Miss Helen M Orme

Preliminary Matters
1. The Panel has been convened to undertake a review of a Substantive Order of suspension imposed in respect of the HCPC registration of the Registrant, Ms Helen Orme, an Occupational Therapist.

Service of the Notice of Hearing
2. The Panel was satisfied that the email sent to the Registrant on 2 November 2023, informing her that this review had been scheduled to take place today constituted good service of the Notice of Hearing.

Proceeding in the absence of the Registrant
3. After the Panel announced its decision that it was satisfied that there had been good service of the Notice of Hearing, the Presenting Officer applied for a direction that the hearing should proceed in the absence of the Registrant.

4. Having carefully considered the matter, the Panel concluded that the hearing should proceed in the Registrant’s absence. The reasons for this decision were as follows:
• Communications from the Registrant demonstrated that the Registrant knew that this hearing had been scheduled to take place.
• The Registrant had repeatedly and recently expressed the view that she would not attend the hearing and saw no point in it taking place as she no longer wished to practise as an Occupational Therapist.
• There had been no suggestion by the Registrant that she would participate in a hearing were it to be held at a different time, and no information from which the Panel could conclude that there was any likelihood of future engagement by the Registrant.
• The Suspension Order currently in place is due to expire in less than a week from the present time. If jurisdiction to consider whether a further sanction is required is not to be lost, a review must take place in the present week. This would not be possible given the necessity of providing 28 days’ notice of the hearing.
• In all the circumstances, the public interest in the hearing proceeding outweighed any disadvantage resulting from the absence of the Registrant.

Background
5. The Registrant is registered with the HCPC as an Occupational Therapist. At the relevant time she was employed in that capacity by Blackburn with Darwen Borough Council (“the Borough Council”). On 4 June 2019 the Registrant made a self-referral to the HCPC to declare a police conditional caution, which she had received on 15 January 2017. The caution was for an offence of criminal damage in 2016 when the Registrant, in the context of a dispute with her ex-partner, scratched his car with a fork.

6. The Registrant had previously renewed her registration with the HCPC online on 5 October 2017 but had not declared the fact that she had received this caution. The Registrant had also failed to notify the Borough Council that she had received the caution until shortly before a DBS check was due.

7. At the Substantive Hearing the HCPC offered no evidence in respect of Particular 5. The Registrant admitted Particulars 1, 2, 3 and 4 but denied Particulars 5 and 6. The panel found all the Particulars of the allegation proved apart from Particular 5. The panel found misconduct in relation to Particulars 2, 3, 4 and 6. The panel found that the Registrant had been in breach of the following standards of the HCPC’s Standards of conduct, performance and ethics (2016):

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession

9.5 You must tell us as soon as possible if …. you accept a caution from the police ….

8. The panel found that the Registrant’s fitness to practise was impaired in respect of both the personal and public components of impairment.

9. In relation to the personal component, the Substantive Hearing panel considered that the Registrant was unlikely to repeat the conduct which had resulted in the police caution. However, that panel was of the view that the Registrant’s denial of dishonesty in concealing the police caution indicated a lack of insight. In addition, the Registrant had provided no evidence of meaningful reflection or remediation. The substantive hearing panel concluded that the Registrant was liable in the future to bring the profession into disrepute, to breach fundamental tenets and to act dishonestly. Accordingly, her fitness to practise was impaired with regard to the personal component.

10. In relation to the “public” component, the panel considered that the fact of receiving a police caution for criminal damage was a serious matter for which a finding of impairment was required to uphold proper standards and maintain public confidence in the profession.

11. The panel also considered that the Registrant’s failure to be open and honest to her employer and the HCPC about the police caution required a finding of current impairment.

12. With regard to sanction, the panel decided to impose a Suspension Order for a period of 12 months.

13. The panel advised that a subsequent reviewing panel might be assisted by the following:

a. A written reflective statement from the Registrant demonstrating:

i. an understanding of the importance of honesty from the perspective of the service user;

ii. an understanding of the importance of honesty as a member of the OT profession, upholding a fundamental tenet of the profession;

iii. an understanding of the importance of honesty from the perspectives of both the Council and the HCPC;

iv. an understanding of the importance of honesty with regard to public perception;

v. an understanding of her dishonesty on all parties referred to in the previous bullet points and what steps she can take to avoid acting dishonestly in the future.

b. Evidence of the Registrant keeping her knowledge of the OT profession up to date;

c. Any testimonials or references relating to work undertaken by the Registrant, whether paid or voluntary.

14. The Suspension Order for 12 months imposed on 12 May 2022 was due to expire on 9 June 2023. It was reviewed by another panel on 12 May 2023 (“the first review”).

15. The Registrant did not attend the first review, having written prior to the date of it to say that she would not be attending. At the review, the Presenting Officer submitted that in the view of the absence of engagement on the part of the Registrant, her fitness to practise remained impaired. It was submitted on behalf of the HCPC at the first review that the outcome should either be a striking off order or a further period of suspension to give the Registrant an opportunity to address the outstanding concerns.

16. The panel conducting the first review decided that the Registrant had not discharged the persuasive burden on her to demonstrate that she had addressed the concerns that had been identified by the substantive hearing panel. That being so, the first reviewing panel determined that the Registrant’s fitness to practise remained impaired in respect of both the personal and public components.

17. When the Panel considered what sanction order should result from its finding that the Registrant’s fitness to practise remained impaired, it applied the Sanctions Policy and considered the available sanctions in an ascending order of seriousness. Having considered, and rejected, making a conditions of practice order, the decision of the first reviewing panel continued in the following terms in paragraphs 27 and 28 of its written determination.

    27. The Panel next considered extending the current Suspension Order. The panel at the substantive hearing, when imposing the Suspension Order, had given the Registrant an opportunity to address the findings that her fitness to practise was impaired. They had also made clear to the Registrant what she needed to do to prepare for, and participate in, the subsequent review hearing. It is very disappointing that the Registrant has failed to take the opportunity provided to her.

      28. The Panel today gave serious consideration to imposing a Striking Off Order but decided that, on balance, the Registrant should be given a further opportunity to address the concerns identified at the substantive hearing. The Panel therefore decided to impose a further Suspension Order for a period of 6 months upon the expiry of the current Suspension Order.”

18. The first reviewing Panel then made suggestions to the Registrant of steps she might wish to consider taking if she wished to engage in the process. They suggested that the next reviewing panel (i.e. the present Panel) might be assisted by the following:
  a. The Registrant’s attendance at the hearing.

  b. A written reflective statement from the Registrant demonstrating:

  i. an understanding of the importance of honesty from the perspective of the service user;

  ii. an understanding of the importance of honesty as a member of the OT profession, upholding a fundamental tenet of the profession;

  iii. an understanding of the importance of honesty from the perspectives of both the Council and the HCPC;

  iv. an understanding of the importance of honesty with regard to public perception;

  v. an understanding of her dishonesty on all parties referred to in the previous bullet points and what steps she can take to avoid acting dishonestly in the future.

  c. Evidence of the Registrant keeping her knowledge of the OT profession up to date;

  d. Any testimonials or references relating to work undertaken by the Registrant, whether paid or voluntary.”

19. Finally, the concluding paragraph of the written determination of the first reviewing panel was in these terms:
“The Registrant should be in no doubt that if she fails to engage with the HCPC between now and the next review, there is a significant risk that she will be subject to a Striking Off Order.”

Submissions at the present hearing
20. On behalf of the HCPC, the Presenting Officer outlined the background to the case. She stated that it was the HCPC’s submission that the absence of engagement on the part of the Registrant should lead the Panel to decide that her fitness to practise is still impaired in respect of both the personal and public components. As to the sanction that should be imposed when the present Suspension Order expires, the Presenting Officer submitted that a striking off order would be appropriate. In advancing this submission, the Presenting Officer referred to relevant elements of the HCPC’s Sanctions Policy.

21. There were no formal submissions made by or on behalf of the Registrant. However, the Panel did consider it relevant to the issues to be decided that the Registrant has stated on more than one occasion that she had no intention of practising as an Occupational Therapist in the future.

Decision
22. The Panel approached the decision it was required to make by accepting the decision of the Substantive Hearing panel in relation to the facts and that the proven facts amounted to misconduct. The task of the Panel was to decide if as a result of those past findings, the Registrant’s fitness to practise is still impaired, and if it is, whether a further sanction is required upon the expiry of the present Suspension Order.

23. The Panel accepted the Presenting Officer’s submission based on the decision of the High Court in Abrahaem v GMC, that in practical terms there is a persuasive burden on the Registrant to demonstrate that she has fully acknowledged the deficiencies which led to the original finding and that she has addressed her impairment. In the view of the Panel this is no more than a recognition that, if any steps have been taken in this regard, they will be known to the Registrant but would not be known to the HCPC. The absence of engagement on the part of the Registrant has the consequence that, in common with the first reviewing panel, the present Panel cannot conclude that the Registrant’s fitness to practise is any less impaired than it was when the substantive hearing panel announced its decision on 12 May 2022. The Panel was satisfied that the Registrant’s fitness to practise remains impaired in respect of the personal component because, without insight having been demonstrated, she remains liable to repeat her past dishonesty. So far as the public component is concerned, fair-minded members of the public would be very troubled by a professional person who has not acknowledged their shortcomings being permitted to return to unrestricted practice. Furthermore, the Panel would be failing in its duty to uphold proper professional standards were it not to mark the unaddressed findings by a finding of current impairment of fitness to practise.

24. The findings of dishonesty in this case are serious. The Panel takes the view that dishonesty shown towards the regulator of a professional person and to the employer of that person are serious. Quite apart from any other consideration, a lack of integrity that could result in dishonesty of that sort calls into question the integrity of the professional person in the way they conduct their professional work.

25. The Panel was of the clear view that a further sanction is required upon the expiry of the current Suspension Order. The Panel concluded that a Caution Order would neither reflect the seriousness of the findings nor would it provide the required degree of protection against the risk of repetition. Furthermore, for two distinct reasons the Panel rejected the making of a Conditions of Practice Order as an appropriate outcome. First, the requirement to act honestly is not one that either can or should be imposed by bespoke conditions; it is a fundamental requirement of registration. Secondly, it would not provide adequate protection against the risk of repetition.

26. The Panel therefore next considered whether a yet further Suspension Order should be made. In this regard it had regard to paragraph 121 of the Sanctions Guidance. The present case does not meet the circumstances suggested in that paragraph as being typical of those that would result in the making of a Suspension Order. First, the Registrant lacks insight. Secondly, there is no evidence to suggest that the Registrant will be likely to be able (or willing) to resolve or remedy her failings. In short, the Panel conclude that the making of a further Suspension Order would be pointless as the position at the end of any further period would be exactly as it is at the present time.

27. The Panel therefore considered whether a Striking Off Order should be made. The Panel was satisfied that the present case did meet the circumstances suggested in paragraph 131 of the Sanctions Policy. The Registrant lacks insight and she has very clearly demonstrated that she is unwilling to resolve matters.

28. Before finally concluding that a Striking Off Order should be made the Panel considered whether such an outcome would represent a proportionate response. The Panel was satisfied that it would. It was not the decision of the Panel that findings of the type made against the Registrant, notwithstanding the seriousness of them, necessarily had to result in a Striking Off Order; rather it was the absence of constructive response on the part of the Registrant to those findings makes any other outcome inappropriate at the present time.

29. Accordingly, the Panel has decided that a Striking Off Order should be made when the present Suspension Order expires.

ORDER: Upon the expiry of the present Suspension Order, namely on 9 December 2023, the Registrar is directed to strike the name of Helen Orme from the Register.

The Order imposed today will apply from 9 December 2023.

History of Hearings for Miss Helen M Orme