Toni Louise Allen

Preliminary Matters

1.         The Panel has been convened to consider an application made jointly by the HCPC and the Registrant, Mrs Toni Allen, a Physiotherapist, that effect should be given to an agreement for voluntary removal of the Registrant from the HCPC Register.

Application to hold the hearing partly in private

2.         The skeleton argument submitted on behalf of the HCPC indicated that it was desired to apply for a direction that part of the hearing should be conducted in private, and the Presenting Officer renewed the application orally at the hearing.  The application was made so that the Presenting Officer could articulate a matter that had been mentioned by the Registrant that related to an acutely private matter concerning a close family member.  The Panel acceded to this application on the basis that the protection of private life required the direction to be made.  For the avoidance of doubt, it should be noted that this written determination is a public document, and the Panel has not found it necessary to produce an additional, redacted private version of the private issue as that issue did not impact on the decision made by the Panel.

Proceeding in the absence of the Registrant

3.         As the Registrant did not attend the hearing, the Panel initially satisfied itself that there had been good service of the notice of hearing, and that it would be proper to proceed with the hearing in her absence.

·         The Panel was satisfied that the email sent to the Registrant on 23 June 2023, informing her of the date and time of the hearing, as well as the fact that the hearing would take place by video conferencing, constituted good service of the notice of hearing.

·         After the Panel announced that it was satisfied as to good service, the Presenting Officer applied for a direction that the hearing should proceed in the Registrant’s absence.  In reaching its decision, the Panel had regard to the relevant HCPTS Practice Note and accepted the advice of the Legal Assessor.  The conclusion of the Panel was that the hearing should proceed for the following reasons:

                                      i.        In reply to an email sent to her on 4 August 2023 by the Hearings Officer by which he introduced himself and referred to this hearing, on 7 August 2023, the Registrant replied by email stating that she would not be attending.  It was apparent that the Registrant had earlier informed the Scheduling Officer that she did not wish to attend the hearing.

                                    ii.        Accordingly, the Panel concluded that the Registrant had voluntarily waived the right she had to attend the hearing.

                                   iii.        Furthermore, there was no request for an adjournment and no suggestion that the Registrant would wish to attend the hearing if it were to be held on another occasion.

                                   iv.        Whilst a Registrant seeking voluntary removal from the HCPC Register has an undoubted right to attend the hearing at which that application will be considered, the Panel does not find it surprising that they should not wish to exercise that right; their position is made very clear by the execution of the formal agreement document and the preceding correspondence.  In the judgement of the Panel there is little, if any, additional information a Registrant attending such a hearing would be able to give that would bear upon the issues being considered, and, accordingly, there is no prejudice to a Registrant when they do not attend.  Indeed, as the outcome of the application is sought by the Registrant, the Panel considered there to be merit in the Presenting Officer’s submission that proceeding with the hearing without further delay would be an outcome in the Registrant’s own interests.

                                    v.        For these reasons, the Panel concluded that the clear public interest in the matter being considered outweighed the absence of the Registrant.

Background

4.         The Registrant is registered as a Physiotherapist, and the events underpinning the HCPC’s allegation concern her employment in that capacity by the Queen Elizabeth Hospital King’s Lynn Foundation NHS Trust (“the Trust”).

5.         On 2 June 2020, the HCPC received from the Trust a referral concerning the Registrant.  In that referral it was stated that on 15 May 2020, while the Registrant was working from home, the Registrant’s Line Manager had come across a large amount of the Registrant’s patient notes dating back to 2018 which highlighted various deficiencies.  In view of the fact that the issue has now resulted in the Investigating Committee referring an allegation to the Conduct and Competence Committee, the Panel does not feel it necessary to deal in detail with the complaints that were made by the Trust’s referral.

6.         The Trust itself conducted an internal investigation that resulted in a disciplinary hearing.  Internal allegations were upheld and a final written warning was issued.

7.         So far as the HCPC investigation was concerned, as the Trust’s evidence related to approximately 300 records, the Trust was requested to provide a sample of the criticisms advanced, rather than the entirety of the evidence. The result of this request was that the 59 service users were selected and is on the basis of this representative pool that the HCPC’s allegations is founded.

8.         On 17 March 2021 the matter was put before a panel of the Investigating Committee for a “case to answer” decision on the basis of the information received in relation to the 59 service users.  The decision was that there was a case to answer that the Registrant’s fitness to practice is impaired by reason of her misconduct.  The particulars of the misconduct are very lengthy, and for that reason has not been set out in the body of this determination, but rather in Appendix A at the end of it.  However, the nature of the criticisms contained in the Allegation can be summarised as follows:

                  i.        failure to maintain complete treatment records;

                 ii.        failure to ensure patient identifiable details were completed in documents;

                iii.        failure to complete discharge and/or consultant letters;

                iv.        failure to appropriately and securely store patient records;

                 v.         failure to complete and/or sign patient objective plans; and,

                vi.        failure to ensure patient records were signed appropriately.

 

9.         Following the referral by the Investigating Committee, the HCPC’s Solicitors investigated the case.  The Panel has been provided with lengthy witness statements made by Registrant’s former Line Manager and the individual who conducted the internal Trust investigation.  The Panel was informed that the documentary exhibits extend to some 1,262 pages.

10.      In 2022 discussions took place between the HCPC and its Solicitors and the Registrant concerning the voluntary removal process, and these discussions culminated in the Registrant expressing a wish to enter into a Voluntary Removal Agreement (“VRA”).

The submissions of the parties

11.      The Panel was provided with a skeleton argument dated 4 August 2023, prepared on behalf of the HCPC.  At the hearing, the Presenting Officer made oral submissions that were consistent with the terms of the skeleton argument.  The background was helpfully and concisely summarised, and the communications by the Registrant relating to her wish to seek voluntary removal were identified.  It was submitted that the Panel should be satisfied that permitting the VRA would provide an appropriate level of public protection and would not be detrimental to the wider public interest.  It was also submitted that the present application satisfied those requirements and should accordingly be permitted to take effect.

12.      No submissions were made by the Registrant that were specifically directed to the Panel for the purposes of today’s hearing, but the Panel has had regard to all the documents sent by the Registrant and recording her views in reaching its decision.

The Panel’s decision

13.      The Panel accepted the advice it received from the Legal Assessor and had regard to the HCPTS Practice Note entitled, “Disposal of Cases by Consent”.  Accordingly, the Panel sought to be satisfied that:

                              i.                The Registrant does indeed wish for her name to be removed from the HCPC Register in the manner and on the terms dictated by the VRA.

                            ii.                That giving effect to the VRA would afford a proper degree of public protection.

                           iii.                That there were no other or wider public interest considerations that made disposal by a VRA inappropriate.

14.      The Panel was satisfied that the effect of the VRA was indeed sought by the Registrant in full knowledge of what it involves. On a number of occasions she has demonstrated that she understands the effect of the VRA (in particular, that she will not be entitled to re-apply for registration for a period of 5 years). She has expressed why, despite her desire to remediate the shortcomings identified by the allegation, she considers that her personal circumstances do not permit her to do that at the present time.

15.      So far as the degree of public protection that would be afforded is concerned, the effect of VRA would be akin to the consequences of a striking off order, as it involves removal from the Register, and a period of five years must pass before restoration could be sought. Accordingly giving effect to the VRA would afford the same degree of public protection that would be provided if the matter proceeded to a substantive hearing, the allegation was proved, and the ultimate sanction of striking off imposed.  Further, by the VRA the Registrant admitted the allegation (including misconduct and impairment of fitness to practise), and that those admissions could be considered in the event of an application for restoration.  In short, no greater public protection could be provided were the matter to proceed in the ordinary way.

16.      So far as the wider public interest is concerned, the Panel readily acknowledges that there will be many cases in which it would not be appropriate for fitness to practise proceedings to be resolved in a “back door” manner as a public airing of the issues is required.  However, having carefully considered the matter, although the allegation in this case is clearly a serious one, in the judgement of the Panel it is not so egregious to require a public hearing given that (for the reasons already expressed) the maximum degree of public protection will be provided by giving effect to the VRA.  In particular, the Panel is satisfied that fair-minded and fully informed members of the public would not have their confidence in the Physiotherapy profession or the regulation of that profession diminished were they to understand that the VRA had been given effect.

17.      For these reasons, the Panel considered that it was appropriate to permit the VRA to be given effect.  Accordingly, the Panel Chair will sign the Notice of Withdrawal.

 

APPENDIX A

 

The Allegation referred by the Investigating Committee on 17 March 2021

 

As a registered Physiotherapist (PH100466) your fitness to practise is impaired by reason of your misconduct. In that:

 

1. Between 3 January 2018 and 04 April 2020, you did not maintain complete treatment records in relation to Service Users set out in Schedule A.

 

2. Between 16 May 2018 and 21 February 2020, you did not ensure Patient identifiable details were completed on consent forms for Service Users set out in Schedule B.

 

3. Between 8 February 2018 and 4 May, you did not ensure that discharge and/or consultant letters were completed in relation to Service Users set out in Schedule C.

 

4. Between 14 March 2018 and 20 June 2019, you did not ensure Patient identifiable details were completed on outcome measure forms, for Service Users set out in Schedule D.

 

5. Between 16 March 2018 and 9 April 2019, you did not ensure Patient identifiable details were completed on the bladder diary, for Service Users set out in Schedule E.

 

6. Between 16 March 2018 and 1 October 2019, you did not ensure Patient identifiable details were completed on the patient records, for Service Users set out in Schedule F.

 

7. Between 23 November 2017 and 19 July 2020, you did not store Service User records securely, in relation to Service User’s set out in Schedule G.

 

8. Between 23 August 2018 and 23 August May 2019, you did not complete and/or sign patient objective plans, in relation to:

 

1. Service User 6
2. Service User 14
3. Service User 23
4. Service User 33
5. Service User 52

 

9. Between 12 September 2018 and 21 January 2020, you did not ensure patient records were signed, in relation to:

 

1. Service User 2
2. Service User 3
3. Service User 4
4. Service User 34
5. Service User 59

 

10. Between 29 April 2018 and 6 April 2020, you did not ensure patient identifiable details were recorded on the food diaries for Service User 21.

 

11. Between 3 April 2018 and 8 February 2020, you did not ensure patient identifiable details were recorded on NMES contraindications form, in relation to:

 

1. Service User 10
2. Service User 38

 

12. Your actions at particulars 1 - 11 amount to misconduct.

 

13. By reason of your misconduct your fitness to practise is impaired.

 

 

Schedule A

 

Service User 1

Service User 3

Service User 4

Service User 5

Service User 7

Service User 8

Service User 9

Service User 10

Service User 11

Service User 12

Service User 13

Service User 14

Service User 15

Service User 16

Service User 17

Service User 18

Service User 19

Service User 20

Service User 21

Service User 22

Service User 24

Service User 25

Service User 26

Service User 27

Service User 28

Service User 29

Service User 30

Service User 31

Service User 32

Service User 33

Service User 34

Service User 35

Service User 36

Service User 37

Service User 38

Service User 39

Service User 40

Service User 41

Service User 42

Service User 43

Service User 44

Service User 45

Service User 50

Service User 51

Service User 52

Service User 53

Service User 54

Service User 55

Service User 56

Service User 57

Service User 58

Service User 59

 

 

Schedule B

 

Service User 1

Service User 3

Service User 4

Service User 7

Service User 12

Service User 14

Service User 22

Service User 23

Service User 27

Service User 31

Service User 32

Service User 34

Service User 37

Service User 41

Service User 45

Service User 46

Service User 49

Service User 50

Service User 52

Service User 54

Service User 55

Service User 56

Service User 57

Service User 58

Service User 59

 

 

Schedule C

 

Service User 2

Service User 3

Service User 4

Service User 5

Service User 6

Service User 7

Service User 8

Service User 9

Service User 10

Service User 11

Service User 12

Service User 13

Service User 14

Service User 15

Service User 18

Service User 19

Service User 20

Service User 22

Service User 23

Service User 24

Service User 25

Service User 26

Service User 28

Service User 29

Service User 30

Service User 33

Service User 34

Service User 35

Service User 36

Service User 37

Service User 38

Service User 39

Service User 40

Service User 41

Service User 42

Service User 43

Service User 44

Service User 45

Service User 46

Service User 48

Service User 49

Service User 50

Service User 51

Service User 53

Service User 54

Service User 56

Service User 57

Service User 58

Service User 59

 

 

Schedule D

 

Service User 9

Service User 11

Service User 12

Service User 13

Service User 14

Service User 28

Service User 38

Service User 42

Service User 43

Service User 45

Service User 47

Service User 48

Service User 52

Service User 55

Service User 56

 

 

Schedule E

 

Service User 10

Service User 13

Service User 21

Service User 29

Service User 38

Service User 40

Service User 41

Service User 42

Service User 45

Service User 53

 

 

Schedule F

 

Service User 14

Service User 26

Service User 32

Service User 39

Service User 41

Service User 48

Service User 49

Service User 52

Service User 58

 

 

Schedule G

 

Service User 1

Service User 2

Service User 3

Service User 4

Service User 5

Service User 6

Service User 7

Service User 8

Service User 9

Service User 10

Service User 11

Service User 12

Service User 13

Service User 14

Service User 15

Service User 16

Service User 17

Service User 18

Service User 19

Service User 20

Service User 21

Service User 22

Service User 23

Service User 24

Service User 25

Service User 26

Service User 27

Service User 28

Service User 29

Service User 30

Service User 31

Service User 32

Service User 33

Service User 34

Service User 35

Service User 36

Service User 37

Service User 38

Service User 39

Service User 40

Service User 41

Service User 42

Service User 43

Service User 44

Service User 45

Service User 46

Service User 47

Service User 48

Service User 49

Service User 50

Service User 51

Service User 52

Service User 53

Service User 54

Service User 55

Service User 56

Service User 57

Service User 58

Service User 59

ORDER: The Panel decided to grant the VRA Application.

No notes available

History of Hearings for Toni Louise Allen

Date	Panel	Hearing type	Outcomes / Status
18/08/2023	Conduct and Competence Committee	Voluntary Removal Agreement	Voluntary Removal agreed