ‘expert witness’, and he should not be permitted to give opinion evidence.

8. Mr Fortune submitted that the Panel should receive WC’s evidence. He stated that whilst WC attended as a ‘good character’ witness and not an ‘expert witness’, he was entitled to make comment on his understanding of the term ‘Consultant’ within the context of his statement about the Registrant’s good character.

9. The Panel accepted the advice of the Legal Assessor and considered the guidance within the HCPTS Practice Note on “Opinion Evidence, Experts and Assessors”. The Panel also considered Rule 10(c) of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the ‘Rules’) in respect of the admissibility of evidence.

10. The Panel decided to receive the evidence from WC in relation to his understanding of the term ‘Consultant’, noting that he was not providing evidence as an expert. The Panel indicated that it would place such weight on his evidence as it considered appropriate.

11. At the Finding of Facts stage, after the HCPC’s closing submissions, Mr Fortune sought to submit additional evidence prior to making his closing submissions on behalf of the Registrant. This was to clarify the effective commencement date of the British Psychological Society Guidance on the use of the Title ‘Consultant Psychologist’ (the ‘BPS Guidance’). This formed a part of the HCPC’s written evidence. The HCPC made no objection to the additional evidence on behalf of the Registrant being received by the Panel.

12. The Panel accepted the legal advice that it should consider fairness to the proceedings and Rule 10(c) of the Rules in respect of the admissibility of evidence. The Panel decided to receive the additional evidence as part of the evidence in this case.

Background

13. The Registrant is a registered Practitioner Psychologist who was initially employed unregistered as a Band 8a, Clinical Psychologist by NHS Tayside between 2 November 2015 to 12 November 2015. The Registrant was then required to stop work to await her HCPC registration. The Registrant was employed as a registered Clinical Psychologist from 3 December 2015 to 9 March 2017.

14. The Registrant was absent from work due to ill health from on or around 31 October 2016 to on or around 23 January 2017.

15. From March 2017, the Registrant worked as the Chief Executive Officer and Consultant Clinical Psychologist at The Autistic Academy UK. This was established by the Registrant originally as the ‘Aspie Academy’. It offered accessible diagnostic and therapeutic services for autistic adults. It also offered advocacy activity to promote awareness in the field of Autism Spectrum Disorder (‘ASD’) and to promote health and wellbeing.

16. On 26 June 2017, the Registrant received a telephone call from the father of a university student, Service User A (‘SUA’). The father stated that he was phoning as SUA “had a spot of bother” on the internet and he had made a “silly” mistake.

17. On 30 June 2017, the Registrant received an email from the father enclosing:

• the Charges brought by the Procurator Fiscal;

• background information;

• completed Pre-Assessment Questionnaire;

• directions to property.

18. The Registrant was instructed by SUA’s father to prepare a ‘Clinical Psychology, Diagnostic Autism Report’ for the purpose of establishing if SUA demonstrated certain characteristics and observed behaviours which may be attributable to ASD. Further, SUA’s father also instructed the Registrant to complete a ‘Clinical Forensic Assessment Report’.

19. SUA had been charged with multiple offences of a sexual nature and he had been served with an indictment in respect of criminal proceedings.

20. On 3 July 2017, the Registrant went to SUA’s home, having accepted the instructions from SUA’s father. She was accompanied by a lay colleague. The Registrant completed a ‘Clinical Psychology, Diagnostic Autism Assessment Report’ dated 3 July 2017 and a report headed ‘Clinical Forensic Assessment Report’ dated 9 July 2017.

21. On 14 September 2017, VO, a Forensic Psychologist at NHS Tayside, received a request from Perth Sheriff Court to prepare a forensic report. This request was in respect of SUA and it made reference to a prior assessment of SUA completed by the Registrant. VO was provided with documentation relating to the previous assessment completed by the Registrant.

22. VO had concerns about the content of both the Registrant’s Report dated 9 July 2017 regarding SUA and the Registrant’s Curriculum Vitae (‘CV’). VO brought this to the attention of KP, Consultant Clinical Psychologist, NHS Tayside, and Director of the Psychological Therapies Service.

23. KP subsequently undertook a joint review of the documentation with VO. They collated their findings into an investigation report which formed the basis of a referral to the HCPC made by KP dated 14 June 2018.

24. The concerns identified in his report form the basis of the current Allegation.


The Evidence

25. The Panel heard evidence from the following witnesses.

26. On behalf of the HCPC:

• KP, Consultant Clinical Psychologist, NHS Tayside;

• Dr Harry Wood, Expert, Consultant Clinical Psychologist and Forensic Psychologist.

27. On behalf of the Registrant:

• The Registrant;

• Dr Clare Allely, Expert, Clinical Psychologist and Associate Professor in forensic psychology;

• WC, ‘good character’ witness.

28. The Panel heard the submissions of both Mr Foxsmith for the HCPC and Mr Fortune for the Registrant and considered the written evidence. It also accepted the advice of the Legal Assessor.

Decision on Facts

29. In considering this case the Panel bore in mind that the burden of proof rests with the HCPC and that the standard of proof is the civil standard; that is, on the balance of probabilities. It has taken account of all the evidence, including the documentation listed at Annex A, as well as the detailed submissions. It has accepted the advice of the Legal Assessor.

30. The Panel noted the Legal Assessor’s advice that, notwithstanding that the HCPC had not sought to lead any evidence against the Registrant in respect of Particular 1.a, 1.b, 1.c, and 1.d of the Allegation, the Panel would still be required to make a Finding of Fact. The HCPC submitted that it now accepted that consent had been correctly obtained in respect of the conduct in that Particular. Consequently, the Panel considered the lack of evidence as determinative of that Particular. In addition, the Panel considered the HCPC’s and the Registrant’s bundles of documents as listed at Annex A.

Assessment of witness credibility

KP

31. The Panel found KP to be a reliable and honest witness. He gave full answers to the questions put to him. In a number of areas, he stated that his recollection was not complete and he accepted in his evidence that there were events that may have taken place under his directorship of which, if had he been aware, he would not have approved. An example was the existence of an unofficial hard copy list of patients waiting for treatment. This was referred to as the ‘non-list list’ and was distinct from the official digitalised list of waiting patients. He gave evidence about the applicability of the BPS Guidance to the definition of the term ‘Consultant’. After the evidence had concluded and Mr Foxsmith had made his closing submissions, the Panel received further written evidence on behalf of the Registrant which established that the said BPS Guidance was published on 7 April 2017. The Panel was satisfied that the witness had not sought to mislead the Panel but had been mistaken in respect of the relevant effective date in this distinct part of his evidence.

32. The Panel has borne this in mind when assessing his evidence. The Panel detected no intention on the witness’s part to deliberately mislead in this respect and his mistake was limited to the BPS Guidance’s publication date and its applicability, rather than the provisions applicable as at the date the Registrant first set up as a Consultant. The Panel was satisfied this mistake did not undermine the substance of his evidence.

Dr Harry Wood

33. The Panel found the HCPC’s expert witness, Dr Harry Wood, to be a reliable witness, and it was satisfied that he was well-qualified to provide evidence to the Panel. He demonstrated extensive experience as a clinician and he is registered with the HCPC. He answered questions clearly and in a balanced way, and the Panel found his evidence helpful. He recognised and acknowledged the Registrant’s expertise in the field of autism.

The Registrant

34. The Panel noted and accepted the Registrant to be of good character. The Panel considered her to be broadly reliable and consistent in her evidence, although there were aspects of the Registrant’s evidence that the Panel did not find credible. The Panel considered that at times the Registrant’s answers appeared to demonstrate an unshakeable belief as to the correctness of her approach and there was an impression that the Registrant believed her approach was unchallengeable.

35. The Registrant gave contradictory evidence at times, for example, in relation to her reasons for finishing her employment at NHS Tayside. At times the Registrant stated that she was ‘forced’ out, but at other times she stated that it was her intention to leave the NHS and go into the area of private practice in any event. The Panel noted that both Dr Allely and Dr Wood, in their Joint Expert Report, agreed on the matter of the Registrant’s expertise in the field of autism. This was also acknowledged by KP.

Dr Clare Allely

36. Dr Clare Allely gave expert evidence to the Panel, having been called on behalf of the Registrant.

37. The Panel noted that this was her first occasion giving evidence as an expert witness at a tribunal or Court hearing. She indicated that she felt nervous whilst giving evidence, but the Panel considered that this did not adversely affect the quality of her evidence.

38. The Panel found Dr Allely to be mainly credible and reliable as a witness in the information she provided to the Panel. It noted that Dr Allely was a highly qualified academic at the ‘cutting edge’ of her specialism. She had particular interests in investigating how autism symptomatology contributed to different types of offending behaviour in the field of autism across the whole of the criminal justice system.

39. Whilst Dr Allely mainly answered questions clearly and knowledgeably, the Panel did consider that at times Dr Allely’s evidence lacked objectivity. At these times, there was a tendency for Dr Allely to argue for the Registrant’s position without making any concession.

40. An example of this was when Dr Allely supported the Registrant’s lack of corroborative evidence about SUA’s background circumstances in the preparation of the Forensic Assessment Report. This report was being prepared for the purpose of the disposal of the criminal proceedings in respect of very serious charges against SUA.

41. The Panel noted that it was put to Dr Allely that SUA might be motivated to give the Registrant false information in order to avoid a custodial sentence. It was only following further questions and the Panel raising why SUA’s account required corroborative evidence to be reliable that Dr Allely did ultimately accept that SUA might have had a motive to provide inaccurate information, and hence the need for collateral evidence. The Panel considered this approach demonstrated a lack of objectivity in respect of this.

42. Dr Allely recognised and acknowledged the Registrant’s expertise in the field of autism. The Panel was assisted by the combination of Dr Wood’s clinical practice and Dr Allely’s academic expertise.

43. Dr Allely stated that as an academic, she does not require to be and is not registered with HCPC. She stated she had not practised as either a forensic psychologist or a forensic clinical psychologist.

44. Where there was a conflict between the evidence of the two experts the Panel preferred Dr Wood’s evidence, which reflected his objectivity and his extensive experience in the practice of forensic clinical psychology.

45. Additionally, the Panel had regard to the joint report prepared by Dr Allely and Dr Wood following their discussion on day one of the Hearing and noted the matters on which they agreed.

WC

46. The Panel found WC to be a reliable ‘good character’ witness. He limited his answers to what he knew. He stated that his brother was a medical consultant and volunteered his understanding of what a ‘Consultant (psychologist)’ was, but did not profess any specific expertise on this subject. The Panel determined that WC was no better an authority than any member of the public about the requirements needed for use of the title of ‘Consultant Psychologist’. The Panel placed little weight on his evidence in this regard.

Written Testimonials

47. The Panel also took account of the written testimonials submitted as evidence of the Registrant’s ‘good character’ at the fact-finding stage, to the extent that they were relevant. There was positive content about the Registrant, as well as a reference to her being ‘naïve’ and perhaps being more direct in pointing out others’ mistakes than the Registrant appreciated was acceptable to her audience.

Findings of Fact

Particular 1 (a, b, c, and d) – Not Proved

1. Did not obtain and/or record the informed consent of Service User A;

a. To carry out a diagnostic assessment on him on or around 3 July 2017, and/or 

b. To write a report about him on or around 6 July 2017, and/or 

c. To carry out a forensic assessment on him on or around 3 July 2017, and/or

d. To write a report about him on or around 9 July 2017

48. The Panel considered the above Particulars of the Allegation. The Panel noted the HCPC offered no evidence in respect of Particular 1. The Panel, having considered the totality of the evidence in this case, was not satisfied that Particulars 1.a, 1.b, 1.c, and 1.d were proved on the balance of probabilities.

Particular 2

2. Acted outside of your scope of practice in that you;

49. The Panel restricted its consideration of Particular 2 to the Clinical Forensic Assessment Report dated 9 July 2017 in respect of SUA. Both experts agreed, having regard to SUA’s solicitor’s email requesting such a report, that this was consistent with a forensic purpose. The Panel considered that the Registrant’s own evidence about her limited previous experience at NHS Tayside demonstrated her lack of sufficient experience in the area of completing Clinical Forensic Assessment Reports.

50. The Panel accepted Dr Wood’s evidence that the Registrant’s CV indicated she did not have the depth of relevant experience to provide expert opinion regarding the risk of sexual offending.

51. Dr Allely stated that whilst the Registrant carried out a risk assessment for this case which was informed and supported by evidence-based literature, it would have been prudent for the Registrant to have made explicit in her report the modified approach she took in this particular case and the reason for it.

52. The Panel accepted the evidence from the Joint Expert Report that psychologists are responsible for ensuring they are sufficiently competent and expert in offering an opinion.

53. The Panel also accepted the evidence from the Joint Expert Report that the Registrant’s failure to elicit clear instructions from SUA’s solicitor, and her failure to obtain an appropriate range of documentation prior to making a risk assessment, demonstrated the Registrant’s lack of experience in completing Clinical Forensic Assessment Reports.

54. The Panel was satisfied that this lack of expertise and knowledge meant that the Registrant was acting outside of her scope of practice.

Particular 2.a – Proved

2. Acted outside of your scope of practice in that you;

a. Accepted instructions to complete a Clinical Forensic Assessment Report in respect of Service User A

55. The Panel accepted the evidence from both experts that, having regard to the emails sent on SUA’s behalf requesting such a report, this was consistent with a forensic purpose.

56. The Panel also had regard to the Registrant’s reference in correspondence to the report as a “Court report” and a “Forensic report”. The Registrant also emailed SUA’s father to the effect that it was highly likely SUA’s solicitor would consider it necessary for her to attend Court. The Registrant entitled the report a ‘Clinical Forensic Assessment Report’ .

Particular 2.b – Proved

2. Acted outside of your scope of practice in that you;

b. Carried out a Clinical Forensic Assessment of Service User A on or around 3 July 2017

57. The Panel accepted the evidence from the Joint Expert Report that the assessment carried out by the Registrant was a Clinical Forensic Assessment in respect of SUA. This was agreed by the experts, having regard to the Registrant’s focus on the offending behaviour and the risk of reoffending in her assessment.

Particular 2.c – Proved

2. Acted outside of your scope of practice in that you;

c. Completed a Clinical Forensic Assessment Report dated 9 July 2017 in respect of Service User A

58. The Panel accepted the evidence in the Joint Expert Report that the report of 9 July 2017 was a Clinical Forensic Assessment Report in respect of SUA. This was agreed by the experts having regard to the Registrant’s focus on the offending behaviour and the risk of reoffending in her Assessment Report.

Particular 2.d – Not Proved

2. Acted outside of your scope of practice in that you;

d. Made specific recommendations regarding medication for Service User A

59. The Panel noted Dr Wood’s reservations, but also noted that he accepted it was not unreasonable for the Registrant to give her opinion regarding this treatment. The Panel accepted the evidence from Dr Allely that it was appropriate for the Registrant to provide her opinion regarding treatment approaches to depression for SUA. The Panel was satisfied with the Registrant’s evidence that a GP could choose to ignore this, as a GP would be required to satisfy themselves as to the appropriateness of any treatment.

60. The Panel was satisfied that the Registrant’s comment should be read in the context that a doctor prescribing medication would have to be satisfied as to the appropriateness of the medication. The Panel determined that whilst the Registrant’s phrasing might appear clumsy, the Registrant was not acting outside of her scope of practice.

Particular 3.a.i – Proved

3. Did not carry out an adequate risk assessment of Service User A in that you;

a. Did not obtain and/or seek to obtain any;

i. documents relating to the Court proceedings

61. The Panel considered the Registrant’s evidence and the Expert evidence from Dr Wood and Dr Allely.

62. Dr Wood gave evidence that corroboration of SUA’s account was essential, hence collateral information was needed.

63. The Panel considered the expert evidence of Dr Wood that corroboration of SUA’s account was essential to make a robust, valid, and safe assessment of the risk of offending behaviour in these circumstances; hence collateral information was needed, as it was not possible to make an assessment of offending behaviour in the absence of this additional information.

64. The Panel also considered Dr Allely’s expert evidence that this was a different set of circumstances from a Clinical Forensic Assessment Report prepared for a Court. She gave evidence that the Registrant would have been relying on subsequent assessments taking place as a result of any reports the Court would order as part of its standard procedure.

65. The Panel noted that the Registrant’s evidence accorded with that of Dr Allely.

66. The Panel considered both the risk assessment and the material available to the Registrant at the time that she carried out that risk assessment. The Panel noted the information that this was at a very early stage of the criminal proceedings and the charge sheet received from the Procurator Fiscal may have been the only documentation relating to the Court proceedings immediately available to the Registrant. The Panel was not satisfied that this was an adequate basis on which to complete an adequate risk assessment.

67. The Panel took account of the email sent by the Registrant to SUA’s father in respect of SUA dated 1 July 2017. Although the Registrant requested “supplementary documentation relating to the Court case such as a criminal justice social work report, and indeed any professional reports (including full Court documentation) and contact details”, she did not await this documentation prior to preparing her report.

68. The Panel was satisfied, on the balance of probabilities, that the Registrant did not carry out an adequate risk assessment, in that she did not obtain and/or seek to obtain any documents in relation to the Court proceedings.

Particular 3.a.ii – Proved

3. Did not carry out an adequate risk assessment of Service User A in that you;

a. Did not obtain and/or seek to obtain any;

ii. medical records

69. The Registrant accepted that she had not obtained medical records, but she stated that this was because she was focussed on carrying out a risk assessment of SUA. She stated this risk assessment was modified to reflect the differences found in those with ASD, such as SUA. 

70. Dr Wood gave compelling evidence that the medical records were required for the assessment to be adequate, as corroboration/collateral evidence of the information provided by the subject of the report is essential.

71. The Panel considered the Registrant’s evidence and the expert evidence from Dr Wood that corroboration of SUA’s account was essential, hence collateral information was needed. Dr Wood stated it was not possible to make an assessment of offending behaviour in the absence of this information.

72. The Panel also considered Dr Allely’s expert evidence that this was a different set of circumstances from a Forensic Report prepared for a Court and the Registrant would have been relying on subsequent assessments taking place, ordered by the Court. The Panel noted Dr Allely’s evidence that she herself had no previous experience in preparing a Clinical Forensic Assessment Report for Court. The Panel noted that whilst initially she was emphatic that such medical reports were not needed, she then conceded that view and accepted that it would have been prudent to have had the medical records which were required to carry out an adequate assessment.

73. The Panel was satisfied that the Registrant did not carry out an adequate risk assessment of SUA in that she did not obtain and/or seek to obtain any medical records.

Particular 3.b – Proved

3. Did not carry out an adequate risk assessment of Service User A in that you;

b. Did not utilise any and/or an appropriate risk assessment tool

74. The Registrant was focussed on performing a risk assessment of SUA which was modified so as to be suitable for the ASD population. The Registrant was not satisfied that the tool referred to by Dr Wood, HCR-20, was sufficiently sensitive to the Registrant’s ASD condition, as it would have been ‘normed’ using the general population, which was insufficient to reflect SUA’s unique presentation.

75. Dr Allely gave evidence that the Registrant had appropriately used a finely tuned tool particularly appropriate for the purposes of assessing this particular service user. This was with reference to the assessment that SUA had ASD, and tools such as the HCR-20 were normed against a sample of the general population and therefore not sensitive to the specifics of a service user with ASD.

76. However, Dr Allely did concede in the course of her evidence that however finely tuned the Registrant’s assessment tool might be to this individual service user, it was not a tool which was in general use within the profession. This meant that the results obtained by the Registrant for SUA could not be assessed by a fellow professional, hence the tool used was not appropriate for risk assessment.

77. The Panel accepted the evidence of Dr Wood. Dr Wood stated that the risk assessment carried out by the Registrant was not adequate. He stated that it is widely accepted that unstructured professional judgment is not appropriate, valid, or safe.

78. Dr Wood continued that Forensic Psychologists use an accepted, structured professional judgment approach. In this case the Risk for Sexual Violence Protocol would have been an appropriate tool. The Registrant had pulled elements out of the tool and adapted the tool, but Dr Wood was not satisfied that this was an appropriate or safe use of the tool.

79. The Panel considered the evidence and was satisfied that the Registrant did not carry out an adequate risk assessment of Service User A, in that she did not utilise any and/or an appropriate risk assessment tool.

Particular 4 – Proved

4. Advised that Service User A was at low risk of re-offending, despite any or each of the failures at 3 above.

80. The Panel considered Dr Allely’s opinion that the Registrant’s use of the nonstandard method of risk assessment was correctly informed by the literature on ASD and internet offending. Dr Allely stated it is argued that offenders with ASD re-offend at lower rates than neurotypicals.

81. This supported the Registrant’s evidence that she had effectively adapted the standard test and had not applied it as it is designed to be carried out. She gave evidence that she did so because of the unique characteristics inherent in the ASD population. She stated that she considered the test could not be applied as it was designed, as the results would not reflect the differences found in those with ASD, such as SUA.

82. Dr Allely stated that the approach by the Registrant to the assessment of SUA identified ASD specific features which contributed directly to SUA’s behaviour. Dr Allely stated that recognising this was a significant step towards him addressing his own risk and behaviours.

83. However, Dr Allely did concede in the course of her evidence that however finely tuned the Registrant’s assessment tool might be to this individual service user, it was not a tool which was in general use within the profession. This meant that the results obtained by the Registrant for SUA could not be assessed by a fellow professional, hence the tool used was not appropriate for risk assessment.

84. Dr Wood’s evidence was that the Registrant was inadequately informed such as to reach a safe conclusion about the level of risk. He gave evidence that due to the Registrant’s use of an inadequate assessment tool, the information obtained was inappropriate and flawed. In view of this, the information could not be used by another professional in making an assessment.

85. The Panel accepted Dr Wood’s evidence, which was in part acknowledged and accepted by Dr Allely. The Panel was satisfied that the Registrant advised that SUA was at low risk of re-offending despite any or each of the failures at Particular 3.

Particular 5 (a, b, c, d, and e) – Proved

5. Used the title ‘Consultant Clinical Psychologist’ in the following documents when you were not entitled to do so;

a. Autism Spectrum Disorders Diagnostic Assessment Report relating to Service User A dated 6 July 2017

b. Clinical Forensic Assessment Report relating to Service User A dated 9 July 2017

c. Letter relating to ‘Re: Psychological reports pertaining to Service User A’ dated 11 July 2017

d. Therapy Progress Report dated 27 July 2017

e. Curriculum Vitae dated 9 July 2017

86. The Panel considered and accepted the evidence of KP in relation to the measure and breadth of experience required, and that the number of years of expertise that a Clinical Psychologist would have needed to accrue to justify the use of the title ‘Consultant Clinical Psychologist’ would normally be at least 5-7 years’ experience post-Clinical Psychologist training.

87. The Panel reminded itself of the evidence received on behalf of the Registrant in relation to the introduction date of the BPS Guidance. This was accepted after the substantive case on the facts had been led. The Panel was satisfied that the evidence established that the BPS Guidance was not available online until 7 April 2017.

88. This satisfied the Panel that the BPS Guidance as referred to by KP would not have been in force at the time KP spoke to the Lead National Assessor about the appropriateness of the Registrant using the term ‘Consultant Clinical Psychologist’. In view of this, it would appear that he was mistaken in his reference to the BPS Guidance’s date of publication.

89. Nevertheless, the Panel took account of KP’s experience both as Director of Psychology NHS Tayside and his experience throughout a period of 17 years as a National Assessor. The Panel was satisfied that KP’s evidence on the entitlement of the use of the term ‘Consultant’, and the inappropriateness of the Registrant using the term ‘Consultant Clinical Psychologist’ in the documents referred to in Particular 5 when she was not entitled to do so, was credible and reliable.

90. The Panel also considered Dr Wood’s and Dr Allely’s Joint Expert evidence that the result of a combination of professional qualifications, ‘apprenticeship’ or period of ‘mentorship’, post-qualification training (for example, in clinical supervision), length of supervised practice, relevant experience/contact hours, and attending conferences and courses would evidence a justifiable basis for using the title ‘Consultant Clinical Psychologist’.

91. The focus of Dr Wood’s evidence was that the use of the title ‘Consultant’ was justified by a practitioner having obtained a wide breadth of experience, whereas Dr Allely submitted that the Registrant’s esoteric experience was sufficient to be entitled to use ‘Consultant’.

92. The Panel noted the Registrant’s evidence of her strong belief that her own esoteric experience and her specialist practice in the field of ASD justified the use of the title ‘Consultant’.

93. The Panel accepted the evidence of Dr Wood and KP, but did not accept the Registrant’s evidence and the evidence of Dr Allely that the Registrant’s expertise in the field of ASD was sufficient, even when taken into account with her other experience, to satisfy the entitlement to use the title ‘Consultant’.

94. The Panel was satisfied that the Registrant had used the title ‘Consultant Clinical Psychologist’ in the documents set out at Particular 5 when she was not entitled to do so.

95. The Panel noted and considered the Consultant Clinical Psychologist job descriptions and information within the NHS advertisement and recruitment packs from NHS Tayside, Dumfries and Galloway, NHS Greater Glasgow and Clyde, and NHS Fife. The Panel considered these with reference to the skill level and experience required of a Consultant. The Panel determined that the job descriptions identified did not assist the Panel in being satisfied that, based on these, the Registrant was entitled to use the title ‘Consultant’. The information indicated that these were roles requiring more experienced, more senior practitioners than the Registrant. She had been employed in the NHS for approximately 15 months at a lower grade than ‘Consultant’.

96. The Panel also heard evidence from WC, the ‘good character’ witness, on his understanding of the term ‘Consultant’ as a lay person. The Panel noted that he is a qualified teacher. WC stated he had not worked in the NHS. He stated that his brother is a Consultant Paediatrician and that as a lay person he did not really know what that meant, but he perceived it was a status associated with “experience” and also with “managerial responsibility”. The term ‘Consultant’ discerned a degree of seniority and did not necessarily mean expertise across all fields. For example, a Consultant Paediatrician might not know much about autism, but ‘Consultant’ attributed the recognition of status. The Panel noted WC’s evidence as an example of, but not conclusive of, a lay person’s understanding of the term ‘Consultant’.

Particular 6.a – Proved

6. In your Curriculum Vitae dated 9 July 2017 you incorrectly stated that;

a. You were the Lead Clinical Psychologist, Forfar Community Mental Health Service between August 2016 and March 2017.

97. The Panel noted the Registrant’s reference to herself in her CV as “Lead Clinical Psychologist between August 2016 and March 2017”. The Panel also noted KP’s evidence that the Registrant’s line manager at NHS Tayside was AP. KP stated that AP was the Lead Clinical Psychologist/Consultant Psychologist for Angus Adult Psychological Therapies Service.

98. The Panel did not accept the Registrant’s account that AP had given her this title as a “sop” because of the pressure on the Registrant arising from the absence of other staff and that consequently she had been told she was now “the lead”.

99. The Panel accepted the evidence from KP that such an appointment would have been held by a Consultant with management responsibilities, as opposed to a Clinical Psychologist at the Registrant’s level who would not have been able to lead a team.

100. The Panel noted that if the Registrant had been given this post it would have given rise to a new contract, reflecting a different pay grade, a different job description, and a title denoting the Lead Clinical Psychologist role.

101. The Panel determined that, had the Registrant believed she had been made Lead Clinical Psychologist despite having the same contract, the Registrant would have, for example, changed her email signature to reflect her new role as Lead Clinical Psychologist. She did not do this, nor was she able to demonstrate any other steps taken to reflect her new role.

102. Hence the Panel was satisfied on the evidence that the Registrant incorrectly stated that she was the Lead Clinical Psychologist, Forfar Community Mental Health Service between August 2016 and March 2017.

Particular 6.b – Not Proved

6. In your Curriculum Vitae dated 9 July 2017 you incorrectly stated that;

b. You provided clinical supervision to all CBT-trained health and social care staff across Angus between 2015 and 2017

103. The Panel considered the wording of this Particular and was satisfied that the evidence supported the contention that the Registrant could have been providing administrative supervision, including some ‘clinical supervision,’ to some CBT-trained staff, including nurses. The Panel was not satisfied that the HCPC’s evidence in respect of this was sufficient to establish this Particular on the balance of probabilities.

Particular 6.c - Proved

6. In your Curriculum Vitae dated 9 July 2017 you incorrectly stated that;

c. You were the CPD co-ordinator for NHS Tayside, Psychological Services from 2015

104. The Panel accepted the evidence produced of the records from 2015 to March 2017 of the Minutes from the NHS Tayside, Psychological (Therapies) Services, Continuing Professional Development Committee Meetings.

105. The Registrant neither attended these meetings nor was she recorded as ‘absent’. The Panel was satisfied that the Registrant had incorrectly stated she was the CPD co-ordinator for NHS Tayside, Psychological Services from 2015. The Panel was satisfied on the basis of both the written documentation and the evidence of KP that the Registrant was not the CPD co-ordinator for NHS Tayside, Psychological Services from 2015, and that the Registrant incorrectly stated that she held this role.

Particular 7

7. Your actions at paragraphs 5 and/or 6 were;

a. Misleading

b. Dishonest

Particular 7.a (misleading) in relation to Particular 5a,b,c,d,e – Proved

106. The Panel noted that this Particular referred to its finding regarding the Registrant using the title ‘Consultant Clinical Psychologist’ on dates over a three week period from 6 July 2017 to 27 July 2017, both dates inclusive in the following documents:

• Autism Spectrum Disorders Diagnostic Assessment Report relating to Service User A dated 6 July 2017

• Clinical Forensic Assessment Report relating to Service User A dated 9 July 2017

• Letter relating to ‘Re: Psychological reports pertaining to Service User A’ dated 11 July 2017

• Therapy Progress Report dated 27 July 2017

• Curriculum Vitae dated 9 July 2017

107. The Panel took account of the Legal Assessor’s advice in deciding if the Registrant’s actions were misleading. The Panel determined that an action is misleading if the person making it knows that it is, or might be, untrue or misleading. Actual knowledge that the representation might be untrue is required. Misleading here cannot be effected by accident.

108. The Panel considered the evidence from KP and Dr Wood as to what career progression within the NHS is required to achieve a Consultant’s post and to merit the title of Consultant, and how this compared to the Registrant’s own, then recent, 15 months as a Registrant Band 8a role at NHS Tayside.

109. Dr Wood gave evidence that a minimum of five years post-qualification experience within the NHS would have been expected to attain a Consultant role. He stated that there would be no reason why this should be any different in private practice.

110. Both Dr Wood and Dr Allely gave evidence that reference could be made to the guidance of National Assessors as to the use of the term Consultant. There was no evidence that the Registrant had embarked on any meaningful or objective external validation.

111. The Panel also had regard to the evidence provided from the Registrant as to her specialist experience and to Dr Allely’s evidence in respect of this.

112. The Panel was satisfied that when the Registrant used ‘Consultant Clinical Psychologist’ in her CV, she was aware that she was not entitled to use this. The Panel noted the Registrant’s evidence to the effect that she had not obtained peer input but had canvassed her use of the title ‘Consultant’ with her multidisciplinary team of experienced professional and non-professional associates.

113. The Panel was satisfied that the Registrant was aware she was using the title ‘Consultant’ when she was not entitled to do so, in order to embellish her role. The Registrant was aware that she would mislead the reader as regards her level of experience and achievement.

Particular 7.b (dishonesty) in relation to Particular 5a,b,c,d,e – Not Proved

114. The Panel applied the two-stage test in relation to dishonesty, following the case of Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67).

115. The Panel considered what the Registrant’s knowledge or belief as to the facts was at the time when she used the title ‘Consultant Clinical Psychologist’ in the documents referred to in Particular 5. The Panel considered that the Registrant had not been as thorough and diligent as a professional might have been expected to be in researching and applying the use of the title Consultant. The Panel was satisfied that the Registrant was aware the use of the term Consultant was misleading. Whilst the Panel was satisfied it was misleading it was not satisfied that the use of the term Consultant was part of a dishonest plan, rather, in the course of a short period when the Registrant had recently established herself in private practice she used this title to gain credibility in her role. The Panel then went on to consider whether, in view of that knowledge or belief at the time, the Registrant’s conduct was dishonest by the standards of ordinary decent people. The Panel took into account that the Registrant is a person of good character. The Panel noted the short period of time during which the title was used which was approximately a period of 3 weeks. It also noted the distinct circumstances surrounding the use of the title, which was solely in the context of the documents prepared for a single service user as referred to in Particular 5. The Panel was not satisfied that there was sufficient evidence to prove, on the balance of probabilities, that the Registrant’s conduct in relation to Particular 5 was dishonest.

Particular 7.a (misleading) in relation to Particular 6 – Proved (6.a, 6.c); Not Proved (6.b)

116. Particular 6.a related to the Registrant incorrectly stating in her CV dated 9 July 2017 that she was the Lead Clinical Psychologist, Forfar Community Mental Health Service between August 2016 and March 2017.

117. Particular 6.c related to the Registrant incorrectly stating she was the CPD co-ordinator for NHS Tayside, Psychological Services from 2015.

118. The Panel, having found 6.b not proved, therefore found Particular 7.a in relation to 6.b not proved.

119. As stated above, the Panel accepted the legal advice that an action is defined as misleading if the person making it knows that it is, or might be, untrue or misleading. Actual knowledge that the representation might be untrue is required. Misleading here cannot be effected by accident.

120. Having regard to the findings in Particular 6.a, the Panel was satisfied that the Registrant was aware that she had not been promoted to or appointed to this post.

121. The Registrant knew that the post of Lead Clinical Psychologist, Forfar Community Mental Health Service did not exist; hence the Panel was satisfied that the Registrant knew she had not been appointed to this role.

122. The Registrant would have been aware that using the title in her CV did not represent the true position. The Panel was satisfied that the Registrant’s actions were misleading when she incorrectly referred to Lead Clinical Psychologist, Forfar Community Mental Health Service so as to mislead people reading her CV as to the level of her experience.

123. Having regard to the findings in Particular 6.c, the Panel was satisfied that the Registrant was aware that she had not been appointed to the CPD co-ordinator post at NHS Tayside. The Registrant would have been aware that using the title in her CV did not represent the true position. The Panel was satisfied that the Registrant’s actions were misleading when she incorrectly referred to her role as the CPD co-ordinator for NHS Tayside, Psychological Services from 2015 so as to mislead people reading her CV as to her level of experience as a Clinical Psychologist.

Particular 7.b (dishonesty) in relation to Particular 6 – Proved (6.a, 6.c); Not Proved (6.b)

124. As indicated above, the Panel, having found 6.b not proved, therefore found Particular 7.b in relation to 6.b not proved.

125. With regard to Particular 6.a, the Panel applied the two-stage test for dishonesty, following the case of Ivey v Genting Casinos.

126. The Panel considered what the Registrant’s genuine knowledge or belief as to the facts was at the time she stated she was the Lead Clinical Psychologist, Forfar Community Mental Health Service, and, in view of that knowledge or belief at the time, whether the Registrant’s conduct was dishonest by the standards of ordinary decent people. The Panel took into account that the Registrant is a person of good character. However, the Panel was satisfied that there was substantive evidence to establish, on the balance of probabilities, that the Registrant knew she had not been appointed to this role and there was no truth in her claim to have been in this role. The Panel was therefore satisfied that the Registrant’s conduct in incorrectly stating her role was dishonest by the standards of ordinary decent people.

127. With regard to Particular 6.c, the Panel again applied the two-stage test, following the case of Ivey v Genting Casinos.

128. The Panel considered what the Registrant’s genuine knowledge or belief as to the facts was at the time she stated that she was the CPD co-ordinator for NHS Tayside, Psychological Services from 2015, and, in view of that knowledge or belief at the time, whether the Registrant’s conduct was dishonest by the standards of ordinary decent people. The Panel took into account that the Registrant is a person of good character. The Panel had regard to its findings at 6.c and was satisfied that there was substantive evidence to establish, on the balance of probabilities, that the Registrant knew she had not been appointed to this role and there was no truth in her claim to have been in this role. The Registrant knew that she was incorrectly stating her role in that respect to demonstrate a level of experience and qualification she did not have. The Panel was therefore satisfied that the Registrant’s conduct was dishonest by the standards of ordinary decent people.

Decision on Grounds

129. Having announced the finding on the facts the Panel moved to the next stage.

130. The Panel heard evidence from the Registrant and received further written evidence. This included the Registrant’s Reflective statement dated 10 July 2020, an expert report from Dr Allely dated 12 July 2020 as well as a “Parliamentary Review” article featuring the Registrant.

131. The Panel heard submissions from both Parties on grounds and impairment together.

Submissions on Grounds

132. Ms Vignoles submitted that the matters found proved amounted to misconduct. She invited the Panel to find misconduct, in respect of all the matters found proved.

133. Ms Vignoles drew the Panel’s attention to the HCPC “Standards of conduct, performance and ethics”. She submitted that the Registrant had breached fundamental tenets of the profession and in particular

1. Promote and protect the interests of service users and carers
Treat service users and carers with respect

3 Work within the limits of your knowledge and skills
Keep within your scope of practice

6 Manage risk
Identify and minimise risk

134. Ms Vignoles also drew the Panel’s attention to “The standards of proficiency for practitioner psychologists.” and submitted that the Registrant was in breach of these standards.
 
135. With regard to impairment, Ms Vignoles drew the Panel’s attention to the relevant law and emphasised the Panel’s duty to consider the wider public interest as well as the protection of the public.

136. Mr Fortune submitted that none the Registrant’s acts and / or omissions, whether considered individually and / or in combination, did in fact constitute a serious falling short of the professional standards expected of her as a Clinical Psychologist and therefore did not constitute misconduct.

137. In relation to Service User A, Mr Fortune submitted that when the Panel reviewed all the evidence in relation to Particulars 2.a., 2.b., 2.c., 3.a.i., 3.a.ii and 3.b. and 4 relating to the Registrant’s involvement with Service User A and his father, the Registrant’s acts and / or omissions, whether individually and / or in combination, whilst now found to be outside her scope of practice, were well-intentioned albeit misguided. He submitted that as such, those specific acts and / or omissions did not in fact constitute a serious falling short of the professional standards expected of her as a Clinical Psychologist and therefore did not constitute misconduct.

138. Mr Fortune submitted that it was accepted on behalf of the Registrant that the misleading conduct found at Particular 7.a. (misleading) in relation to Particulars 5.a .5.b., 5.c., 5.d., 5.e.,6.a. and 6.c. and the dishonest conduct found in Particular 7.b(dishonesty) in relation to Particular 6.a and 6.c. were likely to be viewed by the Panel differently. Mr Fortune submitted that these were likely to fall into a different category and may be found to constitute misconduct. However, Mr Fortune continued that the particular findings fell at the lowest end of the spectrum and as such, questioned whether they should be labelled as constituting misconduct.

139. Mr Fortune submitted that the Panel should note that the Allegation against the Registrant was historic, dating back to the period 2015 to 2017 and that secondly, KP, although aware of concerns in September 2017 raised by VO in respect of the Registrant’s Diagnostic Assessment Report (DAR), CFAR, CV and correspondence with SUA’s father, did not make any complaint to the HCPC until 18 June 2018.

140. Mr Fortune submitted that the Registrant’s fitness to practise was not currently impaired. He submitted that the Registrant had allayed fears of repetition through her insight and by undertaking remediation through her reflection and further understanding and research. He relied on the report of Dr Allely and the contents of the Registrant’s reflective piece, as well as her good character and conduct as evidenced by the testimonials.

The Panel’s decision on grounds

141. The Panel heard and accepted the advice of the Legal Assessor, which it has reflected in its decision below. The Panel bore in mind that both grounds and impairment are matters for its independent judgment. The Panel considered the additional oral evidence from the Registrant and the Registrant’s Reflective statement dated 10 July 2020, a report from Dr Allely dated 12 July 2020 as well as a “Parliamentary Review” article featuring the Registrant. The Panel also considered the submissions made by both Parties.

142. The Panel then considered whether the facts found proved amounted to misconduct. It bore in mind that not every failure by a registrant will amount to misconduct. The question is whether the conduct falls sufficiently below what is expected to amount to misconduct which case law provides should be serious.

143. The Panel considered Particular 2.a, 2.b, 2.c; and its findings in respect of this Particular in the determination above that the Registrant had acted outside her scope of practice in accepting instructions, carrying out a clinical forensic assessment (CFA) of SUA and completion of a CFAR in respect of SUA.

144. The Panel noted the lack of skill, expertise and experience the Registrant had in this area of clinical practice and determined that her conduct demonstrated a significant and serious falling short of the standards expected of a Registrant. The Panel determined this amounted to misconduct.

145. The Panel considered Particular 3.a.i and 3.a.ii and its findings in respect of this Particular in the determination above. The Panel noted the joint expert evidence and the need for obtaining collateral information to provide corroboration when preparing a report such as the CFAR for SUA.  The Panel noted the evidence that it was unsafe to rely solely on information from SUA and his family alone, in circumstances where the purpose of the report was to avoid criminal proceedings. It was hoped by the family that the criminal proceedings would be referred on to a diversionary disposal of the case that would avoid SUA receiving a conviction. The Panel determined this conduct was very serious and amounted to misconduct.

146. The Panel considered Particular 4 and its finding in respect of this Particular. The Panel considered it was extremely concerning and serious that the Registrant whilst carrying out a CFA and completing a CFAR in respect of very serious charges in criminal proceedings against SUA, had not utilised an appropriate risk assessment tool. The Registrant had effectively invented her own tool without reference to anyone. This meant that the assessment of SUA as at low risk of re-offending, an assessment to be relied in the judicial process, was not properly measured. This had the potential to expose both the public and SUA to risk with serious consequences. The Panel determined this conduct was very serious and amounted to misconduct.

147. The Panel considered Particulars 5.a.,5.b.,5.c.,5.d.,5.e and its finding and determination above in respect of this Particular. The Panel had regard to all the information and circumstances of the Registrant’s use of the title ‘Consultant Clinical Psychologist’ in the CFAR in respect of SUA, over a three week period when the Registrant was not entitled to do so.

148. The Panel noted that the use of the title ‘Consultant Clinical Psychologist’ was accepted by the experts and KP as one that conveyed to the public and professionals, including court users that the individual had a certain depth and breadth  of experience and skill and this could be relied on particularly in a court setting. There was a high risk of those relying on the title to measure the Registrant’s expertise and standing in her profession and the reliability of her assessments being misled. She had only a short amount of post training experience, albeit with specific expertise in ASD, but nevertheless decided that her esoteric and objectively unquantified very limited experience was sufficient to justify her use of the title. The Panel determined this conduct was very serious and amounted to misconduct.

149. The Panel considered Particular 6.a. and 6.c. and its finding and determination above in respect of this Particular.  The Panel considered that it was very serious to incorrectly state positions not held by the Registrant on her CV. Additionally, providing incorrect information, may cause a risk to the public relying on the Registrant’s experience described in the CV. The Registrant had sought to enhance her position and expertise. This had the potential to expose third parties and stakeholders to risk with serious consequences. The Panel determined this conduct was very serious and amounted to misconduct.

150. The Panel considered the finding at 7.a (misleading) in relation to Particulars 5.a. ,5.b., 5.c., 5.d., 5.e,.and its finding and determination above in respect of this Particular. The Panel determined that the Registrant’s actions were misleading in her use of the title ‘Consultant Clinical Psychologist’. The Panel considered there was a high risk of the public, including professionals being misled into relying on the title to measure the Registrant’s expertise and her standing in her profession and the reliability of her assessments. The Registrant had only a short amount of post training experience, albeit with specific expertise in ASD. The Panel determined this conduct was very serious and amounted to misconduct.

151. The Panel considered the finding at 7.a (misleading) in relation to Particulars 6.a. and 6.c. and its finding and determination above in respect of this Particular. The Panel determined that the Registrant’s actions were very serious in misleading readers by incorrectly stating positions not held by the Registrant, on her CV. Additionally, providing incorrect information, may cause a risk to the public relying on the Registrant’s experience described in the CV. The Registrant had sought to enhance her position and expertise. This had the potential to expose third parties and stakeholders to risk with serious consequences. The Panel determined this conduct was very serious and amounted to misconduct.

152. The Panel considered the finding at 7.b (dishonesty) in relation to Particulars 6.a. and 6.c. and its finding and determination above in respect of this Particular. The Panel noted the standards of professionals and the requirement for honesty and trustworthiness. The Panel determined that this conduct was very serious, amounted to a clear breach of one of the fundamental tenets of the profession and amounted to misconduct.

153. The Panel had regard to the HCPC Standards of conduct, performance and ethics and in particular:

1. Promote and protect the interests of service users and carers
Treat service users and carers with respect

3 Work within the limits of your knowledge and skills
Keep within your scope of practice

6 Manage risk
Identify and minimise risk

9. Be honest and trustworthy
Personal and professional behaviour

154. It also had regard to the “Standards of Proficiency for Practitioner Psychologists” and in particular:

Registrant practitioner psychologists must:

1. be able to practise safely and effectively within their scope of practice

1.1 know the limits of their practice and when to seek advice or refer to another professional

2. be able to practise within the legal and ethical boundaries of their profession

2.7 be able to exercise a professional duty of care

13. understand the concepts of the knowledge base relevant to their profession

13.3 recognise the role of other professions and stakeholders relevant to the work of their domain


14 be able to draw on appropriate knowledge and skills to inform practice

14.3 be able to conduct appropriate assessment or monitoring procedures, treatment, interventions, therapy or other actions safely and effectively

14.7 be able to gather appropriate information

14.10 be able to make informed judgements on complex issues in the absence of complete information

14.13 be able to select and use appropriate assessment techniques

14.14 be able to undertake and record a thorough, sensitive and detailed assessment, using appropriate techniques and equipment

14.15 be able to choose and use a broad range of psychological assessment methods, appropriate to the service user, environment and the type of intervention likely to be required

14.17 be able to use formal assessment procedures, systematic interviewing procedures and other structured methods of assessment relevant to their domain

14.18 be able to undertake or arrange investigations as appropriate

14.19 be able to analyse and critically evaluate the information collected

14.20 be able to critically evaluate risks and their implications


155. The Panel found that the Registrant breached all of these provisions and all the matters found proved amount to serious misconduct.

156. The Panel found that each of the matters found proved was serious misconduct a breach of the standards and amounted to misconduct.

Decision on Impairment

157. The Panel next considered whether the Registrant’s current fitness to practise is currently impaired by her misconduct. The Panel heard evidence from the Registrant and received her reflective statement dated 10 July 2020 (3 days prior to the Panel’s Decision on the Findings of Fact) in respect of the Allegation. The Registrant’s representatives also submitted a report from Dr Allely dated 12 July 2020 which assessed the Registrant’s remediation. Additionally, the Panel was sent a weblink which uploaded an undated “Parliamentary Review” featuring the Registrant’s ASD work at The Autism Academy UK.

158. The Panel considered the evidence, and submissions from both Parties. The Panel accepted the advice of the Legal Assessor and carefully considered the HCPTS Practice Note ‘Finding that Fitness to Practise is Impaired'.

159. In addressing the personal component of impairment, the Panel considered whether the Registrant was liable, now and in the future, to repeat conduct of the kind which led to the findings against her. In reaching its decision, the Panel had particular regard to the issues of insight, remediation and the Registrant’s history. The Panel noted that the Registrant had no adverse regulatory history prior to these proceedings.

160. The Panel had careful regard to the Registrant’s reflective statement dated 10 July 2020 and her evidence. She stated that between the adjourned hearing in February 2020 and 10 July 2020 she had reflected very thoroughly. She had considered the experts’ evidence given at the hearing in February 2020 and reached a new perspective on her own actions during a three week period in July 2017, the subject matter of the Facts found proved.

161. The Registrant acknowledged whilst she had given evidence in defence of  the Allegation only five months previously, she now accepted that she had incorrectly used the title ‘Consultant Clinical Psychologist’ and stated  that she would not prepare forensic reports with her current lack of expertise and experience.

162. However, the Registrant’s evidence confirmed she did not fully accept the factual basis for the Panel’s finding of dishonesty in relation to her CV dated July 2017 in which she incorrectly stated her employment record. In respect of the finding of dishonesty at Particular 7.b. in relation to Particulars 6.a and 6.c., the Registrant gave evidence that, in future, she would need to ensure that she obtained proper documentation of her employment. She did not accept the Panel’s findings that she had not held the positions of Lead Clinical Psychologist, Forfar Mental Health and CPD Co-ordinator NHS Tayside, Psychological Services.

163. The Panel was satisfied that the conduct arising from the Registrant’s involvement with SUA was remediable and then went on to consider whether the Registrant had remediated. The Panel considered that the Registrant’s reflective statement in respect of her involvement with SUA did show the Registrant had developed some insight which had commenced prior to the Panel making its Finding on Facts. The Registrant’s oral evidence confirmed that she had established an appropriate level of insight and remorse to the satisfaction of the Panel. The Panel observed that the Registrant had been fixed and dogmatic in her evidence in February 2020 and accepted that it may have taken the Registrant some considerable reflection to alter her previous stated position, in defence of the Particulars of the Allegation.

164. The Panel was not satisfied that any weight could be placed on Dr Allely’s written report regarding the Registrant’s remediation.  She was, not a Registrant with the HCPC, nor was she an expert on remediation. The Panel also noted a substantial number of character witness statements, however these were of limited value as they were prepared prior to the Panel’s findings of fact.

165. The Panel noted that the Registrant had not completed recent Continuing Professional Development (CPD) and had had only recently recommenced active clinical work at a very basic level in respect of one service user. The Registrant’s evidence was that this lack of CPD and clinical practice were because of ill health, which she attributed to the pressure of these proceedings although the Panel noted that no medical evidence had been provided. It was also noted that CPD opportunities were restricted by the pandemic.

166. The Panel considered that the Registrant’s recent joining of a BPS Special Group for Independent Practitioners and the appointment of a Supervisor to discuss and monitor her future work were consistent with the start of a longer programme towards full remediation of the misconduct.

167. The Panel was satisfied that the Registrant had demonstrated sufficient insight and remediation in relation to her involvement with SUA and the use of the title Consultant Clinical Psychologist.  Accordingly, the Panel was satisfied that the Registrant is not currently impaired in respect of these matters as regards the personal component.

168. However, in relation to the matters in respect of which the Panel had found the Registrant had been misleading and dishonest, the Panel found there was a lack of insight and very limited evidence of remediation. Hence the Panel determined the Registrant did still present a risk to service users and there was a risk of repetition of her misconduct. The finding of dishonesty against this Registrant breached a fundamental tenet and brought the profession into disrepute. The Registrant did not accept that she had been dishonest in incorrectly stating her employment titles in her CV and still sought to attribute this to defective administration which she believed could be addressed, by ensuring she kept better documentation to evidence her job titles in her employment.

169. The Panel could not be assured of the Registrant’s integrity at this time. The Registrant’s actions were misleading, and she acted dishonestly. In so doing the Registrant breached a fundamental tenet of the profession and her conduct undermines confidence in the profession. On the personal component of impairment, the Panel found the Registrant’s fitness to practise currently impaired with respect to the dishonest information she had included in the relevant documentation.

170. The Panel next considered the public interest component of impairment. The Panel had careful regard to the critically important public policy issues identified by Silber J in the case of Cohen when he said:

“Any approach to the issue of whether … fitness to practise should be regarded as ‘impaired’ must take account of ‘the need to protect the individual patient, and the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.”

171. While the Panel recognised that the behaviour that led to the finding of misconduct in this case did not appear to have resulted in harm, the Panel determined that the conduct was such that it had the potential to expose the public to a serious risk of harm. The Registrant had undertaken a risk assessment on SUA, for use in the disposal of criminal proceedings in a serious matter, without using an appropriate risk assessment tool. The Panel also noted that as a result of this SUA did not receive a CFAR that could be uniformly interpreted and relied upon by other professionals familiar with forensic assessment. This was at a critical stage of the criminal proceedings against SUA when the assessment was instructed with a view to satisfying the Procurator Fiscal it was in the public interest to agree to an alternative disposal.

172. Nevertheless, the Panel noted that it had found that the Registrant was not currently impaired on the personal component as regards her involvement with SUA and the use of the title “Consultant Clinical Psychologist”. In view of her satisfactory remediation in relation to those matters, the Panel concluded that the public interest was served in those circumstances and hence the Panel found that the Registrant was also not currently impaired on the public component in that respect.

173. The Registrant had been dishonest in respect of two posts incorrectly stated in her CV and incorrectly used job titles which would mislead any readers as to her seniority and experience.  This was a breach of the HCPC “Standards of conduct, performance and ethics”. and a breach of the fundamental tenets of the profession and in particular

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
9.2 You must be honest about your experience, qualifications and skills.

174. In all the circumstances, the Panel was unable to conclude that the Registrant would not repeat the conduct which gave rise to the finding of dishonesty. As a consequence, the Panel decided that a finding of current impairment in respect of the public component is necessary.

175. In addition, the Panel had no doubt that the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and performance would be undermined if it did not make a finding of current impairment of fitness to practise on public interest grounds.

176. In the Panel’s view, the confidence of reasonable members of the public, in the Regulator would be undermined if a finding of impairment was not made.

177. For all the reasons set out above, the Panel determined that the Registrant’s fitness to practise is currently impaired by reason of her dishonesty, in terms of both the personal and public component. Accordingly, the Panel found the Allegation well founded.

Decision on Sanction

178. Having concluded that the Registrant’s fitness to practise is impaired, the Panel proceeded to consider what, if any Order is both appropriate and proportionate to protect the public and to safeguard the public interest.

179.  Ms Vignoles made submissions on behalf of the HCPC and Mr Fortune made submissions on behalf of the Registrant.

180. Ms Vignoles emphasised that the decision as to the appropriate sanction to be imposed was a matter for the judgement of the Panel and the HCPC did not intend to make any specific submissions as to the appropriate sanction. She reminded the Panel of the principle of proportionality. She said that the Panel should have regard to the Sanctions Policy published by HCPTS. She reminded the Panel that it should have regard to both aggravating and mitigating factors; in respect of the former she identified in particular that the Registrant’s actions had been misleading and dishonest and caused a risk to the public. She submitted that the mitigating factors were that the dishonesty was limited to a single act over a limited time. Whilst it was at the lower limits of dishonesty, the Panel needed to mark the dishonest conduct and referred to a Conditions of Practice Order as a disposal the Panel may consider, but emphasised it was a matter for the Panel to decide.

181. Mr Fortune submitted that the Panel could properly impose a Conditions of Practice Order as being an appropriate and proportionate sanction. He identified a number of conditions that he submitted would adequately address any risk that the Panel might identify. He further submitted that a Suspension Order would be disproportionate. He asked the Panel to take into account a number of mitigating factors which included that the Registrant had an unblemished personal and professional character.

182. Mr Fortune submitted that the Registrant was heart-broken and extremely distressed by the Findings but had accepted the Findings of Fact and had given evidence that she had not set out to and never had tried either to mislead or to be dishonest, either in the investigation or in her evidence to the Panel. Mr Fortune referred the Panel to the cases of Yusuff v GMC [2018] EWHC13 (Admin) and GMC v Awan [2020] EWHC 1553 (Admin) in this regard.

183. Mr Fortune submitted that the Registrant’s misleading actions and dishonesty should be seen as limited solely to her involvement with SUA and not on a wider and/or a more sustained basis in her clinical duties in relation to other clients and/or service users. Mr Fortune submitted that there was no evidence outside SUA’s diagnosis that once the Registrant was actually and for the first time notified in November / December 2018 of KP’s detailed complaint, when the NHS Tayside Investigation Report was disclosed to the Registrant  about her use of the title ‘Consultant’, that the Registrant continued using that title.

184. Mr Fortune stated that as a result of the Registrant’s assessment of SUA’s risk of re-offending and whether SUA had a condition that could be treated, the Public may have been put at risk, or further risk, should SUA have been allowed to remain at large in the community. However, he submitted that the Registrant was aware that a further report would have be undertaken by the Court.

185. The Panel considered the sanctions available to it in ascending order of severity and had regard to the HCPTS Sanctions Policy. The Panel accepted the advice of the Legal Assessor.

186. The Panel was aware that the function of Fitness to Practise panels is not punitive and that the primary function of any sanction is to address public safety from the perspective of the risk the Registrant may pose to those using or needing her services in the future. In reaching its decision, the Panel must also give appropriate weight to the wider public interest considerations, which include the deterrent effect on other registrants, the reputation of the profession and public confidence in the regulatory process.
 
187. The Panel firstly considered the mitigating and aggravating factors in this case.

188. The Panel identified the following aggravating factors as follows:
 
· misleading and dishonest conduct in the course of her professional practice
· breaching a fundamental tenet of the profession
· the potential for harm to SUA and also to the wider public

189. The Panel identified the following mitigating factors:

· there were discrete circumstances involving one service user which were limited in timescale
· there is no evidence of resultant harm
· the Registrant was newly qualified and inexperienced
· the Registrant has expressed some insight, remorse and apology including a personal reflection.
· there is no evidence of adverse regulatory or personal history
· the Registrant has demonstrated remediation

190. This was a case where the Panel had found that the Registrant had acted outside the scope of her practice by accepting instructions for preparing and completing a CFA and CFAR. The CFA and CFAR were completed without using an appropriate risk assessment tool. The Registrant also used the title 'Consultant Clinical Psychologist’ which she was not entitled to do in her involvement with SUA over a period of three weeks from 6 July 2017 to 27 July 2017, which was misleading. The Registrant was dishonest in incorrectly stating on a CV, two positions of responsibility that she had not held within the broader context of her substantive employment from 2015 to 2017 as a Band 8a Clinical Psychologist in the NHS. These were stated within a CV provided by the Registrant in 2017 relating to a single instruction to undertake a CFA and CFAR in respect of SUA.

191. This potentially placed SUA and members of the public at risk of harm. These were not the standards expected of Practitioner Psychologists. Being honest to the public, including stakeholders and service users was a fundamental requirement of the profession, as was the necessity to act within one’s scope of practice. Although the Registrant had expressed some insight and remorse, the Panel was not satisfied that she had fully appreciated the adverse consequences of her dishonesty on service users and colleagues and on the reputation of the profession.

192. The Registrant had engaged with these proceedings and during the hearing the Panel heard about the Registrant’s reflections on the misconduct, her action towards remediation and her willingness to return to practice and contribute to her specialism within the profession. The Registrant gave evidence that she had not practised or been involved with clinical psychology for some considerable time until June 2020. She had now engaged a work supervisor privately and she has taken on a piece of work which the Registrant stated was appropriate to a first year trainee.

193. The Panel first considered whether to take no further action and was of the view that this would not be sufficient to protect the public, having identified a risk of recurrence and only remediation of part of the misconduct identified.

194. The Panel also considered mediation and was of the view that it was not appropriate in these circumstances.

195. The Panel next considered a Caution Order. The Indicative Sanctions Policy stated that a Caution may be appropriate where the lapse was isolated or of a minor nature, there was a low risk of recurrence and the Registrant had shown insight and taken remedial action. The Panel had found that these were discrete circumstances relating to a single service user including dishonesty that took place over a 3 week period. The Registrant had demonstrated some insight but had not yet fully remediated her failings. In these circumstances, the Panel was of the view that a Caution would not be an appropriate sanction as it would not address the seriousness of the conduct, the need for further remediation and the risk of repetition.

196. The Panel next considered the imposition of a Conditions of Practice Order. The Panel was satisfied that this case did not raise any clinical concerns which may be appropriately addressed through conditions. The Panel was of the view that it was not possible to formulate workable or practicable conditions which would address the Registrant’s dishonesty. Further, the Panel considered that the case was too serious for a Conditions of Practice Order.

197. The Panel next considered a Suspension Order and concluded that this was the appropriate and proportionate sanction in the circumstances of this case. Although the Panel had found that the Registrant’s insight was limited at this time, it considered that a Suspension Order would provide the opportunity to the Registrant to further reflect on her misconduct and to demonstrate that she had developed an appropriate level of insight. The Panel also considered that such an Order is required to maintain public confidence in the profession and to uphold professional standards.

198. The Panel considered that the length of the Order should be for 4 months with a review towards the end of that period. This is with a view to the Registrant demonstrating to the next Panel that she has reflected on her actions and has developed sufficient insight into them. The Panel also considered that public confidence in the profession would be damaged if any lesser period were imposed.

199. The Panel acknowledged that the Policy lists dishonesty as the type of case in which a Striking Off Order may be appropriate. However, in the context of the Registrant’s early career to date, the Panel was of the view that a Striking Off Order for this incident of dishonesty would be unduly punitive. While a finding of dishonesty is always serious, in the particular circumstances of this case, the Panel considered this was at the less serious end of the scale. In light of this and given that the Panel has found that the Registrant may be able to develop sufficient insight over the course of a Suspension Order, the Panel is of the view that a Striking Off Order would be disproportionate at this time.

200. This Panel does not seek to fetter the discretion of a future reviewing Panel, but it considers that such a Panel may be assisted by any information which evidences a developing level of insight, including:

• a reflective piece which
a. demonstrates the Registrant’s learning on professional ethics;
b. demonstrates her understanding of the impact her dishonesty may have on public confidence in the profession;
c. considers how she would avoid a repetition of her dishonesty in the future

201. The future reviewing Panel may also be assisted by:

• evidence of CPD in relation to professional ethics as well as demonstrating that the Registrant is keeping her skills up to date.
• a report from the supervisor (s) appointed since June 2020.
• a report from an HCPTS approved supervisor on the Registrant’s progress in relation to understanding ethics especially in relation to honesty in relation to professional practice

202. The Panel acknowledged that such an Order may have an adverse impact upon the Registrant. However, the Panel determined that the interests of protecting the public and maintaining public confidence in the profession outweigh the interests of the Registrant

Order

That the Registrar is directed to suspend the registration of Dr Claire V M Evans-Williams for a period of 4 months from the date this order comes into effect.

This Order will be reviewed again before its expiry.

 

Notes

Right of Appeal

You may appeal to the Court of Session against the Panel’s decision and the order it has made against you.
Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you.  The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Immediate Interim Order

The Panel considered whether an immediate order should be imposed in terms of Article 31(3) of the Health Professions Order 2001.

The Panel heard submissions from the Parties as to whether an immediate order should be imposed.

Ms Vignoles submitted in view of the Panel's finding of dishonesty an immediate order was necessary to protect the public and also in the wider public interest. Ms Vignoles submitted that an Interim Order of Suspension should be put in place for a period of 18 months.

Mr Fortune submitted that an Interim Order was not necessary. He made no submission as to the duration of such an order if one was made.

The Panel heard and accepted the legal advice from the Legal Assessor and referred to the guidance in the Sanctions Policy on Interim Orders.

The Panel assessed the risk to the public and the wider public interest and considered whether an order was necessary and proportionate.

The Panel had regard to the nature of the Allegation found proved and decided that there was a serious and ongoing risk to service users and the public arising from the Registrant's conduct. The Panel was satisfied that confidence in the profession would be seriously harmed if the Registrant was allowed to remain in unrestricted practice.

The Panel determined that an immediate Interim Suspension Order should be imposed to protect the public and in the wider public interest. It further determined that a period of 18 months was appropriate and proportionate given the current pandemic and any potential delays in proceedings.

Hearing History

History of Hearings for Dr Claire V M Evans-Williams

Date Panel Hearing type Outcomes / Status
13/07/2020 Conduct and Competence Committee Final Hearing Suspended
03/02/2020 Conduct and Competence Committee Final Hearing Adjourned part heard