Mr Vijayakumaran Kuttampoil
Profession: Practitioner psychologist
Registration Number: PYL23901
Hearing Type: Review Hearing
Date and Time of hearing: 10:00 06/04/2023
End:
17:00 06/04/2023
Location:
This hearing is being held remotely.
Panel: Conduct and Competence Committee
Outcome: Suspended
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Allegation
Whilst registered as a Psychologist with the Health and Care Professions Council, (HCPC) you worked at Woodland View Hospital, and:
1. Between 25 September 2018 and 28 December 2018, you did not maintain adequate records, in that:
a) There were no clinical records on the electronic records system (CareNotes) for all the patients you had seen save for one record
b) Your handwritten notes did not have full entries relating to your patient contact;
2. Between 25 September 2018 and 23 January 2019, you did not maintain accurate records, in that:
a) The records on the CareNotes system did not match the information contained within your handwritten notes, specifically in relation to the following patients:
(i) Patient A;
(ii) Patient B;
(iii) Patient C;
(iv) Patient D;
(v) Patient E;
(vi) Patient F;
(vii) Patient G;
(viii) Patient H
b) There were no handwritten notes to correspond with the electronic records for the notes you later made on the “CareNotes” system, specifically in relation to the following patients:
i) Patient B
ii) Patient C
iii) Patient D
iv) Patient E
v) Patient F
vi) Patient G
vii) Patient H
viii) Patient I
ix) Patient A
c) [redacted – No Evidence Offered]
3. Between 25 September 2018 and 23 January 2019, you falsified patient records in that there were no handwritten notes for the electronic clinical entries you made on the ‘CareNotes’ system;
4. [redacted – No Evidence Offered]
5. On 15 April 2019, during a substantive review hearing into your fitness to practise with the HCPC’s Conduct and Competence Panel (the Panel), you misled the Panel when you stated you did not disclose to the Panel the reason for your departure from Woodlands View Hospital, when you stated in your witness statement that:
a) [redacted – No Evidence Offered]
b) [redacted – No Evidence Offered]
c) that you were offered a permanent job at Woodlands View Hospital and that you turned this down, when this was not correct
6. Your conduct in paragraphs 3 and 5 was dishonest and/ or misleading.
7. The matters set out in paragraphs 1 to 6 constitute misconduct and/ or lack of competence.
8. By reason of your misconduct and/ or lack of competence your fitness to practise is impaired.
Finding
Background
1. The Registrant began working as a Locum Psychologist at Woodland View, part of the Priory Group, on 24 September 2018.
2. On 28 December 2018 it came to light that the Registrant had not been recording notes of his patient sessions on the Priory’s electronic system CareNotes since he began working at Woodland View. The Registrant had instead been keeping his own handwritten session notes. Colleague Z reviewed the handwritten records and noted that many of these were inadequate.
3. The Registrant had also been keeping his handwritten notes in a locked cabinet that only he had access to, meaning they could not be easily accessed by other clinicians.
4. Colleague Z instructed the Registrant to type up his handwritten notes onto CareNotes as soon as possible. When Colleague Z checked the Registrant’s entries to CareNotes on 21 and 22 January 2019 he realised that, with the majority of the entries, the content was inconsistent with the corresponding handwritten note. Colleague Z also found that some CareNotes entries did not have a corresponding handwritten note, and vice versa. Colleague Z subsequently discussed this with the Registrant.
5. The Registrant finished working at Woodland View on 24 January 2019.
6. At the Substantive Hearing the Panel found all the matters alleged proven. That Panel found that those matters constituted serious misconduct and so made a finding of misconduct.
7. At the impairment stage the Substantive Hearing Panel had concluded that the Registrant’s lack of insight meant that the conduct shown by the Registrant in the past was likely to be repeated in the future. In respect of dishonesty (record-keeping having been addressed). He had considered his own position before that of patients and colleagues, placed patients at unwarranted risk of harm, breached fundamental tenets of the profession and brought the profession into disrepute. The Substantive Hearing Panel had therefore determined that the Registrant’s fitness to practise was currently impaired on the personal component.
8. The Substantive Hearing Panel had also considered that the public interest demanded a finding of current impairment. The Registrant was operating as a Psychologist in a role in which accurate notes were required. He did not consider learning to access and use an electronic system of patient records a priority notwithstanding that he was working in a medium - high security unit with vulnerable individuals and did not appear to take personal responsibility for ensuring he was able to do his job as required. On any view that is a serious matter which would cause concern to the public.
9. As noted above, that Panel found that the proportionate and appropriate sanction in such circumstances was a Suspension Order for a period of twelve months, all other sanctions being insufficient to guard against the possibility of repetition.
10. The Substantive Hearing Panel identified three elements that the Registrant may helpfully address before a review. These were:
⦁ Evidence of how his insight has meaningfully developed further via reflection about the standards he should operate under and why it is not acceptable to prioritise his own position over patients and colleagues.
⦁ Stress management strategies that he will employ so that such conduct is not repeated and given his contention that this added to the environment in which his dishonest conduct occurred.
⦁ Evidence that he is keeping up to date with technological changes such as electronically recording material.
11. The Registrant had requested an early review of that decision and on 25 November 2022 a Panel determined that the Registrant had not discharged the burden upon him to show that his practise was no longer impaired and recorded that:
‘The Panel has considered carefully what has happened since the original decision was reached and was not of the view that the Registrant had satisfied the persuasive burden to demonstrate that he has fully acknowledged the deficiencies which led to the original finding or that he has addressed that impairment sufficiently through insight. In reaching this conclusion the Panel referred to the Registrant’s reflective statements in which he states ‘It would not be right of me to say to you that I accept that my actions were overtly dishonest, but I am coming to understand why my actions could have been viewed as dishonest, and I would like the opportunity to reflect on this further if the panel would allow me to retain my registration’ and ‘Turning to my dishonesty, I can only apologise and beg of the panel, to give me an opportunity to reflect further on this.’. The Registrant is in effect asking the Panel to allow him further time to reflect on and to address the issues raised. The Panel considers that further time is required in order for the Registrant to develop sufficient insight into his misconduct as found at the substantive hearing.
The Panel has noted the efforts that the Registrant has taken to develop and implement a stress management strategy and has taken into account his own reflection that his “…unfailing optimism is coming back”. The Panel wish to give the Registrant credit for this but considered that this was an ongoing process which was, as yet, incomplete.
The Panel took into consideration the action taken by the Registrant to address the record keeping concerns found by the original panel. This Panel noted that he has undertaken a one-hour online course in Digital Technology in Healthcare. The Panel considers that there is insufficient evidence that the Registrant has fully addressed his shortcomings in keeping up to date with technological changes, such as electronically recording material.
Having considered all of the information provided, the Panel finds that there has not been a significant and material change in circumstances since the original finding was made. The Panel determines that the Registrant’s fitness to practice remains impaired taking into account both the public component and the personal component. The concerns raised by the original panel have not been addressed sufficiently to allow this Panel to conclude that the Registrant’s fitness to practise is no longer impaired’.
12. That reviewing Panel concluded that a period of suspension remained the proportionate and appropriate sanction in all the circumstances.
Fresh evidence before this Reviewing Panel
13. The Registrant had provided the Panel with a reflective piece of writing and a statement relating to his improved wellbeing. There was a body of CPD undertaken and references from fellow practitioners. There was a reference from Professor Hacker Hughes who was prepared to be a mentor for the Registrant and a reference from Clarissa Gregory, Interim Clinical Lead and Advanced Practitioner Occupational Therapy and Pain Management, who indicated that she was content to employ the Registrant.
Submissions
14. The HCPC stated, that whilst it is a matter for the Panel, the evidence presented to the Panel today did not, in the HCPC’s view, show sufficient insight into the issues which the Substantive Hearing Panel had identified required to be addressed. The HCPC considered that the Registrant lacked insight into his former dishonest actions and this being the case, there was a likelihood of a repetition of that dishonest behaviour. Some form of restriction should therefore be maintained to ensure that there is no such further misconduct.
15. The Registrant’s Representative had provided the Panel with a short-written submission which referenced the reflection, references, and CPD undertaken by the Registrant. The Panel was reminded that the Registrant had been working without supervision from the time of the events till the hearing. It was submitted that there is nothing further that the Registrant can do to address his failings. The Registrant appreciated how his actions have impacted on his profession and his reputation. The Suspension Order ‘has hit him hard’ but it was submitted that he understands that it was required in the public interest. It was also emphasised that those answering questions may become stressed and defensive particularly when they are trying to save their professional career. The Panel was invited to take a global view on the Registrant’s level of insight. It was confirmed that if appropriate the Registrant would again work under Conditions of Practice.
Legal Advice
16. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive review to determine if the Registrant is fit to return to unrestricted practice. She reminded the Panel that its role was not to conduct a rehearing of the Allegation nor was it to go behind the previous findings. She advised that in carrying out this assessment, the Panel must exercise its own independent judgment.
17. The Legal Assessor advised that the Panel should consider whether the Registrant has demonstrated that he has successfully addressed his misconduct and that going forward there is now little, or no, likelihood of the matters alleged being repeated.
18. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired, then the Panel must go on to consider what restriction, if any, should be imposed. She also advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the Sanctions Policy document issued by the HCPTS. The Panel should also ensure that any order that it makes under Article 30 is not punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or would otherwise be in the public interest.
Panel decision
19. The Panel noted that it had a lot of positive information before it. The references before the Panel attest to the Registrant’s abilities as a practitioner. Those references had been written by those who worked with him during the period between the events that lead to the Allegation and the Substantive Hearing. They attest to his abilities at that time.
20. The Panel noted the number of certificates of training. A sizeable portion of that training related to mandatory training which was required by employers at the start of a locum position. The Panel also noted that there was an acceptable amount of training in relation to record keeping. There was also training related to the issues of stress management and personal wellbeing, both of which were very recent.
21. The Panel noted that whilst suspended from practice the Registrant had the opportunity to undertake further study and restyle himself as a counsellor, for which he would not have required his registration. The Registrant should therefore be given credit for focusing on his studies and the further personal work undertaken which in his words were aimed at, ‘making himself perfect’.
22. The Panel noted that at the time of the events the Registrant was under Conditions of Practice and finding it difficult to find work in those circumstances. The Registrant has stated that whilst he had been under those conditions, he had found it very stressful, always conscious that if he failed in any way he could be reported to the HCPC again. The Registrant has stated that he is only now getting his confidence back.
23. Having noted those positive aspects the Panel focused its consideration upon the evidence which was relevant to the two allegations of dishonesty. One in the preparation and presentation of falsified patient records, and the other relating to misleading a panel of the Conduct and Competence Committee of the HCPC about the status of a job offer. The Panel noted the strident terms in which the Substantive Hearing had recorded its views on these issues. It was clear to this Panel that there had been no uncertainty about that panel’s decision on the evidence before it in April 2022. This was in contrast to the oral evidence presented today by the Registrant who was, through the terms he employed, trying to go behind those findings and still challenging their legitimacy. The Registrant had told the Panel that he was not a dishonest person and did not have a criminal record.
24. The Registrant had stated that he had not intended to make a false record and what he had written was in his notes; the Registrant referenced the fact that those notes had not been given back to him. He had found himself in a difficult position and had been forced to write from memory. He had not been given the chance to go back and change the records and that he had not had the level of support he needed.
25. In relation to the misleading of a panel, he stated that he did not have evidence to support his position that he had been given a job offer as he had nothing in writing. He stated that he had been alone in the room when the offer was made and so had no corroborative evidence from a third party. Both of these are clear challenges to the evidence which was accepted at the Substantive Hearing.
26. The Panel noted that at the Substantive Hearing the Registrant had emphasised that he had been able to deal with stress and that he had worked in a maximum security situation and so the stressors he encountered when under conditions had not been greater. The Panel noted that the Registrant’s reflection had led him now to consider that this was not the case, and that he had suffered greatly during his time at Woodland View. He told the Panel of his current stress management and coping strategies although it was unclear to this Panel from his description as to what precisely those were.
27. The Registrant’s statement within his reflective piece of writing stated that he
‘wholeheartedly’ accepted the decision of the Substantive Hearing Panel. However, further statements within that document had led to the Panel undertaking further exploration of that issue. From those answers to the Panel’s questions, it was clear that the Registrant’s acceptance was limited and qualified. The Panel has identified three ways in which the Registrant has failed to provide evidence of his insight into his former dishonesty and misconduct. Firstly, he was still attributing blame to others. Secondly, there remained no recognition of his culpability in those two sets of dishonest events. Thirdly, he was now producing further and enhanced reasons or excuses for his actions. These are the same issues that were identified by the Substantive Hearing Panel.
28. The Panel has therefore concluded that the Registrant has not satisfied the persuasive burden on him. He has failed to demonstrate that he has fully acknowledged the deficiencies which led to the original finding or that he has addressed his impairment sufficiently through insight.
29. The Panel has determined that the concerns raised by the original panel have not been addressed sufficiently to allow this Panel to conclude that the Registrant’s fitness to practise is no longer impaired on the personal component and therefore some form of restriction is required.
30. In relation to the public component, the Panel is of the view that members of the public would rightly be concerned that a member of the profession, who has been twice before his regulator, and who has been found guilty of incidents of falsification and misleading a panel, has not been able to demonstrate fully that he has gained insight into his former behaviour and completely remediated his failings. A restriction is therefore also required on the public component of the Panel’s decision.
31. The Panel then moved on to consider the appropriate and proportionate restriction to place on the Registrant’s registration. In doing so the Panel took into account the terms of the Sanctions Policy issued by the HCPTS and the advice of the Legal Assessor.
32. The Panel agreed that taking no further action, Mediation or a Caution Order would not be appropriate as they would not address service users concerns or be in the wider public interest. They would not prevent a repetition of the misconduct nor would they be a sufficient deterrent to others to act in the same way. Further they would not provide any mechanism to address the dishonest elements of the Registrant’s behaviour.
33. The Panel considered that conditions of practice could not be formulated that would address the lack of insight shown by the Registrant. Further, as stated in the Sanctions Policy, conditions would not be appropriate for addressing issues of dishonesty.
34. The Panel has therefore considered whether to continue the period of suspension. It has noted the steps which the Registrant has taken to date to improve his knowledge, his understanding and to address his wellbeing. However, his insight into his former misconduct is extremely limited. This being the case, in order to assess whether a further period of suspension was appropriate and proportionate the Panel went on to consider the next sanction up.
35. The Panel considered the wording at paragraph 131 of the Sanctions Policy which states:
⦁ A strike off is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to the protect the public…..In particular wherte the Registrante:
i. Lacks insight;
ii. [not applicatble]
iii. Is unwilling to resolve matters.
36. Whilst this Panel considers that this guidance is applicable, in this instance the Registrant’s failure to address his lack of insight is, in this Panel’s view, remediable and there is evidence that the Registrant is capable of resolving the matters. The Panel did consider the sanction of strike off but concluded, that at this stage, a strike off is not the proportionate sanction. The Registrant should be aware that such a step is a possibility in the future without robust evidence of contrition for, insight into, and understanding of, his former misconduct.
37. The Panel has concluded that a further period of suspension for six months would, in all the circumstances, be sufficient for the Registrant to demonstrate that he has remediated his former misconduct and persuade a panel that there will be no repetition of that misconduct in the future. The Panel notes that the continuation of the Suspension Order will have a punitive impact on the Registrant however it considers that it is in the wider public interest to impose such a sanction and that public interest outweighs that of the Registrant in this time.
Order
ORDER: The Registrar is directed to suspend the registration of Mr Vijayakumaran Kuttampoil for a further period of 6 months on the expiry of the existing order.
Notes
The Order imposed today will apply from 5 May 2023.
Hearing History
History of Hearings for Mr Vijayakumaran Kuttampoil
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 05/10/2023 | Conduct and Competence Committee | Review Hearing | Restored |
| 06/04/2023 | Conduct and Competence Committee | Review Hearing | Suspended |
| 25/11/2022 | Conduct and Competence Committee | Review Hearing | Suspended |
| 07/04/2022 | Conduct and Competence Committee | Final Hearing | Suspended |
| 21/02/2022 | Conduct and Competence Committee | Final Hearing | Adjourned part heard |