Miss Sutapa Halder

Preliminary Matters

Partly Private Hearing

1. At the start of the hearing, Ms O’Connor applied for any parts of the hearing in which the health of the Registrant or that of her family were mentioned, to be heard in private in order to protect her private life.

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

3. The Panel bore in mind the HCPTS Practice Note entitled “Conducting Hearings in Private” and Rule 10(1) of the Conduct and Competence (Procedure) Rules 2003.

4. The Panel decided that any reference to the Registrant’s health or that of her family, should be in private in order to protect the Registrant’s right to a private life.

Background

5. The Registrant was employed as a Band 5 Speech and Language Therapist by the East London NHS Foundation Trust (the Trust) from 1 October 2014 to 22 July 2016 when she resigned. She was responsible for providing speech and language therapy to children between the ages of 4 and 11 with speech, language, and communication needs.

6. During the Registrant’s employment, concerns were raised about her clinical documentation and record keeping. Her employer provided joint supervision arrangements and additional support and she was placed on a performance improvement plan. The problems, however, continued and so the Trust referred the case to the HCPC.
7. On 8 November 2017 a Panel of the Investigating Committee determined that the Registrant had a case to answer in relation to failures to:

• carry out and/or record appointments;

• complete or record contemporaneous clinical progress notes; and/or

• complete and/or record review reports and programmes reports in relation to three children (A, B and E) between October 2014 and September 2016. There were similar allegations in relation to two other children (C and D).

8. In a formal response to the allegation dated 27 September 2017, the Registrant accepted that her fitness to practise was impaired and that she was not yet ready to return to practice. She requested voluntary removal from the register until she was well enough to return. The Registrant set out mitigating circumstances in relation to her health and personal life and identified support mechanisms and coping strategies that would enable her to return to the profession.

9. On 4 February 2019 a panel of the Conduct and Competence Committee disposed of the matter by consent and imposed a 12-month suspension order, having determined that the Registrant’s fitness to practise was impaired by reason of her misconduct or lack of competence.

10. On 7 January 2020 at the first substantive order review, the panel determined that the Registrant’s fitness to practise remained impaired and extended the suspension order for a further period of 12 months. The panel also made recommendations that the Registrant should provide certain information and documents for the purpose of a future reviewing Panel.

11. On 6 January 2021 at the second substantive order review, the Registrant provided the following:

• a letter from a Band 6 and 7 Speech and Language Therapist who confirmed her agreement to act as the Registrant’s mentor;

• evidence of her placement with the Robert Blaire Primary School;

• extracts from her PIP application on behalf of her sister;

• invoices from Asian Care in relation to homecare services provided to her sister.

12. Notwithstanding the above, the HCPC submitted that the Registrant’s fitness to practise remained impaired and drew to the panel’s attention that the Registrant had not fully addressed the recommendations of the previous review panel; in particular:

• she had not provided any references or testimonials in relation to any paid or unpaid work;

• she had not yet applied for any courses that might help her address her deficiencies in practice, as recommended by the previous Panel;

• she had not yet properly addressed the original concerns about her failure to keep proper records;

• she had been unable to obtain a letter from her GP about her health.

13. The Registrant herself acknowledged that she had been unable to fully comply with the recommendations of the previous review Panel and did not oppose the imposition of a further 12-month period of suspension.

14. In light of the above, the panel at the second substantive order review determined that the Registrant’s fitness to practise remained impaired and imposed a further suspension order for a period of 12 months. The panel advised the Registrant that the next reviewing panel might be assisted by the following:

• references and testimonials relevant to her acknowledged impairment;

• evidence that she understands and follows a record-keeping policy;

• a CPD portfolio that meets all 5 of the HCPC’s standards;

• completion of an accredited Speech and Language Therapy return to practice short course;

• a personal action plan identifying objectives to be addressed and how to achieve them;
• evidence in relation to the management of her health;

• her attendance at the next review hearing.

15. The third review took place on 24 January 2022. The Registrant submitted that she had made good progress towards satisfying the recommendations of the previous review Panel. However, she acknowledged that she had further work to do. In particular, she intended to resume regular sessions with her mentor, undertake CPD and enrol on a Return to Practice course. She told the Panel that she now felt fully motivated to address the outstanding issues relating to her practice and to implement the recommendations of the previous review Panel.

16. The third review panel determined that the in the absence of evidence that the Registrant had fully gained insight into and addressed the deficiencies in her practice, her fitness to practise remained impaired in relation to the personal component and on public protection grounds. The third review Panel decided that, in all the circumstances, the appropriate and proportionate sanction was to impose a further Suspension Order for a period of 12 months.

17. The panel advised the Registrant that the next reviewing panel might be assisted by the following:

• the Registrant’s attendance in person at the hearing;

• references and testimonials relevant to showing how she has addressed her shortcomings outlined in the original allegations relating to record-keeping and clinical documentation;

• a reflective statement on her past shortcomings in record keeping, demonstrating that she understands the expectations of a Speech and Language Therapist in relation to record-keeping as outlined in the HCPC’s policy and giving practical examples of meeting the required standards;

• a CPD portfolio structured around competencies, cataloguing examples of how she meets each of the 5 HCPC standards;

• evidence that she has satisfied the HCPC return to practice requirements (60 days of updating) for someone who has been out of practice for more than 5 years;

• a SMART personal action plan setting out how she will achieve the objective of remedying her deficiencies in record keeping and completing clinical documentation.

18. At the fourth review, 6 January 2023, the Registrant attended and submitted a number of documents, including:

• An undated reflective piece which included an example of how the Registrant is recording her CPD;

• Written confirmation, dated 27 June 2022 of the Registrant’s appointment as a Teaching Assistant and the unsigned acceptance form, dated 1 September 2022;

• Various medical letters and reports from 2020 to 2022;

• A screenshot of the Registrant’s acceptance at Birmingham City University to study on the Return to Practise Course via distance learning;

• Extracts of notes written by the Registrant in her role as a Teaching Assistant.

19. That reviewing panel considered all the evidence before it and decided that while the efforts which the Registrant had made were worthy of significant credit, as the Registrant herself acknowledged, she still had some way to go. The Panel found that her fitness to practice remained impaired and decided that a Suspension Order should be imposed for a further period of 12 months, whereby the Registrant would be given the opportunity to demonstrate that she was committed to addressing the deficiencies in her practise and collating the evidence to put before a future reviewing Panel.

20. The panel advised the Registrant that the next reviewing panel would be assisted by the following:

• the Registrant’s attendance in person at the hearing;

• references and testimonials from professional colleagues relevant to showing how she has addressed her shortcomings outlined in the original allegations relating to record-keeping and clinical documentation;

• an updated reflective statement on her past shortcomings in record keeping, demonstrating that she understands the expectations of a SLT in relation to record-keeping as outlined in the HCPC’s policy and giving practical examples of meeting the required standards;

• a CPD portfolio structured around competencies, cataloguing examples of how she meets each of the 5 HCPC standards;

• a SMART personal action plan setting out how she will achieve the objective of remedying her deficiencies in record keeping and completing clinical documentation.

• A report from an SLT mentor specifically covering record keeping and clinical documentation;

• Any evidence of work-based placements and/or shadowing placements including

Today’s hearing

21. The Panel had before it the HCPC bundle, and a document submitted by the Registrant entitled “Request to be considered for Voluntary Removal”.

Submissions on behalf of the HCPC

22. Ms O’Connor, on behalf of the HCPC, outlined the background to the case. Ms O’Connor informed the Panel that the Registrant had submitted her document, entitled “Request to be considered for Voluntary Removal” to the case manager on 12 January 2024. Ms O’Connor submitted that the Registrant’s fitness to practise remained impaired on the basis that she had not been able to make progress since the last hearing. Ms O’Connor invited the Panel to impose a further Suspension Order for a period of 12 months in order to protect the public. This would also allow the HCPC to consider the request for voluntary removal and decide whether or not to proceed on that basis. Ms O’Connor informed the Panel that this was an agreed position between the parties which had been discussed in a pre-hearing meeting with the Legal Assessor present.

23. The Registrant gave evidence under Affirmation and gave details of the health issues of her family members which had meant that since the last review hearing, (REDACTED). The Registrant outlined in detail the responsibilities she had in this regard, which, combined with her need to take on a second job to meet her financial responsibilities, meant that she had been unable to take the steps suggested by the previous reviewing Panel. Her responsibilities also meant that she was unable to continue with the Return to Practise course upon which she had enrolled in 2023. She asked that the Panel see that she had tried very hard to remedy her failings, had shown contrition, and was aware of the impact of her failings in 2014-2016. She sought an opportunity to be voluntarily removed from the register because she needed to focus on her family, and that she had, as a result, become reconciled to the fact that she would not be able to practice in the future.

Decision

The Panels approach

24. In undertaking this review, the Panel took into account the documentary evidence, the submissions from Ms O’Connor, and the Registrant’s oral evidence.

25. The Panel accepted the advice of the Legal Assessor as to the proper approach it should adopt. The Panel was aware that its purpose today was to conduct a comprehensive review of the Registrant’s fitness to return to unrestricted practice and considered the HCPTS Practice Notes entitled “Review of Article 30 Sanction Orders”, and “Fitness to Practise Impairment”. The Panel must exercise its own independent judgement with regard to impairment. Only if Impairment remained, would the Panel then go on to consider what sanction, if any to impose.

Impairment

26. The Panel considered the Registrant’s evidence and was of the view that she demonstrated considerable insight, remorse and candour before it today. Her difficult personal circumstances about which she gave oral evidence, and which were not challenged by the HCPC, were put forward by her as the reason why she was unable to continue with action to address her failings. The Panel accepted her evidence in this regard.

27. In light of the lack of remediation, this Panel could not be satisfied that the concerns highlighted by the Consent Hearing Panel would not be repeated. There remained a real risk of harm to service users. Therefore, the Panel determined that the Registrant’s fitness to practise remained impaired on the basis of the personal component, by reason of her previous misconduct and/or lack of competence.

28. The Panel went on to consider the wider public interest and concluded that, in light of the ongoing risk to service users, public confidence in the profession and the need to uphold proper standards of conduct and performance, would be undermined if no finding of impairment were made. As a consequence, the Panel determined that the Registrant’s fitness to practise remained impaired based on the public component.

Sanction

29. Having determined that the Registrant’s fitness to practise remained impaired the Panel went on to consider what sanction, if any, should be imposed. The Panel bore in mind that the purpose of a sanction was not to punish the Registrant but to protect the public.

30. The Panel first considered taking no action. The Panel concluded that given the fundamental nature and seriousness of the Registrant’s previous misconduct and/or lack of competence which had not been remedied and in the absence of exceptional circumstances, it would be inappropriate to take no action. Further, it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.

31. The Panel then considered a Caution Order. The Registrant’s conduct and behaviour was not minor in nature and had the potential to have wide-ranging adverse consequences. Furthermore, the Registrant has not yet demonstrated that failings in her skills and knowledge identified in the Consent Hearing, had been adequately addressed. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the public interest.

32. The Panel went on to consider a Conditions of Practice Order. The Panel noted that the Registrant was not in a position to return to work and was seeking voluntary removal from the register In these circumstances, conditions were not workable.

33. The Panel next considered extending the current Suspension Order for a further period of time. A Suspension Order would send a further signal to the Registrant, the profession, and the public, reaffirming the standards expected of a registered SLT. A Suspension Order would continue to protect the public and uphold the public interest by preventing the Registrant from practicing. A duration of 12 months, the maximum period, would reflect the seriousness of the failings and the lack of remediation of them. A Suspension Order would also provide an opportunity for the parties to explore the possibility of voluntary removal.

34. Thus, the Panel decided that the appropriate and proportionate order is a Suspension Order. A Striking Off Order would be disproportionate as the failings in the Registrant’s practice are capable of being remedied, she has shown considerable insight and remorse, there are no attitudinal issues, and she has found herself in personal circumstances which have prevented her taking steps to remediate, rather than being unwilling to do so.

35. The Suspension Order will be reviewed shortly before expiry.

ORDER: The Registrar is directed to suspend the registration of Miss Sutapa Halder for a further period of 12 months on the expiry of the existing order.

This Order will be reviewed again before its expiry on 4 February 2025.

History of Hearings for Miss Sutapa Halder