Mrs Lisa J Cumisky

Preliminary Matters:

Service

1. The Panel was satisfied that notice of this hearing had been served in accordance with the rules, having seen that the notice was sent by email to the Registrant’s registered email address on 10 May 2021.

Proceeding in the Registrant’s absence

2. The Panel received a bundle of documents which had been provided by the Registrant to the HCPC dated 23 July 2021, the covering letter of which explained that the Registrant would not be attending the hearing due to family illness. The Registrant requested, in the covering letter, for the hearing to proceed in her absence and stated that she did not wish for the hearing to be adjourned. The Registrant also provided written submissions in relation to the allegations and other evidence which she asked to be considered by the Panel.

3. Ms Luscombe applied for the hearing to proceed in the Registrant’s absence. She submitted that the Registrant had voluntarily absented herself from the hearing and had not requested an adjournment. Ms Luscombe informed the Panel that further material relating to a separate fitness to practise hearing concerning Person 1, who was the only HCPC witness, had been served on the Registrant’s then legal representatives in November 2020. The Legal Assessor confirmed that, having discussed the procedure with Ms Luscombe, the Registrant’s case would be put by either him or Ms Luscombe so as to ensure a fair hearing.

4. The Panel noted that the Registrant had been engaging with the HCPC and had been expected to be attending this hearing and be represented. The Panel also noted that shortly before the hearing start date, the HCPC had been informed by the Registrant’s Representatives that they would not be representing the Registrant at the hearing. The HCPC was also notified by the Registrant in her communication dated 23 July 2021, that she would not be attending the hearing and asked for her written submissions to be taken into account.

5. The Panel considered that in the circumstances, it was fair for the hearing to proceed in the Registrant’s absence. The Panel noted that the Registrant had not applied for the hearing to be adjourned and had specifically requested that the hearing went ahead in her absence so as to achieve finality in this matter. The Panel also noted that the factual allegations dated back to 2015. It considered that there was a strong public interest in the hearing proceeding without any further delay.

6. The Panel was confident that the hearing could be conducted fairly in the Registrant’s absence, given the duty of the Case Presenter and the Independent Legal Assessor to ensure fairness and to put the Registrant’s case. Moreover, the Panel would be alert to ensure that the hearing was conducted fairly. Finally, the Panel was of the view that an adjournment would achieve no useful purpose, as there was no indication that the Registrant would attend on any future date. For all these reasons, the Panel decided to grant the application and to proceed in the Registrant’s absence.

Background:

7. At the material time, the Registrant was employed as a Technician by North West Ambulance Service NHS Trust (NWAS). The Registrant met Person 1 through work in 2013, prior to the Registrant qualifying as a Paramedic. Eventually they became good friends, meeting up socially outside of work but mainly at each other’s houses. Person 1 experienced a traumatic event in 2013 and exclusively confided in the Registrant about it on 8 September 2014. On 22 September 2014, the Registrant commenced her paramedic course at Edge Hill University to qualify as a Paramedic. Person 1 gained her paramedic qualification through the academic route in 2012 at a different university.

8. In April 2019, Person 1 submitted a referral to the HCPC with reference to the Registrant. She noted that she had completed a number of assignments on behalf of the Registrant. In the referral she stated that due to her having completed her university course a few years prior she had relevant journals and materials. Person 1 alleges that these journals and materials had initially been offered to the Registrant to assist but claims the Registrant later took advantage of Person 1, expecting that she write several, if not all of the Registrant’s assignments for her. Person 1 states that she completed the Registrant’s assignments out of fear that the Registrant would disclose the confidential information she had shared with her in September 2014 if she did not comply. Person 1 was also concerned that she would lose the friendship and support provided by the Registrant should she not comply.

9. In support of her allegations, Person 1 attached a number of text and Facebook messages that the two had exchanged at the relevant time, in which the Registrant provided Person 1 with details of the work that needed to be completed as part of the Registrant’s assignments. Person 1 also provided evidence of emails from Person 1 to the Registrant to which the completed assignments were attached.

10. On 29 April 2020 the case was considered by a Panel of the Investigating Committee and referred on for consideration before a final Fitness to Practise Panel of the Conduct & Competence Committee.

Decision on Facts:

11. The Panel heard oral evidence from Person 1 called on behalf of the HCPC. The Panel was provided with the HCPC bundle of documentary exhibits, which included the texts, emails and Facebook messages between Person 1 and the Registrant referred to by Person 1 in her witness statement. The Panel also received the Registrant’s bundle which included her response to the allegations, reflective pieces in relation to the assignments set out in the allegations and character references.

12. The Panel assessed the credibility and reliability of both Person 1 and the Registrant, even though the Registrant was not present. In respect of Person 1, the Panel bore in mind the additional information which it had received, which was to the effect that following a substantive hearing which finished on 29 August 2018, findings of dishonesty had been made against Person 1, resulting in Person 1 having been struck off the HCPC register.

13. Notwithstanding the previous findings of dishonesty made against Person 1, the Panel found that Person 1 was a credible witness. The Panel considered that Person 1 gave consistent evidence relating to the crucial issue in the case, which was whether she had written the Registrant’s assignments. As well as being consistent from the time that she made her referral to her witness statement and then through to her oral evidence at the hearing, Person 1 had also provided an abundance of supporting evidence in the form of texts, emails and Facebook messages, none of which were disputed by the Registrant. Some of the emails produced provided strong support to Person 1’s evidence. Neither was it suggested by the Registrant in her written submissions, that any of the texts, messages or emails had been fabricated in order to construct a case against the Registrant.

14. Further, the Panel noted that Person 1’s evidence was supported by the undisputed fact that all 6 of the completed pieces of work had been stored on Person 1’s computer which has a Windows operating system with Word and Power Point, whereas the Registrant’s computer was an Apple Mac operating system without these applications. The Registrant described herself at that time as not being IT literate nor academically inclined. The Panel considered that the quality and detail of the assignments which had been produced and saved on Person 1’s computer was a further indication that Person 1’s account was true.

15. Finally in relation to the Panel’s assessment of Person 1, the Panel considered that Person 1 gave evidence which, as well as being consistent, was open, frank and honest. Person 1 explained why she had not referred the matter to the HCPC until 2019 and was also open regarding her relationship with the Registrant, including that she had requested the Registrant be a character witness in her own FTP hearing in 2018 (to which the Registrant did not respond), and how their friendship was ended by the Registrant. The Panel was unable to infer that Person 1’s evidence was tainted by malice or a desire for any sort of revenge.

16. In respect of the documentary evidence provided by the Registrant, the Panel was conscious that the Registrant’s comments in respect of the facts amounted to hearsay evidence which had not been tested under cross-examination and had not been subject to any questions from the Panel.

17. The Panel carefully considered the written submissions made by the Registrant. In summary, the Registrant’s case was that the Registrant had worked on the assignments along with Person 1. Her case was that Person 1’s role was as a guide/mentor/friend and that the Registrant would do her own research and then dictate what she wished Person 1 to type.

18. The Panel came to the conclusion that the Registrant’s submissions were wholly inconsistent with the texts, emails and messages which are dated around the exact dates of each piece of work submitted. Further, the Panel noted that the Registrant has not produced any other evidence, for example, different assignments which she may have submitted to the University. The Panel considered that the Registrant submissions on the facts were vague and non-specific in relation to each assignment and lacked detail. The Panel also considered that the Registrant’s account that Person 1 merely typed what the Registrant was dictating lacked credibility, given the Registrant’s admitted lack of knowledge as to the subject matters of the assignments and her inexperience in respect of academic disciplines such as assignment planning, writing and referencing.

19. For these reasons, the Panel gave reduced weight to the Registrant’s written submissions and preferred the evidence of Person 1. The Panel acknowledged that the Registrant has provided some character references, however, was only able to give these references very limited weight, given that it was not clear that all the authors were aware of the HCPC Allegation, several references emanated from the Registrant’s friends and failed to deal in detail with the Registrant’s honesty and integrity at the relevant time.

Particulars 1 (a) to (f) of the Allegation – Proved in their entirety

20. Having carefully considered the oral and documentary evidence, the submissions made by Miss Luscombe and the advice of the Legal Assessor, the Panel found all of Particulars 1(a) to (f) of the Allegation proved in their entirety. The Panel preferred the evidence of Person 1 to the submissions in writing made by the Registrant. The Panel accepted the evidence of Person 1 set out in paragraphs 87 and 88 of her witness statement, in which Person 1 stated,

87. “I have been asked whether I was just proof reading [the Registrant’s] assignments for her. That is not the case; I prepared and wrote whole assignments as detailed above. The evidence I have provided shows that was not the case. I would not have been asking for all the details of what needed to be included, books and papers, word count and font size if I was just proof reading.

88. I have also been asked about whether [the Registrant] was just using my computer to write her essays. Again, that was not the case. She had a MacBook and the first practice assignment we did on her MacBook. Once I had actually written the assignments for her, I emailed them to her and she was able to upload them from her MacBook to the university’s Turnitin system. She therefore had the software to be able to open the assignments and then upload them to the Turnitin system from her own laptop.”

21. The Panel considered that Person 1 gave consistent and cogent evidence in relation to each of the matters alleged in Particulars 1(a) – (f) of the Allegation.

22. The Panel also noted the supporting text messages, emails and Facebook messages which supported each of the allegations. In particular:

• Message dated 21 September 2014 in which Person 1 offered to do research for assignments (prior to the matters alleged);

• Message dated 9 December 2014 in which the Registrant writes “When WE get our nxt assignment”.

• Messages dated 4 February 2015 in which the Registrant refers to the assignments she has to complete, and Person 1 refers to having started the essay plan for the Mental Health Reflection and assisting her with other work and she thanks Person 1 for her help. [Particular 1(a)]. The Registrant also refers to feeling guilty as Person 1 is quicker on the computer and the work would take her a long time if she were to do it.

• Messages dated 11 February 2015 in which Person 1 refers to having done 6 pages of the Registrant’s essay to which the Registrant responded “I do hope you’ve saved the referencing for me?!”.

• Messages dated 15 February 2015 in which Person 1 refers to maybe having a draft copy of the Registrant’s burns assignment ready [Particular 1(b)].

• Messages dated 25 February 2015 in which Person 1 says that she had almost finished the Mental Health Reflection and the Registrant thanks her. [Particular 1 (c)].

• Messages dated 18 March 2015 in which Person 1 says she had made a start on the Registrant’s presentation [Particular 1(d)].

• A message dated 20 March 2015 in which the Registrant says “That’s ace hun”; [Particular 1 (d)]. This was referring to the completed Burns Presentation Person 1 had emailed to the Registrant the day before.

• Messages dated 25 March 2015 in which the Registrant refers to sticking with her “mate” for doing her presentation.

• Messages dated 9 April 2015 in which Person 1 asked the Registrant if she has another assignment due and the Registrant responds “No hun, we’ve done both”.

• Messages dated 9 June 2015 in which the Registrant says to Person 1 “You kind of shine when ur helping people”.

• Messages dated 4 July 2015 in which Person 1 refers to the Registrant having two assignments for her course to go and Person 1 not letting her down with them. [Particulars 1 (e) and (f)].

• Messages dated 15 August 2015 in which Person 1 refers to getting as much of the Registrant’s assignment done as possible and the Registrant thanking her for her help. [Particular 1 (f)].

• Messages dated 16 August 2015 in which Person 1 refers to making progress on the Registrant’s assignment and hoping to finish it that day apart from the referencing. [Particulars 1 (f)]. The Registrant responded, offering to do the referencing if Person 1 wanted and immediately followed that with a message that said “you can stop laughing now! Xx”.

• Messages dated 1 September 2015 in which the Registrant refers to her course results and that Person 1 had helped her “so much”. [Particulars 1(a) -(f)]

• Messages dated 29 September 2015 in which the Registrant talks about her last assignment results and thanks Person 1 for “…all of your help this year hun xx”. [Particulars 1(a) -(f)].

23. The Panel also noted other messages which may not be specific to any particular allegation but are strongly probative of the case against the Registrant. For example, on 28 February 2015 Person 1 had sent the Registrant a photograph of Person 1’s desk containing a range of documents some of which included the title “Edge Hill University”. There was also an accompanying message which stated, “Both complete, just need proof reading xx”.

24. On 30 March 2015, the Registrant was panicking because Person 1’s name came up at the end of her presentation as being the author. The Registrant messaged Person 1 to tell her that and stated, “I’m going to say we used ur computer and that’s why it was there!!!!! . F*** I hope I don’t get suspended!!!!X”.

25. The Panel considered that this particular message strongly indicated that the Registrant knew that she was not just using Person 1’s computer but that Person 1 was actually doing the work. There is no other reasonable explanation for the Registrant’s disproportionate panic; had there been an innocent explanation then there would have been no need for the Registrant to state, “I’m going to say” and “f*** I hope I don’t get suspended”.

26. Further, on 15 April 2015, the Registrant messaged Person 1 to report that her presentation had been “slated” and that she had received brutal feedback. Person 1 replied to her and said, “Aww sorry Hun I should have put the references in the actual presentation for you xx.”

27. Another example is a message on 1 July 2015, when Person 1 tells the Registrant that, “NWAS website has come up trumps with loads of info. Just done a very brief plan, should be able to start writing soon”. Having received the completed Ethics Assignment the Registrant later replies, “I’ve just read it hun! Fan-bloody-tastic! Thank you. Xx”.

28. On 29 September 2015, the Registrant sent a message to Person 1 stating “Haha I got slated hun! The feedback was awful… I got 51%... Thanks for all of your help this year hun xx”. Person 1 replied “Sorry hun, I wasn’t feeling my best when I wrote it xx”.

Particular 2 of the Allegation – Proved

29. In relation to each of the factual particulars found proved, the Panel applied the legal test of dishonesty as set out in the case of Ivey v Genting Casinos Ltd [2017 UKSC 67]. The Panel was satisfied on all of the evidence, that the Registrant’s genuine belief throughout was that she knew that all of the particularised work had been completed by Person 1. As stated on the cover sheet of each submitted assignment, the Registrant was certifying that the work being submitted was her own work when the Registrant knew that was not the case. The Panel was under no doubt that such behaviour would be regarded as being dishonest by ordinary decent people.

Decision on Grounds:

30. The Panel took into account that the matters which have been found proved involved the Registrant dishonestly submitting another person’s work which she passed off as her own, in order to complete her University assignments and to gain her qualification as a Paramedic.

31. The Panel was satisfied that the Registrant’s conduct breached standards 3 and 13 of the HCPC Standards of Conduct, Performance and Ethics (valid from August 2012 until January 2016) which requires Registrants to behave with honesty and integrity and ensure that their conduct does not damage the reputation of their profession.

32. The Panel was in no doubt that the Registrant’s conduct would be regarded as deplorable by other professionals. The Registrant’s conduct was sufficiently serious to cross the threshold of misconduct which is clearly established.

Decision on Impairment:

33. The Panel had regard to the seriousness of the Registrant’s misconduct, the need to protect the public, the need to uphold the reputation of the profession and of the HCPC as Regulator and the need to maintain proper standards of conduct and behaviour.

34. The Panel took into account the submissions made by Ms Luscombe on behalf of the HCPC. It accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note on Finding that Fitness to Practise is Impaired.

35. The Panel considered both the personal and public components of impairment. In respect of the personal component and the seriousness of the misconduct, the Panel noted that the Registrant’s misconduct involved not only dishonesty, but also the obtaining of a professional qualification as a Paramedic in circumstances in which the validity of such qualification has to be in doubt. The Panel was particularly concerned that there was some evidence that the Registrant may not have the required knowledge or academic ability to have passed her written assessments had Person 1 not completed her assignments for her.

36. The Panel further considered that in her written submissions, the Registrant has demonstrated no insight, particularly in relation to the serious damage, actual and potential, done by her dishonesty. The Registrant made no admissions in the face of overwhelming evidence and provided no explanation as to why she had acted in such a blatantly dishonest way. Furthermore, the Registrant has provided no evidence of reflection or remediation and has given no assurance that her dishonest behaviour will not be repeated.

37. Accordingly, the Panel was of the view that the Registrant’s fitness to practise is currently impaired on the personal component of impairment.

38. The Panel was also of the view that a finding of current impairment was necessary under the public component of impairment. It considered that a member of the public who was fully aware of all of the facts concerning this matter, would be gravely concerned as to how the registrant obtained her qualification as a Paramedic and would expect a finding of impairment.

39. For all of the above reasons, the Panel came to the conclusion that the Registrant’s fitness to practise is currently impaired on both the personal and public components of impairment.

Decision on Sanction:

40. The Panel considered the submissions made by Ms Luscombe on behalf of the HCPC. The Panel received and accepted the advice of the Legal Assessor.

41. The Panel was mindful that the purpose of any sanction was not to punish the Registrant but to protect the public and maintain public confidence in the profession and the HCPC as its regulator, by the maintenance of proper standards of conduct and behaviour and to serve as a deterrent in relation to such behaviour.

42. The Panel had regard to the Sanctions Policy [March 2019]. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of seriousness.

43. The Panel first considered the aggravating factors in this case. The Panel noted that the Registrant’s dishonest conduct was not a one-off incident but comprised a course of conduct over a period of 8 months, all of the way through her university course, leading to her paramedic qualification. Further, the Registrant played an active and not a passive role in her dishonesty and has provided no evidence that she actually submitted any of her own work in her assignments. The Panel also considered that the Registrant took advantage of the opportunity which was presented to her of somebody else doing her university academic assignments. The Registrant has demonstrated no insight, remorse or apology and there remains a risk of repetition.

44. As mitigating factors, the Panel took into account that the Registrant has worked for current employer, NWAS first as a Technician, then as a Paramedic and currently as a driving instructor without any concerns being raised about her practice. The Registrant, although she has made no admissions, did engage with the HCPC and with the disciplinary process, although she did not attend this final hearing.

45. In determining the appropriate and proportionate sanction, the Panel had regard to its findings of fact, misconduct and impairment. Having found that the Registrant’s fitness to practise is currently impaired due to misconduct involving serious dishonesty, the Panel considered that it would be inappropriate and not in the public interest, to take no action or refer the matter to mediation. For the same reasons, the Panel determined that a caution order was inappropriate as the misconduct in this case was far removed from being a single incident of a minor nature.

46. The Panel next considered whether a conditions of practice order was appropriate and proportionate. The Panel, however, was of the view that the Registrant’s misconduct which involved serious, sustained dishonesty which led to the Registrant obtaining qualification as a Paramedic meant that conditions of practice would be inappropriate and insufficient to protect the public and the public interest. The Panel was also mindful that conditions of practice have to be workable, practical, enforceable and verifiable. Given the nature of the Registrant’s misconduct which is not confined to clinical concerns but involves fundamental dishonesty and hence serious attitudinal issues, the Panel was unable to formulate any workable conditions in this case.

47. The Panel next considered a suspension order which is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order but which do not require the Registrant to be struck of the Register or where a strike off is not an available sanction.

48. The Panel noted, as stated in the Sanctions Policy, that there should also be a prospect of the Registrant achieving remediation during any period of suspension. The Panel however, reminded itself of its findings that the Registrant has demonstrated no insight, remorse or remediation. Indeed, the Panel has found that the Registrant continued to deny the allegations in the face of overwhelming evidence against her.

49. Further, the Panel considered that the Registrant had no compunction in submitting six assignments which she knew would significantly contribute to her ability to obtain a professional qualification as a Paramedic. The Registrant lied on a university form on each occasion on which she submitted a piece of work which had been completed by Person 1, by signing a declaration that it was all of her own work when she knew that it wasn’t. The seriousness of the matters was compounded by the fact that when the Registrant was doing this, she was already subject to the HCPC standards of honesty and integrity as a student paramedic.

50. The Panel was of the view that the Registrant has shown a propensity for acting dishonestly, given that she maintained this course of action over a long period of time and the active role which she played in it. The Panel concluded that the misconduct was far too serious for it to be dealt with by a suspension order and that such a sanction would diminish public confidence in the profession and the regulatory process, as it would send out the message that it is acceptable to cheat one’s way onto a professional register.

51. The Panel carefully considered the Sanctions Policy in relation to a striking off order and noted that it is, “a sanction of last resort for serious, persistent, deliberate or reckless acts involving dishonesty…..”

52. The Panel concluded that the Registrant’s serious dishonesty in this case made it fundamentally incompatible for her name to remain on the register. The Panel determined that the only appropriate and proportionate sanction was a striking off order.

That the Registrar is directed to strike the name of Mrs Lisa J Cumisky from the Register on the date this order comes into effect.

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.

Interim Order Application:

1. The Panel heard submissions from Ms Luscombe on the need for an Interim Order to cover the period during which an appeal may be made and, if one is made, whilst that appeal is in progress. The Panel noted that Notice of this hearing had been served on the Registrant by email dated 10 May 2021 which included notice that were the Allegation found proved and a sanction is imposed “which removes, suspends or restricts your right to practise”, the Panel could impose an Interim Order.

2. For the same reasons for the Panel deciding to proceed with the substantive hearing in the Registrant’s absence i.e. the need for the expeditious disposal of the case and the public interest, the Panel decided to hear this application for an Interim Order in the Registrant’s absence. There has been no change in circumstances and the Registrant has not indicated any wish to attend the hearing.

The Panel’s Decision

3. The Panel is of the view that, given the nature and seriousness of the misconduct in this case, public confidence in the regulatory process would be undermined if the Registrant was allowed to remain in practice on an unrestricted basis during any appeal period, which could be prolonged. The Panel therefore determined that an Interim Order is necessary to protect the public and is otherwise in the public interest.

4. The Panel first considered whether an Interim Conditions of Practice Order would be sufficient. However, for the same reasons as dealt with at the sanction stage, the Panel concluded that interim conditions would not be workable, appropriate or proportionate in this case.

5. The Panel therefore decided to make an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001. The Panel considered that the Interim Suspension Order should be imposed for the maximum duration period of 18 months to cover any appeal.

Interim Suspension Order:

The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, for a period of 18 months, the same being necessary to protect members of the public and being otherwise in the public interest.

This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mrs Lisa J Cumisky