Miss Rosemary J Anderson

The Skeleton Argument

1. For the purposes of this hearing, the HCPC has submitted and the Panel has read, a Skeleton Argument signed by Mr Mitchell Reece, Case Manager and dated 14 January 2022 [the Skeleton Argument]. Ms Manning- Rees adopted the Skeleton Argument as the basis for her submission to the Panel.

Service

2. The Panel has seen the Notice of today’s hearing dated 13 December 2021 which the HCPC sent by email to the Registrant at her registered email address. The Notice of Hearing made clear that this hearing would take place today as a virtual hearing. The Notice informed the Registrant of the time and date of this hearing.
3. Having seen the relevant service documents and having heard and accepted the advice of the Legal Assessor, the Panel was satisfied that good service of the Notice of Hearing has taken place.

Proceeding in the absence of the Registrant

4. The Panel has seen an email dated 11 January 2022 from Mr Godric Jolliffe, Solicitor, National Legal Officer at The Chartered Society of Physiotherapy and addressed to Mr Reece. In that email Mr Jolliffe informed the HCPC that the Registrant would not be attending or be represented at this hearing. He stated that any submissions would be made on receipt of the Skeleton Argument. The Panel has seen a further email from Mr Jolliffe dated 14 January 2022 in which he confirms that the Registrant will not be attending or be represented at this hearing. She is content for the hearing to proceed in her absence and asks the Panel to endorse the VRA.
5. Ms Manning-Rees on behalf of the HCPC, submitted that the Panel should consider the case in the absence of the Registrant.
6. The Panel heard and accepted the advice of the Legal Assessor.
7. The Panel was aware that a decision to proceed in the absence of the Registrant was one to be taken with great care and caution. However the Panel has decided to proceed in the absence of the Registrant. The reasons are as follows:

• Service of the appropriate notice of this hearing has been properly effected.
• Mr Jolliffe, by his emails dated 11 January 2022 and 14 January 2022 has stated that the Registrant will not be attending this hearing or be represented at it and is content for the hearing to proceed in her absence. The Registrant submits that the Panel should endorse the VRA.
• The Panel has kept in mind the guidance contained in the Practice Note issued by the HCPTS.
• There is no reason to suppose that an adjournment would result in the future attendance of the Registrant.
• There is a public interest in proceeding in order to bring these proceedings to a conclusion, which is the wish of both the Registrant and the HCPC.
• In these circumstances it is right to conclude that the Registrant  has voluntarily absented herself.

Background as extracted from the Skeleton Argument

8. The Registrant is a registered Physiotherapist.
9. On 5 December 2019, the HCPC received a fitness to practise referral from the Powys Teaching Health Board (PTHB). At the relevant time, the Registrant was employed by the Board as a band 7 Paediatric Physiotherapist.
   
   

10.The concern was that the Registrant had been found to be demonstrating a lack of competence in her role as a Physiotherapist in the Paediatric and 14 + Learning and Physical Disability Physiotherapy Service. In particular, the Employer summarised the concerns as:

1. Lack of competence: extensive and consistence evidence of lack of knowledge, skill and judgment, including poor record keeping, inadequate professional knowledge as a Band 7 Paediatric Physiotherapist.
2. Inadequate clinical assessments including appropriate outcome measures.
3. Lack of sound clinical reasoning consistently observed in records and displayed in clinical supervision sessions which could lead to patients receiving the wrong treatment or lack of treatment.
4. Lack of ability to safeguard children and young people in Powys.
5. Risk of exposure of PTHB as an organisation in terms of litigation and further complaints.

11. The Employer has fully investigated the matter and the investigating officer provided investigation documents included in the Investigating Committee Panel (ICP). bundle. Initially, the Employer investigated two concerns about a) physiotherapy treatment for a palliative teenager b) timely care for a baby with torticollis. Both complaints required a formal response. However, in February 2019, a disciplinary process began to investigate the Registrant’s failure to follow reasonable instructions from the Head of the Paediatric Physiotherapy Service- in regard to the first concern.
12. Following the concern, lessons learned and areas for improvement were identified. The Registrant was apparently remorseful and agreed to the findings of the disciplinary hearing, and no further action was taken. Capability objectives given to her in July 2018 were updated and aligned to the Allied Health Professionals framework for a Band 7 clinician.
13. In July 2019, two staff members raised another concern in relation to a therapy treatment / episode of care from the Registrant. The Registrant took 69 days to respond to the concern, and a formal capability hearing was held – her objectives were revised, and the Registrant was issued with a formal warning.
    
    
14. There was also a concern about the Registrant being contacted by another Health Board for a court statement regarding a child, where she didn’t seek supervision from the line manager or Head of Service. The evidence for that concern was limited and was not alleged to the ICP.
15. In light of the issues, the Registrant’s cases were assessed, and a number of issues were identified in terms of clinical reasoning and application of safe use of equipment, lack of engagement and poor record keeping. The Health Board provided a number of tables describing the issues identified within the Registrant’s case load, including whether there were issues with her clinical reasoning, the case notes or both.
16. The Registrant provided representations in relation to the allegations for ICP and those accompany the request for legal advice and were put before the ICP. Some health concerns were identified by the Registrant, but it was not identified as a health case or alleged as such. The Registrant retired from any clinical duties.

17. On 05 July 2021, the Registrant’s representative, Mr Godric Jolliffe, emailed the HCPC to request voluntary removal. The Representative stated in his email, “The Registrant has not practised since 2020 as she has completely retired. She has no intention of returning to practice. She remains on the HCPC Register because of the HCPC’s investigation. The Registrant is aware of and has read the Disposal of Cases by Consent Practice Note. She accepts all of the factual allegations (1- 4) and that the factual allegations constitute misconduct and/or lack of competence (5) and that by reason of her misconduct and/or lack of competence her fitness to practise is impaired (6)”.
18. On 11 January 2022 the Registrant, by way of her Representative, returned the signed Voluntary Removal Agreement.

Disposal by consent

19. 1 Following the Investigating Committee decision, the Registrant, by her representative Mr Jolliffe, requested voluntary removal from the Register. The request was made by the email dated 05 July 2021 which is referred to above.
20. The Registrant later returned to the HCPC the signed Voluntary Removal Agreement which the Panel has read.

Guidance as set out in the Skeleton Argument

21. The HCPC have set out in the Skeleton Argument some guidance as to the nature and the consequences of a VRA. That guidance is expressed in the following terms;

The Voluntary Removal Agreement is an agreement to the effect that the HCPC will not take any further action against the Registrant in relation to this matter on the understanding that she will remove herself from the Register, cease from practising as a Physiotherapist and not attempt to re-join the register.

If the Registrant were to apply to come back on to the Register, their application would be treated in the same way as someone who had been struck off.

The Health Professions Order 2001 does not explicitly provide for consent arrangements. There is instead a practice note that the HCPC has approved as a means of allowing matters, where suitable, to be disposed of by consent.

The Practice Note states that a Panel should not agree to resolve a case in this way unless it is satisfied of two things: firstly, that the appropriate level of public protection is being secured and, secondly, that doing so would not be detrimental to the wider public interest.

Similarly, in Cohen v GMC1 the High Court stated that there are “critically important public policy issues” which must be taken into account by Panels in fitness to practise proceedings, including the ‘public’ component of impairment. This ‘public’ component requires consideration of the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

The Submissions of the HCPC

22. The submissions of the HCPC, as set out in the Skeleton Argument and adopted by Ms Manning -Rees are as follows;

The  HCPC submits that, in all the circumstances, voluntary removal from the Register would be an appropriate means of resolving the current matter.

It is clear from the correspondence received that the Registrant has no desire to practise as an (sic) Physiotherapist in the future, they (sic) have accepted the allegations and that consequently their (sic) fitness to practise is impaired.

The Registrant has been provided with detailed information about the consent process and the effect of voluntary removal from the Register, should the application be granted. The Registrant has had time to review this information and query its implications with HCPC.

Public Protection

Should voluntary removal be permitted in this case, the HCPC submits that public protection would be ensured as the agreement is equivalent, in effect, to a Striking off Order.

The Registrant would no longer be registered as an Physiotherapist and has confirmed that she does not intend to practise as a Physiotherapist in the future, therefore the public would be adequately protected from any potential risk posed by the Registrant’s potential future practise.

Public Interest

The HCPC submits that the wider public interest would not be put at risk should this matter be disposed of by way of consent.

The HCPC submits that the public would not be concerned, nor would public confidence in the profession be put at risk, should the Panel grant this Voluntary Removal Agreement.

The stated position of the Registrant

23. The Registrant’s position was initially communicated to the HCPC by Mr Jolliffe’s email dated 05 July 2021, which is referred to above.
24. The Panel has also seen an “Agreed Statement” signed by the Registrant and dated 11 January 2022 which is in the following terms:

Schedule C Agreed Statement

Miss Rosemary J Anderson (the Registrant) was the subject of an allegation relating to a failure to provide adequate care for a patient, not demonstrating sound clinical reasoning when providing care for a number of patients, not making adequate case notes for some patients, and not demonstrating effective communication with a colleague. The HCPC alleged that by reason of the Registrant’s misconduct and/or lack of competence her fitness to practise was impaired.

That allegation was withdrawn by the HCPC on the basis that the Registrant wished to be removed from the HCPC Register voluntarily. The Registrant admitted the allegation, accepts current impairment, and has undertaken not to practise as a Physiotherapist or use any title associated with that profession. If the Registrant seeks to return to the HCPC Register at any time the application would be treated as if the Registrant had been struck off as a result of that allegation.

25. Panel has also seen a letter dated 11 January 2022 signed by the Registrant and addressed to the Registrar of the HCPC, in which she requests the HCPC to remover her name from the register, effective from 17 January 2022.
26. The documents identified in paragraphs 24 and 25 were prepared and executed as part of the preparation and implementation of the  VRA. The VRA was signed by the Registrant on 03 January 2022. It was signed on behalf of the HCPC on 21 December 2021.   

Order: That the HCPC may withdraw the Allegation set out above and the Registrant is to be permitted to remove her name from the HCPC Register, with immediate effect.

No notes available

History of Hearings for Miss Rosemary J Anderson