Tracy Hogg

Preliminary Matters
Application to proceed in private
1. Ms Hogg applied for part of the hearing to be heard in private on that basis that she would be providing evidence relating to her health and family circumstances.

2. Mr Moran supported the application.

3. The Panel accepted the advice of the Legal Assessor, which included reference to Rule 10(1)(a) of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 as amended (“the Rules”), which states that:
“the proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice or for the protection of the private life of the registrant, the complainant, any person giving evidence or of any patient or client, the public should be excluded from all or part of the hearing”.

4. The Panel concluded that any parts of the hearing relating to Ms Hogg’s private life should be heard in private.

Admission
5. Ms Hogg admitted Particular 1.

Background
6. On 15 February 2021 the HCPC received a referral from the Registrant.

7. The Registrant had been convicted by the South Cheshire Magistrates Court, on 10 February 2021, for failing to provide a specimen of blood on 25 December 2019, without reasonable excuse and when required to do so, when suspected of having driven a vehicle. She was disqualified for a period of 18 months, reduced to 18 weeks if by 5 February 2021 she satisfactorily completed a course approved by the Secretary of State.

8. The facts lying behind the conviction are that between 1am and 2am on 25 December 2019, the Registrant drove her car into a crash barrier located between a motorway and a slip road, causing her car to overturn. She was freed from the driver’s seat with the assistance of fire and ambulance staff and was breathalysed. She provided a positive reading of 75. She was conveyed by ambulance to hospital, with a suspected fractured collar bone. At approximately 3am a blood sample was requested of her by the police, which she refused.

Decision on Facts and Grounds
9. The Panel accepted the Advice of the Legal Assessor, which included reference to Rule 10(1)(d) which states:
“where the registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction ….shall be admissible as proof of that conviction and of the findings of fact upon which it was based”.

10. The Panel found Particular 1 proved on the basis of the Memorandum of Conviction, supported by the police documentation and Ms Hogg’s admission.

Evidence on Impairment
11. The Registrant informed the Panel that she had worked for her current employer, CWP, as a physiotherapist, within the integrated Community Care Team, for approximately 12 years.

12. The Registrant said that her actions had been out of character and that she was deeply sorry.

13. The Registrant said that when she crashed into the barrier, no other cars had been involved. She said that she was then placed on a spinal board and was transferred to hospital with a fractured shoulder. She said that whilst she accepted that she had refused a blood specimen, she had been in shock at the time and had been unable to take in what was being asked of her. She said that she now understood why she needed to supply the sample.

14. The Registrant said that following the incident she remained off work until the start of 2021. However on returning to work she had become a valued member of the team once more.

15. She explained that she is now working full-time for her Community Care Team and is a Mental Health Team Resilience Based Supervisor, which involved taking part in group discussions to improve wellbeing and mental health within the team. She said that she was the only physiotherapist on the team. In her written statement she said:
“I absolutely love my job; I can’t express how much. I love helping people, listening, and making their life better where ever I possibly can”.

16. When asked by the Panel what a member of the public would be likely to think on hearing about her conviction, she said that if made aware of the mitigating circumstances and of fact that this was an isolated event that had occurred some three years ago, and that she had provided a high quality of care since, the public would be likely to conclude that her fitness to practise is not impaired.

17. At her request, the Registrant was provided with time during the hearing to seek workplace references. She obtained references from two workplace referees, both of whom confirmed that they were aware of the allegation that had been brought by the HCPC and the details of it.

18. JW, Clinical Lead, OT Community Care Team stated:
“I have known Tracy for 6 years in my role as Clinical Lead Occupational Therapist, Cheshire and Wirral Partnership. I have had an overview of Tracy’s work and competence to practice for this period of time and have worked closely with her direct line manager to ensure her professional
practice is of a high standard.
I can confirm that Tracy works to an extremely high standard. She has well established, advanced clinical skills and works up to and beyond the level of professional practice required of her role.
Tracy had a sustained period of ill health and on her return to work was supported by myself to return to practice. She followed all guidance and proved herself to be capable of returning to work at band 6 level.
Tracy is a well liked and respected member of the team and is often asked to share her knowledge with colleagues. She takes responsibility for her own workload and provides support and supervision to therapy assistant staff.
I would have no hesitation in recommending Tracy and indeed have interviewed her for a move to another team which she successfully completed”.

19. HF, Band 6 physiotherapist, stated:
“I have known Tracy for 15 years both personally and professionally
On her return to work after her period of absence I supervised Tracy on a weekly basis to offer support and ensure high standards of practice were met.
Tracy manages her own caseload efficiently and demonstrates high patient care.
Tracy supervises other members of staff and is extremely supportive to all colleagues and members of the MDT.
As an Educator, Tracy has supported many Physiotherapy students, enabling them to gain experience in assessing and treating patients within the community.
Tracy is well respected and is a valued member within the Community Care Team”.

Submissions on Impairment
20. Mr Moran accepted that the Registrant had not posed a risk of harm to members of the public in the past and would not pose such a risk in future. However he submitted that a finding of impairment was required to maintain and uphold standards and confidence in the profession in light of the seriousness of the conviction. He submitted that the Registrant’s insight was limited.

21. Ms Hogg submitted that this had been an isolated incident in an otherwise unblemished career. She submitted that a member of the profession or public would take the view that a finding of impairment was not required in light of the mitigating circumstance, the period of time that had passed since the allegation, her previous good character and her good standard of care at work.

Decision on Impairment
22. The Panel accepted the advice of the Legal Assessor, who advised the Panel to consider the first criteria set out in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Paula Grant [2011] EWHC 927.

23. In accordance with the case of Cohen v General Medical Council [2008] EWHC 581, the Legal Assessor advised the Panel to ask whether the Registrant’s conduct is easily remediable, whether it has in fact been remedied, and whether it is highly unlikely to be repeated. However she reminded the Panel that the issue of remediation is of less relevance in cases involving public interest issues in the absence of public protection issues. She advised the Panel to consider whether the behaviour which lay behind the Registrant’s conviction could be regarded as an isolated incident in an otherwise unblemished career and whether the Registrant had demonstrated genuine insight into her past behaviour. She advised the Panel to ask whether the need to uphold proper professional standards and public confidence in the Registrant, her profession, and her Regulator, would be undermined if a finding of impairment of fitness to practise were not made in the circumstances of the case.

24. The Panel accepted that there was no suggestion that a finding of impairment was required to protect the public. The HCPC did not assert that the Registrant had in the past or was liable in the future to act so as to cause harm to members of the public, and the Panel accepted this.

25. The Panel accepted that the behaviour that led to the conviction was an isolated incident that had occurred some 3 years ago in the context of an otherwise unblemished career.

26. The Panel also accepted that the Registrant is a good clinician. She had provided evidence in the form of two workplace testimonials confirming that she is a physiotherapist with an excellent clinical record. The Panel took account of the fact that the public interest can include allowing a good practitioner to continue in practice.

27. However the Panel concluded that the Registrant’s conviction was serious. She had refused to supply a blood sample requested by a person in authority, namely a police officer, thereby breaching a fundamental tenet of the profession and bringing the profession into disrepute. The Panel concluded that she had not demonstrated full insight into her past behaviour. In her written submissions and oral evidence she had expressed remorse for what had taken place, but she had provided no evidence to suggest that she understood the importance of her actions and the adverse effect that her conviction would have on the standing of her profession and regulator, despite being given ample opportunity in which to do so.

28. The Panel concluded that the need to uphold proper professional standards and maintain confidence in the profession and its Regulator demands a finding of impairment in the circumstances.

29. Accordingly, the Panel found the Registrant’s fitness to practise is currently impaired on public interest grounds.

Additional evidence on Sanction
30. The Panel handed down its decision on impairment on 23 May 2023. On 30 June 2023 the Panel reconvened to consider the issue of Sanction.

31. By then the Registrant had provided further documentation for the Panel to consider, namely:
• A reflective statement
• A further character reference, dated 13 May 2023, from HF, Band 6 Physiotherapist, stating that the Registrant is a valued member of the Community Care Team, and confirming the personal circumstances that the Registrant said she had been experiencing at the time of the Allegation.
• A character reference from CP, CCT Manager of the Trust
• A Certificate of Completion of an Approved Drink-Driver Offenders Course, dated 31 January 2022
• A Certificate of Attendance on a one day online Adult MHFA course, dated 30 March 2023, providing the Registrant with the title of Mental Health First Aid Champion
• A certificate dated 30 May 2023 confirming completion of a course in Resilience Based Clinical Supervision
• An Absence from Work Summary, confirming that since her return to work with the Trust in December 2020 the Registrant had taken only 3 days sickness leave, and that was due to a chest infection

32. In her reflective statement the Registrant stated, in relation to the Drink Driver Offenders Course:
“I learned so much on this course regarding the effects of such behaviour I was responsible for. On reflection it could have caused devastating consequences to other peoples lives.
The acceptance of this has reaffirmed my personal values and the acceptance of the responsibility for the offence committed……
I did not realise at the time the importance of the blood test or the implications of refusing. I feel that the information provided to me at the time was unclear….
I have often reflected on this incident since it occurred and I am very remorseful about it….
Also, I thought about what would my colleagues and peers would think of my actions and whether it would affect my professional relationship with my patients, would they trust me as a physiotherapist, would they feel comfortable knowing what I had done?...
At that time there were mitigating circumstances surrounding my actions which led me to behave “out of character”….
I am continuing to demonstrate mitigation through CPD, especially within mental health, close supervision and reflection.
I work 30 hour maintaining per week in a physiotherapy role in a community setting. I am respected and deliver a high standard of care, making a difference for the quality of life and function to the patients.
I am passionate about my role and truly enjoy caring for others and making a difference in their lives; I hope you allow me to do so”.

33. In oral evidence the Registrant explained that whilst she had informed the Panel at the impairment stage that she was of previous good character, this was incorrect. She said that she had been referring to the period of time prior to her disqualification. She disclosed to the Panel that following her conviction for refusing a blood sample, she had been convicted for a public order offence, for which she had been fined. She said that on 14 November 2021, she fell down the stairs when intoxicated. She said she banged her head, knocking herself unconscious, On the arrival of the police, she swore at them, as a result of which she was charged with a public order offence, to which she entered a plea of guilty at the Magistrates Court.

Submissions on Sanction
34. Mr Moran submitted that a short period of suspension was the appropriate sanction, taking into account the seriousness of the conviction, aggravated by the fact that the Registrant had informed the Panel at the impairment stage that she was of previous good character when in fact she was not.

35. The Registrant relied on the factors set out in her written and oral evidence and asked the Panel to impose a Caution Order.

Decision on Sanction
36. The Panel accepted the advice of the Legal Assessor, and took into account the current Sanctions Policy published by the HCPC. The Panel kept in mind that the purpose of sanction is not to be punitive but is to protect the public and the wider public interest. The Panel understood that it should apply the principle of proportionality, by weighing the Registrant’s interests against the need to protect the public and the wider public interest, with a view to applying the least restrictive sanction available to meet those needs. The Panel accepted the advice of the Legal Assessor on the relevance of the Registrant’s evidence at the impairment stage regarding her character. The Legal Assessor had advised, in accordance with the case of Haydar Al-Nageim v GMC [2021] EWHC 877, that the Registrant’s evidence in this regard would be relevant to the issue of insight if the Registrant had sought to deliberately mislead.

37. The Panel concluded that the Registrant’s reference to “good character” at the impairment stage had been an innocent error on her part and not the result of a deliberate intention to mislead. The Panel took note of the fact that she had not had the benefit of legal representation. The Panel concluded that when the Registrant had said she was of previous good character, she had intended to refer to the period of her life pre-dating her disqualification for refusing to give blood; it had been around that time that her life had taken a downwards turn.

38. The Panel regarded the Registrant’s second conviction to be an aggravating factor; for a second time she had displayed an obstructive attitude towards the police after she accepted she had consumed alcohol.

39. The Panel concluded that the Registrant’s behaviour was mitigated by the personal circumstances that she faced at the time; by her admission of her conviction; by her remorse; by her remediation in the form of self-help groups and work supervision; and by her insight, which had now progressed to a stage where she properly understands the importance of her past actions and the effect they have on public confidence in the profession.

40. The Panel reminded itself of its finding at the impairment stage that there are no public protection concerns.

41. The Panel concluded that the majority of factors set out in Paragraph 101 of the Sanctions Guidance, indicating the appropriateness of a Caution Order, are now all present, namely:
• There is a low risk of recurrence,
• the Registrant has shown good insight and
• the Registrant has taken appropriate remedial action.

42. The Panel accepted that this could not be regarded as an isolated incident in light of the fact that the Registrant has a conviction for a public order offence involving an obstructive attitude towards the police.

43. The Panel was heavily influenced by the fact that the Registrant is clearly a good clinician, as demonstrated by her evidence and by testimonials sent in on her behalf. Taking that and all the mitigating circumstances into account, the Panel concluded a Caution Order is sufficient to maintain standards of professional conduct and uphold public confidence in the profession.

44. The Panel concluded that a Conditions of Practice Order would be inappropriate in light of the nature of the conviction. The Panel concluded that a Suspension Order would be disproportionate in light of the lack of risk to patient harm, the mitigating factors and the fact that the Registrant is a good clinician who has remained in practice since December 2020.

45. In considering the length of order, the Panel concluded that a period of 5 years was required in light of the seriousness of the conviction together with the aggravating factor of a second conviction in 2021.

46. Accordingly, the Panel imposed a Caution Order for a period of 5 years.

That the Registrar is directed to place a 5 year Caution Order against the name of Ms Tracy Hogg from the date this order comes into effect.

The order will apply on the expiry of the appeal period.

Right of Appeal
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

You may appeal to the County Court against the HCPC’s decision to do so. Any appeal must be made within 28 days of the date when this notice is served on you. This right of appeal is separate from your right to appeal against the decision and order of the Panel.

Interim Order
47. Mr Moran did not apply for an Interim Order.

48. The Panel also concluded that an Interim Order is not necessary in the circumstances.

History of Hearings for Tracy Hogg