Dr Annemarie Dalhuijsen-Bendijk

Profession: Practitioner psychologist

Registration Number: PYL24113

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 12/07/2021 End: 17:00 20/07/2021

Location: This hearing will take place virtually

Panel: Conduct and Competence Committee
Outcome: Caution

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Allegation

Whilst registered as a Practitioner Psychologist with the Health and Care Professions Council, you:

1. Breached your professional boundaries by engaging in an inappropriate relationship with Patient A outside of a clinical setting, in that you:

a) On or around 24 July 2014, sent an email to Patient A which referenced a CD

b) On or around 03 August 2014 wrote to Patient A via email which discussed ideas for artistic work with Patient A

c) On 28 August 2015 sent a text to Patient A stating ' Hope you have a late summertime in the south xx and I'm still very much like to help with your film with the sequence and the words and I will find a day to do more pictures as I promised xx' or words to that effect

d) On an unknown date, collaborated with Patient A in filming of a video which depicts:

i. you and Patient A on a bed in a state of undress

ii. you groping and/or stroking Patient A

iii. you saying to Patient A “You have a beautiful hole – two holes” or words to that effect;

iv. you saying to Patient A “Of course there’s a connection, that’s what it is, isn’t it? There’s something there” or words to that effect;

v. you saying to Patient A “This is the most beautiful thing I’ve seen so far – you falling out of your outfit” or words to that effect.

e) On an unknown date, sent a text to Patient A stating ' haha ...your way! I chickened out of treating the ultimate artist as a psychologists.... No fucking chance (hysterical face emoji)'

f) On an unknown date in or around 2014, had lunch with Patient A

g) On unknown dates, visited Patient A at her parents house

h) On an unknown date, visited the Baltic art gallery with Patient A

2. On or around September 2014, you destroyed some clinical records relating to Patient A

3. Your actions at paragraph 2 were dishonest.

4. Your actions at paragraph 1(c), 1(d), 1(f), 1(g) and 1(h) were sexually motivated and/ or inappropriate.

5. The matters set out in paragraphs 1 - 4 constitute misconduct and/or lack of competence.

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

Finding

Preliminary Matters:

1. The case for the Health and Care Professions Council (HCPC) was presented by Mr Greg Foxsmith of Kingsley Napley Solicitors. The Registrant was present and represented by Mr Jonathon Goldring, Counsel, instructed by Mr John Williams of Bankside, Solicitors.


Application to amend the Allegation:


2. Mr Foxsmith advised the Panel that his initial application was to amend particular 1(f) by adding the words “in or around 2014” after the word “dates” and to amend particular 2 by deleting the words “you deleted and/removed” and substituting the word “destroyed”. He submitted that the Registrant had been put on notice of these proposed amendments. He advised the Panel that following engagement with the Registrant’s representatives, further amendments were proposed to particulars 1a), 1c), 1f) and 1g) as shown in bold and struck through above. Mr Foxsmith advised the Panel that the proposed amendments were minor in nature, did not extend the scope of the Allegation and that they better reflected the evidence and the Registrant’s position. Mr Goldring confirmed that he supported the application.


3. The Panel considered the submissions of Mr Foxsmith and Mr Goldring together with the advice of the Legal Assessor. The Panel agreed to grant the application in full as it was satisfied that the amendments did not cause any injustice to the Registrant.


4. The Registrant admitted the facts of particulars 1a), 1b), 1c) 1f), 1g), 1h) and 2 of the amended Allegation. Subject to the context set out in her statement, she also admitted 1d)iii - v) and 1e). The Registrant admitted particular 4 in so far as the actions she admitted were inappropriate but denied that they were sexually motivated. The Registrant denied particulars 1d)i), 1d)ii), and 3.


5. The Registrant accepted that the factual particulars, as admitted, amounted to misconduct. She submitted that her fitness to practise was impaired by misconduct on public grounds alone.


Application for evidence to be taken in private


6. Prior to the commencement of the Registrant’s case, Mr Goldring made an application under rule 10(1)(a) of the Conduct and Competence Procedure Rules 2003 for any references to the nature of Patient A’s work or alternatively for the entirety of the Registrant’s evidence, to be heard in private, given that the references to the nature of Patient A’s work may lead to the patient being identified. Mr Foxsmith confirmed that he would have no objection to the relevant parts of the Registrant’s evidence being heard in private.


7. The Panel considered the relevant HCPTS Practice Note on “Proceeding in Private”, and the advice of the Legal Assessor. The Panel decided that it would not be appropriate or proportionate for the entirety of the Registrant’s evidence to be taken in private. The Panel decided that any matters which could potentially lead to the identification of the patient should be taken in private in order to protect the private life of the patient.


8. The Panel considered a further application by Mr Goldring for parts of the Registrant’s evidence relating to her private life to be taken in private. Mr Foxsmith did not oppose the application. The Panel considered the relevant HCPTS Practice Note on “Proceeding in Private”, and the advice of the Legal Assessor. It acknowledged that some evidence related to the Registrant’s private life and concluded that the Registrant’s right to privacy, in these circumstances, outweighed the general presumption of hearings being conducted in public. The Panel therefore decided that those matters should be heard in private.


Background:


9. The Registrant is a registered practitioner psychologist and at the time of the Allegation was employed as a Band 8a Clinical Psychologist at both North Tees and Hartlepool NHS Trust and separately at Northumbria Hospital.


10. On 19 February 2016, a complaint was made by a friend of one of the Registrant’s former patients (Patient A) to North Tees and Hartlepool NHS Trust. The complaint concerned the relationship between the Registrant and Patient A. It was alleged that the Registrant and Patient A had developed a personal relationship outside of their therapy sessions and recorded an artistic film together, a project which lasted over a year. It was alleged that this had caused emotional disturbance to Patient A.


11. The complaint was subsequently investigated by North Tees and Hartlepool NHS Trust, citing three areas of concern: failure to maintain adequate patient records, the destruction of clinical records without consent, and an inappropriate relationship with a service user.


12. Having been made aware of the complaint, in May 2016 the Registrant made a self-referral to the HCPC and informed her other employer of these concerns.


Decision on Facts:


13. The Panel considered all of the exhibits submitted on behalf of the HCPC and the Registrant.


14. The Panel heard live evidence from four witnesses on behalf of the HCPC:


• EM, Head of Clinical Health Psychology at North Tees and Hartlepool NHS Foundation Trust;
• RB, Operational Manager for Hospital Care at North Tees and Hartlepool NHS Foundation Trust;
• DP, Service Improvement and Patient Safety Lead at North Tees and Hartlepool NHS Foundation Trust; and
• BG, General Manager for the Medicine and Emergency Care Department at Northumbria Healthcare Foundation Trust.


15. The Panel also considered the written statements of ST, a Legal Assistant at Kingsley Napley Solicitors, which exhibited video footage of Patient A and the Registrant; and the statement of AF, a Legal Assistant at Kingsley Napley Solicitors, which exhibited a screenshot of the Registrant’s professional profile.


16. The Panel also heard live evidence from the Registrant and from CNB, a Clinical Psychologist who had previously been employed by North Tees and Hartlepool NHS Foundation Trust. The Panel considered a further 26 positive testimonials from friends and professional colleagues of the Registrant.


17. The Panel found EM to be a helpful witness. She assisted the Panel on relevant issues in respect of receipt of the complaint and the process followed thereafter, which were supported by documentary evidence. It was clear from cross-examination, that she did not always have a good relationship with the Registrant and that there had been a difficult working environment which may have impacted upon the effectiveness of the supervision.


18. In the course of her evidence, EM provided useful additional documentation including supervision records and emails relating to the complaint. The supervision records showed that there had been a discussion with the Registrant about maintaining boundaries with Patient A as early as April 2014, but this does not appear to have been followed up in subsequent supervision sessions.


19. The Panel considered that the evidence of EM had only limited relevance to the decisions of the Panel in relation to the conduct of the Registrant.


20. The Panel found RB to be a credible and reliable witness whose oral evidence was consistent with her written statement. She answered questions openly and in a balanced manner.


21. The Panel found BG’s evidence to be credible, balanced and supported by documentary evidence. She was open about the limitations of her investigation which relied heavily upon information supplied to her by the Registrant and North Tees and Hartlepool NHS Foundation Trust.


22. The Panel found DP to be a helpful and credible witness who exhibited the notes of the Patient Experience Meeting which Patient A attended. He also exhibited copies of emails and texts, provided by Patient A, between the Registrant and Patient A. His evidence was not challenged in the course of the hearing.


23. The Panel accepted the written statement of ST in so far as it exhibited the video footage and the written statement of AF which exhibited the Registrant’s professional profile.


24. The Panel found the Registrant was thoughtful in the answers she gave during her evidence and her responses to questions asked were open. Her oral evidence was consistent with her written statement. She also provided a reflective statement which demonstrated insight, remorse and remediation.


25. However, the Panel found that at times the Registrant minimised the relationship for example, her recollection about when her personal relationship with Patient A developed which differed from some of the evidence contained within the email exchanges from her personal email address.


26. Patient A did not give oral evidence to the Panel nor did she provide a signed statement. Patient A’s account was contained within the notes of meetings between Patient A and North Tees and Hartlepool NHS Foundation Trust and between Patient A and Kingsley Napley Solicitors.


27. The Panel has not had the opportunity to test Patient A’s evidence or to assess her credibility or reliability. The Panel accepts that there are areas of the Registrant’s and Patient A’s evidence which are consistent. Where Patient A’s evidence was ambiguous, the Panel adopted an interpretation consistent with the Registrant’s account. Where there were inconsistencies between Patient A and the Registrant’s evidence, the Panel looked closely at the exhibits provided for external objective clarification. For example, the exhibits demonstrated when the Registrant used her personal email account to correspond with Patient A about collaboration on a future artistic project.


28. The exhibits considered by the Panel included emails and text messages selected by Patient A and lengthy personal notes Patient A had made following the session with the Registrant on 04 August 2014. The Panel also had sight of video footage, provided by Patient A to Kingsley Napley Solicitors, of approximately eleven minutes duration (“the Video”). This appeared to be a compilation of clips from footage filmed as part of an artistic collaboration between Patient A and the Registrant. The footage produced was edited and compiled by Patient A from a longer duration of filming.


29. The Panel found CNB provided helpful evidence to the Panel which included positive testimonial evidence in respect of the Registrant and evidence of tension in the Psychology Department at North Tees and Hartlepool NHS Foundation Trust.


30. The Panel accepted the very positive testimonials submitted on behalf of the Registrant from a broad range of friends and professionals, including her current employers. These testimonials attest to her competence and professionalism. The Panel accepts that she was a competent practitioner of previous good character.


Particular 1a)


31. The Registrant admitted the facts of this particular and has advised that the CD was a relaxation or mindfulness CD. The Panel has had sight of an email dated 24 July 2014 which makes reference to Patient A receiving the CD. The Panel is satisfied that the Registrant’s admission is supported by the evidence and finds the facts of particular 1a) proved on the balance of probabilities.


32. The Panel next considered whether in providing Patient A with a relaxation or mindfulness CD, the Registrant has breached professional boundaries by engaging in an inappropriate relationship with Patient A outside of a clinical setting. From the evidence, it is clear that the CD was provided as part of Patient A’s therapy and the correspondence in relation to the CD was conducted through the Trust email address. While the Panel finds that as a matter of fact, the Registrant sent an email referencing the CD, it does not find that this amounted to a breach of professional boundaries.


33. Therefore this particular is not found proved.


Particular 1b)


34. The Panel has had sight of the email dated 3 August 2014 from the Registrant to Patient A in which she discusses ideas for artistic work. The Registrant has admitted the facts of this particular. The Panel finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved on the balance of probabilities.


35. The Panel next considered if the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Registrant has made an admission in relation to this matter. The Panel finds that sending this email from her private email address was a breach of professional boundaries, in that she was engaging in an inappropriate relationship with Patient A outside of a clinical setting.


36. The Panel finds that this personal relationship which started prior to discharge from treatment, was not in Patient A’s best interest. It blurred the boundaries between a personal and professional relationship and could have put Patient A at risk of emotional harm due to her evident vulnerability and the boundary issues which were identified early in the therapy. The imbalance of power in a therapeutic relationship could transfer to a personal relationship where the boundaries are not maintained. Taking all these matters into account the Panel finds that the Registrant engaged in an inappropriate relationship.


37. The Panel therefore finds this particular proved.


Particular 1c)


38. The Panel has had sight of the text from the Registrant to Patient A. The Registrant admits the facts of this particular and has confirmed that the text was sent on 28 August 2015. The Panel finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved.


39. The Panel next considered if the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Registrant has made an admission in relation to this matter. The Panel finds that the sending of this text was part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate relationship for those reasons set out in paragraph 36.


40. The Panel therefore finds this particular proved.


Particular 1d)(i)


41. The Registrant has denied the facts of this particular. The Registrant maintained that Patient A and herself were wearing Victorian lingerie as costumes and were not in a state of undress.


42. The Panel has had sight of the Video. This appears to be a compilation of clips from footage filmed as part of an artistic collaboration between Patient A and the Registrant. At times it is clear, both parties were aware that filming was taking place, although the Panel accepts that the footage produced was edited and compiled by Patient A.


43. Having viewed the footage, the Panel finds that when they were both dressed in Victorian lingerie, this was in keeping with the artistic project they were embarking upon. However, towards the end of the Video it briefly depicts both the Registrant and Patient A on a bed in a state of undress, in that they were both only partially clothed.


44. The Panel therefore finds this particular proved.


Particular 1d)(ii)


45. The Registrant has denied the facts of this particular. The Panel has had sight of the Video which did depict the Registrant stroking Patient A’s hair with her hand and twice stroking the top of Patient A’s legs with a feather. The Panel has seen no evidence of the Registrant groping Patient A.


46. The Panel therefore finds this particular proved only to the extent of stroking Patient A.


Particular 1d)(iii)


47. The Registrant admitted the facts of this particular and the Panel finds that the Registrant’s admission is supported by the evidence. The Registrant explained the context of this conversation was that Patient A was talking about a memory card being full and that it would not let her take any more photographs and that the memory card didn’t go in the right hole. The Registrant further explained that Patient A had holes in her stockings to which the Registrant was referring. The Panel has viewed the Video in which the Registrant can be heard saying the alleged words to Patient A. The Panel accepted the Registrant’s account that she was referring to Patient A’s stockings and considered that both the Registrant and Patient A appeared to realise the innuendo after the comment was made.


48. The Panel therefore finds this particular proved.


Particular 1d)(iv)


49. The Registrant admitted the facts of this particular and the Panel finds that the Registrant’s admission is supported by the evidence. The Panel has viewed the Video in which the Registrant can be heard saying these words to Patient A. The Registrant explained the context of this conversation was that she was talking about an artistic connection and not a sexual connection. The Panel accepts the Registrant’s explanation about the context of the comments.


50. The Panel therefore finds this particular proved.


Particular 1d)(v)


51. The Panel has viewed the Video in which the Registrant can be heard saying to Patient A “you’re falling out of your outfit” not “you falling out of your outfit”. From the footage, it is clear that the Registrant’s comment “This is the most beautiful thing I have seen so far” is made in relation to her sleeve, which she is holding up and that the two comments in particular 1d)v) are not linked. While noting that the Registrant has admitted the facts of this particular and has explained the context of this conversation, the Panel does not find the facts of this particular proved as the actual words used could not be described as “words to that effect” as the actual words used have a completely different meaning.


52. The Panel therefore does not find this particular proved.


53. The Panel next considered if in collaborating with Patient A in filming of a video which depicts the matters found proved in particulars 1d)i) to iv) amounted to a breach of professional boundaries by engaging in an inappropriate relationship with Patient A outside of a clinical setting.


54. The Panel finds that the Video is only 11 minutes long and that the artistic collaboration took place over weeks or months. Patient A appears to have compiled her favourite clips which she describes as “precious moments, just like your child on holiday”. Therefore, the Panel do not consider that the Video is representative of the entire process. However, the clips that the Panel viewed did occur and in the context of a relationship that commenced prior to discharge from treatment, are of a concerning nature.


55. The behaviour found proved in particulars 1d)i) – iv), clearly amounts to a breach of professional boundaries and demonstrates engagement by the Registrant in an inappropriate relationship with Patient A outside a clinical setting.


Particular 1e)


56. The Panel has had sight of a screenshot of the text message. The Registrant has admitted the facts of this particular and has explained that it appeared that they had been texting and referring to art and psychology. The Panel finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved on the balance of probabilities.


57. The Panel next considered if in sending this text, the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Registrant had made an admission in relation to this matter. The Panel finds that the sending of this text was part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate relationship for those reasons set out in paragraph 36.


58. The Panel therefore finds this particular proved.


Particular 1f)


59. The Panel has had sight of the minutes of the fact-finding meeting held by Northumbria Foundation Healthcare Trust on 18 May 2016 in which the Registrant admits that she had lunch with Patient A. The Registrant has admitted this factual particular at the commencement of this hearing. The Panel therefore finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved.


60. The Panel next considered if in having lunch with Patient A in or around 2014, the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Panel finds that having lunch with Patient A was part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate relationship for those reasons set out in paragraph 36.


61. The Panel therefore finds this particular proved.


Particular 1g)


62. The Panel has had sight of the minutes of the fact-finding meeting held by Northumbria Healthcare Foundation Trust on 18 May 2016 in which the Registrant admits that she visited Patient A at her parents’ house. The Registrant has admitted the facts of this particular. The Panel finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved.


63. The Panel next considered if in visiting Patient A at her parents’ house, the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Registrant has admitted this. The Panel finds that visiting Patient A at her parents’ house was part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate relationship for those reasons set out in paragraph 36.


64. The Panel therefore finds this particular proved.


Particular 1h)


65. The Panel has had sight of the minutes of the fact-finding meeting held by Northumbria Healthcare Foundation Trust on 18 May 2016 in which the Registrant admits that she visited the Baltic Art Gallery with Patient A. The Registrant has admitted the facts of this particular. The Panel finds that the Registrant’s admission is supported by the evidence and finds the facts of this particular proved.


66. The Panel next considered if in visiting an art gallery with Patient A, the Registrant breached professional boundaries by engaging in an inappropriate relationship outside of a clinical setting. The Registrant has admitted this. The Panel finds that the visit to the Baltic Art Gallery was part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate relationship for those reasons set out in paragraph 36.


67. The Panel therefore finds this particular proved.


Particular 2


68. The Panel considered the evidence from EM and RB in support of this particular. The Panel also had regard to the North Tees and Hartlepool NHS Foundation Trust’s Investigation Reports dated July and September 2016, fact-finding meeting of 18 May 2016 and the minutes of the Investigatory Meeting held by Northumbria Healthcare Foundation Trust on 21 March 2016. The Registrant has admitted the facts of this particular. The Panel therefore finds that the Registrant’s admission is supported by the evidence.


69. The Panel therefore finds this particular proved.


Particular 3


70. The Panel next considered whether the Registrant’s actions found proved in particular 2 were dishonest. In considering this issue, the Panel has applied the test set out in the case of Ivey v Genting Casinos Ltd [2017] UKSC 67.


71. The Panel has first considered the Registrant’s actual knowledge or genuinely held belief in relation to the Registrant destroying some clinical records relating to Patient A.


72. The Registrant informed the Panel that she destroyed the summary and process notes because Patient A had made repeated requests for her to do so. She told the Panel that Patient A was particularly concerned about a potential breach of confidentiality. EM gave evidence that she understood that Patient A wanted the notes destroyed for fear of any information disclosed during therapy sessions getting out into the public domain. The Panel has also had sight of the notes of Patient A’s meeting with Kingsley Napley Solicitors, in which Patient A confirmed that she had told the Registrant not to keep the notes.


73. The Registrant informed the Panel that at the time she thought that it was in the patient’s best interest to destroy the notes. She said that she weighed it up in her mind and felt she could clinically justify it and that there was “still quite a lot left on the file”. The Registrant gave evidence that at the time she destroyed the notes, she had ceased treating Patient A two months beforehand, had referred her on to another service and had provided a brief summary of their meetings in the referral letter which was also provided to Patient A’s GP. The Registrant also gave evidence that she had carried out some research prior to shredding the notes and that it appeared to be a grey area.


74. In terms of the North Tees and Hartlepool NHS Foundation Trust’s Healthcare and Records Management Policy (a copy of which was produced), when a patient requests that their health records are destroyed, they must submit a written request to the Caldicott Guardian with the reason for their request and such records must not be destroyed until the minimum retention period has elapsed (in this case at least 8 years). The Registrant was unaware of this provision, although now accepts that she should have sought advice before shredding the notes.


75. The Panel accepts that the Registrant genuinely believed that it was in the patient’s best interest and that it was not dishonest to destroy the notes because she was of the view that there was sufficient information remaining in the file. The Panel has taken account of the undisputed fact that the Registrant left a note within the file confirming that she had shredded some of the notes; that she told EM immediately when she was asked to produce the notes; and also that she removed the notes from the filing cabinet and shredded them in the course of a working day while other staff were present in the same office. In reaching this conclusion, the Panel has also given weight to the Registrant’s good character.


76. The Panel next considered whether the Registrant’s actions, in the light of that state of mind, were dishonest according to the standards of ordinary decent people. The Panel has accepted an alternative credible explanation provided by the Registrant for her actions. On the basis of that finding, the Panel is of the view that ordinary decent people would not find the Registrant’s actions to be dishonest.


77. The Panel has therefore concluded that the Registrant’s actions in destroying some clinical records in relation to Patient A were not dishonest.


Particular 4


78. The Panel next considered whether the Registrant’s actions found proved in particulars 1c), 1d), 1f), 1g) and 1h) were sexually motivated and/or inappropriate.


79. The Panel has considered the Registrant’s explanation for embarking on the relationship with Patient A and accepts that her motivation was the pursuit of artistic goals, not sexual. The Panel has taken account of the Registrant’s good character and Patient A’s account was clear that there was no sexual activity in the relationship. The Panel has carefully reviewed the exhibits in particular the exchange of emails and text messages as well as the Video. The Panel is not satisfied that the Registrant’s actions were carried out for the purposes of her own sexual gratification or in pursuit of a future sexual relationship.


80. The Panel considers that the HCPC has not discharged its burden of proof in this regard. The Panel does not find that the Registrant’s actions as found proved in particulars 1c), 1d), 1f), 1g) and 1h) were carried out for the purposes of her own sexual gratification or in pursuit of a future sexual relationship. The Panel therefore is not satisfied that they were sexually motivated.


81. The Panel finds that the Registrant’s actions found proved in particulars 1c), 1d), 1f), 1g) and 1h) were inappropriate and the Registrant has made an admission in this regard. The Registrant’s actions in sending the text to Patient A, collaborating with Patient A in filming the video, having lunch and visiting a gallery and visiting her at her parents’ home were part of a continuing course of action and amounted to a breach of professional boundaries in the continuing of an inappropriate personal relationship.


82. The Panel finds that this personal relationship which started prior to discharge from treatment, was not in Patient A’s best interest. It blurred the boundaries between a personal and professional relationship and could have put Patient A at risk of emotional harm due to her evident vulnerability and the boundary issues which were identified early in the therapy. The imbalance of power in a therapeutic relationship could transfer to a personal relationship where the boundaries are not maintained. Taking all these matters into account the Panel finds that the Registrant’s actions were inappropriate.


83. The Panel has therefore concluded that the Registrant’s actions were not sexually motivated, but they were inappropriate.


Decision on Grounds:


84. The Panel next considered whether the Registrant’s actions found proved in particulars 1b), 1c), 1d)i)-iv), 1e), 1f), 1g), 1h) and 2 amount to lack of competence and/misconduct. The Registrant has admitted that her actions amounted to misconduct. The Panel is aware that this is a matter for its professional judgement. In reaching its decision, the Panel has considered the submissions of Mr Foxsmith and Mr Goldring and also accepted the advice of the Legal Assessor.


85. The Panel has considered the wide range of very positive testimonials submitted on behalf of the Registrant and accepts that the Registrant is a well-respected and competent practitioner. There is no evidence before the Panel to suggest that there are issues in relation to her competence by reference to a fair sample of her work. The Panel does not therefore find that the matters found proved amount to a lack of competence.


86. The Panel has concluded that the Registrant’s conduct found proved breached the following standards of the HCPC’s Standards of Conduct, Performance and Ethics (2012):


• Standard 1 –You must act in the best interests of service users
• Standard 3 – You must keep high standards of personal conduct
• Standard 7 – You must communicate properly and effectively with service users and other practitioners.
• Standard 10 – You must keep accurate records.


87. The Registrant has accepted that the facts as admitted amount to misconduct. Mr Foxsmith has submitted that the Registrant’s conduct amounts to misconduct, as opposed to a lack of competence. The Panel finds that the Registrant prioritised her own artistic goals over her professional role in acting in the patient’s best interest. This conduct fell well below the standards expected of a psychologist and as such amounts to misconduct.


Decision on Impairment:


88. The Panel next considered whether the Registrant’s current fitness to practise is currently impaired by that misconduct. The Panel has considered both the personal component and the public component. The Registrant has accepted that her fitness to practise is impaired by her misconduct on public grounds alone. In reaching its decision, the Panel has considered the submissions of Mr Foxsmith on behalf of the HCPC, the submissions of Mr Goldring on behalf of the Registrant and has had regard to the HCPC Practice Note on Finding Fitness to Practise is Impaired. The Panel also accepted the advice of the Legal Assessor.


89. In terms of the personal component, the Panel has considered the level of insight, remorse and remediation shown by the Registrant and has also considered her good character. In her evidence to the Panel, the Registrant has demonstrated insight into her actions and has explained what she would now do differently. In addition, the Registrant has expressed remorse for the impact of her actions on Patient A, she has attended a course on Maintaining Boundaries and has successfully applied her learning in her current role as a psychologist. It is clear to the Panel that the Registrant has reflected on and learned from this experience and is determined not to repeat her mistakes. Taking all of these matters into account, the Panel has concluded that the risk of repetition is low and that the Registrant has addressed the personal component.


90. The Panel has also considered the critically important public policy issues which include the collective need to maintain public confidence in the profession and in the regulatory process, the protection of service users and the declaring and upholding of proper standards of behaviour. The Panel is of the view that the Registrant’s misconduct would impact on public confidence in the profession. The Panel has found that the Registrant has breached professional boundaries by engaging in an inappropriate relationship with a vulnerable patient over an extended period of time and destroying patient notes at the request of the patient. In these circumstances, the Panel has concluded that there is a serious risk of an adverse impact on public confidence in the profession and in the regulatory process, if a finding of impairment were not made. The Panel therefore finds that the Registrant’s fitness to practise is impaired by her misconduct on public grounds alone and that the Allegation is well founded.


Decision on Sanction:


91. The Panel heard submissions from Mr Foxsmith and from Mr Goldring on the issue of sanction. The Panel considered the sanctions available to it in ascending order of severity and had regard to the HCPC Sanctions Policy. The Panel also accepted the advice of the Legal Assessor.


92. The Panel is 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 their 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.


93. The Panel has considered the mitigating and aggravating factors in this case. The aggravating factors are:


• The Registrant’s actions were serious;
• The inappropriate relationship with a service user lasted over an extended period of time;
• There was potential for harm to the service user;
• The service user was vulnerable.


94. The Panel also had regard to the following mitigating factors:


• The Registrant made admissions to her employers in 2016, self-referred to the HCPC and made formal admissions at the outset of the hearing;
• The Registrant has demonstrated insight into her actions and has explained what she would now do differently in relation to protecting boundaries with patients and record management;
• The Registrant has expressed remorse for the impact of her actions on Patient A and others;
• The Registrant has demonstrated remediation and has attended formal training on maintaining boundaries and has successfully applied her learning in her current role as a psychologist;
• The Registrant has produced a comprehensive reflective statement and has also provided oral evidence to the Panel of her reflections and how she has learned from this experience and is determined not to repeat her mistakes;
• The Registrant has produced 27 outstanding testimonials attesting to her character and professionalism, including one from her current employer;
• The Registrant has had an otherwise unblemished career;
• The Registrant has been successfully working since March 2020 as a practitioner psychologist in a challenging environment.
• The Panel has found that the risk of repetition is low.
• The Panel has found that the Registrant has fully addressed the personal component and is impaired solely in respect of the public component.


95. The Panel first considered whether to take no further action and was of the view that this would not be sufficient to mark the seriousness of the conduct found proved.


96. The Panel considered that mediation would not be appropriate in the circumstances of this case.


97. The Panel next considered a Caution Order. In terms of the Sanctions Policy, a caution may be appropriate where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, and the Registrant has shown good insight and has undertaken remedial action. The Registrant has demonstrated insight and undertaken remedial action, such that the Panel has concluded that the risk of repetition is low.


98. Although the Panel is of the view that the Registrant’s conduct found proved is serious, involving an inappropriate relationship with a service user, it has not found that this was sexually motivated, coercive or predatory.


99. The Panel has concluded that given the period of time that has elapsed since the Allegation and the extent of the mitigating factors identified, a caution would be an appropriate and proportionate sanction which would address the public interest considerations and allow a competent practitioner to continue to practise.


100. The Panel considers that a Caution Order for a period of three years would be sufficient to mark the seriousness of the conduct found proved.


101. The Panel considered that a Conditions of Practice Order would not be appropriate as there are no issues in respect of the Registrant’s competency in her practice.


102. The Panel also considered a Suspension Order. In terms of the HCPC Sanctions Policy, a Suspension Order may be appropriate where there are serious concerns which cannot be reasonably addressed by a Conditions of Practice Order. However, taking account of the significant mitigating factors, the time period which has elapsed since the Allegation and the beneficial role the Registrant is fulfilling in her current employment, the Panel has concluded that such an order would be disproportionate in all of the circumstances.

 

Order

The Panel directs the Registrar to annotate the register entry of Dr Annemarie Dalhuijsen-Bendijk with a Caution Order for a period of three years.

Notes

Right of Appeal:


You may appeal to the High Court in England and Wales 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.

Hearing History

History of Hearings for Dr Annemarie Dalhuijsen-Bendijk

Date Panel Hearing type Outcomes / Status
12/07/2021 Conduct and Competence Committee Final Hearing Caution