Rebekah Gibson

Preliminary Matters

Service of Notice
1. Notice of this hearing was sent to the Registrant by email to her
Registered email address as it appeared in the Register on 12 October
2023 and to the Registrant’s representative. The notice contained the date
and time of today’s hearing and that it would be held by way of a virtual
hearing via video conference.

2. The Panel accepted the advice of the Legal Assessor and is satisfied that
notice of today’s hearing has been served in accordance with Rules 6(1) of
the Health and Care Professions Council (Conduct and Competence
Committee) (Procedure) Rules 2003 (“the Rules”).
Proceeding in the absence of the Registrant

3. The Panel then went on to consider whether to proceed in the absence of
the Registrant pursuant to Rule 11 of the Rules. In doing so, it considered
the submissions of Mr Rokad on behalf of the HCPC.

4. Mr Rokad submitted that the HCPC has taken all reasonable steps to
serve the notice on the Registrant. He further submitted that the Registrant
has engaged with the HCPC in relation to the application for voluntary
removal, and that an adjournment would serve no useful purpose. The
Registrant has signed and returned the Voluntary Removal Agreement
(“VRA”).

5. On 29 November 2023, the Registrant’s representative emailed the HCPC
stating:
“Thank you for your email. Please can you ensure that all correspondence
is also sent to us as the Registrant’s representatives.
I can confirm that the Registrant will not be attending the hearing and will
not be represented at the hearing, please note that no discourtesy is
meant by her non-attendance however this is to save costs.
As can be seen by the bundle, the Registrant has left the profession and
has no intention of returning to practise so therefore has entered into a
voluntary removal agreement with the HCPC. We therefore respectfully
request that the voluntary removal agreement is approved by the panel.”
6. He reminded the Panel that there was a public interest in this matter being
dealt with expeditiously.

7. The Panel has also been provided with a copy of an email from the
Registrant’s Representative, Ms Grace Tyson, dated 27 November 2023
returning the completed VRA.

8. The Panel accepted the advice of the Legal Assessor. He advised that, if
the Panel is satisfied that all reasonable efforts have been made to notify
the Registrant of the hearing, then the Panel had the discretion to proceed
in the absence of the Registrant recognising that in doing so, it must
exercise the utmost care and caution.

9. The Legal Assessor also referred the Panel to the cases of R v Jones
[2002] UKHL 5 and GMC v Adeogba and Visvardis [2016] EWCA Civ 162
and advised that the Adeogba case reminded the Panel that its primary
objective is the protection of the public and of the public interest and that
the “fair, economical, expeditious and efficient disposal of allegations
made against medical practitioners is of very real importance”. In that
regard, the case of Adeogba was clear that “where there is good reason
not to proceed, the case should be adjourned; where there is not,
however, it is only right that it should proceed”.

10. The Panel was satisfied that all reasonable efforts had been made by the
HCPC to notify the Registrant of the hearing. It was also satisfied that the
Registrant is aware of the hearing.

11. In deciding whether to exercise its discretion to proceed in the absence of
the Registrant, the Panel took into consideration the HCPTS Practice Note
on ‘Proceeding in the Absence of a Registrant’. The Panel weighed its
responsibility for public protection and the expeditious disposal of the case
with the Registrant’s right to a fair hearing. The Panel was mindful to
ensure that fairness and justice were maintained when deciding whether
or not to proceed in a Registrant’s absence.

12. In reaching its decision the Panel took into account the following:
 the Registrant’s representative has unequivocally stated that the
Registrant will not be attending this hearing and will not be
represented;
 there is an implicit expectation by the Registrant that the hearing
today proceeds in her absence due to her request, and
agreement to the voluntary removal, and the nature of this
hearing;
 the Registrant has not made an application to adjourn today’s
hearing; and  there is a public interest that this matter is dealt with
expeditiously.

13. The Panel was satisfied that the Registrant had voluntarily absented
herself from the hearing. It determined that it was unlikely that an
adjournment would result in the Registrant’s attendance at a later date
given the nature of this hearing. Having weighed the public interest against
the Registrant’s own interests, the Panel concluded that there was no
unfairness or injustice to the Registrant and therefore decided to proceed
in her absence.

Background
14. The Registrant is a Registered Occupational Therapist ("OT"). At the
relevant time, the Registrant was employed by Aneurin Bevan University
Health Board ("the Health Board") as a Senior OT.

15. On 10 September 2020, the HCPC received a referral from the Health
Board regarding the Registrant. In the referral, it was noted that a call was
received into South Monmouthshire duty desk on the morning of 26
September 2019 from the live-in carer in relation to Service User B. During
the call, the live-in carer explained that Service User B had been
discharged from Chepstow Community Hospital the day before.

16. The Registrant was the Senior OT to whom Service User B had been
allocated and who was responsible for the occupational therapy
intervention whilst Service User B was an in-patient, and also for the
discharge planning required. The live-in carer had arrived at the service
user's property following Service User B's discharge from the ward on 25
September 2019, and had not been able to move or handle the service
user to make him comfortable in bed or support him to use the commode.
The carer stated that the information on the safer handling care plan did
not help her to identify how the service user needed to be moved. She
could not move him on her own and there were no slide sheets at the
property to be able to move or re-position the service user safely and
comfortably in bed.

17. Nicola Pendry, Team Lead OT, in response to a query from Eleri Price,
Duty OT, reviewed the service user's case notes on the electronic
recording system (FLO), but could not see any OT entries relating to the
discharge planning for the service user. The most recent entry by the
Registrant was on 24 September 2019 (relating to a discussion around the
provision of ceiling track hoists and stair lifts) and the manual handling risk
assessment and safer handling care plan that had been uploaded by the
Registrant on 23 September 2019.

18. Ms Pendry and Ms Price discussed and agreed to visit the service user's
house.

19. On arrival at Service User B's house Ms Pendry and Ms Price found:
a) the service user in bed and unable to move. He was distressed and,
because of two episodes of diarrhoea, was lying in his own excrement;
b) limited information on the safer handling care plan with regards to how
the service user was to be moved and handled;
c) no slide sheets provided on the service user's discharge from hospital;
d) a sling for the hoist that was too small for the service user;
e) the service user was unable to roll onto his left side due to increased
pain in his fractured left arm; and
f) the service user reported that two nurses had cared for him in the
hospital, but there was only one carer arranged for discharge.

20. The absence of slide sheets, the pain that Service User B was
experiencing and a sling that was too small for him meant that Ms Pendry
and Ms Price were unable to make the service user clean and
comfortable. Further, due to the non-availability of an additional carer to
support the service user at home, the decision was made to re-admit the
service user to Chepstow Community Hospital. The service user was duly
re-admitted on 26 September 2020 and his OT care transferred to another
Senior OT, Claudine Lewin.

21. The referral form also stated that the Health Board completed its internal
investigation, which led to a Disciplinary Hearing on 6 August 2020. At the
hearing, the allegations of gross misconduct involving Service User B were
upheld. A final written warning was placed on the Registrant’s file to stay
live for two years.

22. On 14 April 2021, the HCPC received a further referral from the Health
Board regarding the Registrant, by way of email. The email confirmed that
a further allegation of gross misconduct involving Service User A was
being investigated following a concern raised in early January 2021.

23. On 6 August 2021, and following a request for further information
regarding this referral, Rhian Giles provided Blake Morgan with the
Disciplinary Hearing Outcome letter dated 29 July 2021.

24. Within the letter, it was noted that the Registrant was the Senior OT on
duty on 14 December 2020. There was a request received for a Duty OT to visit Service User A's property to conduct a manual handling assessment. The Registrant undertook the home visit that day. There  would be an expectation that, prior to any visit, there would be a
conversation with the service user or their family regarding Covid-19 related risks, and any previous risk assessments available reviewed. It was necessary to record details of the visit on FLO. However, there is no such evidence that these arrangements were made.

25. During the visit, no risk assessment was carried out or, if it was, no record
of it was made. The "What Matters" document, designed to confirm the
service user's level of function and the risks and equipment in their home,
was also not updated. During the visit, the Registrant became aware that
the live-in carer had recently changed and that the manual handling
technique that she observed was not in accordance with the Wales
Manual Handling passport. The expectation is that having witnessed that,
the Registrant should have a conversation with the care agency and make
a safeguarding referral, neither of which she did.

26. The Registrant identified an issue with the Mackworth hoist and agreed to
return on 15 December 2020 to resolve it. That issue should have been
risk assessed and resolved on 14 December 2020.

27. As part of the HCPC's investigation into these matters, witness statements
were obtained from the following:
a) Rhian Giles, Clinical Lead;
b) Nicola Pendry, Team Lead OT;
c) Eleri Price, Deputy OT;
d) Hannah Henson, Investigating Officer; and
e) Claudine Lewin, Band 6 OT.

28. On 23 March 2023, the Registrant's representative emailed outlining that,
as the Registrant had left the profession and did not intend on returning,
she would likely be looking to come off the HCPC's Register and would
apply for voluntary removal.

29. On 12 May 2023, and following a panel of the Investigating Committee
determining that the Registrant had a case to answer, the Registrant's
representative was asked to clarify if it was, at that time, the Registrant's
intention to be removed from the Register. It was confirmed by the
Registrant's representative on 16 May 2023 that the Registrant was still
seeking voluntary removal.

30. On 23 May 2023, the Registrant was sent information on the process for
voluntary removal, including a copy of the HCPTS's Practice Note on
consensual disposals (“the Practice Note”) and the consensual disposal
request pro-forma.

31. On 13 June 2023, a copy of the completed and signed form was sent back
by the Registrant's representative, together with supplementary
information.

32. Following the scheduling of this voluntary removal hearing, a voluntary
removal agreement was drafted and sent to the Registrant's representative
on 2 November 2023, which the Registrant returned signed on 17
November 2023.

HCPC Submissions
33. In support of the application, the HCPC has submitted a skeleton
argument dated 29 November 2023. The HCPC submitted that, in all the
circumstances, voluntary removal from the Register is an appropriate
means of resolving the matter.

34. The HCPC highlighted in support of the Registrant's application for
voluntary removal that:
a) The Registrant has had the opportunity to review the voluntary removal
process, consider its implications and understand her decision to
proceed with it;
b) The Registrant has made full admissions in relation to the current
allegations;
c) The Registrant has cooperated with the HCPC throughout the
investigation; and
d) The Registrant has no plans to return to practise as an OT.

35. The Practice Note sets out two matters that a Panel should be satisfied of
before agreeing to resolve a case by consent:
a) Firstly, that the appropriate level of public protection is being secured;
and
b) Secondly, that doing so would not be detrimental to the wider public
interest.

Public Protection
36. Given that the agreement signed by the Registrant has the equivalent
effect of a striking off order, the Registrant will no longer be able to
practise as or use the title of a Registered OT.
37. Should the Registrant wish 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 the allegations before her.
38. The HCPC submitted that the necessary public protection would be
ensured by allowing the Registrant's application for removal from the
Register.

Public Interest
39. The HCPC submitted that it would not be detrimental to the wider public
interest to dispose of this matter by way of voluntary removal.
40. The Registrant has admitted that her actions, as outlined in the allegation,
amount to misconduct.

41. Furthermore, given the Registrant has no desire to return to practise, the
HCPC submitted that it would be fair and proportionate to allow her to
come off the Register by way of voluntary removal.

42. A final hearing would allow members of the public to hear the details of the
Registrant’s admitted conduct. However, it was submitted that this public
interest is outweighed by the efficiency of disposing of this case through a
voluntary removal agreement. Public confidence in the regulator is
strengthened by the efficient removal of Registrants who have admitted
their conduct and do not intend to return to return to practise.

43. The Registrant has admitted the substance of the allegation and that
voluntary removal from the Register will have the same effect as a striking
off order. The HCPC noted that the order to remove the Registrant from
the Register is published and made available for members of the public to
view. Accordingly, the public interest is protected in that voluntary removal
does not deviate from the position that decisions of the regulator at final
hearings are made public.

44. It is submitted that these factors are sufficient to maintain public
confidence in the profession and to declare and uphold proper standards
of behaviour.

Decision

45. The Panel considered all the documentation presented to it together with
the HCPC’s submissions. The skeleton argument outlined the
circumstances that led to the referral to the HCPC and submitted that a
VRA was the appropriate method of finalising this case. In her written
correspondence, and that written on her behalf, the Registrant has fully
admitted the factual particulars and that her fitness to practise was
impaired because of her misconduct. The HCPC was satisfied that the
Registrant fully understood the effect of the VRA and that granting the
application would not compromise the protection of the public or have any
detrimental effect on the wider public interest.

46. The Panel has seen various emails from the Registrant and her
representative from which it is clear that that she accepts the findings
made against her and that her fitness to practise remains impaired. She
has stated that she has no intention of practising as an OT in the future.
As a result, she has requested voluntary removal from the HCPC Register.

47. The Panel accepted the advice of the Legal Assessor and considered all
of the evidence presented. The Panel has applied its own judgement to
the application to withdraw the allegation and to discontinue these
proceedings. The Panel has also had regard to the Practice Note.

48. The Panel has had regard to the Registrant’s comprehensive ‘Consensual
Disposal Request Additional Information’ form in which she stated:

“As a Registered Occupational Therapist I fully accept that I am
responsible to my professional body and to those individuals I work with
for my actions and omissions. This is a responsibility I have always taken
seriously and feel regret for failings that have placed individuals at
increased risk….

I failed to conduct a fresh occupational therapy risk assessment at the
point of their admission. I also did not make sufficient notes regarding the
care required prior to Service User B's discharge from hospital. I did not
order the correct hoist and sling and ensure there were slide sheets in
Service User B’s property on discharge. This failure to provide the
adequate level of care to Service User B led to them being readmitted to
hospital on the day of discharge….

I am very sorry that my actions and omissions led to Service user B and
his family experiencing anxiety and distress about being readmitted to
hospital. It meant a lot of additional and unnecessary cost to the health board, and additional work for people in my team who worked with him
following readmission….

As a Registered occupational therapist, I am aware of the professional
obligation to maintain accurate records and I failed to do this….
I accept that this incident occurred because of my lack of fitness to
practice due to mis conduct, however this was not intentional and I feel
great shame and disgrace about what has happened. I was dismissed
from my role as Senior Occupational Therapist in July 2021 and I have not
worked as an Occupational Therapist since this time. I understand the
impact of my actions and omissions and truly regret them. Following great
inner searching and reflection I cannot explain my failure to provide an
adequate level of care or why this incident occurred.

I recognise that my actions and omissions have had an impact on my
profession. My actions fell short of what was expected of an Occupational
Therapist and negatively impacted on people I was working with. These
people and their family members would therefore have a negative view of
myself as an Occupational Therapist. As a Registered Occupational
Therapist, I demonstrated a poor representation of the profession, having
a negative impact of the professions reputation to the wider public. I am
very sorry for this and I want to make sure I do not negatively impact on
other people and further damage to the reputation of the profession. This
is why I have not continued to practice [sic] as an Occupational
Therapist….

I recognise that I have fallen short in my clinical practice and accept the
allegations are true. The process of the disciplinary investigations, being
dismissed for gross misconduct and no longer working as an Occupational
Therapist has been a very difficult process for me. Since this happened I
have come to terms with not working as an Occupational Therapist
anymore and feel that this is a robust way of ensuring no further incidents
happen because of my actions….

My career has taken a different path since the incidents occurred. I have
ambitions for my future career to involve working in leadership and
management roles. I will not return to work as an Occupational Therapist
in the future.

By requesting voluntary removal, I am protecting the public by no longer
working as an Occupational therapist. This will therefore eliminate the risk
of repetition.”

49. The Panel has before it a VRA that has been agreed between the HCPC
and the Registrant. It was signed and executed by both parties in terms of
which the Registrant admitted the allegations which had been made
against her and that her fitness to practise is impaired. She agreed that
she will resign from the HCPC Register on the terms and conditions fully
set out in that agreement. The Registrant also signed a declaration that
there was no other matter of which the Registrant was aware which might
give rise to any other allegation.

50. The Panel noted that the HCPC is satisfied that it would be meeting its
statutory objective of protecting the public and the public interest, if the
Registrant was permitted to be removed from the Register on similar terms
to those which would apply if she were subject to a striking off order under
article 29(5) of the Health Professions Order 2001.

51. The Panel considered whether there were any factors that would make it
undesirable to allow the allegation to be concluded on the consensual
basis set out in the VRA. The Registrant has unequivocally indicated that
she is no longer practising as an OT and that she no longer wishes to
remain in the profession. Taking the above into consideration, the Panel
concluded that there are no overriding public interest factors that would
make the Registrant’s voluntary removal from the Register inappropriate.

52. The Panel understands that the Registrant is aware that if she seeks to
return to the HCPC Register at any time in the future, her application
would be treated as if she had been struck off as a result of the allegation.

53. In all the circumstances, the Panel is satisfied that both the public and the
public interest would be adequately protected by the terms of the
agreement reached between the Registrant and the HCPC in as much as
the Registrant will henceforth be prevented from practising as an OT.

54. Furthermore, the Panel is satisfied that this method of finalising this case
is appropriate and proportionate, and is jointly in the interest of the public,
the HCPC and the Registrant. Accordingly, the Panel approves the
Voluntary Removal Agreement and the discontinuance of proceedings

ORDER: The Registrar is directed to remove the name of Ms Rebekah Gibson from the Register with immediate effect.

No notes available

History of Hearings for Rebekah Gibson