Graham Flatman

Preliminary Matters

Amendment

1. At the commencement of the hearing Mr Jotangia applied to amend the Allegation as follows.

(a) By removal of the words ‘and Educational Psychologist’ in the head of the Allegations;

(b) Deletion the word ‘inappropriately’ where it occurred in the existing Allegation 1, 2,3 and 5.

(c) Change the word ‘provide’ in Allegation 1 to ‘prepare’.

(d) Change the words ‘You reported your opinion and/or commented on the diagnosis of a personality disorder which is matter for psychiatric expertise’ where they occurred in the current Allegation 3 to a stand-alone Allegation 4 and re-number the existing Allegations 4 and 5 as 5 and 6.

2. Mr Jotangia told the Panel that the proposed amendments would result in the Allegation reflecting the expert evidence and submitted that the Registrant would suffer no prejudice if the application were granted.

3. Mr Cridland did not oppose the application.

4. The Panel accepted the advice of the Legal Assessor.

5. The Panel was satisfied that the proposed amendments did not expand the Allegations or vary the regulatory concerns arising from them. The Panel was further satisfied that the Registrant would suffer no prejudice if the Allegations were amended as proposed.

6. The Panel therefore granted the application.

Background

7. The Registrant is registered with the HCPC as a Practitioner Psychologist (Educational). It is alleged that on or around 30 April 2018, the Registrant was instructed as a single joint expert on behalf of all parties in the family proceedings via Mander Cruickshank Solicitors. He was instructed to conduct a psychological assessment of Service User A, (SUA), for the purposes of preparing an expert report as a Clinical Psychologist in family proceedings.

8. It is further alleged between 30 April and 13 June 2018 the Registrant conducted a clinical psychological assessment of SUA pursuant to these instructions.

9. Following the Registrant’s assessment of SUA she raised concerns regarding the Registrant’s conduct. It is alleged that the Registrant had acted outside of the scope of his practice by conducting a psychological assessment.

10. SUA alleged that due to these concerns, the Registrant’s expert report, submitted in the family proceedings was invalid.

11. SUA referred her concerns regarding the Registrant’s conduct to the HCPC on 21 August 2019.

Witness Evidence

12. The Panel heard live evidence from Dr Alwin on behalf of the HCPC and from the Registrant, Dr Hymans and LM on behalf of the Registrant. The Panel also had witness statements before it from AM and LZ on behalf of the HCPC. The Panel also had document bundles from the HCPC and the Registrant and further documentation was provided on behalf of the Registrant during the progress of the hearing at the request of the Panel.

Dr Alwin

13. Dr Alwin took the affirmation, confirmed the terms of his expert report and adopted it as his evidence in chief.

14. Dr Alwin confirmed that he had had sight of the Court Order made pursuant to a case management hearing on 28 April 2018 requiring a report to be provided by a Clinical Psychologist in relation to SUA. He stated that it appeared that the Court was looking for a psychological assessment of SUA and that this was generally the field of a Clinical Psychologist, but that the nature of the psychological speciality required might not be fully appreciated by “the legal world”.

15. In his report Dr Alwin noted that from the Registrant’s registration with the HCPC and from the CV attached to the Registrant’s report in question, that he was qualified and registered as an Educational Psychologist. He stated that there was no indication the Registrant had undertaken clinical psychology training. Dr Alwin opined that consequently the Registrant was not qualified to accept an instruction based on a Court Order referring to him as a Clinical Psychologist. Dr Alwin further opined that the Registrant lacked sufficient training to function as a Clinical Psychologist and that he did not consider it was appropriate for the Registrant to accept instructions from the Court where it was specified that a Clinical Psychologist was needed to provide an expert report.

16. Dr Alwin also indicated in his report that he had concerns as to how an Educational Psychologist with no apparent further training or clinical experience in expert assessments of adults could have acquired the necessary skills or competence to complete an assessment on an individual over the age of 19, or an individual with learning disabilities over the age of 25.

17. In relation to the Registrant’s assessment of SUA, Dr Alwin opined that he did not consider it was appropriate for the Registrant to conduct a clinical psychological assessment of SUA but accepted that he would be likely to be competent in the use of the Weschler Adult Intelligence Scale (WAIS), which was the cognitive assessment tool used by the Registrant.

18. Dr Alwin explained that the MCMI-III is a specialist assessment of personality disorder developed for use in clinical settings by clinicians trained in the use of personality assessments. He stated that the MCMI-III tended to be used by Clinical Psychologists and Forensic Psychologists with a special interest in personality disorders who have developed expertise in the use of personality assessments as part of their clinical specialty. Dr Alwin opined that there was nothing contained in the Registrant’s CV to indicate he had developed a special interest in personality disorders or the application of personality testing to adults in clinical settings. Dr Alwin therefore further opined that the Registrant would be unlikely to have the requisite experience and expertise to use the MCMI-III in his assessment of SUA.

19. Dr Alwin further opined that he had concerns that, in providing an opinion regarding the MCMI-III, the Registrant did not set the results of the personality testing within the formulation of the individual’s functioning. Dr Aldwin explained that it was apparent from the information available that SUA had a complex family history, with reports she witnessed domestic violence and experienced a chaotic childhood environment that included being subjected to sexual abuse. There were also reports that in adulthood SUA had been subject to domestic abuse in her adult relationships, was seen to be vulnerable and to form relationships quickly in which there were concerns she was vulnerable to control. This would lead to a formulation in which SUA’s experience of a chaotic childhood involving abuse and adult functioning was characterised by vulnerability to domestic abuse and control. Dr Alwin opined that it was difficult to see how this outline of these known characteristics of SUA fitted with the diagnostic criteria for Narcissistic Personality Disorder. Dr Alwin noted that in his report the Registrant stated, “In attempting to cope she centred on herself, naturally and imaginatively seeking to make sense of the world around since this was chaotic, traumatic and essentially unfathomable”. Dr Alwin also stated that he considered there needed to be a greater focus upon the lived experience of SUA and how this would be consistent with a diagnosis of Narcissism. He further noted that the Registrant stated SUA was not experiencing any mental disorder but there was no report of any tests of mental disorder other than the outline of the findings of the MCMI III. He opined that he would have expected an assessment of current mental health symptomatology, such as the Symptom Check List 90 Revised, the Hospital Anxiety and Depression Scale or a selection of the Beck inventories which would have been used to identify mental health problems. Dr Alwin commented in his report that he considered it notable that the Registrant’s report did not give the results for the MCMI-III Clinical Syndromes Scales, which could outline any issues with current mental health distress.

20. Dr Alwin also stated that in his view the Registrant had formed his opinion without access to SUA’s medical records, which given her history, would be likely to contain information of use in developing a formulation of her functioning. Dr Alwin accepted that he did not know whether the Registrant had made attempts to access the medical records but would have expected a statement in the report that his views could be affected by information within the medical records. He referred to Understanding Personality Disorder: The Report by the British Psychological Society Feb 2006 where it was recommended assessments of personality should draw upon a range of sources, which in Family Court instructions generally comprise of self-reporting, documents made available and psychometric testing. Dr Alwin opined that in the Registrant’s assessment he had applied the personality characteristics identified as an explanatory factor in SUA’s behaviour rather than setting the findings of the personality testing within an overall formulation based upon psychometrics, self-report and the documents made available. He opined that this made it difficult to identify how SUA’s behaviour had developed over time, what had led SUA to develop the personality characteristics identified and what impact these personality characteristics played in her beliefs, attitudes and behaviour. This in turn made it difficult to provide a coherent formulation that would inform responses to the specific matters the Registrant was required to address as per the letter of instruction and present an accurate impression of SUA’s lived experience.

21. Dr Alwin concluded that the Registrant was not appropriately qualified to provide a psychological report for SUA. In addition, there was nothing in the CV of the Registrant to indicate that they had developed the necessary skills and expertise in the assessment of adults. It was therefore not appropriate for the Registrant to produce a written report in respect of SUA and that in acting as he did the Registrant had acted outside the scope of his practice.

22. In answer to supplementary questions from Mr Jotangia, Dr Alwin explained the differentiation between an Educational Psychologist and a Clinical Psychologist , in particular that an Educational Psychologist was only qualified to assess individuals under the age of 19 or if they had learning difficulties up to 25. He confirmed his view that the Registrant did not have the requisite training to carry out the assessment required by the Court.

23. Dr Alwin told the Panel that when dealing with individuals such as SUA reliance could not be placed on the individual self-reporting and that the Registrant had provided no clear robust formulation. Dr Alwin explained that MCMI-III was a tool normally used in clinical settings and in non-clinical settings it gave rise to underreporting and this affected the scores obtained from it. He explained that in his report the Registrant had noted that SUA had scored highly in relation to narcissism and had written that she was very narcissistic. Dr Alwin said SUA’s personal history and presentation did not fit the picture of narcissistic personality and it was unfortunate her problems had been ascribed to this.

24. In cross examination Dr Alwin accepted that he had not had the Registrant’s statement or Dr Hymans’ report before him when he provided his report, but that he had now seen them, and it had not caused him to change his views. In reply to a suggestion that the distinction between what a Clinical Psychologist and an Educational Psychologist could do had become blurred, Dr Alwin accepted that the distinction might be blurred to the legal profession, but that it was a practitioner’s responsibility to make sure he worked within the parameters of his specialism. He accepted that an Educational Psychologist might gain qualifications and experience in relation to the assessment of adults, but stressed that further clinical training in relation to adults had to be demonstrated. He explained that although it might be possible for an Educational Psychologist to assess adults over the age of 25, and indeed some of them may have been doing so for decades it would not be possible to establish their competency in doing so unless there was evidence of relevant training, review and experience.

25. Dr Alwin maintained in cross examination that the Registrant should have raised that he was not a Clinical Psychologist when he first received the letter of instruction and the Court Order. He further maintained that the Registrant’s report lacked formulation as to how information had been used to reach conclusions and expressed concern that conclusions had been reached without the Registrant having considered SUA’s medical records. He reiterated that it was not just the use of the MCMI-III that caused concern but how the result had been interpreted.

26. Dr Alwin did not accept that there was merely a difference of professional opinion between himself and the Registrant. He maintained his opinion was based on established principles, literature and research.

27. When referred to Allegation 4 in cross-examination, Dr Alwin stated that the Registrant had not made a diagnosis of a personality disorder and that he did not support this Allegation.

The Registrant

28. The Registrant was sworn in by the Hearings Officer, took the Oath and adopted his statement as his evidence in-chief.

29. The Registrant set out his academic and professional practice. He told the Panel that he had initially practised as a trainee Educational Psychologist in Gravesend and had qualified as an Educational Psychologist in 1976. He became a Chartered Psychologist on 15 March 1989 and an Associate Fellow of the British Psychological Society on 3 May 1990.

30. The Registrant explained to the Panel that he held a BSc. Hons in Psychology from Durham University (1970), PGCE, Durham University (1971) (Distinction in Teaching), M.Sc. in Psychology and Education with Clinical Studies from the University of London (1976), Diploma in Ericksonian Hypnosis, Psychotherapy Neurolinguistic Programming Institute of Education (1976) (Distinction in Neurolinguistic Programming (British Hypnosis Research) (1995) (adult training). He said he also held the Cardiff Family Law School Bond Solon Expert Witness qualification (2006), and the Cardiff University Accredited Expert Witness (Family) (2018) and had completed the Bond Solon Update to Part 35 of the Civil Procedure Rules (2009).

31. The Registrant said he was on the BPS register and the UK register of expert witnesses as a vetted expert, was registered with 'Expert Witness', a directory of experts and is included on the Witness Directory' of vetted experts.

32. The Registrant told the Panel that he was experienced in assessing and treating a wide range of psychological conditions in children, adults and families alike and had been undertaking this work for 49 years. He explained that as a Local Authority Educational Psychologist, he worked with children, adults and families in Local Authority Education Authorities from 1974 to 1990. During this period, He worked for Kent County Council (5 years) and the Inner London Education Authority (ILEA) (12 years).

33. He explained his role as a Local Authority Educational Psychologist spanning 17 years, involved work as part of a multi-disciplinary team initially in child guidance clinics and then Departments of Child and Family Psychiatry, which are now known as CAMHS.

34. The Registrant explained that whilst working as an Educational psychologist in ILEA, He was part of a limited number of psychologists who additionally worked at the Ebury Centre in London, where children and families with especially significant and complex learning difficulties were referred by any one of the ten London Boroughs. He stated that he considered that he had gained a great deal of experience in specialist diagnosis and assessment of learning difficulties, within families.

35. The Registrant told the Panel that he set up his own private practice in 1990 and had been running this clinic for over 30 years, offering assessment and treatment to children and families, as well as exclusively assessing and treating hundreds of adults for a range of psychological issues in the absence of children or in the context of any familial relationship. He stated that he had dealt with a significant number of referrals for treatment and assessment of children, adults and families with a range of clinical issues and a number of GP surgeries had requested the Registrant run assessment and treatment clinics for their patients. The Registrant stated he was also asked by Maidstone Psychology Service to run sessional clinics as part of their service to GP practices.

36. The Registrant told the Panel that he was awarded the Diploma in Ericksonian Hypnosis, Psychotherapy and Neurolinguistic Programming (British Hypnosis Research), which was all adult based. He said that within his clinical practice, he developed and used a significant number of treatment methods including CBT, neurolinguistic programming and hypnosis methods for treatment of depression and anxiety conditions, traumas and phobias and provided short, medium and long term treatment and therapy to a large number of adults, the majority of whom have improved considerably.

37. The Registrant said he had been a consultant psychologist for a child fostering agency (Integrated Service Programme, Sittingbourne) from approximately 1995 - 2005, which included Educational assessments, therapy and support training for foster carers. He stated that he had been the consultant psychologist for a probation hostel (from approximately 1995 - 2003), assessing and treating a significant number of late teenage and early adult male offenders and from 2014. He was a consulting psychologist for Symbol Family Support Services that undertakes residential and community-based parenting assessments, including individual psychological assessments of approximately 60 - 80 parents, where psychological status is a factor.

38. The Registrant explained how he had been approached by a children’s guardian in approximately 1997 to become an expert witness in the family Court and that they had said to him “We’ll teach you the ropes”. He started receiving instructions to provide reports to courts and had been instructed in approximately six cases a month, therefore seventy to eighty new family law cases a year. His CV, qualifications and experience are fully notified, and the Court has total discretion as to which expert is to be instructed as being appropriate in their particular matter. He said that he had never once been notified of any concerns and since 1997, had provided expert witness evidence in approximately 1,680 family law matters.

39. The Registrant provided the Panel with a record of his CPD and explained to the Panel his understanding of the procedure involved in the instructing of experts and his perception of his duties when instructed as an expert to the Court.

40. He said that it was his understanding that prior to the application for permission to obtain expert evidence, the lead solicitor in each matter made an initial enquiry as to availability and at that stage would raise any queries with regard to qualifications, experience or expertise. The judge either decides that an expert psychological assessment is necessary or not and if it is necessary the specific expert is selected, and it is the lead solicitor's responsibility to ensure that the letter of instruction is accurate in terms of precisely what was decided at court.

41. The Registrant said the lead solicitor sends the letter of instruction, as seen and agreed by all parties and the Court, and this is the point of reference for the expert witness with regard to the background information, what assessment is required, and any specific questions raised. The expert is responsible for raising any queries that might arise from the letter of instruction prior to or during the subsequent assessment.

42. The Registrant explained to the Panel how he had received instruction in relation to preparing a report on SUA. He said his formal instructions were confirmed by letter dated 20 April 2018 which was the only letter of instruction he received. He explained that the letter of instruction also referred to the "attached" Court Order dated 24 April 2018 which obviously did not then exist and there was also a reference to a 'Draft Order' in the bundle, which was unusual.

43. The Registrant stated that he considered he was qualified and competent to carry out this task and reviewed the documents provided to him and carried out an assessment of SUA on 7 June 2018.

44. The Registrant set out what the assessment involved. He stated it involved completing an initial interview, asking SUA basic questions as to her then current status, asking her opinion with regard to her three children and the current legal proceedings, her response to the Local Authority's parenting concerns. He said he also asked her about her personal history, her life story, asking her a number of questions to determine her present state with regard to any significant life issues, mental health issues and asking her about her young child.

45. The Registrant explained that the assessment also involved completing the psychometric tests:

i. Wechsler Adult Intelligence Scale IV (WAIS IV)

ii. Millon Clinical Multiaxial Inventory-III (MCMI-III)

iii. Neale Analysis of Reading Ability - Revised (NARA)

46. The Registrant stated that the psychometric test results only contributed to his overall clinical assessment.

47. The Registrant referred the Panel to his report dated 13 June 2018, and stated he had correctly referred to himself as a 'Chartered Psychologist' and that the report was a "psychological assessment" of SUA. The Registrant told the Panel that he had not, at any time, stated that he had undertaken a "clinical psychological assessment", nor had he described himself as a "Clinical Psychologist". He said he did not consider that he was instructed to carry out a clinical psychological assessment of SUA.

48. The Registrant explained that he was notified by the HCPC of the complaint from SUA relating to his first report on 9 October 2019. He was surprised that there was a complaint because his report dated 13 June 2018 was quite positive regarding SUA.

49. The Registrant stated that at this time he had already been instructed to complete a second report in respect of SUA’s other two children and immediately notified the lead solicitor about SUA's complaint to the HCPC by email. He said he assumed that once he had told the lead solicitor about the complaint, this would then be considered between the parties and the Court and he would be provided with an update as to whether he was to proceed with a second report or not. The Registrant said that the Court confirmed his instruction to complete a second report, this time on SUA's children and that report was subsequently completed and filed on 7 November 2019. He said he was not informed of any other discussions between the parties and the Court regarding the complaint.

50. The Registrant said he gave brief evidence at a Court hearing on 28 September 2020. He said no criticism was made of him, nor were any queries or concerns raised about his skills or expertise by any party. The Registrant said that SUA was a litigant in person at that hearing and would have had the opportunity to voice any concerns directly to the Court, had she wished to. He was not asked any questions about the HCPC complaint. He referred the Panel to a statement written by SUA dated 18 September 2020 where she stated:

“Mr Flatman's report [sic] was extremely positive but it had the added academic quality to it as Mr Flatman is highly regarded by Cafcass as an expert independent witness for doing comprehensive psychological assessments in cases to which his expertise in my application was exactly that to which he has extensive and lengthy experience in.,, Mr Flatman's report / was extremely positive but it had the added academic quality to it as Mr Flatman is highly regarded by Cafcass as an expert independent witness for doing comprehensive psychological assessments in cases to which his expertise in my application was exactly that to which he has extensive and lengthy experience in. And also that Mr Flatman had already done an assessment on myself when / had (redacted) while / was in a mother and baby foster placement unit. So when he not only did another comprehensive assessment but this time with questions in relation to my application for discharge of care order but that he also had a flu history and timeline of me from when he assessed me when (redacted) was just a few months old. So his conclusion on him recommending the children over a transition period be reunited back to my care if the Court so decides and there are no other areas of concern then on this his opinion would be informed not only on the current assessment but on his now more knowledge as to my journey which he comment of me 'exceeding expectations' should be regarded as a substantial. I have made all the significant changes over the last 4 years and have demonstrated consistency on this. Mr Flatman’s psychological assessment has more credentials in forming an expert witness statement for the purposes of the Court then the /SW who lacks the depth of area of expertise and her report is of in my view very poor quality compared to Mr Flatman. If the CG were to ignore Mr Flatman's conclusion nib favour of the ISW's then I think she would have to evidence the reason for this and to demonstrate why Mr Flatman who has extensive knowledge of not just this area but also of my history and his academic expertise has always in the past been used by CAFCASS in cases such as mine and trusted as such for a number of year”.

51. In specific reply to the Allegations the Registrant stated that when he accepted the instructions to provide a report he considered that he was being asked to undertake the type of assessment that he had been instructed to complete, many times, by both this Court and indeed the experienced lead solicitor, namely a psychological assessment and not a clinical psychological assessment. He said he had worked with the lead solicitor on at least four previous cases prior to this instruction, and she was very familiar with his skills and expertise.

52. The Registrant initially told the Panel that he had no recollection of seeing the actual Court Order or any reference to the instruction of a Clinical Psychologist until the complaint was raised with the HCPC. He stated that he considered that the Court Order ‘erroneously’ refers to him as a ‘Clinical Psychologist’. He said he had accepted the instruction as outlined in the letter of instruction from the lead solicitor which did not refer to a clinical psychologist being instructed or ‘clinical psychological assessment’. However, he later accepted that he would have received a copy of the Court Order as he was aware that medical reports were to be provided to him as set out in the Court Order. The Registrant said he no longer had the initial documents accompanying the letter of instruction and thought that either he had not seen the Court Order at the time or he gave it only a cursory glance and clearly missed the reference to him being described as a "Clinical Psychologist". He accepted that he should have seen this document or paid closer attention to it and had he done so would have clarified with the lead solicitor the ‘erroneous’ reference to a Clinical Psychologist.

53. The Registrant stressed that as far as he understood, he was instructed to assess and report on SUA as a psychologist. He further stressed that he did not accept the instructions on the basis that he was a Clinical Psychologist. He noted the Court Order referred to a psychological assessment of SUA at Paragraph 12(a). Paragraphs 12(b) and (c) both refer to a psychological assessment. It is only in two places where the Court Order refers to a 'Clinical Psychologist’. He told the Panel it was his understanding that the reference to a "clinical psychologist" rather than to a psychologist or a "chartered psychologist" was a mistake, and the intention of the parties and the Court was for him to be instructed, rather than for a clinical psychologist to be instructed.

54. The Registrant stated that he had not presented himself as a Clinical Psychologist which he understood is a protected title with the HCPC and he had not undertaken a clinical psychological assessment. He stated that he was not precluded from undertaking psychological assessments of adults, such as SUA, by virtue of being an Educational Psychologist and not a Clinical Psychologist.

55. The Registrant stressed that he had over twenty years' post-qualification experience of working with children and families before he started working as an expert witness and continued to carry out psychological assessments of adults on a regular basis. He maintained that the qualifications and experience section of his statement clearly set out his qualifications and experience to assess adults for psychological assessments.

56. The Registrant stated that he was suitably qualified and experienced in using the MCMI-IlI psychometric test, having a Pearson Clinical qualification level C, He explained that when assessing SUA the test was used in conjunction with clinical interview and information relevant to the instructions and documents provided.

57. The Registrant said it was not his opinion that SUA was likely to have a personality disorder and there was no evidence from the clinical assessment or from MCMI-III that this was the case. He referred to his report where it stated, ‘the diagnosis of personality disorder is a matter for psychiatric expertise.’

58. The Registrant told the Panel that at no time during the assessment of SUA, or in the provision of his report, did he consider that he had worked beyond the scope of his practice. He told the Panel on a number of occasions that what he had been asked to do was to consider all the information before him and identify what had gone wrong and what could be done to assist SUA.

59. In cross examination, when asked about his letter of instruction, the Registrant agreed that the document before the Panel appeared to be a draft and suggested it looked like a ‘rushed job’. He said he had been unable to locate his actual letter of instruction and could not recall what had been sent along with the letter of instruction. He said he would receive a bundle of documents, probably the Court bundle. The Registrant said that he considered he was able to undertake a psychological assessment in a clinical setting as a result of his extensive experience gained over a number of years. The Registrant stated that he considered the differentiation set out by Dr Alwin between a Clinical and Educational Psychologist was too simplistic and that through experience he had extended his scope of practice extensively. When asked about specific training the Registrant referred to his training in Neuro Linguistic Programming and his CPD training.

60. When asked in cross examination about what documents he had seen when assessing SUA, the Registrant stated that he had not been provided with her medical records and therefore may not have been aware of the full background. He explained that there was sometimes a delay in the provision of medical records and that he would have much preferred to have had the medical records. He stated that it was important that he could see them as it was in the Court Order.

61. In relation to the tests the Registrant used, he said he used the MCMI-III “lightly”. With regard to his reference to narcissism, the Registrant stated that he considered that SUA had demonstrated significant egocentric narcissism and had been unable to see beyond her immediate needs. He said his main thoughts were how he could explain to the Court about SUA and what had gone wrong. The Registrant stated it was his view that SUA was obviously vulnerable, had dependency issues, gone through trauma including sexual abuse and that he had found this out from discussion of her history with SUA.

62. Prior to commencing Panel questions, the Panel asked to be provided with copies of the relevant Court Practice Directions for the use of experts in children proceedings and the British Psychological Society (BPS) guidance applicable at the date of the Allegations. In response the Panel was provided with Practice Directions 25 A – F and the BPS Guidelines on Psychologists as Expert Witnesses (2017 Guidance) and the BPS Guidance for Psychologists as Expert Witnesses in the Family Courts: Standards, Competencies and Expectations (2016 Guidance).

63. Having been provided with these documents the Panel confirmed with the parties that they had no further matters they wished to question the Registrant on prior to the Panel commencing its questions.

64. Panel questions did not commence until the following day. In Panel questions the Registrant made reference to having read his personal notes of his evaluation of SUA overnight and the contents of them. He also referred during his evidence to an email from his instructing solicitor. The Panel raised this issue with parties and it was agreed that these documents should also be provided to the Panel. Again, this did not raise the need for any further questioning by Mr Jotangia or Mr Cridland. The additional evidence provided was a 35 page bundle of redacted notes taken by the Registrant during his assessment of SUA as well as a short email exchange between the Registrant and his instructing solicitor.

65. In response to Panel questions the Registrant confirmed he had a supervisor who was a Senior Clinical Psychologist with whom he had general discussions about cases and this had started about 9 or 10 years ago. When asked why he had not used his title of Educational Psychologist in his report the Registrant said he did not have a ‘good answer’ for this question, but overall courts asked for a psychological report and rarely defined a specialism. He said that he was not aware of the BPS Guidance which states that “all psychologists that are eligible to do so should use their protected title”. The Registrant stated that he believed he had not been trying to hide anything by not using his protected title. When asked if he believed that he was acting as an Educational Psychologist when assessing SUA he said that he did. He said that he had regretted not applying to be registered as a Clinical Psychologist at the time of the initial registration of psychologists in 2009. He said he “didn’t think it was a problem”. He said he could not put an exact date on when he started to use MCMI-III but thought it was around 2015, that initially he had gained experience under peer supervision but had also undergone training in its use. The Registrant accepted that when assessing SUA he had yet to undertake such training. He could not provide an explanation why his report did not contain the scores he had obtained when using MCMI-III. He suggested that Family Courts had indicated that reports should be as brief as possible. It was pointed out that, other than his cognitive assessment that there were no other details of what was done or when. The Registrant explained that everything was done on one single occasion and that an assessment might take up to 6 hours.

66. The Registrant accepted that he had not undertaken any specific training for assessment of adults but that he had a great deal of experience in such assessments, particularly since he started his own practice. He stated that he would have preferred to have had SUA’s medical records, but was also aware that “there were things going on behind the scenes”. He said that his instructing solicitor would be able to explain why no medical records had been provided to him.

67. The Registrant was referred by the Panel to the BPS 2016 Guidance and in particular the requirements set out in paragraph 4.9:

“In order, therefore, to provide valid evidence and opinion to the Court, the report has to include sufficient detail to explain, and justify the conclusions drawn, threading together the relevant factors and providing a coherent explanation. A failure to provide coherent evidence is likely to arise if there is an exclusion or over simplification/summarisation of often complex and multiple contributory factors or if the Psychologist is not allowed sufficient access to relevant information and data (e.g. no access to medical records or permission withheld to undertake direct observation) Such circumstances are likely to lead to the requirement for clarification, either by the provision of further written evidence or Court attendance, both of which often cause additional cost and delay”.

The Registrant stated that he believed he had conducted an appropriate assessment, had read all the records available to him and that the Court had accepted his report. He said he “did his very best” to do a competent assessment of SUA and understand her background and presentation, but added “One could always want more evidence”.

68. During Panel questions, the Registrant was referred to Practice Direction 25B ‘The Duties of an Expert’. The Panel referred him to paragraph 9.1 which sets out all the requirements for the contents of an expert report. When asked by the Panel whether his report complied with these requirements he said it did, he had done his best.

69. The Panel also referred him to Practice Direction 25C “Children Proceedings – The Use of Single Joint Experts and the Process Leading to an Expert Being Instructed, or Expert Evidence being Put Before the Court” and he was asked what preliminary enquiries had been made of him by the instructing solicitors and he said it was about his availability and fees. When referred to the letter of instruction and asked how he knew what date he was to provide the report by as this was not contained in the letter the Registrant stated he could not recall. He suggested that as this letter appeared to be a draft the date might be in the final letter he received. The Panel also asked the Registrant how he knew the Court Order directed that he was to be provided with SUA’s medical records, the Registrant stated it was difficult to recall the sequence of events that occurred, but he had seen the reference to medical records in the Court Order. The Registrant also accepted that the reference to the assessment being undertaken by a Clinical Psychologist was in the Court Order and he had not noticed it.

70. The Registrant was referred to the four specific questions in the Letter of Instructions he was asked to answer. He stated that the questions were not specifically framed for either an Educational Psychologist or a Clinical Psychologist but a psychologist with relevant experience.

71. During Panel questions the Registrant confirmed that he could not recall ever being specifically instructed by the Court as an Educational Psychologist. He said that a newly qualified Clinical Psychologist could not have carried out the assessment of SUA and that it was dependent upon experience.

72. The Registrant said that he did not always receive a copy of the Practice Directions when he received instructions, but he was aware of them. The Registrant told the Panel that when providing the report, he had a duty to the HCPC, the Court and those instructing him. The Panel asked whether he had any responsibility to anyone else and he said “No”.

Dr Hymans

73. Dr Hymans took the affirmation, confirmed the terms of his expert report and adopted it as his evidence in chief.

74. Dr Hymans, in his report commented that the retaining of the Registrant in Court proceedings suggests that the Court was aware of his CV and qualifications, as was the lead solicitor who had instructed him several times in the past. He opined that the content of the Registrant’s CV fulfilled the HCPC’s Standards of Conduct, Performance and Ethics, in that he has been honest about his experience, qualifications and skills and that the central issue for the Panel to consider was whether the Registrant has the requisite expertise to carry out the work that he was instructed to do. Dr Hymans referred the Panel to ‘BPS Psychologists as Expert Witnesses guidance’ dated July 2021 and opined that the Registrant had clearly acted in accordance with this guidance.

75. Dr Hymans stated that he disagreed with Dr Alwin ’s concerns that “an Educational Psychologist with no apparent further training or clinical experience in experts’ assessments of adults could have acquired the necessary skills or competence to complete an assessment on an individual over the age of nineteen or an individual with learning disabilities over the age of twenty-five.” Dr Hymans commented that such a view lacked the necessary evidence to be substantiated. He further commented that the Registrant’s description of CPD activity highlights that he had completed several training courses, which includes for example, ‘Mental Illness within Parenting Assessment (2 x 3 hours) in April and May 2020; ‘Attachment within the Parenting Assessment’ (2 x 3 hours) in February and July 2021; ‘Parenting and Personality Disorder’ (2 x 3 hours) in November 2021 and March 2022; a ‘Millon Webinar’ in February 2021; and attended The Millon Personality Group (December 2022).

76. Dr Hymans commented that it is too simplistic to say, as Dr Alwin did that the Registrant was not qualified to accept an instruction based on a Court Order referring to him as a Clinical Psychologist. Dr Hymans referred to the Registrant’s CV which stated that he is qualified and registered as an Educational Psychologist and noted the Registrant was retained as an expert in the proceedings and instructed in linked care proceedings involving SUA’s other children and gave evidence at the final hearing in September 2020. Dr Hymans opined that the retaining of the Registrant in Court proceedings suggests that the Court was aware of his CV and qualifications, as was the lead solicitor who had instructed him several times in the past. Dr Hymans further commented that by virtue of the ongoing and retained instruction, it could be inferred that no party to the proceedings had raised any concerns about the Registrant’s involvement.

77. Dr Hymans accepted that as a matter of “good practice” the Registrant should have informed the Court of what was maybe a typographical error in the Court Order referring to him as a Clinical Psychologist. He stated that he would not be critical of the Registrant in the context of a regulatory investigation, for not raising this, especially as from his experience it is commonplace amongst the judiciary to confuse Educational and Clinical Psychologists. Dr Hymans stated he did not believe that the Registrant was unregistered /not qualified to accept the instruction, because irrespective of the Clinical Psychologist wording, what was required was a psychological assessment. He opined that based on his psychological report in the bundle the Registrant conducted the assessment as any competent HCPS registered psychologist would by interviewing the client, using appropriate psychological assessments/tests, analysing the data collected and writing a report that answers the letter of instruction.

78. Dr Hymans stated that he considered that the central issue was whether the Registrant had the requisite expertise to carry out the work that he was instructed to do, that is whether he was registered and/or qualified to do so.

79. Dr Hymans opined that the Registrant’s CV satisfied the criteria in 6.1.2.3 in that “through specialist training, study, or experience, is able to provide a Court, tribunal or hearing with relevant scientific, technical or professional information or opinion, based on skills, expertise, or knowledge, that is likely to be beyond the experience and knowledge of the representing lawyers, judge, jury or panel”, the Registrant could practise as an expert witness.

80. Dr Hymans stated that once trained in the use of the WAIS there is no reason why an Educational Psychologist, such as the Registrant could not use such an instrument with SUA.

81. Dr Hymans opined that the Registrant was qualified to administer the MCMI-IV.

82. Dr Hymans accepted that there was nothing directly in the Registrant’s CV that referred to a special interest in personality disorder, the Registrant was a qualified Educational Psychologist and, in his training, (as well as with his first degree in psychology) he would have studied personality and personality disorders.

83. Dr Hymans concluded that the Registrant provided an opinion in relation to the Letter of Instruction. The content of which was what he would expect from an expert witness report for the Family Courts, this evidenced by the fact that he has been retained for completing approximately 72 reports annually on childcare litigation issues.

84. Dr Hymans told the Panel that in general in recent years Educational Psychologists have broadened the scope of their practice and worked with adults as well as children.

85. In cross examination Dr Hymans accepted he was giving evidence as an Educational Psychologist and that he was not involved in Family Court work a lot. He also accepted that the only training which the Registrant had undertaken on ‘Parenting and Personality Disorders’ post-dated the Allegations. Dr Hymans also stated that he personally would not diagnose personality disorders. He re-iterated that it was not necessary to use the actual word ‘formulation’ in a report but that a formulation process did require to be carried out during an assessment, although he commented that different experts had different views on what is required to go into a formulation. Dr Hymans stated that any expert must summarise findings, link them to what they were asked to do and explain the basis for any conclusions. He re-iterated his view that there existed a difference of opinion between Dr Alwin and the Registrant.

86. When questioned by the Panel, Dr Hymans stated that the Registrant had gone further than most Educational Psychologists in expanding his practice. He also explained that he would insert in any report he produced that he was a specialist Educational Psychologist and that a practitioner should use his protected title. Dr Hymans opined that it was up to the individual practitioner to self-regulate and that if he received instructions involving adult mental health issues that would be his ‘cut off’. He also commented that he personally would have gone further and explained how the lack of medical records might impact on the assessment and he would have gone back to the instructing solicitor and asked for the records. He accepted that the Registrant should have put a caveat in the report regarding the lack of medical records. He also stated that he would put in an addendum once he had received the medical records.

87. Dr Hymans accepted that, as an Educational Psychologist, he could not criticise Dr Alwin ’s opinion on what should be in an assessment produced by a Clinical Psychologist. Nor was he best placed to say whether the Registrant had produced a good clinical psychological report as he was not a Clinical Psychologist.

88. Dr Hymans also accepted that it was not simply a matter of good practice for the Registrant’s to raise the issue about the Clinical Psychologist reference in the Court Order if he became aware of it, but rather it was his duty to do so.

89. Dr Hymans was referred to both the 2016 and 2017 BPS Guidelines and accepted that the 2016 BPS Guidelines were specific to experts instructed in the Family Court.

LM

90. LM took the oath, confirmed the contents of her witness statement and adopted it as her evidence in chief. She set out her qualifications and experience and her current employment. LM confirmed that she was the ‘Lead Solicitor’ in relation to the proceedings involving SUA.

91. LM explained that she knew the Registrant in a professional capacity and set out her interactions with him as an expert witness. She stated she was aware that the Registrant was a chartered psychologist and had the protected title of Educational Psychologist. She said she had worked with him on a number of occasions.

92. LM took the Panel through the process of instructing an expert in the Family Court in general terms. However, in relation to the instruction of the Registrant she had difficulty in recalling how she had instructed him. She told the Panel that the reference in the Court Order to a Clinical Psychologist was ‘erroneous’ and that she had no explanation for it. She said the Court was well aware that the Registrant was an Educational Psychologist.

93. LM also told the Panel that she had moved firms since the date of the Allegations, and had no access to the case file and therefore could not confirm the contents of the actual Letter of Instruction sent to the Registrant. She also could not recall the contents of the bundle that she sent to the Registrant but said it was her usual practice to include the same bundle that had been sent to the Court.

94. In cross examination LM could not recall which other experts may have been considered in relation to the production of a report for SUA. She also said that she had not spotted the use of the words Clinical Psychologist in the Court Order, and had she seen it she would have raised it with the Court.

95. In answer to Panel questions, LM explained that she had left Mander Cruickshank in January 2021 and did not have access to the file. She stated she was not made aware of any complaint by SUA to the HCPC in 2019 and that the issue was not raised in the hearing. LM was referred to Practice Direction 25C and asked about preliminary enquiries as per paragraph 3.2. She said she would have asked about timescale, fees and the Registrant’s availability. In response to a question regarding paragraph 3.11, concerning the terms of the Draft Order to be attached to her Application, she said they did not follow the Practice Direction in Leicester. She further explained that a copy of the relevant Practice Directions would not necessarily be included with any Letter of Instruction but there would be a link to them set out in the letter.

96. LM confirmed that the Court Order would have been sent to the Registrant once sealed.

Submissions

97. Mr Jotangia adopted his case summary and the evidence matrix set out therein.

98. He submitted that Dr Alwin was consistent and credible. He further submitted that as he was a Clinical Psychologist the Panel should attach greater weight to his evidence. He submitted that SUA was a complex adult. He referred to the BPS guidelines on Standards, Competencies and Expectations 2016, in particular paragraphs 2.3, 2.8, 4.8, 4.9, 5.7, 5.8 and 5.15 and submitted that what was critical was that the assessment should contain a formulation.

99. Mr Jotangia submitted that the Court Order referred to the Registrant as a Clinical Psychologist and that the assessment was to be conducted by a Clinical Psychologist. It was highly unlikely that these were administrative errors. He submitted that the Panel should find Allegation 1 proved.

100. Mr Jotangia explained that he did not intend to go into further Allegations in detail, but referred to the BPS and HCPC guidance and submitted that the Panel should find the further charges proved, albeit he accepted that Dr Alwin no longer supported Allegation 4.

101. Mr Cridland addressed each Allegation in turn.

102. In relation to Allegation 1 he submitted that the issue was “what was the intention of the Court”. He submitted that either the Court wished for a Clinical Psychologist to be appointed or it wished for the Registrant to be appointed and the term ‘clinical psychologist’ was ‘surplus’. Mr Cridland submitted the latter was more likely as the known facts supported this conclusion.

103. Mr Cridland argued that both the Registrant and LM had given evidence that the Court had a copy of the Registrant’s CV and that the Registrant was not the only expert available – there could have been up to 5. Mr Cridland submitted the Court was aware that the Registrant was an Educational Psychologist and it was its intention to instruct him rather than a Clinical Psychologist. He referred the Panel to the letter of instruction before it and the evidence of LM. He submitted that it was clear that the application asks for a psychological assessment to be prepared not an assessment by a Clinical Psychologist. He submitted that any reference to a Clinical Psychologist in the Court Order was an ‘error’.

104. In relation to Allegation 2, 5 and 6 Mr Cridland submitted that the Registrant’s wide range of experience resulted in him being competent to carry out a clinical assessment of SUA and that he was not required to be registered as a Clinical Psychologist to do this.

105. In relation to Allegation 3, Mr Cridland stated that the Registrant accepted the factual matrix of this Allegation but denied his actions were outside the scope of his practice.

106. Mr Cridland reminded the Panel that Dr Alwin no longer supported Allegation 4.

107. In relation to Allegation 6, with reference to his prior submissions Mr Cridland submitted that it was clear the Registrant had not worked beyond the scope of his practice.

Decision on Facts

Legal Advice and Approach

108. The Panel accepted the advice of the Legal Assessor. He referred the Panel to the cases of Suddock v NMC [2015] EWHC 3612 (Admin), Dutta v GMC [2020] EWHC 1974 (Admin), Khan v GMC [2021]EWHC 374 (Admin) and Byrne v GMC [2021] EWHC 2237 (Admin)in relation to its approach to the assessment of witness evidence.

109. The Panel considered each particular of the Allegation in turn. In reaching its decision the Panel considered how the relevant witness evidence fitted with the non-contentious or agreed facts, contemporaneous documents, the inherent probability or improbability of any account of events and any consistencies and inconsistencies.

110. The Panel took into account all evidence before it, including the submissions of Mr Jotangia and Mr Cridland.

111. The Panel considered that Dr Alwin was knowledgeable and gave his evidence in a clear and confident manner. His oral evidence was consistent with his expert report and the Panel considered he was fair and balanced. He was at pains not to denigrate or criticise the Registrant personally. The Panel considered that he was an experienced Clinical Psychologist. He was clear when he did not support an Allegation.

112. The Panel considered that the Registrant was vague when he gave evidence – in particular in relation to the exact training he had undertaken prior to the date of the Allegations that he asserted allowed him to undertake such work. The Panel also considered that the Registrant’s oral evidence was at times inconsistent and he demonstrated a lack of understanding of an expert’s obligations under Practice Direction 25 B. The Panel also considered that the Registrant failed to demonstrate a clear understanding of who he had had a duty to when acting as an expert. In addition, he failed to demonstrate an understanding of The HCPC Standards of Proficiency for Practitioner Psychologists: “Standard 2.1 Registrant practitioner psychologists must understand the need to act in the best interests of service users at all times”.

113. The Panel considered Dr Hymans was knowledgeable and gave his evidence in a clear manner. The Panel considered that he was fair and balanced. He was careful to limit his answers to his area of experience as an Educational Psychologist and accepted that he lacked recent experience of acting as an expert witness in the Family Court.

114. The Panel considered that LM’s evidence was consistent with her written witness statement. However, her specific recall in respect of the matters arising from the Allegations was limited. Her evidence in relation to when she had been informed of the complaint to the HCPC was inconsistent with that of the Registrant.

115. The Panel attached appropriate weight to the witness statement of AM, a Registrations Manager at the HCPC and LZ, a Senior Paralegal at Kinglsey Napley LLP.

The Panel’s Reasons

1. On or around 30 April 2018, you accepted the instructions pursuant to a Court Order referring to you as a 'clinical psychologist', to conduct and prepare an independent expert
witness psychological assessment report of Service User A when you were not registered and/or qualified to do so.

116. Found Proved.

117. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant, Dr Hymans and LM.

118. The Panel noted that it was not a matter of dispute that the Registrant had accepted the instructions.

119. The Panel considered that it was first required to address the question of whether the insertion of the words ‘Clinical Psychologist’ was ‘erroneous’ or a mistake as asserted by the Registrant and LM.

120. The Panel determined that it is clear from the Court documentation that the psychologist who was to carry out the assessment and report to the Court was to be a Clinical Psychologist. The protected title of Clinical Psychologist was clearly used twice in the Court Order and specifically referred to Graham Flatman (Clinical Psychologist). The Panel did not accept the general assertions of the Registrant and LM that this must have been an error and there was nothing before the Panel to undermine the terms of the Court Order. The Panel noted that nothing had been produced from the Court to state that the use of this protected title was incorrect.

121. The Panel noted that the Registrant did not attribute the protected title of Clinical Psychologist to himself in his reports and stated that he did not realise the Court Order required the assessment to be carried out by a Clinical Psychologist until the complaint was made to the HCPC in August 2019, at which point he told the Panel that he raised this with LM. LM told the Panel that she also did not realise this term was used in the sealed order when she received it from the Court and sent it to the Registrant. She was unable to state when she initially found out about the use of Clinical Psychologist in the Court Order, but the Panel noted that whenever she did find out she did not appear to have raised the issue with the Court. The Panel considered that if the insertion of Clinical Psychologist had clearly been an error, then on becoming aware of what had occurred LM would have immediately raised the matter with the Court. The Panel considered that it was inherently implausible that she became aware of such a mistake and did not raise it with the Court. The Panel also took into account that there was no evidence before it that any other party to the Court proceedings had raised any concern about the use of Clinical Psychologist. In these circumstances the Panel did not accept that the use of these words in the Court Order was an error and that it correctly reflected what had been directed by the Court at the Case Management Meeting on 23 April 2018. The Panel therefore determined that the Court Order expressly required the assessment of SUA to be carried out by a Clinical Psychologist.

122. The Panel therefore went on to consider whether the Registrant was registered as a Clinical Psychologist and/or qualified to carry out such an assessment.

123. The Panel took into account the witness statement of AM which stated that the Registrant was not registered under any modality other than as an Educational Psychologist. This witness statement was not the subject of any challenge. The Panel was satisfied therefore on the balance of probabilities that the Registrant was not registered as a Clinical Psychologist.

124. The Panel also took into account the evidence of the Registrant and Dr Hymans that the Registrant had sufficient training and experience to carry out the assessment required in the Court Order. The Panel noted that when asked to provide examples of specific training undertaken prior to April 2018 that would have qualified him to undertake the assessment he was unable to do so. Further, the Panel considered the Registrant’s evidence that his “vast experience” over the years prior to April 2018 qualified him to undertake the assessment was again vague, lacking in detail and there was no specification of exactly how any experience resulted in him being qualified to undertake such an assessment.

125. The Panel also took into account that Dr Hymans accepted that the training by the Registrant referred to in his report took place after the assessment of SUA. He had relied on and accepted without investigation the Registrant’s assertions that his general experience prior to April 2018 qualified him to carry out the assessment required by the Court Order.

126. The Panel did not consider the evidence of LM assisted it in relation to this matter.

127. The Panel therefore concluded that there was no cogent reliable and corroborated evidence before it that, on the balance of probabilities, the Registrant was qualified to accept the instructions pursuant to the Court Order to conduct and prepare an independent expert report of SUA.

128. Allegation 1 is therefore found proved.

2. Between 30 April 2018 and 13 June 2018, you conducted a clinical psychological assessment of Service User A when you were not registered and/or qualified to do so.

129. Found proved.

130. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant, Dr Hymans and LM.

131. The Panel again noted that there was no dispute between the parties that during the period set out in the Allegation the Registrant conducted a psychological assessment of SUA.

132. The Panel noted that it was the position of the Registrant himself that this assessment was a clinical assessment and this was also the position of Dr Alwin and Dr Hymans.

133. For the reasons set out in Allegation 1 the Panel has determined that, on the balance of probabilities, during the period set out in Allegation 2 the Registrant was neither registered nor qualified to carry out such a clinical psychological assessment.

134. Allegation 2 is therefore found proved.

3. Between 30 April 2018 and 13 June 2018, you conducted psychometric tests during your psychological assessment of Service User A. In that you used the Millon Clinical Multiaxial Inventory Ill (MCMl-I11) psychometric test in your psychological assessment of Service User A.

135. Found Proved.

136. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant and Dr Hymans.

137. The Panel took into account that the Registrant admitted that he conducted psychometric tests during his psychological assessment of SUA by using the Millon Clinical Multiaxial Inventory Ill (MCMl-III) psychometric test in his psychological assessment of SUA.

138. The Panel also took into account that both Dr Alwin and Dr Hymans had given evidence that this occurred.

139. The Panel therefore determined that, on the balance of probabilities between 30 April 2018 and 13 June 2018, you conducted psychometric tests during your psychological assessment of SUA in that you used the Millon Clinical Multiaxial Inventory Ill (MCMl-III) psychometric test in you psychological assessment of SUA.

140. Allegation 3 is therefore found proved.

4. You reported your opinion and/or commented on the diagnosis of a personality disorder which is a matter for psychiatric expertise.

141. Not proved.

142. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant and Dr Hymans.

143. The Panel took into account that Dr Alwin had clearly stated that there was no evidence to support this Allegation and that he did not support this Allegation as although reference was made in the Registrant’s report to personality disorder that the Registrant had not made any diagnosis.

144. The Panel took into account that this was also the position of the Registrant and Dr Hymans.

145. There was no other evidence before the Panel in relation to this Allegation.

146. The Panel therefore determined that, on the balance of probabilities, the Registrant had not reported his opinion and/or commented on the diagnosis of a personality disorder.

147. Allegation 4 is found not proved.

5. On or around 13 June 2018, produced a written expert witness report in respect of the clinical psychological assessment you conducted of Service User A, when you were not registered and/or qualified to do so.

148. Found Proved.

149. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant, Dr Hymans and LM.

150. Again, the Panel noted that it was not a matter of dispute that the Registrant produced the written report referred to in the Allegation.

151. Again, for the reasons set out in Allegation 1 the Panel has determined that, on the balance of probabilities, during the period set out in Allegation 2 the Registrant was neither registered nor qualified to carry out such a clinical psychological assessment.

6. In respect of particulars 1 - 5 you have worked beyond your scope of practice.

152. Found Proved.

153. In considering this Allegation, the Panel took into account all relevant evidence including the evidence of Dr Alwin, the Registrant and Dr Hymans.

154. Having found Allegation 1,2 and 5 proved for the reason set out therein the Panel was satisfied that, on the balance of probabilities, in acting as set out in these Allegations, the Registrant had acted beyond the scope of his practice.

155. In respect of Allegation 3, the Panel took into account the Registrant’s evidence that he was qualified to use the MCMI-III psychometric test in 2018. The Panel took into account that this was also accepted by both Dr Alwin and Dr Hymans.

156. However, the Panel considered that Allegation 3 went beyond the actual use of the test as it narrates that the test was used in the Registrant’s psychological assessment of SUA.

157. For the reasons set out in Allegation 1, the Panel had determined that the Registrant was neither registered nor qualified to carry out this assessment.

158. The Panel therefore determined that, whilst the Registrant may have been qualified to use the test, on the balance of probabilities, its use in the context of carrying out a psychological assessment of SUA was beyond the scope of the Registrant’s practice.

159. Allegation 6 is therefore found proved in relation to Allegation 1,2,3 and 5.

Further evidence

160. The Panel read a defence bundle which included:

• Registrant’s reflective statement dated 27 March 2024 and his letter to solicitors dated 23 November 2023;

• Schedule of Continuing Professional Development (CPD);

• CPD certificates and reflections;

• Testimonials.

161. The Panel heard oral evidence from PJ, a former headteacher and currently an educational consultant. She has known the Registrant for over forty years and is his friend. In 2007, when she was a headteacher she commissioned the Registrant to carry out work at her school over a period of approximately eighteen months. This work was in respect of one child and their family together with more general work advising staff. PJ described her experience of the Registrant as a skilled educational psychologist. PJ has spoken with the Registrant since the Panel’s decision in October 2023, and she described that the decision has had a big impact on the Registrant and that it has deeply affected him. Her view was that it would be a significant loss for the Registrant and for the profession if he were not able to practise.

162. The Panel also heard oral evidence from Dr LH, Senior Clinical Psychologist at the Kent and Medway NHS Foundation Trust. Dr LH has engaged in discussions with the Registrant from 2015. Following his qualification as a clinical psychologist in 2020, Dr LH described the meetings as peer supervision. Initially the peer supervision meetings were on an ad hoc basis, but since the Panel’s decision in October 2023 they have been monthly. The meetings have included discussion of the outcome of the October 2023 hearing and Dr LH described the Registrant’s desire to learn and improve his practice.

163. Dr LH also described the impact of the Panel’s decision on the Registrant. He confirmed the Registrant’s decision to cease carrying out expert work and to focus his practice on the work of an educational psychologist. Dr LH’s view is that the Registrant’s profession is part of his identity and that it would be devastating for the Registrant, and he would lose his purpose if he were not able to continue to practise as an educational psychologist.

Decision on misconduct

Submissions

164. Mr Jotangia submitted that the facts found proved were sufficiently serious to amount to misconduct. He referred the Panel to standard 3 and 8 of the HCPC Standards of conduct, performance and ethics.

165. Mr Cridland, on behalf of the Registrant, accepted that the matters found proved amounted to the statutory ground of misconduct.

Legal advice and approach

166. The Panel accepted the advice of the Legal Assessor. She advised that whether the facts amount to misconduct is a matter for the Panel’s independent judgement. There is no burden or standard of proof. There is no statutory definition of misconduct, but the Panel may have regard to guidance in the case of Roylance v General Medical Council (No 2) [2000] 1 AC 31 that “misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a …practitioner in the particular circumstances”. Guidance was also given in the case of Nandi v GMC [2004] EWHC 2317 that the falling short of the standards of conduct should be serious.

Panel’s reasons

167. The Panel considered the applicable HCPC Standards of conduct, performance and ethics and bore in mind the submissions made by Mr Jotangia. The Panel was of the view that the Registrant’s conduct in acting outside the scope of practice breached the following standards:

3 Work within the limits of your knowledge and skills
Keep within your scope of practice

3.1 You must keep within the scope of practice by only practising in the areas you have appropriate knowledge, skills and experience for.

3.2 You must refer a service user to another practitioner if the care, treatment or other services they need are beyond your scope of practice.
Maintain and develop your knowledge and skills

3.3 You must keep your knowledge and skills up to date and relevant to your scope of practice through professional development.
You must keep up to date with and follow the law, our guidance and other requirements relevant to your practice..

3.5 You must ask for feedback and use it to improve your practice.

8. Be open when things go wrong

Openness with service users and carers

8.1 You must be open and honest when something has gone wrong with the care, treatment or other services that you provide by:

- informing service users or, where appropriate, their carers, that something has gone wrong;

- apologising;

- taking action to put matters right if possible; and

- Making sure that service users or, where appropriate, their carers, receive a full and prompt explanation of what has happened and any likely effects.

9 Be honest and trustworthy
Personal and professional behaviour

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

168. The Panel was also of the view that the Registrant’s conduct in Allegations 1, 2, 3, 5, and 6 was not in accordance with the British Psychological Society Guidance on Psychologists as Expert Witnesses in Family Courts (January 2016).

169. The Panel considered that the Registrant’s conduct in Allegation 1, of accepting instructions to act as a “clinical psychologist”, which was outside the scope of his practice, was serious. The Registrant had the responsibility to ensure that he was sufficiently competent and expert to provide opinion evidence. He assumed that he had such expertise, based on his long history of having undertaken similar work and his belief that he was competent. This attitude towards his professional responsibilities was entirely unacceptable. The Registrant’s action had the consequence that both SUA and the court were mis-lead in the precise nature of his expertise. Although the HCPC did not produce any evidence of actual harm to SUA, there was the potential for serious harm. The expert evidence provided by an HCPC registered Practitioner Psychologist in a family court may have life changing consequences for the affected individuals.

170. Although the Panel had no evidence of any wider consequences of the Registrant’s actions, there is the potential for his expert evidence in other cases to be discredited and this could potentially have a significant effect on the families involved.

171. The Panel therefore decided that the Registrant’s conduct in Allegation1 was sufficiently serious to amount to misconduct.

172. The Panel also decided that the Registrant’s conduct in Allegation 2 was sufficiently serious to amount to misconduct for the same reasons. The Registrant conducted the psychological examination of SUA without having undertaken appropriate training for the assessment of adults.

173. When considered within its context, the Registrant’s conduct in Allegation 3 was also sufficiently serious to amount to misconduct. Although the Registrant was technically qualified to access the MCMI-III psychometric test, the Panel found that his use of the test in assessing SUA was outside the scope of his practice.

174. The Registrant’s conduct in Allegation 5 was also far below the HCPC Standards of conduct, performance and ethics. The report was outside the scope of the Registrant’s practice. It did not alert the reader to his protected title of Educational Psychologist. It was produced without the Registrant having sight of SUA’s medical notes, or a reference to the absence of medical notes within the report. Dr Alwin’s conclusion was that he had “no confidence in the report” and that expert reports in the family courts may have a profound impact on the decision and consequent outcome for individuals.

175. It is the responsibility of an HCPC registered professional to ensure that they act within their scope of practice and this responsibility is enhanced when a registrant undertakes work as an expert witness with the consequent duties to the court. The courts rely and depend upon on the professionalism of experts who provide their reports and that in accepting to provide those reports they are qualified to do so and doing so falls within their scope of practice. The Registrant’s conduct in Allegation 6 was therefore sufficiently serious to amount to misconduct.

176. It is clear from the preceding paragraphs that the Panel considered that viewed individually the proven Allegations are serious and amount to misconduct. When viewed in the round they involve significant departures from the HCPC Standards of conduct ,performance and ethics and a disregard for established protocols such as the BPS Guidance 2016- ‘Psychologists as expert witnesses in the Family Courts in England and Wales: Standards, competencies and expectations’ (notably, but not limited to paragraphs 3.2,4.1,4.2,4.4, 4.5, 5,6,7, appendices 1,2,3 ) as well as the overriding duty to the Court as an expert (set out in the relevant Family Procedure Rules and Practice Directions). The Panel took into account the substantial evidence it heard from the Registrant himself and it is important to provide some context at this stage.

177. The Registrant was keen to point out that there was never any malice in his acting outside the scope of his practice, he simply wanted to help people. However, the HCPC is in effect the kitemark of health and care professionals which allows the public to be assured that those with protected titles are indeed qualified to practise within the remit of their title. The Registrant, not being a registered clinical psychologist, was not in a position to accept instructions, undertake an assessment or produce a report in respect of SUA, yet he chose to do so.

178. During his evidence the Registrant reminded the panel of the details of his CV, the extent of his experience in working with adults and providing expert reports to the Family Court. However, in answer to questions it became clear that the Registrant had never undertaken any training specific to the assessment of adults. He gave evidence as to how he came to produce his first ever expert report in 1997 when he was asked by a Children’s Guardian to do so. He told the Guardian that he did not ‘know the ropes’ and that the Guardian had told him ‘We will teach you the ropes’ and the Registrant explained, “So that is where it started”.

179. In 2009 the HCPC introduced the protected titles of both clinical and educational (amongst others) psychologists and therefore registration for psychologists became compulsory. The Registrant registered as an educational psychologist at around this time. Nothing would have precluded the Registrant from applying for registration as a clinical psychologist had he been qualified to do so.

180. The Registrant of his own volition, gave evidence as to the number of psychological assessments he produced to date which amount to well over one thousand. It has not been alleged by the HCPC that these reports were all required to be produced by a clinical psychologist and we do not seek to broaden the facts found proved. It was the Registrant himself who told the panel that he had never been specifically instructed in the Family Court in his capacity as an educational psychologist and further that most psychological assessments in the Family Court were undertaken by clinical psychologists. The seriousness of the misconduct in this case is confined to the facts proved, specifically in relation to the report on SUA. However, the context provided by the Registrant, which sets out the extent to which the Registrant acted outside the scope of his practice as an educational psychologist, was noted by the Panel.

181. In summary, taken separately and in the round, the facts found in Allegations 1,2,3,5 and 6 amount to a finding of serious misconduct.

Decision on impairment

Submissions

182. Mr Jotangia submitted that the Registrant’s fitness to practise is impaired. He invited the Panel to consider the Registrant’s current practice and behaviour and whether the misconduct is likely to be repeated. He also referred to the “public component” and the need to declare and uphold standards of conduct and uphold public confidence in the profession.

183. Mr Cridland accepted that in light of the Registrant’s misconduct it is likely that his fitness to practise would be regarded as impaired.

Legal advice and approach

184. The Panel accepted the advice of the Legal Assessor. Her advice included reference to the HCPTS Practice Note “Fitness to Practise Impairment” (November 2023). Her advice also included reference to the case of Cohen v General Medical Council [2008] EWHC 581 and CHRE v NMC and Grant [2011] EWHC 927.

Panel’s reasons

185. The Panel considered what weight, if any, to give to the character references at this stage of its determination. While acknowledging the impact of the Panel’s decision in October 2023 on the Registrant, the Panel gave no weight to the evidence of PJ because evidence related to the Registrant’s professional work in 2007, rather than the Registrant’s current practice.

186. The evidence of Dr LH did not reassure the Panel that the Registrant has fully understood the Panel’s decision and its implications. Dr LH is a Clinical Psychologist, with a different scope of practice to the Registrant. The Registrant has continued peer supervision sessions with Dr LH. Dr LH told the Panel that these discussions have included the clinical psychology side of the Registrant’s work. Although the Panel does not have detailed evidence about the content of the discussions, it considered that in such discussions or as a consequence of such discussions there is the potential for the Registrant to act outside the scope of his practice. The Panel might have expected the Registrant, in his efforts to refocus his practice, to make arrangements for appropriate supervision from an Educational Psychologist.

187. The Panel considered the written testimonials. They were not focussed on the work the Registrant has undertaken since the Panel’s decision in October 2023 to change his practice and return to core educational psychology. The Panel therefore gave the testimonials little weight when considering the Registrant’s current competence and behaviour.

188. The Panel carefully reviewed the Registrant’s written reflective statement dated 27 March 2024. In the Panel’s view the statement demonstrated developing insight. The statement included an acceptance of the Panel’s findings, an acknowledgement of wrongdoing, an apology to the Panel, and a commitment that the Registrant would not in future act outside the scope of his practice. Following the Panel decision in October 2023, the Registrant decided that he would not undertake any work as an expert witness and informed all relevant parties by letter dated 23 November 2023.

189. The Panel considered that the Registrant has begun the process of reflection, but that his statement was mainly focussed on the Registrant himself and his family circumstances. The Panel considered that his statement did not address the impact of the Registrant’s behaviour on others, particularly SUA. His reflections did not include the potential impact of his misconduct on the court, other service users where he has acted as an expert witness, public confidence in the professionalism of expert witnesses, or public confidence in the profession. While the Registrant has demonstrated respect for the decision made by the Panel and appears to have understood the seriousness of the potential outcome, his reflective statement did not demonstrate that he has fully understood the potential impact of his behaviour.

190. The Panel was also of the view that the Registrant may be isolated from other Educational Psychologist colleagues and may not have appreciated the risks that can arise from such isolation. The Panel noted that most of the recent CPD completed by the Registrant was on-line courses. This form of participation does not provide the benefit of direct contact with other professionals, and, in the Panel’s view, the Registrant’s current peer supervision arrangement with Dr LH is not appropriate supervision because they are members of different psychological professions.

191. The Panel noted that the Registrant has taken some steps to ensure that the conduct will not be repeated. He has withdrawn entirely from work as an expert witness and has refocussed his practice on the core tasks of an Educational Psychologist. The Registrant has also undertaken CPD in ethics. This learning was undertaken before the Registrant prepared his reflective statement, and the Panel was concerned that, notwithstanding the Registrant’s efforts, his reflective statement did not persuade the Panel that he had fully acknowledged the impact and potential risks of his past behaviour.

192. In considering the risk of repetition the Panel took into account the level of insight demonstrated by the Registrant. The Registrant has withdrawn from work as an expert witness, and therefore it is unlikely that the Registrant would in the future present an expert report to the court which was outside the scope of his practice. However, the Registrant previously had the view, as outlined in his evidence, that he could rely on his extensive experience, regardless of his qualification and training. This is an attitudinal issue, which is more difficult to remedy. The Registrant’s developing insight, which the Panel has described, does not fully address this issue and the potential for the Registrant to act outside his scope of practice on the basis of his experience, and because he has done so in the past. Therefore, the Panel was unable to exclude a residual risk that the Registrant might act outside the scope of his practice. An example is that such risks could potentially arise from the Registrant’s peer supervision discussions with Dr LH.

193. The Registrant has demonstrated in his reflective statement a willingness to change and take remedial steps. His acceptance of the Panel’s decision is a foundation on which further reflection could be built.

194. Having found that there is a residual risk that the Registrant might again act outside the scope of his scope of practice, the Panel decided that there is an ongoing risk to the public and that his fitness to practise is impaired.

195. The Panel next considered the need to uphold the expected standards of conduct and to maintain public confidence in the profession. The requirement for an expert witness to work within the scope of their practice is fundamental and is part of the expert’s core responsibilities to the court. A finding that the Registrant’s fitness to practise is impaired is therefore required to mark the seriousness of the Registrant’s departure from professional standards. The Registrant’s misconduct brought the profession into disrepute and had the potential to harm SUA. A finding of current impairment is therefore required to maintain public confidence in the profession.

196. The Panel therefore concluded that the Registrant’s fitness to practise is currently impaired on the basis of the “personal” and “public” components.

Decision on sanction

Submissions

197. Mr Jotangia referred the Panel to the HCPC Sanctions Policy. On behalf of the HCPC he did not propose a sanction, but submitted that this was a matter for the Panel’s judgment.

198. Mr Cridland referred the Panel to the Registrant’s CV, and outlined his career as an Educational Psychologist. He submitted that the Registrant’s reflective statement includes the Registrant’s personal and heartfelt reflections. Mr Cridland submitted that the statement demonstrates developing insight. He submitted that the Registrant does not wish to retire and intends to only act within the traditional confines of an Educational Psychologist. Mr Cridland also referred the Panel to the large number of CPD certificates which included topics focussing on probity and ethics and CPD subjects relating to the traditional remit of an Educational Psychologist.

199. Mr Cridland referred to the testimonials and highlighted the testimonial of TB, a qualified Speech and Language Therapist, Dr NF, a Counselling Psychologist, and JS, Specialist Health Visitor and General Nurse. TB, Dr NF and JS worked alongside the Registrant as colleagues and they recommended the services that the Registrant provided, commenting on his expertise and his support.

200. Mr Cridland submissions included references to the HCPC Sanctions Policy. He submitted that in view of the seriousness of the misconduct conditions of practice would not be appropriate. He submitted that a short period of suspension would be the appropriate and proportionate sanction and a striking off order would be disproportionate.

Legal advice and approach

201. The Panel accepted the advice of the Legal Assessor. She advised that the Panel should have regard to the HCPC Sanctions Policy and consider whether there are any mitigating or aggravating features. The purpose of a sanction is not to punish the Registrant, although it may have that effect. The Panel should apply the principle of proportionality. It should consider the Registrant’s interests and carefully balance them against the need to protect the public and the wider public interest. Foremost in the Panel’s mind must be the over-arching objective of protecting the public, maintaining public confidence in the profession and upholding proper professional standards. The Panel should impose the minimum sanction which is sufficient to protect the public and therefore should begin its consideration with the least restrictive option. The Panel should bear in mind that personal mitigation carries less weight in regulatory cases than it would do in a criminal case and that the reputation of the profession is more important than the fortunes of an individual member.

202. The Panel identified the following aggravating features:

• the potential for harm to SUA;

• the Registrant’s actions misled SUA and the court;

• the Registrant had the professional responsibility as an expert to declare that he was not qualified/competent.

203. The Panel identified the following mitigating features:

• the Registrant’s long career as an Educational Psychologist with no previous fitness to practise history;

• the Registrant’s remedial steps including restricting his practice;

• the Registrant’s acknowledgement of wrongdoing, apology to the Panel and expression of regret;

• the Registrant’s developing insight;

• positive testimonials from colleagues who have worked alongside the Registrant in the past.

204. The Panel considered that limited weight should be given to some of the mitigating features it had identified. Some of the positive testimonials describe work that was carried out by the Registrant many years ago. They also included some references to the Registrant’s work as an expert witness and this may have included work that was outside the scope of his practice. The Panel also had reservations about the level of the Registrant’s insight as explained in its decision on impairment. The Registrant’s remedial steps and his apology were at a late stage, after findings of fact had been made, and there was no apology to SUA.

205. The Panel was not of the view that the Registrant’s misconduct was within any of the categories identified as “serious cases” within the Sanctions Policy.

206. The Panel was of the view that the case was at the top end of the scale of gravity of acting outside the scope of practice because of the Registrant’s additional responsibilities to the court as an expert witness. The Registrant’s misconduct was highly likely to reduce the public’s trust in him and the profession and potentially the court itself.
207. The Panel considered the option of taking no action, but decided that this would be insufficient to protect the public and to mark the gravity of the Registrant’s departure from professional standards.

208. The Panel next considered the option of a Caution Order which is a non-restrictive sanction. It decided that guidance in the Sanctions Policy was not applicable because the Registrant’s misconduct was not relatively minor in nature. The Panel has also explained in its decision on impairment that there are concerns relating to the level of insight demonstrated by the Registrant. The Panel decided that a Caution Order would be insufficient to protect the public and insufficient to maintain public confidence in the profession.

209. The Panel noted the guidance in the Sanction Policy for Conditions of Practice Order. It considered that it might be possible to formulate realistic and verifiable conditions of practice that would monitor and supervise the Registrant’s practice to ensure that he complies with the limits of his practice. However, the Panel decided that conditions of practice were not appropriate or sufficient. The Panel’s view is that the Registrant’s insight is developing, but that he is not yet able to reflect more widely on the consequences and risks of his past behaviour. Although, this case does not fall within the category of “serious cases”, the Panel’s view was that the Registrant’s misconduct was so serious that a more restrictive sanction was required to uphold public confidence in the profession and to mark the gravity of the misconduct.

210. The Panel next considered a Suspension Order which would prohibit the Registrant from practising as an Educational Psychologist for a period of time. The guidance for a Suspension Order in the Sanctions Policy is that:

“A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:

• the concerns represent a serious breach of the Standards of conduct, performance and ethics;

• the registrant has insight;

• the issues are unlikely to be repeated; and

• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.”

211. The Panel considered whether the listed factors applied. The Panel has made a careful assessment of the level of the Registrant’s insight. In the Panel’s view the insight demonstrated is sufficient for consideration of a suspension order. The Panel noted the change in the Registrant’s position between the evidence he gave at the hearing in October 2023 to the content of his reflective statement. The Registrant is fully engaging with the fitness to practise process and there was evidence before the Panel that he is willing to engage in further learning and development. In its decision on current impairment, the Panel considered that there is a residual risk of repetition, but it did not consider that this risk was so high to exclude consideration of a suspension order.

212. The Panel gave serious consideration to the possibility of a Striking Off Order, noting that it is a sanction of last resort. The guidance in the paragraph 131 of the Sanctions Policy is that:

“A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:

• lacks insight;

• continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or

• is unwilling to resolve matters."

213. The Panel considered that the factors listed in paragraph 131 of the Sanctions Guidance did not apply. In its decision on impairment the Panel found that the Registrant has developing insight, that he is willing to change and take remedial steps, and that he has taken steps to reduce the risk that he would again act outside his scope of practice.

214. The Panel considered carefully whether a sanction of Suspension Order was sufficient to mark the gravity of the Registrant’s misconduct, or whether the sanction of a Striking Off Order was required. The sanction of a Suspension Order is a serious sanction. It sends a very clear message to the Registrant, members of the profession, and the public, that it is entirely unacceptable for a registrant to act outside their scope of practice, particularly when they undertake the responsible role of an expert witness. The Panel also had regard to the principle of proportionality, taking into account the Registrant’s interests. The Registrant is committed to his profession and it is part of his identity.

215. Given that none of factors in paragraph 131 applied, and its view that a Suspension Order sufficiently marked the gravity of the Registrant’s misconduct, the Panel decided that a Striking Off Order would be disproportionate. It concluded that a Suspension Order was the appropriate and proportionate sanction.

216. The Panel next considered the length of the Suspension Order. The primary reason for the imposition of a Suspension Order is to mark the seriousness of the Registrant’s misconduct and to uphold public confidence in the profession. The Sanctions Guidance indicates that in such cases short term sanctions can be appropriate. The Panel decided that the appropriate and proportionate length of the Suspension Order was six months. This would provide the Registrant with time to further reflect not only on the seriousness but also the impact of his misconduct on others. It would also give the Registrant time to update his practice and supervision arrangements as an Educational Psychologist.

217. The Suspension Order will be reviewed before it expires. While this Panel cannot bind a future reviewing Panel, it considered that the reviewing panel would be assisted by:

• An updated reflective statement from the Registrant addressing the effects of his misconduct on others;

• Evidence of CPD which references up to date Educational Psychology practice (and whether such CPD was in person or completed on-line);

• Evidence of any arrangements made by the Registrant for appropriate supervision by an Educational Psychologist should he be permitted to return to practice.

ORDER: The Registrar is directed to suspend the name of Graham Flatman from the Register for a period of 6 months.

Interim Order

1. In light of its findings, the Panel next considered an application by Mr Jotangia for an Interim Suspension Order to cover the appeal period before the final order becomes effective. Mr Jotangia submitted that an Interim Suspension Order should be made to cover the 28-day appeal period, and if an appeal is made, the time taken for that appeal to be heard. He submitted that an Interim Order is necessary for the same reasons the Panel decided to impose a Suspension Order.

2. Mr Cridland on behalf of the Registrant opposed the application for an Interim Suspension Order. He submitted that no interim order is currently in place and that the grounds for imposing an interim order did not apply in the circumstances of this case.

3. The Legal Assessor advised the Panel that it could make an interim order if doing so was necessary for the protection of the public, otherwise in the public interest, or in the interests of the Registrant. The Panel should bear in mind its previous findings and also consider the appropriate form and duration of any interim order.

4. The Panel considered whether to impose an interim order. It was mindful of its earlier findings, that the Registrant is not fit to practise, and that his conduct was of such gravity that in order to both protect the public and uphold the public interest, he should be suspended from the Register. The Panel was of the view that there would be a risk to the health, safety or welfare of members of the public if the Registrant were to practise without restriction because of its conclusion that there is residual risk of repetition that the Registrant would act outside the scope of his practice, and the absence of supervision that the Panel considers to be appropriate. The Panel was also of the view that the gravity of the Registrant’s misconduct was such that the Panel’s decision and the imposition of a suspension order was insufficient to maintain public confidence in the profession without an interim order in place. The Panel considered that an informed reasonable member of the public would be surprised and troubled if the Registrant were permitted to practise during the appeal period and while any appeal is ongoing. The Panel therefore concluded that it would be incompatible with its findings if there was no interim order in place.

5. Accordingly, the Panel concluded that an Interim Suspension Order is necessary for the protection of the public and is otherwise in the public interest. An Interim Conditions of Practice Order would not be appropriate for the same reasons that a substantive order of this nature has not been made. The Panel made the interim order for 18 months, to allow for any appeal to be dealt with. When the appeal period expires, this interim order will come to an end unless an appeal has been filed with the High Court. If there is no appeal, the final order shall take effect when the appeal period expires.

6. The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001 on the grounds that it is necessary to protect members of the public and is otherwise in the public interest.

7. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

 

History of Hearings for Graham Flatman

Date	Panel	Hearing type	Outcomes / Status
02/04/2024	Conduct and Competence Committee	Final Hearing	Suspended
23/10/2023	Conduct and Competence Committee	Final Hearing	Adjourned part heard