Martina King

Preliminary matters
Service
1. The Panel was satisfied that a Notice of the Hearing was sent to the Registrant by an email dated 14 January 2021 at 12.57.13. The Notice was sent to the Registrant’s email address held by the HCPC and copied to her representative, Mr R Oliver. The email gave notice of the hearing date and informed the Registrant that the hearing was to be a virtual hearing. The Panel had sight of a confirmation of delivery email timed at 13.35.05 on 14 January 2021. 

2. The Panel was satisfied that there had been proper service of the notice of hearing in accordance with the requirements of Rule 6 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”).

Application to proceed in the absence of the Registrant
3. Mr Bridges applied on behalf of the HCPC to proceed with the hearing in the absence of the Registrant. He referred to an email from the Registrant’s legal representative, Mr R Oliver, dated 6 January 2021, in which he stated that the Registrant did not intend to attend the hearing of her case but that she intended to send written submissions. An email from Mr Oliver of 28 May 2021 also confirmed that neither he nor the Registrant would be attending.    

4. Mr Bridges submitted that the Registrant had clearly decided not to attend and that an adjournment would not serve any useful purpose. It was in the interests of the public, and of the HCPC witnesses who were ready to give evidence, that the matter should proceed today.

5. The Panel considered the submissions on behalf of the HCPC. It accepted the advice of the Legal Assessor. The Panel was referred to the HCPTS Practice Note of September 2018, Proceeding in Absence, which sets out guidance from the cases of R v Jones (Anthony) [2004] 1 AC 1HL and GMC v Adeogba and GMC v Visvardis [2016] EWCA Civ 162. Applying that guidance, the Panel was careful to remember that its discretion to proceed in absence is not unfettered and must be exercised with the utmost caution and with the fairness of the hearing at the forefront of its mind.

6. The Panel was satisfied that the HCPC had made all reasonable efforts to inform the Registrant of the details of the hearing.  It was clear from the correspondence from the Registrant and Mr Oliver that they did not intend to attend the hearing. The Panel noted that the promised written submissions have been received from the Registrant and are available to the Panel.

7. The Panel was mindful of the public interest in the fair and expeditious resolution of disciplinary cases.  The HCPC’s witnesses were ready to proceed. The Panel was satisfied that the Registrant had voluntarily absented herself from the hearing and waived her right to attend. The Panel concluded that an adjournment to a future date would not serve any useful purpose and that it was fair and in the public interest to proceed with the hearing in the Registrant’s absence.

8. The Legal Assessor reminded the Panel that its duty in the absence of the Registrant would be to ensure that the hearing was as fair as circumstances permit. In considering the evidence the Panel could take into account the Registrant’s written submissions, bearing in mind that they are hearsay evidence. The Panel should also raise any issues which were reasonably evident from the evidence and might have been asked by the Registrant.

Documents
9. The Panel received the following documents:
- Service documents (C1)
- Hearing bundle comprising 287 pages (C2)
- Production Statement (C3)
- Supporting Witness Statement (C4)
- Completed HCPC Proforma and Pre-hearing Form (C5)
- Email chain in relation to Service User Evidence (C6)
- Registrant submission - representative’s non-attendance 28 May 2021 (R1)
- Registrant submissions 28 May 2021 (R2)
- Registrant submissions – Employment Tribunal Decision (R3)

Redaction of the hearing bundle (C2)
10. Mr Bridges informed the Panel that pages D29-D43 and D72-D73 of the hearing bundle (C1) should be redacted. The redactions related to the findings of the investigation by the Hertfordshire Partnership University NHS Foundation Trust (“the Trust”).  The first version of the bundle provided to the Panel was not fully redacted.
 
11. Having taken legal advice, the Panel was satisfied that as an experienced professional panel it could put these matters out of its mind. The Panel was reminded that it was not bound by the findings of earlier investigations undertaken by other bodies in other proceedings. The bundle in any event included the judgment of the Employment Tribunal in respect of the Registrant’s unfair/wrongful dismissal claim against the Trust. The Registrant had submitted a copy of the judgment, asking that it be considered by the Panel. The judgment itself referred to the Trust’s investigation and so, to that extent, information about the Trust proceedings were before the Panel.

Application to amend the Allegation
12. Mr Bridges applied to amend the date referred to in Particular 3(a) of the Allegation from 21 September 2018 to 5 October 2018.

13. The Registrant was given notice of the proposed application in an email dated 2 July 2020. The HCPC had received no objection to the proposed amendment from the Registrant.

14. The Panel took advice from the Legal Assessor. This was an amendment to correct an erroneous date in Particular 3(a). The Panel was satisfied that no unfairness or prejudice would be caused to the Registrant and that the correction should be made in order that the Particular was accurate.
 
Application to hear evidence in private
15. Mr Bridges made an application for part of the evidence to be heard in private, as it would be necessary to hear of matters relating both to the private life of the Registrant and of the Service Users referred to in the Allegation.

16. The Panel was reminded by the Legal Assessor of the terms of Rule (10)(1)(a). It was mindful of the default position that HCPC proceedings take place in public which ensures transparency and open justice. However, the Panel accepted that in this case the grounds for departing from this position were met. The Panel determined that the relevant parts of the evidence would be heard in private, but otherwise as much as possible of the hearing would take pace in public session.

Background
17. The Registrant was employed by the Trust as a Clinical/Counselling Psychologist between 16 November 2009 and 16 January 2019.

18. On 29 April 2018, Service User A reported concerns regarding the Registrant’s conduct during a session on 10 April 2018. An initial fact-finding investigation into this matter was undertaken by the Trust, during which the Registrant disclosed that she had also discussed matters which were similar to those reported by Service User A with another service user, Service User B.

19. In June 2018, SD, who at the time was Senior Service Line Lead for the Trust, commissioned a disciplinary investigation in respect of these two matters and this was subsequently conducted by MR, Consultant Clinical Psychologist.

20. On 24 October 2018, Service User C submitted a fitness to practise referral to the HCPC in respect of the Registrant’s conduct during a private therapy session which took place on 5 October 2018 at the Registrant’s home.

21. On 16 January 2019, prior to the conclusion of the Trust investigation, the Registrant resigned from her role. The matter proceeded to a disciplinary hearing in any event and this took place on 22 August 2019.

The HCPC’s evidence
Witness SD
22. SD told the Panel that at the relevant time, she was the Senior Service Line Lead for the Trust’s Adult In-Patient and Crisis Services. SD was the Registrant’s line manager between 2017 and 2019. She was not responsible for the Registrant’s clinical supervision. SD was the Disciplinary Officer for the Trust in relation to the proceedings concerning the Registrant.
 
23. SD told the Panel that the Registrant worked in the Psychology Team for Acute Mental Health Services and was responsible for service users with mental health problems which required assessment or treatment in an acute setting. She worked in the Thumbswood Mother and Baby Unit, an acute services unit offering assessment and treatment for mothers and their babies of up to 12 months or so and some antenatal women in their final trimester. Patients are both informal and detained. The Registrant also worked on Robin and Owl Wards, where patients have a range of diagnoses, including schizophrenia, depression personality disorders and bipolar disorder. 

24. SD produced the Trust’s policy entitled Professional and Personal Boundaries (17 January 2018). 
 
Service User C
25. Service User C gave evidence to the Panel. She said she had sought help from the NHS and then privately. Her private doctor advised that psychotherapy might assist her. As a result, Service User C sought therapy from the Registrant. At the time, in September and October 2018, the Registrant had left the employment of the Trust and was working privately

26. At her first session with the Registrant on 21 September 2018, Service User C said that for most of the session the Registrant talked about herself and shared personal matters. Service User C hoped that the next session, which took place on 5 October 2018, would be better. When Service User C arrived, the Registrant told her she looked stressed and talked about alternative therapies. She offered a massage at their next session if Service User C felt this would be more beneficial than talking therapy. The Registrant then carried on talking about her personal and professional life for the majority of the session. She told Service User C about her suspension from her NHS employment with the Trust and about the incident which had occurred. She provided detail about her managers and said she hated the NHS and that she had been treated unfairly. She told Service User C about her personal circumstances and that she was moving house. The Registrant also discussed her own health.
 
27. Service User C told the Panel that the session lasted 45 minutes longer than the planned hour and she felt unable to leave. She barely said anything during the session. No therapy was provided. As she left, the Registrant gave her a big hug and asked her not to tell anyone about what she had said and that she trusted Service User C.

28. Service User C said she felt quite worried about the Registrant and felt burdened, upset and let down, having made a big effort to go and see a therapist. She felt the appointment had made her situation worse in some ways. She said she felt vulnerable and that the experience made her quite distressed. Service User C said she felt uneasy because she was also concerned for other people who might consult the Registrant. After discussing matters with a friend, she referred her concern to the HCPC. 

The HCPC’s application to admit hearsay evidence
29. Mr Bridges applied for the Panel to admit the following hearsay evidence: the minutes of the Trust’s investigatory meeting with Service User A on 12 November 2018; a letter from Service User A to the Trust dated 10 April 2018; the minutes of the Trust’s investigatory meeting with Service User B on 21 December 2018 and the hearsay evidence within the witness statement of SD dated 7 August 2020.

30. Mr Bridges referred to an email dated 30 June 2020 from Mr Oliver stating that the Registrant did not oppose this hearsay evidence being admitted with the “appropriate caveats”, which appeared to refer to the weight to be attributed to the evidence. 

31. Mr Bridges referred to the correspondence between the HCPC’s solicitors, Kingsley Napley and each of the service users within bundle C4, “Supporting Witness Statement 1 June 2021”. In respect of Service User, A, she had been contacted by Kingsley Napley in June 2020 and asked if she was willing to provide a witness statement. She had initially agreed, although she stated that she had a health condition and expressed concerns about attending a hearing. After a discussion with her, a draft witness statement was sent to Service User A for approval. However, on on 24 June 2020, Service User A contacted Kingsley Napley stating that she did not want to attend a hearing and felt it would be too much for her health.

32. In respect of Service User B, she was contacted by Kingsley Napley in June 2020 and asked if she was willing to provide a witness statement. However, Service User B responded on 17 June 2020 in a lengthy email stating that she was still struggling with her health and describing how it affects her life. She expressed some empathy with the circumstances of the Registrant’s disclosure to her, referring to the Registrant’s actions as being “a cry for help” and expressing concerns about the potential impact of the hearing upon her (the Registrant). Service User B said felt she would not be a good witness and would “crumble”. Subsequently, on 23 June 2020, Kingsley Napley told Service User B that it would not ask her to provide a witness statement or to assist in the investigation. 

33. Mr Bridges referred to the to the evidential provisions of the Rules and relevant case law authorities. He accepted that the evidence of Service Users A and B was the sole and decisive evidence in support of Particulars 1 and 2 respectively, but submitted that the HCPC had made all reasonable efforts to secure the service users’ attendance. He submitted that it was fair and appropriate in the circumstances to admit the evidence as hearsay and the Panel could in due course be advised as to the weight to be attached to it. 

Panel decision on hearsay application
34. The Panel took advice from the Legal Assessor, who referred to the Panel to Rules 10(1)(b) and (c) and to the guidance in the cases of El Karout v NMC [2019] EWHC 28 (Admin) and Thorneycroft v NMC [2014] EWHC 1565 (Admin). Applying this guidance, the Panel first considered whether the documents were properly admissible.

35. The Panel bore in mind that the Registrant had agreed that the evidence could be admitted and had thus waived her right to cross-examine the witnesses. The Panel was, however, mindful that the evidence was the sole and decisive evidence in support of Particulars 1 and 2 and also took into account the potentially serious consequences for the Registrant if these matters were found proved.

36. The Panel was satisfied that the HCPC had made all reasonable efforts to obtain witness statements from the service users with a view to asking them to attend the hearing to give oral evidence. Both service users had been vulnerable at the time referred to in the Allegation. The information before the Panel suggested they may both still be dealing with issues in respect of their health. The Panel did not consider it would be appropriate for the HCPC to seek to compel their attendance at a hearing and it may not be in their best interests. 

37. The Panel noted that the records of interview were reasonably contemporaneously with the events. They were formal in nature, having been taken as part of a Trust investigation by the Investigating Officer and a Human Resecures Officer. The letter written by Service User A was her initial letter of complaint and was also reasonably contemporaneous with the events. 

38. The Panel further took into account that the Registrant accepted that the hearsay evidence should be admitted and had foregone her right to cross-examine the witnesses.

39. The Panel similarly accepted that the hearsay evidence of SD was admissible, as the relevant parts were based on and referred to the evidence of Service Users A and B. In all the circumstances, the Panel was satisfied that the evidence was admissible under Rule 10(1)(b). The Panel would be mindful of the weight to be attached to the evidence when considering the facts and would receive further advice at that stage.  

Service User A
40. In respect of Service User A, the Panel had sight of the written record of the investigatory meeting with her on 29 April 2018 and her letter of 7 May 2018. 

41. Service User A stated that during the first session with the Registrant she (the Registrant) disclosed personal issues and the impact of this on her. She said that she had been involved in legal proceedings arising from this. Service User A said that the Registrant appeared very upset and the issue was clearly very raw. Service User A said that in her already very vulnerable state, she was left feeling confused, sad for the Registrant and as if she was the therapist in the room, rather than the Registrant. 

42. At the investigation meeting on 12 November 2018, Service User A described the Registrant’s eyes were “glazed and full of emotion”, she was “frantic, unhinged, not calm and on edge”. Service User A said she was shocked, knew it was not right, felt she needed to contact the Registrant and that it left her feeling awful. She said it was a big thing for her to report the matter.

Service User B
43. In the course of the Trust investigation meeting on 21 December 2018, Service User B stated that she thought she had seen the Registrant on three or four occasions. At her first meeting with the Registrant, she was explaining her own situation. She was crying and the Registrant became upset and had tears in her eyes. The Registrant went on to describe her personal curcumstances.

44. Service User B said that at first, she thought the Registrant’s issue was some time ago, but the more she talked, the more Service User B realised it was still going on. The Registrant seemed upset and bitter.

45. Service User B said she had not known what to expect from the sessions and had never had therapy before. She felt the situation wasn’t right and felt that it was oversharing, especially as she was vulnerable and upset and her head was all over the place. She felt the Registrant should not have been in work and that the sessions with the Registrant should have been focusing on her own situation and not thinking about the Registrant’s situation. 

The Registrant’s case
46. The Registrant did not attend the hearing and so did not give evidence to the Panel. For the purposes of this hearing, by an email dated 28 May 2021, the Registrant’s representative asked the Panel to have regard to the Employment Tribunal judgement, a copy of the notes which the Registrant made in respect of Service User C and a further note from the Registrant. The Panel considered these documents and also had regard to the information in the bundle regarding the Registrant’s earlier responses to the issues. The Panel was able to give this information limited weight in the absence of hearing oral evidence from the Registrant. 

47. The Panel had sight of a witness statement the Registrant sent to the HCPC dated 11 August 2018 and the record of her investigation interview with the Trust on 6 September 2018. In these records, the Registrant did not dispute that she had made personal disclosures to Service User A and B, but said these were appropriate in order to empathise with them and to validate their own responses to their situations which bore similarities to her own experience. The Registrant said that she did not perceive that the service users were distressed by what she told them and she was not distressed herself. She said she would not have made disclosure if the clients were uncomfortable, or if she did not consider it was in their best interests. The Registrant said she had not breached professional boundaries, as she was permitted to make disclosures, it was a matter of how and when this was done. 

48. The Registrant stated that her competence and professionalism had never previously been the subject of complaint. She expressed concern about how long the Trust investigation was taking and that her professionalism was being called into question.

Submissions of the HCPC
49. Mr Bridges drew the attention of the Panel to the relevant legal principles and guidance relevant to each of the decisions before the Panel. He submitted that the facts should be found proved and to amount to misconduct. The HCPC’s position was that the Registrant’s fitness to practise is currently impaired in relation to both the personal and public components of impairment. 

Legal Advice at the facts stage
50. The Legal Assessor advised the Panel that the burden of proof is upon the HCPC. The standard of proof in HCPC proceedings is the civil standard, the balance of probabilities. This means in order to find a fact proved, the Panel must be satisfied it is more likely than not that it occurred.

51. In relation to the issue of the weight to be attached to evidence the Panel’s attention was drawn to the factors set out in Section 4 of the Civil Evidence Act 1995. In relation to any information before the Panel as to the decisions of other bodies, including the Trust investigation and the judgment of the Employment Tribunal, the Panel was reminded that it is not bound by such decisions, but it should consider their significance and take account of them to the extent it considered appropriate. The Panel should be mindful that HCPC proceedings have a different purpose, which is to determine fitness to practice matters.

Decision on facts
52. The Panel considered the submissions of Mr Bridges on behalf of the HCPC. The Panel accepted the Legal Assessor’s advice and bore in mind that the burden of proof of the facts is upon the HCPC and the standard of proof to be applied is the civil standard, the balance of probabilities.

53. The Panel considered all the evidence presented and the submissions of the parties.

54. The Panel considered the written submissions of the Registrant. The Panel noted that she did not dispute the essential facts of the consultations with Service Users A, B and C. In particular, she did not dispute that she had made personal disclosures, but submitted there was therapeutic benefit for the service users.

55. The Registrant referred the Panel to the findings of Employment Judge Bartlett in her claim against the Trust for unfair and wrongful dismissal, in which the Registrant was substantially successful. The Panel took account of the Employment Tribunal judgement, but recognised that it was not bound to follow its conclusions. The Panel was mindful that that the Employment Tribunal considers issues under employment law and has a different purpose and procedure from HCPC proceedings, which must determine fitness to practise issues and are concerned with public protection and public interest.

56. The Panel noted that the grounds of the Registrant’s employment claim against the Trust primarily concerned its investigation and disciplinary process and the Registrant succeeded in these claims. The Panel noted that the Tribunal did not hear oral evidence from the service users. Whilst acknowledging the determination of the Employment Judge, the Panel was mindful that it must reach its own conclusions on the Allegation of impairment of fitness to practise brought by the HCPC based on the evidence it had heard.    

Particular 1 – Found Proved
57. The Panel was satisfied it could rely upon and give weight to the record of the interview with Service User A. There was a valid reason for her not attending the hearing. She had been interviewed as part of a formal investigation process and the Panel had sight of her own letter of complaint which was written soon after the events in question.

58. The Panel was satisfied that all the elements of the Particular were established on the balance of probabilities. The Registrant did not dispute the essential facts. The Panel considered that Service User A’s description of her feelings demonstrated that she was caused distress by the Registrant’s disclosures. Given the nature of the disclosures and the Service User’s own circumstances, the Panel concluded that it was highly likely that she would have been caused distress. The Panel was further satisfied that to make disclosures of this highly personal and sensitive nature to a service user constituted a breach of professional boundaries. It also breached the Trust’s policy on personal and professional boundaries.

Particular 2 – Found Not Proved
59. The Panel noted that the Registrant informed the Trust of her disclosures to Service User B in the course of the investigation of Service Users A’s concern. The Registrant did not dispute the essential facts.

60. Service User B did not instigate a complaint about the Registrant’s conduct, but assisted in the Trust investigation. The Panel was satisfied it could rely upon and give weight to the record of the interview with Service User B. There was a valid reason for her not attending the hearing. She had been interviewed as part of the Trust’s formal investigation process.

61. The Panel was satisfied that the disclosure of personal matters by the Registrant took place as described by Service User B. Service User B expressed concern for other service users and for the Registrant. She stated clearly that she thought the Registrant’s conduct was not right, but did not refer to experiencing distress as a result of it, though clearly her own situation was impacting upon her health at that time. The Panel considered that the allegation of causing of distress to the Service User was an integral part of the Particular as drafted. The Panel was not satisfied that this element was established by the evidence. The Panel therefore found this Particular not proved.

Particular 3(a) - Found Not Proved
Particular 3(b) - Found Proved
62. Service User C’s concern did not form part of the Trust investigation. She submitted her own complaint to the HCPC. The Panel found her evidence at the hearing to be clear, balanced and credible. She appeared open and genuine. 

63. The Panel concluded in respect of Particular 3(a) that the factual elements were established. However, it was necessary, given the wording of the Particular, for the Panel to consider whether the Registrant’s offer of massage at the next session with the service user did not maintain the appropriate professional boundaries. The Panel found the offer unusual and felt that it might be considered inappropriate in the context of a service user who had consulted the Registrant as a Psychologist for talking therapy. The Panel noted Service User C declined this and there was no further conversation on this matter. However, the Particular alleged a failure to maintain professional boundaries. The Panel had no evidence to indicate that the massage was proposed for anything other than therapeutic reasons: Service User C said it was suggested by the Registrant after commenting that she (Service User C) appeared stressed on her arrival for the session. There was no evidence before the Panel to suggest adverse motivation, for example seeking to pursue a personal or sexual relationship with the service user. An allegation of breach of professional boundaries is a serious matter and the Panel had insufficient evidence to determine that the offer of a massage breached professional boundaries. The Panel found Particular 3(a) not proved.

64. In respect of Particular 3(b), the Panel found the elements of the Particular were proved to the required standard by the evidence of Service User C. The Panel was satisfied by Service User C’s evidence that she was caused distress: she described feeling burdened, upset and let down. She told the Panel that she felt vulnerable and the experience made her quite distressed. Given Service User C’s circumstances at the time and given the nature of the Registrant’s disclosures, the Panel considered it highly likely that Service User C would have been caused distress as she described. The Panel was satisfied that Particular 3(b) was proved on the balance of probabilities.
 
Decision on grounds
65. The Panel considered the submissions of Mr Bridges and accepted the advice of the Legal Assessor. The Panel applied its own judgement in considering misconduct.

66. The Panel had found proved that, on two occasions in relation to two different service users, the Registrant breached professional boundaries by disclosing highly personal, distressing and sensitive information about herself. In relation to Service User A, this was clearly contrary to the Trust’s policy on personal and professional boundaries.  Insofar as the Registrant’s disclosures were precisely the same issue which Service User A was dealing with and was obviously likely to cause her distress. 

67. In relation to Service User C the Registrant talked in detail about her family circumstances and the circumstances of her leaving the employment of the Trust. The Service User said that she received no therapy at this session and felt upset, let down and burdened by the Registrant’s disclosure of personal information.   

68. Service Users A and C described feeling concerned about the Registrant, as she appeared distressed when talking about her circumstances, which they found upsetting. Both service users saw the Registrant to receive treatment which was compromised by the nature and extent of the Registrant’s disclosures about her own circumstances and the time taken in the sessions. 

69. The Panel was of the view that the Registrant’s actions breached the following paragraphs of the HCPC Standards of Conduct, Performance and Ethics:

1.  Promote and protect the interests of Service Users and carers
Maintain appropriate boundaries:
1.7  You must keep relationships with service users and carers professional
2 Communicate appropriately and effectively
 Communicate with service users and carers
2.1  you must be polite and considerate
2.2  you must listen to service users and carers and take account of their needs and wishes
2.3  you must give carers and service users information in a way that they need and understand

70. The Panel considered that The Registrant’s actions fell far short of the standards expected of a registered Psychologist and would be considered deplorable by fellow professionals. The Panel found that all the facts proved amounted to misconduct.

Decision on Impairment
71. Mr Bridges’ submission on behalf of the HCPC was that the Panel should find current impairment in relation to both the personal and public components of impairment. The Panel accepted the advice of the Legal Assessor and referred to HCPTS Practice Note, Fitness to Practise Impairment (December 2019).

72. The Panel considered in the light of all the information known to it whether the Registrant’s fitness to practise is currently impaired. The Panel applied its own judgment and bore in mind that not every finding of misconduct will indicate that there is current impairment.

73. In this case, the Panel concluded that the Registrant’s conduct occurred in a professional setting whilst the Registrant was responsible for providing therapy treatment to vulnerable service users coping at the time with their own health issues. The Registrant’s actions caused them further distress and worry, including about the Registrant herself.  

74. The Registrant has not provided any evidence that she has insight into the impact of her actions upon the service users. She does not appear to accept that her actions were inappropriate or breached the required processional boundaries. She sought to justify her actions. She has not demonstrated any remorse or offered any apology. There was no evidence before the Panel of any attempt by the Registrant to remedy her past actions, or that they have been remedied.

75. The Panel was mindful that insight is a critical part of remediation and assessment of future risk and that it is difficult for a Panel to assess this where the Registrant has not engaged substantively in the hearing process. The Panel noted that the Registrant’s conduct in making inappropriate disclosures to Service User A was repeated several months later in the case of Service User C. This was after she had been made aware of the concerns of the Trust that her disclosures to Service Users A and B breached professional boundaries. In Service User C’s case, the Registrant went on to disclose personal information about the very circumstances of her leaving the Trust. 

76. In the circumstances, the Panel concluded that there remained a risk of repetition of such potentially harmful conduct in the future. The Panel found the Registrant’s fitness to practise is currently impaired in respect of the personal component.

77. Considering the guidance in the case of CHRE v NMC and Paula Grant [2011] EWHC 927 (Admin), and the Practice Note, the Panel was mindful that it must consider the wider public interest considerations. In the view of the panel, the Registrant’s actions brought the profession into disrepute.  The Panel concluded that members of the public would expect a psychologist providing therapy to service users with acute mental health issues to ensure they maintain proper professional boundaries.  They would be concerned if the fitness to practise of a Registrant who had acted in this manner were not found to be currently impaired. The Panel took the view that public confidence in the profession and the regulatory process would be undermined if a finding of impairment were not made in this case and found impairment in respect of the public component of impairment.

78. The Panel therefore concluded that the Registrant’s fitness to practise is currently impaired in respect of both the personal and public components of impairment.

Decision on Sanction
Submissions of the HCPC on sanction
79. Mr Bridges addressed the Panel on the issue of sanction. He did not propose a particular sanction in this matter, but referred the Panel to the HCPC Sanctions Policy of March 2019.

Submissions of the Registrant on sanction
80. The Panel took into account such information as had been provided by the Registrant which was relevant to the issue of sanction. She had not put forward any specific submissions for the sanction stage.

Legal Advice
81. The Panel received and accepted the advice of the Legal Assessor. The Panel was aware that the purpose of a sanction is not to be punitive, though a sanction may have a punitive effect. The Panel bore in mind that its primary function at this stage is to protect the public, while reaching a proportionate sanction, taking into account the wider public interest and the interests of the Registrant. The Panel referred to the HCPC’s Sanctions Policy and applied it to the Registrant’s case on its own facts and circumstances.

Panel decision
82. In its decision at the earlier stage, the Panel had identified a lack of insight on the part of the Registrant and a failure to appreciate the impact of her personal disclosures upon the Service Users. As the Registrant had not engaged with this hearing, the Panel had very little up-to-date information about the Registrant’s current employment or personal circumstances. She has told the Panel in her brief submissions for this hearing that, at this time, she does not intend to renew her registration or engage any further with the HCPC. 

83. The Panel identified the following mitigating factors:
• The Registrant has had a long career as a Psychologist and there is no information before the Panel to indicate that she has any adverse fitness to practise history prior to the current matters;
• Whilst the Panel has limited information, it appears the Registrant has had difficult personal issues to deal with in her past;
• The Registrant referred herself to the HCPC in relation to the complaint of Service User C.

84. The Panel identified the following aggravating factors:
• The Registrant has not appreciated the impact of her disclosures upon the service users nor has she appreciated that she transgressed professional boundaries;
• The Registrant repeated her conduct in relation to Service User C after similar concerns had already been brought to her attention and were being investigated by the Trust;
• There has been no meaningful apology and no expression of remorse or regret;
• There is an absence of any evidence of insight;
• There is no evidence that the misconduct has been remedied or that any steps have been taken towards remediation.
• There is a risk of repetition should the Registrant return to practice given her lack of insight.

85. The Panel referred to the HCPC Sanctions Policy (March 2019) in deciding what sanction, if any, sanction should be applied. 

86. The Panel took a proportionate approach and considered the available sanction in ascending order of seriousness:

Mediation
87. This was not appropriate, as the issues found proved were too serious to be addressed by means of mediation and the Registrant was not engaging with the HCPC;

No Further Action
88. Given the risk of harm to the public and the public interest and the risk of repetition, the matter was too serious for no further action to be appropriate;

Caution
89. The factors indicating that a Caution Order may be appropriate were not present.  The issues were not minor in nature or isolated. The Panel had no evidence of insight or remediation and was not reassured that the risk of repetition was low. The Panel also considered that a caution would be insufficient to mark the seriousness of the Panel’s findings and to maintain the confidence of the public and the profession. 

Conditions of Practice Order
90. The Panel did not consider this was a case in which conditions of practice were appropriate. The Panel considered it might have been possible to formulate conditions of practice to address the concerns in this case. However, there had been no meaningful engagement from the Registrant and to date there has been no evidence of acknowledgement or insight. 

91. There is no indication that the Registrant would be willing to comply with conditions.  In fact, she has indicated that she does not wish to engage further with the HCPC or remain registered. 

92. The Panel was also of the view that a Conditions of Practice Order would not be sufficient to mark the seriousness of the findings.    

 
Suspension
93. The Panel carefully considered whether a period of suspension would be an adequate response in this case. In so doing, the Panel referred to the HCPC Sanctions Policy as to when a Suspension Order is appropriate. The Panel concluded that Registrant may be able to resolve or remedy her misconduct if she engages. The Panel concluded that a suspension order may be appropriate in the circumstances of its findings.

94. The Panel went on to consider carefully whether the ultimate sanction, a Striking Off Order, was required in this case. The Panel concluded after careful consideration that whilst the concerns found proved were serious, a Striking Off Order would be disproportionate in the context of the Registrant’s long and previously unblemished record and the concerns found proved in this case. 

95. The Panel concluded that a short period of suspension would appropriately mark the seriousness of the concerns, whilst ensuring that the public were protected and that public confidence was maintained.  

96. In these circumstances, the Panel concluded that a period of suspension of 6 months is the appropriate and proportionate sanction which would protect the public interest and demonstrate the seriousness of the matter to the profession and the public.

97. Before the end of the period of suspension there will be a review hearing where the Registrant will be given the opportunity to demonstrate that she has remediated her failings. Whilst this Panel cannot bind any future panel, the Registrant should be aware that in the absence of being able to show that she has reflected upon, and begun steps to remediate her past misconduct, it would be open to that future panel to make a Striking Off Order.

That the Registrar is directed to suspend the registration of Mrs Martina King from the HCPC Register for a period of 6 months from 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.

Application for an Interim Order
Application to proceed in absence
1. Mr Bridges applied to proceed in the absence of the Registrant with an application for an immediate interim order.

2. Mr Bridges confirmed that the Registrant was put on notice of this potential application in the Notice of Hearing of 14 January 2021. He submitted that there was no change in circumstances from the first day of the hearing when the Panel decided to proceed in the Registrant’s absence: there has been no further contact from the Registrant and she had clearly stated that she did not intend to attend this hearing.

3. The Panel took legal advice and accepted Mr Bridges’ submission.  The Panel was satisfied it was fair and in the public interest to hear the application in the Registrant’s absence.

Application for an interim order
4. Mr Bridges referred to the findings of the Panel that the Registrant lacked insight and there was a risk of repetition of her misconduct.  He applied for an Interim Suspension Order to cover the appeal period, on the ground that it was necessary for the protection of the public and was otherwise in the public interest.

5. The Panel accepted the advice of the Legal Assessor. It bore in mind that an interim order in these circumstances is discretionary. The Panel must consider whether an interim order is required, applying the test set out in Article 31(2) of the Health Professions Order 2001, and if it so decides, must act proportionately. This means balancing the public interest with the interests of the Registrant, and imposing the lowest order which will adequately protect the public.

6. The Panel was referred to the guidance in respect of immediate interim orders in the Sanctions Policy and the HCPTS Practice Note on Interim Orders (September 2018). 

7. The Panel considered the issue of proportionality and balanced the interests of the Registrant with the public interest. The Panel had determined to impose a substantive Suspension Order. The Panel considered it would be inconsistent not to impose an immediate interim order of suspension to address the residual risk and public interest issues. 

8. The Panel considered whether interim conditions of practice would be appropriate, but concluded that conditions would not be appropriate given the absence of engagement by the Registrant.

9. Accordingly, the Panel determined that an interim order of suspension was necessary in order to protect the public and in the wider public interest.    

10. The Panel concluded that the appropriate and proportionate duration of the interim suspension order was 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event of the Registrant giving notice of an appeal with the 28-day period.

Interim Order
The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, 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 Martina King