Alice Langley
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Allegation
As a registered Speech and Language Therapist (SL27744) your fitness to practise is impaired by reason of misconduct and/or lack of competence and/or health. In that:
1. Between June 2015 and June 2016, during your employment with The Royal Wolverhampton NHS Trust, you did not meet the competency for a band 5 Speech and Language Therapist, in that:
a. You did not complete the Identification of Need tool form for one or more of the Service Users set out in Schedule A
b. You did not complete reports in a timely manner for one or more of the Service Users set out in Schedule B
c. You did not close one or more of the Service User records, as set out in Schedule C, on the Trust’s case management system IPM.
d. You did not complete and/or save the Service User reports onto the Trust’s drives and/or case notes for one or more of the Service Users set out in Schedule D.
e. You did not ensure one or more of the Service Users, as set out in Schedule F, were regularly reviewed and/or you failed to set them review dates.
f. You did not complete case notes for one or more of the Service Users set out in Schedule G.
g. You did not document your clinical reasoning and/or your clinical reasoning was incorrect for one or more of the following Service Users in Schedule H.
h. You did not complete the Service Users reports to the required standard, for one or more of the Service Users set out in Schedule I.
i. You did not follow up with one or more of the Service Users as set out in Schedule J
j. You did not discharge one or more of the Service Users as set out in Schedule K
k. You did not complete the Service User plans to the required standard and/or did not review or update plans when necessary, for one or more of the Service Users set out in Schedule M.
2. You have a physical and/or mental health condition as set out in Schedule L.
3. Your actions in paragraph 1 constitute misconduct and/or lack of competence.
4. By reason of your misconduct and/or lack of competence and/or health your fitness to practise is impaired.
Schedule A
Service User 1
Service User 4
Service User 6
Service User 10
Service User 13
Service User 19
Service User 20
Service User 23
Service User 32
Service User 39
Service User 42
Service User 43
Service User 44
Service User 45
Service User 48
Service User 52
Service User 61
Service User 79
Service User 80
Service User 88
Service User 101
Service User 113
Service User 116
Service User 121
Schedule B
Service User 10
Service User 12
Service User 13
Service User 15
Service User 17
Service User 18
Service User 19
Service User 20
Service User 21
Service User 24
Service User 25
Service User 26
Service User 29
Service User 30
Service User 31
Service User 32
Service User 33
Service User 34
Service User 35
Service User 36
Service User 37
Service User 40
Service User 42
Service User 43
Service User 44
Service User 45
Service User 47
Service User 48
Service User 49
Service User 52
Service User 53
Service User 55
Service User 56
Service User 61
Service User 63
Service User 64
Service User 66
Service User 71
Service User 72
Service User 74
Service User 75
Service User 76
Service User 78
Service User 79
Service User 80
Service User 81
Service User 82
Service User 84
Service User 85
Service User 86
Service User 87
Service User 88
Service User 89
Service User 90
Service User 91
Service User 93
Service User 97
Service User 98
Service User 99
Service User 100
Service User 103
Service User 104
Service User 111
Service User 112
Service User 114
Service User 116
Service User 117
Service User 118
Service User 119
Service User 120
Service User 121
Service User 122
Service User 123
Service User 124
Service User 125
Service User 126
Service User 127
Service User 128
Service User 129
Service User 130
Service User 131
Service User 132
Service User 133
Service User 134
Service User 135
Service User 136
Service User 137
Service User 138
Service User 139
Service User 140
Service User 141
Service User 142
Service User 143
Service User 144
Service User 145
Service User 146
Service User 147
Service User 155
Service User 164
Schedule C
Service User 1
Service User 2
Service User 3
Service User4
Service User 5
Service User 6
Service User 7
Service User 8
Service User 10
Service User 66
Service User 67
Service User 68
Service User 69
Service User 102
Service User 108
Schedule D
Service User 3
Service User 4
Service User 7
Service User 12
Service User 13
Service User 15
Service User 17
Service User 18
Service User 19
Service User 22
Service User 23
Service User 24
Service User 25
Service User 26
Service User 28
Service User 29
Service User 30
Service User 31
Service User 32
Service User 33
Service User 34
Service User 36
Service User 37
Service User 38
Service User 39
Service User 40
Service User 41
Service User 42
Service User 43
Service User 44
Service User 46
Service User 47
Service User 48
Service User 49
Service User 51
Service User 55
Service User 56
Service User 57
Service User 61
Service User 62
Service User 63
Service User 67
Service User 71
Service User 72
Service User 73
Service User 75
Service User 76
Service User 77
Service User 79
Service User 81
Service User 82
Service User 83
Service User 84
Service User 85
Service User 86
Service User 87
Service User 88
Service User 89
Service User 90
Service User 91
Service User 92
Service User 93
Service User 94
Service User 95
Service User 96
Service User 97
Service User 98
Service User 99
Service User 100
Service User 101
Service User 102
Service User 103
Service User 104
Service User 117
Service User 119
Service User 120
Service User 121
Service User 126
Service User 127
Service User 136
Service User 137
Service User 139
Service User 140
Service User 143
Service User 144
Service User 147
Service User 156
Service User 157
Service User 158
Service User 159
Service User 160
Service User 161
Service User 162
Service User 163
Service User 165
Service User 166
Service User 168
Service User 169
Service User 171
Service User 173
Service User 174
Schedule F
Service User 11
Service User 14
Service User 16
Service User 17
Service User 27
Service User 35
Service User 38
Service User 50
Service User 55
Service User 59
Service User 60
Service User 62
Service User 65
Service User 70
Service User 74
Service User 86
Service User 88
Service User 89
Service User 95
Service User 97
Service User 106
Service User 116
Service User 122
Service User 130
Service User 147
Service User 169
Service User 170
Schedule G
Service User 4
Service User 7
Service User 12
Service User 15
Service User 19
Service User 23
Service User 24
Service User 25
Service User 30
Service User 31
Service User 38
Service User 39
Service User 41
Service User 43
Service User 44
Service User 46
Service User 47
Service User 48
Service User 49
Service User 51
Service User 55
Service User 61
Service User 62
Service User 71
Service User 72
Service User 75
Service User 76
Service User 77
Service User 79
Service User 81
Service User 82
Service User 83
Service User 84
Service User 85
Service User 86
Service User 87
Service User 88
Service User 89
Service User 90
Service User 91
Service User 92
Service User 93
Service User 94
Service User 95
Service User 96
Service User 97
Service User 98
Service User 99
Service User 100
Service User 101
Service User 102
Service User 103
Service User 104
Service User 118
Service User 126
Service User 127
Schedule H
Service User 42
Service User 44
Service User 48
Service User 74
Service User 77
Service User 81
Service User 85
Service User 87
Service User 99
Service User 140
Service User 167
Schedule I
Service User 6
Service User 24
Service User 28
Service User 29
Service User 30
Service User 31
Service User 32
Service User 33
Service User 35
Service User 36
Service User 37
Service User 40
Service User 44
Service User 50
Service User 56
Service User 57
Service User 62
Service User 68
Service User 72
Service User 73
Service User 75
Service User 78
Service User 80
Service User 84
Service User 85
Service User 86
Service User 87
Service User 88
Service User 89
Service User 90
Service User 91
Service User 93
Service User 94
Service User 96
Service User 97
Service User 99
Service User 100
Service User 101
Service User 103
Service User 104
Service User 105
Service User 113
Service User 114
Service User 115
Service User 119
Service User 122
Service User 125
Service User 126
Service User 127
Service User 128
Service User 129
Service User 130
Service User 131
Service User 134
Service User 138
Service User 139
Service User 140
Service User 143
Service User 144
Service User 145
Service User 150
Service User 164
Service User 166
Service User 171
Service User 173
Schedule J
Service User 11
Service User 16
Service User 38
Service User 42
Service User 45
Service User 49
Service User 50
Service User 59
Service User 60
Service User 65
Service User 70
Service User 74
Service User 77
Service User 79
Service User 84
Service User 88
Service User 89
Service User 93
Service User 94
Service User 95
Service User 96
Service User 97
Service User 100
Service User 105
Service User 106
Service User 107
Service User 111
Service User 116
Service User 120
Service User 130
Service User 162
Service User 172
Schedule K
Service User 1
Service User 2
Service User 3
Service User 4
Service User 5
Service User 6
Service User 7
Service User 8
Service User 10
Service User 20
Service User 21
Service User 35
Service User 66
Service User 67
Service User 68
Service User 69
Service User 92
Service User 102
Service User 108
Service User 176
Service User 177
Schedule L
In Private
Schedule M
Service User 43
Service User 44
Service User 46
Service User 47
Service User 48
Service User 49
Service User 51
Service User 55
Service User 63
Service User 76
Service User 78
Service User 105
Service User 139
Service User 145
Finding
Preliminary matters
Private Hearing
1. At the beginning of the hearing, the Panel considered a joint application by Mr Harris, on behalf of the HCPC, and the Registrant, for parts of the hearing to be conducted in private as reference would be made to the Registrant’s health and private life. Having received advice from the Legal Assessor, the Panel granted that application in view of the principles set out in the HCPTS Practice Note, Conducting Hearings in Private. The Panel determined that those parts of the hearing that concern the Registrant’s health and private life should be conducted in private.
Background
2. The Registrant is a registered Speech and Language Therapist (SLT) who was employed by the Royal Wolverhampton NHS Trust (the Trust) as a Band 5 SLT from 2 February 2009 to 20 January 2017.
3. In June 2015, the Trust carried out an audit of the Registrant’s caseload which revealed a number of concerns regarding her record-keeping. The concerns included:
• issues with the quality of reports produced;
• a lack of reports produced;
• a lack of treatment plans;
• a lack of Identification of Need Tool (INT) documentation; and
• the recording of inaccurate information.
4. The Trust then carried out seven months of informal monitoring of the Registrant’s practice, during which the Registrant met weekly with her Line Manager to review her progress.
5. In February 2016, as there had been no significant improvement in the Registrant’s record-keeping, the Trust commenced Stage One of its Capability Process. During a meeting in May 2016, the Trust’s ongoing concerns were raised with the Registrant with a view to escalating the matter to a Stage Two Capability Meeting. Subsequently, the Registrant was re-deployed to non-clinical duties from May 2016 to June 2016.
6. During the period covered by the Allegation, the Registrant had three periods of sick leave. Between February and September 2016, Registrant’s health and capability issues were managed under the Trust’s Capability and Sickness and Absence Policies.
7. On 2 September 2016, a Stage Two Capability Meeting was held. From 2 September 2016 to January 2017, the Registrant was redeployed to a clerical role within the Orthopaedics department. The Registrant left the Trust on 20 January 2017.
8. On 28 June 2017 the Trust referred the Registrant to the HCPC and, on 12 March 2021, a panel of the Investigating Committee found that there was a case for the Registrant to answer and referred an Allegation to this Committee.
9. The Final hearing in relation to this matter took place in 2023. The Registrant did not attend the hearing and was not represented at it.
10. A panel of the Conduct and Competence Committee found that the failings identified in the Registrant’s professional practice were wide ranging and that her deficiencies constituted a lack of competence in relation to the following areas: not completing the Identification of Need tool form for service users; not completing reports for service users in a timely manner; not closing service user records on the Trust’s case management system; not completing and/or saving service user records onto the Trust’s drives; not ensuring that service users were reviewed regularly; not completing case notes; not completing records to the required standard; not following up with service users; not discharging service users; and not completing treatment plans to the required standard.
11. In coming to its decision on impairment at the Final hearing, the panel commented as follows: “The Panel is satisfied that the Registrant’s lack of competence is remediable. The Trust’s capability process which the Registrant was required to undertake, was intended to allow her to achieve and maintain the relevant standards of practice as a Band 5 SLT. However, as the Registrant has not engaged with these proceedings, there is no evidence before the Panel to show that she has taken any steps since leaving the Trust to remedy her lack of competence. The Panel notes that the Registrant was able to make some progress in some areas of her practice during the capability process, but that she was not always able to maintain this. The Registrant has not shown that she has insight into her lack of competence and its effect on the Service Users concerned, on her colleagues, or on her profession. There is no evidence that the Registrant has properly reflected on her lack of competence. The Panel also notes that while the Registrant’s state of health at the relevant time may have been a factor contributing to her lack of competence, it has no evidence of the current state of her health and how she is managing this. The Panel has concluded that, in the absence of any information to show that the Registrant has taken steps to remedy her shortcomings, there is a real risk of repetition in this case.”
12. The panel found that the Registrant’s fitness to practise was impaired both on the grounds of public protection and from the point of view of the public interest.
13. That panel imposed a Suspension Order for a period of 12 months and considered that a reviewing panel may be assisted by the attendance of the Registrant; a reflective piece from her, evidencing her insight into the consequences of her shortcomings on not only the service users in her care, but also on her colleagues, her profession, and the wider public; information about what the Registrant has been doing by way of employment, since she left the Trust; up to date references and testimonials; evidence of Continuing Professional Development (CPD)and evidence of keeping her knowledge and skills up to date; and evidence from the Registrant’s GP as to the current state of her health and how the Registrant is managing this.
14. This is the first review of the Suspension Order imposed on 14 September 2023.
Evidence
15. The Registrant attended the hearing and represented herself. She gave sworn oral evidence to the Panel. The Registrant told the Panel that she has no intention of returning to work as a registered SLT. She explained to the Panel that that this is principally because she has struggled to recover from the trauma of having to leave her career as an SLT, having worked so hard to achieve her registration. The Registrant explained that the long process of being pursued at the Trust, and then having to leave, has had a huge impact on her life. She stated that returning to work in the SLT profession would be detrimental to her health and well-being. The Registrant explained that she has suffered significant health challenges as a result of the situation at the Trust and these resulting proceedings, and that she has worked very hard to move forward and to rebuild her life. The Registrant told the Panel that she has been working as a Training and Events Manager for a health/technology company for the last seven years.
16. In answer to a question from the Panel, the Registrant stated that she was not asking the Panel for anything specific today; rather, she wanted the Panel to know that she wished to move on with her life, stating that “my priorities are elsewhere” and that she wished for these proceedings to come to a close.
Submissions
17. Mr Harris submitted that the Registrant’s fitness to practise continues to be impaired and that a further 12-month period of suspension would be appropriate in this case. Mr Harris submitted that the Registrant has not provided evidence of compliance with the suggestions made to her by the panel at the Final hearing and no evidence of any remediation. He submitted that, in light of the Registrant’s stated intention not to work in a registered role as an SLT, a conditions of practice order would not be practicable. He referred the Panel to the judgment in Clarke v General Optical Council [2017] EWHC 521 and further submitted that allowing the current Order to lapse upon its expiry on or around 12 October 2024 would not sufficiently protect the public. He noted that the Registrant is of working age, able to work, and could decide to re-register in the future.
18. The Registrant confirmed to the Panel that she had no further submissions to make.
Decision
19. This Panel accepted the advice it received from the Legal Assessor as to the proper approach that it should adopt, and had regard to the HCPTS Practice Notes entitled “Review of Article 30 Sanction Orders” and “Fitness to Practise Impairment”. The Panel is carrying out a comprehensive reconsideration of the Suspension Order in light of the current circumstances. The Legal Assessor advised that, in practical terms, there was a persuasive burden on the Registrant to show that her fitness to practise is no longer impaired and that all the shortcomings which led to the original finding of impairment have now been overcome. The Panel was referred to the case of Abrahaem v GMC [2008] EWHC 183 (Admin) and the principle that it is for a registrant to fully acknowledge why past performance was deficient and demonstrate that they have, “through insight, application, education, supervision and other achievement … sufficiently addressed the past impairments”.
20. The Panel bore in mind that it must first decide if a finding of current impairment is necessary to protect the public from any risk of harm (assessing the extent of any current or future risk), to maintain public confidence in the profession, or to declare and uphold the proper standards of conduct or behaviour. This is a matter for the Panel’s independent judgment and is essentially a risk assessment in light of all the information before the Panel today.
21. The Panel bore in mind that any approach to the issue of whether a Registrant’s fitness to practise should be regarded as impaired must take account of the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.
22. The Panel first considered whether the Registrant’s fitness to practise is currently impaired, and it exercised its own professional judgement in this regard. In undertaking this review, the Panel took into account all of the documentation before it, including the determination from the Final hearing, and the new evidence provided by the Registrant by way of her oral evidence. It also considered the submissions of both parties.
23. The Panel considered that the Registrant’s case has not moved on factually since the Final hearing. It acknowledged and accepted the Registrant’s explanation around her commitment to regain her good health and confidence in the workplace in a non-registered role, outside of the healthcare setting.
24. The Registrant has not, however, evidenced any efforts to remediate the deficiencies found proved at the Final hearing and, as such, determined that the Registrant’s fitness to practise continues to be impaired. In the absence of any evidence of remediation, the Panel remained concerned that there was a risk of repetition of the failings identified. The Panel therefore concluded that the Registrant remained liable to put service users at risk of harm in the future and that the Registrant remained impaired on the personal component.
25. The Panel then considered the public component and the wider public interest in the case. The Panel was of the view that, in the absence of remediation, members of the public would be concerned if such a registrant were able to practise without restriction. In those circumstances, the Panel was of the view that the need to protect the public, and to uphold confidence in the profession and the regulator would be undermined if a finding of impairment were not made.
26. The Panel next considered the issue of sanction and had in mind the HCPC’s Sanctions Policy. The Panel was aware that sanction is a matter for its own professional judgement. It has borne in mind that any sanction must be proportionate and that the primary purpose of sanction is protection of the public. Any sanction it imposes must protect the public but must be the least restrictive sanction that achieves that aim.
27. The Panel first considered taking no action in this case and allowing the current Suspension order to lapse upon its expiry. It was mindful of the Registrant’s evidence that she is no longer paying her professional fees and was of the view that her registration as an SLT is only active by virtue of this regulatory hearing process. On the other hand, the Panel was mindful of the HCPC’s submission that the Registrant is of working age and able to work as an SLT and that her stated intentions not to work as an SLT could change. The Panel bore in mind the guidance given in Clarke v General Optical Council which highlights that the key tenet is the protection of the public, and the need for a reviewing panel to assess future or continuing risk to the public. It was of the view that, at this stage, the evidence of the Registrant’s decision or resolution not to practise again is less compelling than, in that case, Mr Clarke’s retirement and his written declaration/undertaking to that end. In light of this, the Panel was of the view that there is a continuing risk to the public and that the public would not be suitably protected and the public interest would not suitably be upheld by allowing the current Order to expire.
28. The Panel next considered a caution order and decided that this would not be appropriate, because it would not place any actual restriction on the Registrant’s practice to address the public protection concerns.
29. The Panel then considered whether a period of conditions of practice would be appropriate to enable the Registrant to proactively seek employment as an SLT and demonstrate to a future panel that she is a safe practitioner. The imposition of a conditions of practice order requires a registrant to engage fully with the fitness to practise process to protect the public and improve her professional practice, with a view to returning her to safe and unrestricted practice. The Panel took into account the Registrant’s clearly stated intention not to return to professional practice and, as such, determined that a conditions of practice order would not be appropriate or practicable in these circumstances.
30. The Panel decided to extend the current Suspension Order for a period of 12 months. It considered that the time period was appropriate and proportionate in order to protect the public and maintain public confidence in the profession and its regulation.
31. The Panel noted that it did not, at this stage, have the power to make a striking-off order as this is a lack of competence matter and the Registrant has not been subject to a substantive order for two years or more.
32. This Suspension Order will be reviewed towards the end of the twelve month period and this Panel would expect any future panel to be assisted by the following:
• The Registrant’s attendance at the next review hearing, either in person or remotely;
• A written statement or declaration/signed undertaking from the Registrant setting out her future intentions in relation to her professional practice as an SLT.
• If the Registrant on reflection wished to re-establish her career as an SLT then evidence of acting on the suggestions made by the final hearing panel would assist a future panel.
For the avoidance of doubt, this list is not exhaustive and it is provided only for the Registrant’s assistance; she must understand that it does not bind the future reviewing panel in any way.
Order
ORDER: The Registrar is directed to extend the suspension of the registration of Ms Alice Langley for a period of 12 months from the date that this Order expires.
Notes
The Order imposed today will apply from 12 October 2024.
This Order will be reviewed again before its expiry on 12 October 2025.
Right of Appeal
An appeal may be made to the High Court in England and Wales against the Panel’s decision and the order it has made.
Under Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served.
Hearing History
History of Hearings for Alice Langley
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 16/09/2024 | Conduct and Competence Committee | Review Hearing | Suspended |
| 12/09/2023 | Conduct and Competence Committee | Final Hearing | Suspended |
| 15/05/2023 | Conduct and Competence Committee | Final Hearing | Adjourned part heard |
| 13/03/2023 | Conduct and Competence Committee | Final Hearing | Adjourned part heard |