Cameron Collins

Profession: Prosthetist / orthotist

Registration Number: PO04362

Hearing Type: Voluntary Removal Agreement

Date and Time of hearing: 10:00 20/09/2022 End: 17:00 20/09/2022

Location: Virtually via videoconference

Panel: Conduct and Competence Committee
Outcome: Removed

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Allegation

While registered as a Prosthetist/ Orthotist with the Health and Care Professions Council and employed by Steeper Group, you:
1. Did not obtain and/ or record consent from Patient A before providing care.
2. Conducted an inappropriate relationship with Patient A.
3. You made inappropriate comments to Patient A about other people with a disability.
4. Your actions in paragraph 1 amount to misconduct and/ or lack of competence.
5. Your actions in paragraph 2 and 3 amount to misconduct.

Finding

Preliminary Matters

Service and Proceeding in Absence

1. The Panel was provided with a Service Bundle, which contained an email sent to the Registrant on 17 June 2022. This was further to the HCPC Notice of Allegation, dated 1 November 2019, alleging that the Registrant’s fitness to practise was impaired by reason of his lack of competence/misconduct. The Registrant had subsequently notified the HCPC that he wished to be removed from the HCPC Register. The email sent on 17 June 2022 stated that the hearing to consider the Voluntary Removal Agreement would take place at 10am on Tuesday 20 September 2022, by way of video conference, and invited the Registrant to indicate whether he had changed his mind and would be attending. An email was provided confirming that the email had been delivered to the Registrant. The Registrant did not respond to the email sent on 17 June 2022.

2. In an email dated 27 May 2022, the Registrant said to the HCPC, “I will not be attending any such hearing in person or digitally due to my own priorities.” Ms O’Connor thus made an application to proceed in his absence.

3. The Panel took into account the submissions made by Ms O’Connor, the papers provided, the response of the Registrant and the advice of the Legal Assessor. The Panel was satisfied that the Registrant had been properly notified of the date and remote venue of this hearing and had been provided with an opportunity to participate, had he wished to do so. In his response on 27 May 2022, the Registrant had made it clear he would not be attending and the Panel was satisfied that he had voluntarily absented himself from the hearing and thereby waived his right to be present. He had not asked that the matter be adjourned and the Panel could see no advantage to either party in adjourning the matter. It was clearly in the public interest that this matter be dealt with expeditiously and it was also in the Registrant’s own interests that this matter be resolved. Accordingly, the Panel decided it was both appropriate and fair to proceed in the absence of the Registrant.

Background

4. The Registrant is a registered Prosthetist/Orthotist who was employed by the Steeper Group in 2018.

5. On 6 August 2018, the HCPC received a referral from the Steeper Group advising that allegations had been made against the Registrant relating to him having an inappropriate relationship with a service user, Patient A. On 18 August 2018, the Registrant made a self-referral to the HCPC.

6. After receiving Patient A’s complaint, the Steeper Group conducted an internal investigation. During the investigation, concerns came to light regarding the Registrant conducting an inappropriate relationship with Patient A, not obtaining and/or recording consent from Patient A before providing care to her and making inappropriate comments to Patient A.

7. At its meeting on 25 October 2019, the Investigating Committee (IC) of the HCPC determined that there was a case to answer in relation to an allegation of impairment of the Registrant’s fitness to practise. The Panel confirmed the allegation as detailed above.

8. Following the outcome of the IC decision, Kingsley Napley LLP was instructed by the HCPC to conduct an investigation in relation to the allegation. As part of this investigation, Kingsley Napley obtained witness statements from the Director of Orthotic and Prosthetic Business Development at the Steeper Group, together with various exhibits, which were made available to the Panel. The Director provided the following information:

Cameron Collins was employed as a Third Year Graduate Orthotist in Orthotic Services Cornwall between 20 July 2015 and 29 June 2018. Cameron Collins was responsible for supporting general orthotic patient appointments and prescribing and fitting orthotic products.

Patient A was referred to the service on 4 April 2017 for an orthotic evaluation to help manage her condition ‘Ehlers Danlos Syndrome’. This condition left her with very flexible joints (hypermobility) and so it had been identified that she could benefit from Orthotic treatment.

The patient was seen by Cameron Collins between 8 May 2017 and 13 April 2018. After the appointment on 13 April 2018, Patient A contacted our offices requesting she be seen by a different Orthotist.

I was appointed by Steeper’s Human Resources (HR) department to undertake an investigation following the verbal patient complaint [made by Patient A to an Administrator at the Steeper Group]

Patient A expressed a concern that his treatment of her was inappropriate and lacked consent. The patient said that she found Cameron Collins ‘creepy’ and asked to see another Orthotist.

On 10 May 2018, Patient A came into the office for an interview with me and [the Administrator]. We asked Patient A what they were unhappy about with Cameron Collins. Patient A was extremely upset, looked quite tense and expressed animosity towards Cameron Collins, stating ‘he should not be seeing patients. The main accusation was the belief that she had been treated inappropriately and possibly prescribed orthotic devices by Cameron Collins that she did not feel were needed to treat her clinical needs. Patient A also brought printed copies of text messages between her and Cameron Collins to the interview. When I reviewed the messages, it appeared that these were often not complete threads of communications that had taken place and appeared to me that some editing had taken place. The messages provided were only sections of social media platform conversations that had clearly taken place but were difficult to contextualise fully or accurately. I queried this with Patient A and she informed me that it was a complete set. Although the texts I did see could be seen as incriminating against Cameron Collins, there were gaps or missing threads of conversation between the text threads and therefore I could not establish the context of the messages. A lot of what the messages contained appeared quite personal with some related to work.

During the conversation with Patient A, it became clear that a relationship had been formed between Patient A and Cameron Collins.”

9. The Director said he looked at Patient A’s clinical notes. He noted that consent to treat was “seldom recorded.” He said that “It is expected that this would be recorded at the start of each individual clinical intervention.”

10. The Director added:

From looking at the WhatsApp messages provided by Patient A, it is clear that Cameron Collins tried to influence Patient A to continue to see him in clinic after requesting that she sees another clinician.

The recognition of the personal relationship forming and Patient A changing Orthotist was not recorded within the notes but was referenced in the social media communications between Patient A and Cameron Collins. In my opinion, forming a personal relationship with a patient is not unprecedented, however, once a relationship is formed outside the normal bounds of the professional patient-clinician one, a possible conflict exists and therefore this should be recorded in the patient notes. The clinician should disclose this and transfer the patients care to another suitably qualified clinician to support ongoing professional clinical care for the patient.

Cameron Collin’s tried to argue that the reason for him asking Patient A to come back under his care was because he was the only person who had the expertise to deal with her condition. This in my opinion was untrue, and I did not believe this justified Cameron Collin’s sending such a message to Patient A on 12 February 2018. The other clinician that had taken over Patient A’s care had 30 more years’ experience than Cameron Collins and, in my opinion, had as much and probably more expertise than Cameron Collins regarding Patient A’s orthotic needs.

On 10 May 2018, Cameron Collins made a note on Patient A’s record making it clear that Patient A should not be seen by him anymore, and that Patient A would have to be seen by another Orthotist.

During my interview with Cameron Collins on 1 June 2018, I questioned him on why he requested for Patient A to be seen by another Orthotist. Cameron Collins admitted to me that he had a personal relationship with Patient A and explained that he believed he should stop seeing that patient clinically because he was in a relationship with her and that is why he asked for her to be transferred to another Orthotist. For me, the summation of this demonstrated that Cameron Collins recognised he should not be seeing Patient A as a patient as they had begun a personal relationship.

On 13 April 2018, Patient A attended a clinic appointment with Cameron Collins. … During the appointment, Cameron Collins wanted to take 2 full length plaster casts of Patient A’s legs. This full-length cast starts from the bottom of a patient’s leg and goes up to the top of a patient’s thigh. Before beginning the treatment, Cameron Collins did not seek consent or offer to have a chaperone in the room. Instead, he completed one of the casts on Patient A, who expressed at the time that she found the treatment extremely uncomfortable. Cameron Collins asked Patient A if she wanted to continue with having the second cast done and she agreed. Cameron Collins did not record any consent on Patient A’s electronic record for this treatment during this appointment.

When Patient A spoke to me on 10 May 2018, she told me she felt coerced into having the plaster cast done. Patient A told me that she felt that Cameron Collins was pushing her to do the second plaster cast so that the treatment would be done. I asked Patient A why she felt uncomfortable with the plaster casts and she told me she felt uncomfortable because of the intimate nature of the casting, because of how high the cast extended along the patient’s thigh.

I would have expected Cameron Collins to have ensured he obtained and recorded consent.”

11. In a supplementary statement, the Director said:

As previously stated, I was unable to fully ascertain the truth around all the details, facts or the course of the relationship between the patient and Cameron Collins. Both parties agreed that a consensual friendship/relationship had formed, but the accounts from both parties differed greatly after this relationship had supposedly ended, with the complainant effectively saying she believed she had been harassed and/or coerced by Cameron Collins to be seen again by himself as her Orthotist for personal rather than professional reasons. The patient subsequently complained this was inappropriate as she believed he had exploited his clinical position in order to see her again in the hope of reinstating a relationship. Cameron Collins strenuously denied this account explaining that he only wanted to help the complainant in a professional clinical capacity, as he believed as her previous and long term Orthotist, he was best placed to offer her the most appropriate orthotic treatment pathway.

Some of the evidence that the complainant presented as proof of inappropriate communications from Cameron Collins to herself in the form of social media threads were incomplete or even edited. I was therefore unable to rely on these social network communications to form an unbiased judgement as they were incomplete.”

12. One of the allegations is that the Registrant conducted an inappropriate relationship with Patient A. He exchanged multiple messages over several months with her via WhatsApp. Some of these messages were of a sexual nature. They met up at least once for something that Patient A characterised as a "date”. From the messages, it seems there was a kiss but it is described as a “polite” one on the cheek and nothing more intimate occurred. There is reference to both the Registrant and Patient A wanting to do more however. There is further discussion about them meeting up again but no suggestion in the messages that they actually did meet up again in a non-clinical setting.

13. When interviewed by the Director the Registrant said he and Patient A “got along quite well and shared similar interests” and they began to communicate on social media. He said “I tried to act as professional as I could, I realise I could have done things differently.” He said that nothing ever happened in clinic and not whilst he was her Orthotist, but added, “I know I have been stupid.” He maintained that Patient A had consented to the treatment he provided. He added that he was keen to maintain continuity and that was why he tried to continue to treat her.

14. The Registrant was asked about a WhatsApp message he sent which said “There’s only one 'condition' which to my knowledge may or may not exist but results in some of the winiest people ever..post-polio syndrome” “PP syndrome is basically an excuse for older people with polio to whinge about how shit their life has been..when in reality its only because they’re getting older like everyone else”. The Registrant admitted sending the message, saying, “In the context it was written I said it to a friend you don’t expect it to be used later against you, I don’t believe it is my opinion that people suffer more than others it was a wrongful comment to make at the time.

15. The HCPC reviewed the case and considered the circumstances suitable for disposal by way of a Voluntary Removal Agreement as the Registrant admitted the substance of the allegation made against him. The Registrant was therefore asked to confirm his position in respect of disposing of the case by means of voluntary removal and he agreed to such a disposal. This was evidenced by his signature on the Voluntary Removal Agreement dated 24 June 2022.

Decision on the Voluntary Agreement

16. The Panel took into account the content of the bundle provided together with the skeleton argument prepared on behalf of the HCPC, the signed Voluntary Agreement and the submissions made by Ms O’Connor. The Panel heard and accepted the advice of the Legal Assessor and in particular that it should not agree to resolve a case in this way unless it is satisfied of two things: first, that the appropriate level of public protection is being secured and, secondly, that doing so would not be detrimental to the wider public interest.

17. 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 he will remove himself from the Register, cease from practising as a Prosthetist/Orthotist and not attempt to re-join the Register for a period of at least five years.

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

19. It is clear from the correspondence received that the Registrant is not currently practising as a Prosthetist/Orthotist and does not intend to do so in the future. He has accepted the allegations and that consequently his fitness to practise is impaired.

20. The Panel was satisfied that 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, and has signed the Voluntary Agreement in that knowledge.

21. The Panel was also satisfied 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 a Prosthetist/Orthotist and he has confirmed that he does not intend to practise as a Prosthetist/Orthotist in the future. Accordingly, the public would be adequately protected from any potential risk posed by the Registrant.

22. In addition, the Panel was satisfied that public confidence in the profession and the HCPC as its Regulator would not be undermined by the granting of this Voluntary Removal Agreement, since it reflects an acceptance by the Registrant of the matters alleged and that his fitness to practise is impaired. Furthermore, its imposition would be treated in the same way as if he had been removed from the Register following a Substantive Final Hearing. The Panel did not consider this was a case that called for a public hearing. The matters concerned were four years old and restricted to one patient. Patient A had indicated that were she be required to give evidence she would have to re-live matters which would cause her angst and she would require support and the Panel did not consider the case warranted such an approach. The relationship, as far as the Panel could ascertain, consisted of one ‘date’ which was of a non-intimate nature, followed by contact on social media, albeit some of that was of a sexual nature by both parties.

23. The Panel considered that, in all the circumstances, it was appropriate to dispose of this matter in accordance with the terms of the Voluntary Removal Agreement. Disposal by consent on these terms is a suitable, pragmatic and expeditious way of dealing with this matter, whilst meeting the requirements of public protection and public interest.

Order


ORDER: The Registrar is directed to remove the name of Mr Cameron Collins from the Register with immediate effect.

Notes

No notes available

Hearing History

History of Hearings for Cameron Collins

Date Panel Hearing type Outcomes / Status
20/09/2022 Conduct and Competence Committee Voluntary Removal Agreement Removed
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