Miss Susan Griffiths

Profession: Dietitian

Registration Number: DT04474

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 02/03/2020 End: 17:00 06/03/2020

Location: Health and Care Professions Tribunal Service, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Caution

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Allegation (as amended at the Final Hearing):

“Whilst registered as a Dietitian and during the course of your employment as a Paediatric Dietitian with Kent Community Health NHS Foundation Trust (‘the Trust’), you:

  1. On around 9 August 2017, did not adhere to management instructions in that you visited Patient A outside of your normal working hours in your capacity as a Dietitian with the Trust after being informed by your manager, Person B, that this was not appropriate.
  2. Gave preferential treatment to Patient A in relation to the timing of his appointment.
  3. Between around 9 and 24 August 2017, delayed entering your appointment with Patient A onto the Community Information System (‘CIS’).
  4. On or around 24 August 2017:
    a. knowingly entered an incorrect date and/or location of the assessment of Patient A into the patient’s CIS notes;
    b. caused or allowed a letter to be sent to Patient A’s General Practitioner and/or paediatric consultant referrer which incorrectly recorded the date of Patient A’s assessment.
  5. Your conduct at paragraphs 3 and/or 4(a) and/or 4(b) above was:
    a. misleading;
    b. dishonest.
  6. During an unknown period before 31 July 2017 used an unencrypted and/or unapproved USB device to store patient information contrary to Trust policy.
  7. The matters set out in paragraphs 1 – 6 constitute misconduct.
  8. By reason of your misconduct your fitness to practise is impaired.”


Preliminary Matters

HCPC Application to Amend

1. Mr Bridges advised that the HCPC applied to amend the allegation.  Notice of these proposed amendments had been provided to the Registrant who did not object.  He submitted that these amendments were minor and better reflected the evidence and did not alter the substance of the allegation.
2. The Panel accepted the advice of the Legal Assessor as to the interests of justice.  It determined that the proposed amendments were minor in nature and did not alter the overall nature or gravity of the allegation. It therefore decided that it was fair and appropriate to allow the amendments.
3. The Registrant denied particular 1 and admitted particulars 2, 3, 4a), 4 b), 5a), 5b) and 6.  The Registrant also admitted misconduct, although that is a matter for the Panel.
4. At the time of the allegation the Registrant was employed by Kent Community Health NHS Trust (“the Trust”) as a Band 6 Paediatric Dietitian in the Acute Dietetic Service (“the Service”) between January 2005 and December 2017. She had worked for the Trust’s predecessor since 2003.
5. On 8 August 2017 Patient A was referred to the Service and this was received the following day.  On 9 August 2017 a discussion took place regarding Patient A between the Registrant and witness Person B, the Deputy Acute Manager/Nutrition Support Specialist, her Line Manager.  
6. On 22 September 2017 Person B saw on the Community Information System (CIS) that the Registrant had documented a consultation for Patient A on 24 August 2017 despite not having a clinic on that date in her calendar.  On 27 September 2017 the Registrant told Person B that she had visited Patient A on 9 August 2017 after work and in her own time.  The Registrant also wrote to Patient A’s GP on 24 August 2017 reporting to him that she had assessed Patient A on 24 August 2017.
7. HR was appointed by the Trust to investigate the concerns relating to the Registrant’s involvement with Patient A and her recording of that interaction.
8. A further concern was also identified in respect of the Registrant’s use of an un-encrypted USB device in July 2017 contrary to the Trust’s Information Security Policy.
9. It is alleged that the Registrant’s conduct amounts to misconduct and that the Registrant’s fitness to practise is currently impaired.
10. The Panel heard from four witnesses:- HR, the Investigating Officer at the Trust; Person B, the Registrant’s Line Manager; PB, an IT Infrastructure Manager at the Trust; and the Registrant.  The Panel also received the evidence of EH, a Legal Assistant at Kingsley Napley, in a written Witness Statement.
Witness 1 - HR
11. HR is the Community Dietetic Leader for Kent Community Health NHS Trust (“the Trust”). She is a Dietitian registered with the HCPC.  She explained that for 5 years, until 2015, she had been the Registrant’s Line Manager and they had a good working relationship.  She later moved to a different part of the service and no longer line managed the Registrant after November 2015.  HR was succeeded by Person B from that date. 
12. HR was the Investigating Officer asked by the Head of Service to investigate the allegations against the Registrant and she was appointed on 29 September 2017. She interviewed three people including the Registrant and Person B. She completed her investigation and submitted her report in November 2017.
13. HR had concluded that the Registrant had provided Patient A with preferential treatment having met with the patient out of turn, being the same day as the referral. The Registrant had also visited Patient A at home although home visits were not provided by the Service. HR explained that a rapid response in a community dietetic setting was not available and an “urgent” response would typically be 2 to 4 weeks, which was acceptable.
14. HR also concluded that the Registrant had included incorrect information in her clinical records on CIS of the visit to Patient A.  She had inserted 24 August 2017 as the date of the visit, when in fact the visit had taken place on 9 August 2017.  The Registrant had also stated Patient A had been seen in hospital as an out-patient, when in fact she had seen Patient A at home.  This incorrect information had then been repeated in the letter to Patient A’s GP. The Registrant had also failed to contemporaneously record her clinical records as required by the Service, having recorded the visit 15 days later which was not acceptable.
15. HR referred to the Trust policy on record keeping on CIS and she confirmed that records should be made as soon as possible, and in a timely manner.  She explained that records were important as they were the evidence of the interactions and intervention with the patent. This impacted on continuity of care. Records were also an important legal document. 
16. HR agreed that any delay in the interview of the Registrant after the investigation commenced was due to the Registrant being on a two week holiday. HR confirmed that the Registrant had admitted to HR at the investigatory interview that she had seen Patient A out of turn and had not completed the records in a timely manner.  HR said the Registrant had been direct and open at that interview, and she had also been remorseful and apologetic.  HR said that the Registrant had been very open that she had made a mistake about the appointment with Patient A.
17. HR explained that a Disciplinary Hearing took place on 20 December 2017. HR referred to her Witness Statement and to her consideration of the Registrant’s use of the unencrypted USB removable device she had been told about by the Registrant during the investigatory interview.
18. HR explained the terms of the Trust’s Disciplinary Procedure and understood that the falsification of records was a ground for gross misconduct at the time of the allegation, although the copy in the bundle was not in force at the time.  
19. In response to Panel questions, HR stated that management policies were communicated by placing them on the Trust intra-web. Any changes were also noted at team meetings. It was considered the responsibility of the professional to keep themselves up to date on the policies. She also explained that inpatients could be seen swiftly, but not out-patients who should be seen within 2-4 weeks in accordance to referral guidance. 
20. HR explained that she had asked the Registrant about any mitigating factors that may have impacted on her performance at the time of the incident, so had given the Registrant an opportunity to raise any such issues.  She further explained that patients can be contacted informally in a personal capacity, but that was not appropriate when there had been a formal referral which required proper NHS procedures to be followed. HR agreed that the Registrant had been told by Person B that the Registrant could see Patient A in a personal capacity.
Witness 2 - Person B
21. Person B is a Dietitian registered with the HCPC. 
She explained her role at the Trust which involves both a clinical and management aspect.  She told the Panel about her management of the dietetic team including absence and performance management. She was the Registrant’s Line Manager from December 2015 until October 2017. She said she would usually see the Registrant every day as they were based in the same office.
22. Person B was interviewed by HR as part of the internal investigation of the concerns regarding the Registrant’s practice and she signed the interview notes as a true and accurate record of the interview. Person B recalled her discussions with the Registrant at the time and said the Registrant had made it clear that Patient A’s family wanted to see the Registrant as soon as possible.  Person B said she had checked with her Line Manager, KS, who had also told her that the Registrant could see Patient A, to “pop in and have a chat,” but in her own time and informally to provide general advice, but a formal appointment would need to go follow the referral process.
23.   In response to Panel questions, Person B stated that the records of the discussions from the internal investigation interview notes of 2 October 2017 were a fair reflection of what had been discussed as regards the Registrant’s interaction with Patient A. Person B clarified that the dietetic advice to be given by the Registrant to Patient A was to be basic advice only, such as that you might give to someone making a general enquiry. Person B stated that she had made clear to the Registrant that it was not appropriate to add Patient A to the front of the queue or to visit in a formal capacity as an NHS employee and that the visit would need to be in her own time.
24. Person B said her working relationship at that time with the Registrant had been difficult.  She said this was to do with managing work pressures but there had been no question of her bullying or intimidating the Registrant.  Person B said it had been a tense relationship.
Witness 3 - PB
25. PB is employed by the Trust as an IT infrastructure Manager. He explained the use of the USB media devices and the need for encryption to avoid data breaches and fines by the Information Commissioner. He explained the reporting weekly system generated by the CIS and the report on the Registrant’s activity in July 2017. On that report the removal disk is described as “CBM Flash disk USB Device”.  He stated that this meant this device was not an authorised device for use by staff at the Trust.
26.  PB referred to the Trust Information Security Policy and told the Panel that this was available to all staff on the intranet. It required that all clinicians use only approved encrypted devices. He said that he had emailed the Registrant on 31 July 2017 alerting her to the unauthorised use of the USB device.  She had replied on the same day and stated that the USB device was always in a safe place when not in use, such as in her pocket. PB said that was not a secure place and could have resulted in the loss of the device.
27.  PB said that at the time there were approximately 5,500 employees in the Trust. He said that the use of unauthorised devices with patient information was infrequent and he had only ever dealt with two incidents. He said that usually the use of non-encrypted devices was for non-confidential data such as homework and presentations. He said IT were commonly asked to provide encrypted USB devices.
28. The Panel received as evidence the Witness Statement of EH regarding the recovery of evidence by the HCPC solicitors in relation to the allegation and Mr Bridges then closed the HCPC case.
The Registrant’s Evidence
29. The Registrant told the Panel about her career as a Dietitian. She told the Panel about the triage process in the team and the process followed. She recalled that a Consultant Paediatrician had referred Patient A to the Acute Dietetic Service at the Trust. She said she suspected that Patient A would be referred as she had been involved at the earlier stages with Patient A and had attended earlier appointments with them as she knew Patient A personally.
30. The Registrant said that she had raised Patient A with Person B as she wanted to know if it was appropriate to see a patient that she knew personally. Patient A was a distant family member. The Registrant said that she was permitted to visit Patient A, but she could not recall the extent of the discussions as to what level of advice she could provide to Patient A. Person B had said that she, Person B, would need to discuss the issue with her Line Manager, KS. The Registrant said that Person A’s parents wanted the patient to see her, and in any event all the clinics were full until October 2017.  The Registrant said she had recommended to the family of Patient A that they seek advice from another Dietitian, but they did not want to do so.
31. The Registrant said that the discussion later that day with Person B had resulted in the Registrant being advised that Patient A would need to go through the normal procedures for an appointment. The Registrant said that Person B had told her that she could see Patient A in her own time. The Registrant said she had, however, earlier that day already contacted Patient A’s parents to arrange an appointment. She said she had proceeded on this basis as she understood that she had been given permission from Person B and KS, her Line Managers, to make the visit to Patient A. She thought that she must have told the family that she would write to the GP.
32. The Registrant said that prior to the visit on 9 August 2017 she had uploaded Patient A’s details onto CIS and had checked Patient A’s bloods, as she had anticipated that she would be allocated the patient. She accepted that one would not normally check bloods before allocation of the patient, and she ought not to have assumed she would be allocated Patient A. At the visit on 9 August 2017 she took full details and gave clinical advice to Patient A’s parents.
33. The Registrant said that she was not sure what to do after seeing Patient A on 9 August 2017.  She said she needed to do something so, before going on annual leave on 24 August 2017, so she had put the patient records on the system and issued a letter to the patient’s GP.  
34. The Registrant said she considered that the management request to her was that Patient A was not to be prioritised above other patients.  She said she was aware of the NHS policies at the time, including the need to record assessments contemporaneously.  She accepted she had not followed the guidelines.
35. The Registrant accepted that she “lied” when she recorded that the assessment of Patient A was on 24 August 2017.  She knew that accuracy was a fundamental part of record keeping, but she had not thought about that at the time. On reflection, she accepted that this was serious and at the internal investigation interview with HR she had been open and honest about the dates. She had recorded some written notes at the time of the consultation with Patient A but she could not recall when she had typed them up. The written notes were stored in the departmental records storage.
36. The Registrant accepted that it was appropriate that patients go through the normal process from the referral point. That had not been followed by her in respect of Patient A. The Registrant also accepted it was likely that, in the circumstances, her Line Managers, Person B and KS had told her to only have a general discussion with Patient A.
37. The Registrant explained her use of her own USB device on her laptop to create notes. She said she had stored patient information, including patient names, on her USB device. She had not anonymised the information. She said she knew the USB device was not encrypted and understood the implications.  She had forgotten to use the encrypted USB device and said she knew that the security of patient information was fundamental. 
38.  If similar circumstances arose in the future, the Registrant said that she would clearly document the whole matter and would not create false records.  She could not explain why she had done what she had.  She accepted that she had given Patient A preferential treatment but she said she had not made other patients wait longer as she had seen the patient in her own time.
 Closing Submissions for the HCPC
39. Mr Bridges summarised the evidence in respect of each particular and the HCPC’s position in his closing submissions.  He submitted that the Registrant's admissions should be accepted and it was clear that Patient A should not have been considered out of turn.  He relied upon HR’s evidence that the Registrant’s record in respect of Patient A was “sound” and therefore the consultation on 9 August 2017 was an assessment.  This was followed by false details as to date being entered into the CIS and in the GP’s letter by the Registrant. 
40. Mr Bridges reminded the Panel of the case law on dishonesty and submitted that the Registrant had been dishonest.  He submitted that these were serious failures amounting to misconduct. He reminded the Panel as to law on impairment and referred it to the HCPTS Practice Note on Impairment and to the guidance in CHRE v NMC & Grant [2011] EWHC 927 (Admin) and the tests in the Fifth Shipman Report as set out by Dame Janet Smith.
41. Mr Bridges referred in particular to the public component of impairment and submitted that the public would be concerned and surprised were this conduct not marked by a finding of current impairment.
Closing Submissions for the Registrant
42. Ms Bracken referred to particular 1 of the allegation, the only allegation not admitted by the Registrant.  She accepted that it did not alone alter the nature or gravity of the overall allegation. She submitted that the evidence was that the Registrant was told in terms by Person B (and indirectly by KS) that she could attend and give advice to Patient A. The management advice was “grey” and she submitted that, in fact, the evidence did not support the allegation that this visit was “not appropriate”.
43. Ms Bracken advised the Panel that the Registrant admitted dishonesty and reminded it of the test in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67. She submitted that the Registrant did not intend to be dishonest, although what she did was dishonest.  The Registrant now fully accepted that she had been dishonest.
44. Ms Bracken submitted that the Registrant admitted misconduct and that her conduct was deplorable. As to impairment, she submitted that this was an isolated incident in an otherwise blemish free 30 year career.  There was no clinical criticism of the Registrant. She submitted that the Registrant had been reflective and had assisted the Panel in her evidence. The Registrant has been open throughout the Trust’s internal investigation and had admitted her misconduct.  Miss Bracken invited the Panel to find that the Registrant is not currently impaired and referred the Panel to the positive references in her support.
 Legal Advice
45. The Panel heard and accepted the advice of the Legal Assessor.  He advised the Panel on the approach to facts and the applicable civil burden of proof, the “balance of probabilities” which rested on the HCPC. The Registrant need prove nothing. The Panel must assess the witnesses and all the evidence and make individual findings on each particular of the allegation as to facts.
46. On dishonesty, he advised the Panel to consider the guidance in Ivey v Genting Casinos (UK) Ltd t/a Crockfords where the court stated:-
“When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest".
47. On misconduct, the Legal Assessor referred the Panel to the guidance in Roylance v GMC (No 2) [2001] 1 AC 311.  He also referred the Panel to the HCPTS Practice Note on Impairment and to the guidance when assessing impairment in CHRE v NMC & Grant. He reminded the Panel to consider the Registrant’s insight, remorse, remediation and the risk of repetition.  He stressed the central importance of the public interest and the need to declare and uphold proper standards of, and confidence in, the profession and the Regulator.
Decision on Facts
The witnesses
48. The Panel carefully considered the live evidence, the witness statements and all the documents before it together with the submissions from Mr Bridges and Ms Bracken. The Panel heard, and assessed the live evidence of HR, Person B, PB and the Registrant.
49. The Panel found that HR was clear and straightforward and was balanced and fair in her evidence.  Person B, whilst open and helpful, struggled to recollect the detail of the discussions about Patient A with the Registrant.  PB was helpful, clear and direct in his evidence. The Panel found the Registrant was open and honest and sought to assist the Panel.  It found all the witnesses credible and reliable.
50. The Panel did not hear from Person B’s Line Manager, KS, who had also spoken to Person B regarding Patient A’s referral.  It could not test that evidence and accordingly it placed more weight on the live, tested evidence of Person B than on KS’s statement which was contained in the Trust’s internal investigation report.
Particular 1 – Not Proved
51. This particular is not proved.  The Panel heard evidence from Person B who also relayed KS, her Line Manager’s instructions.  They both said that the Registrant could visit Patient A outside her working hours and this was to give general advice in her role as a Dietitian. There was no evidence that it was “not appropriate” for the Registrant to visit Patient A.
Particular 2 - Not Proved
52. This particular is not proved. The Panel carefully considered the ordinary meaning of the word “preferential” being that which is better than that given to others, or in the sense of better treatment. There was no evidence that the Registrant’s actions gave Patient A better or more timely treatment than any another patient.
53. Further, two layers of management had allowed the Registrant to attend Patient A, as a Dietitian, in her own time.  The Registrant was not using clinic time and there was no evidence that there was any disadvantage to any other patient in relation to the timing of appointments.
Particular 3 - Proved
54. The Panel found this proved.  This is admitted by the Registrant and the evidence is that she did delay entering the appointment with Patient A on CIS until 24 August 2017.
Particular 4 a) - Proved
55. The Panel found this proved.  It is admitted by the Registrant and the documentation shows that she entered the wrong date and location in the CIS patient notes.
Particular 4 b) - Proved
56. This is found proved.  It is admitted by the Registrant and the Panel had sight of the letter to the GP which she issued which contains the wrong date for the assessment.


Particular 5 a) - Proved
57. The Registrant admitted this.  The  Panel found that to delay making the entry, to enter the wrong date and wrong location for the assessment in CIS, and to issue the letter to the GP with the wrong assessment date were misleading and it found this particular proved in respect of sub-particulars 3, 4a) and 4 b).
Particular 5 b) - Proved
58. The Panel considered and applied the test in Ivey.   The Registrant knew she had been to visit Patient A on 9 August 2017 and she knew it was not true to record that as the 24 August 2017.  She knew the assessment location was wrong and she knew that the date in the letter she sent to the GP was wrong. 
59. The Registrant gave two explanations for her actions.  She said that the date of 24 August “fitted” with the 2 - 4 week period that was the typical timing of appointments. She also said that she just had to do something before she went on annual leave. She described her actions as a “complete and utter lie.” Subjectively the Registrant knew she was being dishonest.
60. Objectively considered in line with Ivey, the Panel concluded that the Registrant’s actions in sub-particulars 3, 4a) and 4b) would be considered dishonest by ordinary, decent people.  She knowingly entered false information in the CIS and in the letter to the GP. The Panel concluded that the Registrant’s conduct was dishonest.
Particular 6 - Proved
61. This is admitted by the Registrant. She told PB that she was using an unencrypted USB device when he emailed her. PB’s evidence was clear that the report he obtained from CIS showed the use of the unauthorised and unencrypted USB device by the Registrant.  The Panel found this proved.
Finding on Misconduct
62. The Panel considered the allegation in two parts, firstly that part relating to Patient A, particulars 3 - 5; and secondly with respect to the USB device, particular 6. These are factually distinct areas based upon different conduct and circumstances.
63. Patient A - The Panel found that allegations 3, 4, and 5 amount to misconduct. Accurately recording assessments is a fundamental aspect of practice, as accepted by the Registrant, and this conduct and the dishonesty involved, fell far below the proper standards to be expected of an experienced Dietitian.
64. The USB device - The Panel concluded that this allegation did not amount to misconduct. It was not acceptable conduct but the Panel concluded that it was not sufficiently serious to amount to misconduct.  There was evidence of only one incident. There was no data breach and no unauthorised disclosure took place, and there was some evidence that the Registrant had taken care to keep the USB device in a secure place when it was not in her pocket. 
Decision on Impairment
65. The Panel considered the guidance in the case of Grant and the HCPTS Practice Note on Impairment. The Panel considered its findings on facts and misconduct.
66. The Panel found there was no risk of harm to patients, and no issue of the Registrant’s clinical ability or competence arose. However, the Panel found that the dishonesty by the Registrant did bring the profession into disrepute and it also breached a fundamental tenet of the profession, namely honesty.
67. The Panel found that the incident was an isolated one in a long and unblemished career. The Registrant demonstrated full reflection and well developed insight into her behaviour.  She has shown genuine remorse and has apologised.  She admitted her conduct from the start and was open with the Trust at the time of the investigation, and with this Panel. The Panel concluded there was a low risk of repetition and, so far as is possible, she has remediated her practice explaining clearly what she would do in the future should similar circumstances arise.  
68. The Panel concluded that in all these circumstances that the Registrant’s fitness to practise is not currently impaired on the personal component of impairment.
69. On the public aspect of impairment, the Panel was mindful of its findings, which include a finding of dishonesty.  The Panel determined that in these circumstances the public interest would not be served, and that public confidence in the profession and in the regulator would be undermined, were it not to make a finding of impairment. Further, the findings of dishonesty and misconduct are such that a finding of impairment is required on public interest grounds to declare and uphold proper standards in the profession.
70. In all these circumstances, the Panel determined that the Registrant is currently impaired on the public component of impairment.
Decision on sanction
Submissions on Sanction
71. Mr Bridges submitted that it was for the Panel to consider and decide on sanction and he referred the Panel to the HCPC Sanctions Policy, in particular paragraphs 56 to 58.  He remained neutral on the particular sanction to be imposed.  He reminded the Panel that a finding of dishonesty was a serious matter and referred to relevant case law, including Tate v RCVS [2003] UKPC 34; SRA v James, McGregor & Taylor [2018] EWHC 3058 (Admin) and Lusinga v NMC [2017] EWHC 1458 (Admin) which made clear that dishonest conduct may take various forms.
72. Ms Bracken submitted that dishonesty can be serious, but submitted that because of the Registrant’s insight this was a less serious case.  It was more a “moment of madness” case.  She submitted that a Conditions of Practice Order be imposed and referred to paragraph 106 of the HCPC Sanctions Guidance.  She submitted that the Registrant had insight and her failure was capable of being remedied.
73. Ms Bracken suggested conditions of practice might be imposed around record keeping with possible supervision in that regard.  The Registrant was willing to comply with any and all any conditions imposed upon her. Ms Bracken advised that no interim orders had been imposed on the Registrant and she had not worked in a registered role since leaving the Trust. She submitted this was a minor incident of dishonesty and was out of character.
Legal Advice
74. The Panel accepted the advice of the Legal Assessor who referred it to HCPC Sanctions Policy. He reminded the Panel it should consider sanction in ascending order, and apply the least restrictive sanction necessary to protect the public. It should consider any aggravating and mitigating factors and must be mindful of proportionality and the public interest. He reminded the Panel that the primary purpose of sanction was protection of the public and that there was a need to balance that with the interests of the Registrant.
75. The Panel considered all the evidence before it and was mindful of its earlier findings.  It first considered the mitigating factors and found that these were as follows:-
• An unblemished career of almost 30 years
• Good character
• Positive testimonials
• An isolated incident
• No patient harm or risk of harm
• Well-developed insight and remorse
• No personal gain or advantage
• Admission of misconduct from the start
• Full engagement with her employer and the regulatory the process
• The Registrant has been open and honest with the Panel
76. The Panel found that the aggravating feature was the Registrant’s dishonest conduct.
77. The Panel approached the ladder of sanction, beginning with the least restrictive first, bearing in mind the need for proportionality. It found that taking no further action would not be proportionate given the finding of dishonesty. Taking no action would fail to appropriately mark the conduct as unacceptable and would undermine public confidence in the profession and the regulator. 
78. The Panel next considered a Caution Order.  The Panel considered the HCPC Sanctions Policy and the guidance in the Lusinga case which states “...dishonest conduct can take various forms; some criminal, some not; some destroying trust instantly, others merely undermining it to a greater or less extent”.  
79. Mindful of that guidance, and taking a fair and appropriately nuanced approach to dishonesty, the Panel decided that the dishonest conduct by the Registrant in this case was at the lowest end of dishonesty. The Registrant did not act dishonestly to provide herself with any advantage or gain. There was no evidence that the Registrant’s dishonesty was intended to, or caused harm to any patient.  There is no risk to the public and the impairment found in the Registrant’s fitness to practise was on public interest grounds alone.
80. The Panel considered the Sanctions Policy at paragraphs 101 to 103.  It has found that the dishonesty was isolated, that there is a low risk of repetition, and that the Registrant has demonstrated well developed insight and has remediated. She fully understood and appreciated where she had gone wrong.
81. In these circumstances the Panel concluded that a Caution Order was the sufficient and proportionate sanction to impose. This would send the appropriate message to the public and to the profession by marking the conduct as unacceptable. Particularly given the lack of harm to patients, and the context in which this isolated incident of lower level dishonesty took place, the Panel decided that that a Caution Order would not undermine public confidence in the profession or the regulator and it will allow an experienced and capable practitioner to return to practice. It was not in the public interest to deprive the profession of such a practitioner.
82. The Panel considered the guidance on the length of the Caution Order.  It was mindful that it must act proportionately and that it should take the minimum action required to protect the public and public confidence in the profession.  No issue of public protection arises in this case. 
83. Given its findings as a whole, the Panel decided that a one year Caution Order was the sufficient and proportionate order to impose.  That period would serve to sufficiently mark the conduct, uphold proper standards, send the appropriate message to the public, and serve to maintain public confidence in the profession and regulator. To impose a longer order would be unnecessarily punitive.


ORDER: The Registrar is directed to annotate the Register entry of Susan Griffiths with a caution which is to remain on the Register for a period of one year from the date this Order comes into effect.


No notes available

Hearing History

History of Hearings for Miss Susan Griffiths

Date Panel Hearing type Outcomes / Status
02/03/2020 Conduct and Competence Committee Final Hearing Caution