Lisa Forgione
Profession: Practitioner psychologist
Registration Number: PYL039401
Hearing Type: Final Hearing
Date and Time of hearing: 10:00 10/12/2025
End:
17:00 11/12/2025
Location:
Virtually via Video Conference
Panel: Conduct and Competence Committee
Outcome: Suspended
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Allegation
Allegation (as amended at the hearing):
As a registered Practitioner Psychologist ([PYL039401) your fitness to practise is impaired by reason of misconduct. In that:
1. At an unknown time between October 2019 and 12 July 2021, you breached professional boundaries with Service User A in that you entered into an emotional and/or romantic relationship with him while he was assigned to you at HMP Isle of Wight.
2. On 6 September 2021, you provided a response to security questions from the Ministry of Justice in which you stated you had never been in a relationship with Service User A or given him the impression that you would want a relationship with him, when this was not the case.
3. On 6 September 2021, you provided a response to security questions from the Ministry of Justice in which you stated that Service User A had disclosed the presence of a relationship between yourself and him for reasons as set out in Schedule A, when this was not the case.
4. Between 25 December 2021 and 15 February 2022, you breached professional boundaries and/or did not act in the best interests of Service User A by carrying out the course of conduct set out in Schedule B.
5. On 16 May 2022, you breached professional boundaries and/or did not act in the best interests of Service User A during the purple visit by carrying out the course of conduct set out in Schedule C.
6. On 20 May 2022, you wrote a letter to the HCPC in which you stated that you were not in a sexual, financial or emotional relationship with Service User A when this was not the case.
7. On 24 July 2022, you breached professional boundaries and/or did not act in the best interests of Service User A by sending him a birthday card detailed in Schedule D.
8. Your conduct in relation to allegations 1, 4, 5 and/or 7 was sexual in nature.
9. Your conduct in relation to allegations 2, 3 and/or 6 was dishonest.
10. The matters set out in allegations 1 to 9 above constitute misconduct
11. By reason of your misconduct your fitness to practise is impaired.
Schedule A
You said, “My guess is that this may be linked to his personality difficulties, which make it difficult for him to regulate his emotions and deal with perceived rejection and abandonment. This combined with his own sense of victimisation and high levels of vengeful thinking may have led him to behave in this way in an attempt to harm me and cause me distress for leaving him/my job and letting him down.”
Schedule B
25/12/2021: Telephone contact between registrant and Service User A via the ward payphone
04/01/2022: Four-hour call between Service User A and registrant
08/01/2022: Call from registrant to Service User A
09/01/2022: Call between Service User A and registrant
16/01/2022: Four-hour call between Service User A and registrant
23/01/2022: Call between Service User A and registrant finishing at 04:00 on
24/01/2022
29/01/2022: Several hour-long call between Service User A and registrant
01/02/2022: Several hour-long call between Service User A and registrant
02/02/2022: Several hour-long call between Service User A and registrant
03/02/2022: Moonpig Valentine’s Day card received by Service User A from the registrant
04/02/2022: SKYPE session between Service User A and registrant. Registrant observed to share photographs of herself in a bikini and topless with her arms across her breasts during the call
06/02/2022 SKYPE: call between registrant and Service User A followed immediately by phone call between Service User A and registrant
07/02/2022 SKYPE: call between registrant and Service User A
08/02/2022 SKYPE: call between registrant and Service User A including the registrant showing Service User A photos of other men and asking him to rate them
10/02/2022 SKYPE call between registrant and Service User A
12/02/2022 Mobile telephone call between Service User A and registrant
12/02/2022 SKYPE call between registrant and Service User A
14/02/2022 SKYPE call between registrant and Service User A
15/02/2022 SKYPE call between registrant and Service User A
Schedule C
I. You told Service User A, “You make me happy. I will miss your face. I’m seeing you in less that two weeks I’m really excited. I’m with you to the end” or words to that effect.
ii. After Service User A asked you what side of the bed was his, you demonstrated the side of the bed to him.
iii. You agreed to send photographs of yourself to Service User A.
iv. When Service User A spoke about your ‘peach’, you stood up and showed him your clothed buttocks.
Schedule D
i. Cover of the card has photographs of you in a bikini and topless (with an arm across your breasts).
ii. The card contains the following message:
Words are not enough to express my feelings for you. You make my life worth living. You bring smiles to my face even in my worst days and you always show me how much you love me and care for me. Even the darkest thoughts fade away when you smile at me. And when you look me in the eyes my world shines as bright as you. You are my best friend and my lover. I feel like the luckiest woman on Earth because I have the most wonderful man by my side. Thank you for being my rock.
I hope your birthday is as beautiful and full of love as you are. You deserve only the best, and I only wish that for you. May life bring you everything you are dreaming about.
Happy birthday bumbo mio…
This is the first of many birthdays together.
I’m sure we’ll make it special together and we’ll remember it forever for this reason.
Più di ieri, meno di domani
Always and forever
Lisa xxx
Finding
Preliminary Matters
Application to amend the Allegation
1. At the outset of the hearing Ms Hughes made an application to make some minor amendments to the formal Allegation. In respect of Allegation 5 she said there were some errors in the transcription of the contents of the birthday card. Ms Hughes submitted that the proposed amendments would not alter the substance of what was alleged, they were just to correct minor typographical errors, and no injustice would be caused to the Registrant.
2. Ms Hughes added that with regards to Allegation 2, the quotation from exhibit JB/2 of the Registrant’s answers to security questions on 6 September 2021 was not a direct quote, but rather a description of the answer given. Accordingly, she invited the Panel to remove the quotation marks and make it clear this was not a direct quote.
3. The Panel also raised with Ms Hughes the numbering in Schedules C and D which appeared nonsensical. Ms Hughes agreed that the numbering was unhelpful and proposed changing the numbering to Roman numerals in order to provide clarity.
4. Ms Fletcher-Smith did not oppose the application and agreed it would be beneficial to change the numbers as suggested.
5. The Panel considered the application with care and accepted the advice of the Legal Assessor. He advised the Panel that it could amend the Allegation at any stage prior to the findings of fact, unless having regard to the merits of the case and the fairness of the proceedings, the required amendment could not be made without injustice.
6. The Panel was satisfied that the requested and suggested amendments amounted to minor changes, and no injustice would be caused to the Registrant in allowing them. Accordingly, the Panel decided to allow all the proposed amendments and in doing so took into account the lack of any objection by Ms Fletcher-Smith, on behalf of the Registrant.
Application for the hearing to be partly in private
7. Ms Fletcher-Smith made an application for part of the hearing to be heard in private. She informed the Panel that there were parts of the Registrant’s evidence that related to her health, and it would be inappropriate for those matters to be heard in public. The Chair asked Ms Fletcher-Smith if her application extended to include personal matters and family members that are also mentioned in the papers. Ms Fletcher-Smith said that she did not intend going into any further detail about such matters, but that if they were referred to then she would like to include them as part of her application.
8. Ms Hughes on behalf of the HCPC did not object to the application and said she thought it was a “sensible” approach.
9. The Panel considered the application with care and accepted the advice of the Legal Assessor, who advised that Rule 10, of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003, allows for the hearing to be heard partly in private where to so do is necessary for the protection of the private life of a registrant. Accordingly, the Panel decided that where matters relating to the Registrant's health or her private life and that of her family were raised, they would be dealt with in private in order to protect her privacy. The rest of the hearing would be conducted in public in the usual way.
Admissions
10. Ms Fletcher-Smith took the Panel through the Allegation, indicating those parts that were admitted by the Registrant and those disputed, as follows:
1 - The Registrant denied being in an emotional and or romantic relationship and therefore denied there was any breach of professional boundaries.
2 - The Registrant accepted she made the response to the security questions, but denied it was inaccurate.
3 - The Registrant accepted she made the response to the security questions and gave the reasons set out in Schedule A, but denied any inaccuracy.
4 - The Registrant disputed breaching professional boundaries and disputed not acting in the best interests of Service User A. The Registrant accepted the general course of conduct reflected in Schedule B, but not the entirety of that conduct. She is unable to pick out specific dates but disputes the volume and length of some of the calls as recorded in the Schedule.
5 - The Registrant accepted she went on the purple visit with Service User A, but disputed anything she did was a breach of professional boundaries or was not in the best interests of Service User A. The Registrant accepted the entirety of the content of Schedule C (although this was later amended after the video of the call was watched for the first time - during the hearing - and it was apparent that C(ii) was not in fact supported by the evidence).
6 - The Registrant accepted writing the letter to the HCPC and stating she was not in sexual, financial or romantic relationship with Service User A, but disputed that this was not in fact the case.
7 - The Registrant accepted sending a birthday card to Service User A and accepted the contents of Schedule D (i) and (ii), but
denied a breach of professional boundaries and denied not acting in the best interests of Service User A.
8 - The Registrant denied that her conduct was sexual in nature with regards to Allegations 1, 4 and 5, but accepted sending the birthday card, referred to in Allegation 7, was sexual in nature.
9 - The Registrant denied acting dishonestly at any stage.
10 - The Registrant denied the allegation of misconduct.
11 - The Registrant denied the allegation that her fitness to practice was impaired.
11. In the Panel’s view the partial admissions made by the Registrant were helpful in terms of identifying the issues in the case, but did not mean there was a clear admission to any specific allegation. Accordingly, the Panel decided to note the partial admissions, but did not make any formal finding that any of the Allegation was proved by way of admission.
Background
12. The Registrant is a Practitioner Psychologist who, between October 2019 and July 2021, conducted psychology sessions with Service User A, who was (and still is) serving an indeterminate prison sentence.
13. At some stage between October 2019 and July 2021, when the Registrant was conducting sessions with Service User A at HMP Isle of Wight, it was alleged that the Registrant and Service User A developed an emotional and/or romantic relationship.
14. The HCPC’s case was that this alleged relationship amounted to a breach of professional boundaries by the Registrant and was sexual in nature. This was the basis of Allegation 1.
15. In around March 2021, HM Prison and Probation Service (“HMPPS”) Corruption Team received an Intelligence Report via their intelligence management tool, Mercury, which suggested that Service User A had informed a member of prison staff at HMP Isle of Wight, that he had proposed going on a date with the Registrant. She allegedly told him that she would accept his offer of a date. A further Intelligence Report was received in July 2021, which said that Service User A had informed his Probation Officer, A-LW, that he was in a romantic relationship with the Registrant.
16. It was alleged that the Prison Service also became aware, on 23 July 2021, that Service User A had disclosed that the Registrant had made and sent greetings cards and romantic messages to him. On a separate occasion, though after the Registrant had resigned from HMPPS, Service User A disclosed that he had asked his grandmother to send messages to the Registrant via Facebook on his behalf. In August 2021, the Prison Service received information that Service User A had asked his brother to facilitate contact with the Registrant via mobile phone. The Prison Service was aware that the Registrant had responded to messages from Service User A’s grandmother and brother, as this was captured as part of the routine telephone monitoring of Service User A’s PIN phone account, although those records were no longer available.
17. On 12 July 2021, the Registrant was promoted to the role of Registered Psychologist in HMPPS and moved into the South Central Psychology team, with a base at HMP Winchester. She formally resigned from HMPPS on 24 August 2021, although her managers were aware of her intention to leave prior to that date. Her final date of employment was 30 September 2021, although she was on sick-leave for some of August and all of September 2021.
18. Prior to her resignation, in around July/August 2021, HMP Isle of Wight opened an investigation into allegations of an improper relationship between the Registrant and Service User A. The Registrant was not interviewed as part of that investigation, but did provide written answers to a number of questions. In those written answers, which were provided on 6 September 2021, the Registrant denied that she was in a relationship with Service User A and speculated as to why he may have made statements that they were in a relationship. It was the HCPC’s case that those answers were untrue and dishonest. This formed the basis of Allegations 2, 3 and 9.
19. It was ultimately determined by the Police that there was insufficient evidence to commence a criminal investigation into the contact between the Registrant and Service User A’s family.
20. The investigation carried out by HMPPS into the alleged relationship, between Service User A and the Registrant, concluded with a request that Service User A be spoken to and advised that “… from a prison perspective it is likely that this relationship was fabricated with there being no evidence to corroborate that Lisa was either in contact with [Service User A] directly or indirectly as [Service User A] has stated.” The Prison Service treated the information as “malicious” and Service User A was “strongly recommended” to stop “spreading these rumours”.
21. In December 2021, Service User A was transferred to the Oswin Unit, following a referral that contained, inter alia, the Registrant’s professional opinion that he should be moved. The Oswin Unit is based within the Secure Care at the Bamburgh Clinic in Newcastle Upon Tyne. The unit is designed for offenders who are serving sentences of imprisonment and who have personality disorders or are high-risk offenders with additional personality needs, which can sometimes result in difficulties with impulse control and relationships. Offenders stay on the Oswin Unit as in-patients during their treatment.
22. On arrival at the Oswin Unit Service User A provided the Registrant’s details as his next of kin, reporting to staff that “they are together”. Concerns were raised by staff on the Oswin Unit who recognised the Registrant’s name from Service User A’s admission paperwork. They contacted HMP Isle of Wight, who confirmed that they were already aware of concerns regarding an alleged inappropriate relationship between Service User A and the Registrant.
23. It was alleged that during his time on the Oswin Unit, between December 2021 and February 2022, Service User A and the Registrant spoke frequently and for long periods of time either on the phone or via Skype (see Schedule B above). In addition, on 3 February 2022, an incident was recorded as Service User A said he was only able to receive a photocopied version of a Moonpig Valentine’s Day card sent by the Registrant and there had been delays in him receiving a parcel he said she had sent.
24. The following day, on 4 February 2022, a SKYPE session between Service User A and the Registrant took place during which, it was alleged, the Registrant was observed to share photographs of herself in a bikini and topless with her arms across her breasts. The interactions between the Registrant and Service User A, whilst he was on the Oswin Unit, are detailed in the course of conduct alleged in Allegation 4 and Schedule B.
25. The HCPC’s case was that this course of conduct amounted to a breach of professional boundaries by the Registrant and/or that she had not been acting in the best interests of Service User A. It was also alleged that the course of conduct was sexual in nature.
26. On 8 February 2022, the Registrant was contacted by the HCPC in relation to concerns about her fitness to practise and requesting further information about her current employment status and details of her Line Manager. The Registrant responded to this letter on 14 February 2022, providing the information requested.
27. On 24 February 2022, Service User A was relocated from the Oswin Unit to HMP Frankland. His contact with the Registrant continued, and it was alleged that they would speak at length over the phone.
28. On 16 May 2022, the Registrant participated in a purple (video-link) visit with Service User A, whilst he was a prisoner at HMP Frankland. It was alleged that the following exchanges were recorded during the visit and they form the basis of Allegation 5:
(i) The Registrant told Service User A “You make me happy. I will miss your face. I’m seeing you in less that two weeks I’m really excited. I’m with you to the end” or words to that effect.
(ii) After Service User A asked the Registrant what side of the bed was his, she demonstrated the side of the bed to him.
(iii) The Registrant agreed to send photographs of herself to Service User A.
(iv) When Service User A spoke about her ‘peach’, the Registrant stood up and showed him her clothed buttocks.
29. The HCPC’s case was that this visit amounted to a breach of professional boundaries by the Registrant and/or that she had not been acting in the best interests of Service User A. It was also alleged that the visit was sexual in nature.
30. The Registrant subsequently visited Service User A in person on 29 May 2022, however that visit was not monitored.
31. On 20 May 2022, the Registrant sent a follow up letter to the HCPC regarding the concerns raised in February 2022 about her fitness to practise. In the letter, the Registrant stated “I would like to confirm that I am not in a professional relationship with the prisoner, nor in a sexual, financial or emotional relationship with him and never have been.” The HCPC’s case was that this statement was untrue and dishonest, as reflected in Allegations 6 and 9.
32. On 24 July 2022, the Registrant sent a birthday card to Service User A. The cover of the card contained an image of the Registrant in a bikini and a second image in which the Registrant was topless (with an arm across her breasts). The card contained the message detailed in Schedule D above. It was the HCPC’s case that the sending of this card represented a breach of professional boundaries by the Registrant and/or that she was not acting in his best interests. It was also alleged that her conduct in sending the card was sexual in nature.
The Registrant’s case
33. On 25 October 2022, the Registrant wrote to the HCPC and provided the following information:
“I wish to emphasise that over this period of time and for the entire duration of our professional exchanges, the relationship I had with SUA was always strictly professional. Whilst saying this, I do not wish to deny that SUA’s case had attracted a very deep sympathy from my part due to the type of sentence he is serving (i.e., IPP) - As you may be aware this is a sentence that still is to date very debated due to the numerous disastrous, unintended consequences it has for individuals’ lives. Notwithstanding my personal and professional opinions on this matter and the consequences that this, together with a number of other difficult working conditions I endured at HMP IOW, [redacted], I can honestly say that for as long as I worked with SUA, I always strived to treat this individual with professionalism. This included treating him with dignity and respect and providing him with the same level of service I would offer to any of the people I have worked with.
Despite the limited involvement I had in his case and the firm boundaries I had set in our working relationship, there were a few instances, in particular between February 2021 and April 2021, when I noticed that SUA had developed an attachment towards me. During a couple of meetings that took place over that time, and in spite of the presence of other staff members, SUA had made some attempts to push boundaries through inappropriate questions and gifts. This was however picked up by the MDT quite early in the process and addressed at the time.
The impression I was left with back then was that the plan we had implement[ed] had been effective and that SUA’s inappropriate attachment towards me had been handled and resolved appropriately.
Moreover, as far as I could notice, SUA had not manifested any other apparent inappropriate behaviours towards me and when I had informed him that I would be moving to a different job soon (and that his case would be handed over to another colleague until his transfer), he had appeared to be able to manage this appropriately.
Our professional relationship was eventually terminated in July 2021, in a way that I thought had provided adequate closure and preparation for the following professional relationships he would have encountered.”
34. The Registrant added that whilst being employed at HMP Isle of Wight she did not breach any professional boundaries, nor did she enter into an emotional and/or romantic relationship with Service User A. Accordingly, the statement she made to the Ministry of Justice on 6 September 2021 was true, as was the content of Schedule A.
35. With regards to Allegation 4, the Registrant said she partly refuted this allegation. She accepted that between 25 December 2021 and 15 February 2022, she carried out “the majority (although not all the behaviours) of the course of conduct set out in Schedule B.” She added that she accepted that had she still been in a professional relationship with Service User A then the conduct set out in Schedule B would represent a breach of professional boundaries. However, she maintained that at the time the professional relationship had terminated, Service User A was "no longer a service user but was instead a former service user.”
36. The Registrant referred to the purple visit on 16 May 2022, and reiterated that had she still been in a professional relationship with Service User A then the conduct set out in Schedule C would represent a breach of professional boundaries. However, the professional relationship had been terminated.
37. With regards to Allegation 6, the Registrant said that at the time of writing her letter to the HCPC on 20 May 2022, she was not in a sexual, financial or emotional relationship with Service User A and therefore this letter was accurate. She went on to say, “I accept however that in line with the intention stated in said letter, I was in contact with (former) Service User A and had a friendly rapport with him.”
38. The Registrant accepted that she sent a birthday card to Service User A on 24 July 2022, the subject of Allegation 7, but denied this breached professional boundaries, because she was no longer in a professional relationship with him.
39. With regards to Allegation 8, the Registrant denied that any of her conduct in relation to Allegations 1, 4, 5 and 7 was sexually motivated. She added, “… my conduct towards Service User A was always professional and never sexual in nature.” She said her conduct was “of a friendly nature and not sexual.”
40. The Registrant denied that any of her conduct was dishonest, as alleged in Allegation 9, saying, “To the best of my knowledge and understanding, the statements I provided were a truthful and/or accurate representation of my position at the times in question.”
The evidence called
41. The Panel heard oral evidence from the following witnesses (with their respective roles at the time of completing their statements):
i. A-LW - Service User A’s Probation Officer;
ii. GM - Lead Consultant Psychologist at the Oswin Unit;
iii. EL - Consultant Clinical Psychologist and Associate Director for Psychological Services within Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust;
iv. SW - Supervising Officer and Intelligence Analyst at HMP Frankland;
v. JB - Head of Psychology for HMPPS;
vi. R-JS - Regional Corruption, Prevent and Pursue Manager within the Corruption Team for HMPPS.
42. During the evidence of SW, he made reference to the fact that the purple visit on 16 May 2022 had been recorded. He said he had burned it on to a DVD and provided that to Capsticks Solicitors. The hearing was then paused for enquires to be made about this DVD, since clearly it would represent the best evidence of what transpired during that video-call between Service User A and the Registrant. The recording was located, together with a full transcript prepared by Capsticks solicitors. Ms Fletcher-Smith did not raise any objection to the video-call recording being played to the Panel and the transcript was also provided as an agreed transcript, without the need to obtain a statement exhibiting it.
43. Having seen the video-recording it was apparent that Schedule C(ii) was incorrect and that at no time did the Registrant indicate a side of her bed to him.
Submission of no-case to answer
Submissions on behalf of the Registrant
44. At the conclusion of the Council’s case, Ms Fletcher-Smith made an application that there was no-case to answer in respect of Allegations 1, 2, 3, 4, 5, 7, 8 (insofar as it related to Allegation 1) and 9 (insofar as it related to Allegations 2 and 3).
45. With reference to Allegation 1, Ms Fletcher-Smith submitted that the only evidence of the existence of an emotional/romantic relationship between Service User A and the Registrant came, allegedly, from Service User A himself. However, she argued, the evidence said to have come from Service User A was vague and inconsistent and she provided a number of examples to support her assertion. She said the evidence from Service User A was all hearsay and often multiple hearsay, passed on through a number of people and documents and because it was so inconsistent and vague the Panel could not rely on it to find Allegation 1 proved.
46. Ms Fletcher-Smith submitted that if Allegation 1 failed this had a consequential effect on Allegation 8 (insofar as it related to Allegation 1) and also on Allegations 2 and 3, since they were predicated on there being a (non-professional) relationship between the Registrant and Service User A during the period when they were both at HMP Isle of Wight.
47. This, Ms Fletcher-Smith submitted, meant that Allegation 9 (insofar as it related to Allegations 2 and 3) must also fail, since they were predicated on a positive finding in relation to Allegations 2 and 3.
48. With regards to Allegation 4, Ms Fletcher-Smith submitted that there was no evidence that it was the Registrant on the phone to Service User A on seven out of the 19 calls in Schedule B. Furthermore, by December 2021 there was no professional relationship between Service User A and the Registrant and accordingly there was no evidence of a breach of professional boundaries.
49. In addition, Ms Fletcher-Smith submitted, “… the evidence that the conduct as set out in Schedule [B] was evidence of the Registrant not acting in the best interests of Service User A is tenuous.” She pointed to an absence of evidence indicating appointments were missed, or the opportunity to engage with staff and peers were affected, by Service User A being on the phone. She said Service User A reported that the majority of the contact between himself and the Registrant was in the evenings and early mornings and there had been no evidence to undermine that assertion.
50. When addressing Allegation 5, Ms Fletcher-Smith indicated that, having watched the video of the purple visit on 16 May 2021, it was apparent that Schedule C (ii) was not in fact made out, since at no time did the Registrant turn the camera to ‘his side of the bed’. This had been erroneously admitted by the Registrant before she had seen the video and whilst trying to recall events from some time ago.
51. Ms Fletcher-Smith submitted that Allegation 5 was not made out because there was no evidence that the Registrant was in breach of professional boundaries at this point in time, the professional relationship having ceased almost a year prior to this call. Furthermore, she submitted, there was no evidence that the purple visit had a negative impact on Service User A, or was not in his best interests.
52. Ms Fletcher-Smith submitted that there was no case to answer on Allegation 7 because there had not been a professional relationship between the Registrant and Service User A for more than a year. She said there was no evidence that having contact with Service User A at that time was a breach of professional boundaries and no evidence that sending the card was not in the best interests of Service User A.
Submissions on behalf of the HCPC
53. Ms Hughes opposed the application, submitting that there was sufficient evidence in support of all the matters alleged.
54. Ms Hughes acknowledged that the evidence in support of Allegation 1 came primarily from Intelligence Reports and she provided a chronology of the relevant reports. Ms Hughes submitted that the reports painted a clear picture of an ongoing relationship between the Registrant and Service User A during his time at HMP Isle of Wight. She refuted the suggestion that this evidence was vague and inconsistent. Ms Hughes further submitted that, although some of the intelligence information came from comments made by Service User A, his disclosures were corroborated by reliable records of conversations between Service User A and his grandmother, which were monitored by the Prison Service. She submitted that the contents and timing of the messages were consistent with the referenced female being the Registrant, in terms of her job, the timing of her job changes, her age and her birthday.
55. Ms Hughes also referred to a birthday card containing a typed message, and handwritten “I heart you” message that was received by Service User A on 23 July 2021. During the purple visit on 16 May 2022, Service User A showed the Registrant a locket containing a handwritten note saying “I [picture of a heart] you”. He said on the video that it had been written on his birthday. Service User A’s last birthday would have been on 24 July 2021. This card was shown to staff and detailed on RIO (the computer recording system used at the Oswin Unit). The inference being this was the same “I [picture of a heart] you” message the Registrant had sent to Service User A on 23 July 2021.
56. There were also, said Ms Hughes, monitored conversations between Service User A and his grandmother that took place in August 2021, during which a phone number is provided to Service User A’s brother, which corroborated Service User A’s later disclosures that his brother would call the Registrant whilst he was on the phone. In addition, the Registrant began contact with Service User A shortly after arriving at the Oswin Unit, which, submitted Ms Hughes, corroborated Service User A’s disclosure that they would resume direct contact once he was moved to the hospital.
57. Ms Hughes acknowledged that most of the disclosures were after the Registrant had left HMP Isle of Wight, but submitted that the content of the information suggested that the relationship was formed whilst the Registrant was assigned to Service User A. Ms Hughes also relied on the fact that a relationship between the Registrant and Service User A did in fact develop as evidence in support of there having been one whilst they were both at HMP Isle of Wight.
58. With regards to Allegation 8, insofar as it applied to Allegation 1, Ms Hughes submitted that if Allegation 1 were capable of proof, then the disclosures by Service User A included allegations that the relationship was sexual in nature.
59. Allegations 2 and 3 were dealt with together by Ms Hughes. She submitted that the evidence she had referred to in relation to Allegation 1 was sufficient to prove that by September 2021 there was a relationship between the Registrant and Service User A. Ms Hughes said the HCPC relied on: the disclosures made by Service User A (detailed in her Appendix A); the Facebook communication between Service User A and his grandmother; the phone calls between Service User A and his grandmother and brother; and the direct contact between the Registrant and Service User A resuming upon his admission to the Oswin Unit.
60. Ms Hughes submitted that if the Panel were satisfied there was enough evidence to proceed on Allegations 2 and 3 then it followed that Allegation 9 (insofar as it related to Allegations 2 and 3) should also be allowed to proceed as there was sufficient evidence to suggest the Registrant’s answers were false and therefore dishonest.
61. With reference to Allegation 4, Ms Hughes submitted that the Registrant accepted the majority of the conduct detailed in Schedule B. Ms Hughes also submitted, with reference to the Health Care Professions Tribunal Service (“HCPTS”) Practice Note on Professional Boundaries, that: “The mere fact that a personal or sexual relationship between a registrant and a service user or carer began after the registrant had stopped treating the service user in question does not necessarily mean that there is no breach of professional boundaries.”
62. Ms Hughes submitted that the Registrant was assigned to Service User A from October 2019 to July 2021, a significant period of time (i.e. 21 months) and through a global pandemic. This was a long period of treatment and, Ms Hughes submitted, they clearly developed a relationship of trust such that her leaving HMP Isle of Wight had to be very carefully managed. Further, the Registrant played a key role in Service User A’s care during this period and contributed to the referral to the Oswin Unit, which was made in August 2020.
63. Ms Hughes also relied on the fact that Service User A was “highly vulnerable” as a result of his mental health conditions which included a personality disorder, and a history of suicide attempts and self-harm. She added that Service User A was also vulnerable by virtue of being an IPP (Imprisonment for Public Protection) prisoner with very limited access to anyone on the outside world. Service User A also had a history of inappropriate behaviour towards female members of staff, which, said Ms Hughes, the Registrant was aware of. Ms Hughes also pointed to there being a “significant power imbalance” between them.
64. Ms Hughes submitted that there was, therefore, sufficient evidence that the Registrant’s conduct, as set out in Schedule B, did amount to acting in breach of professional boundaries. With regards to not acting in the best interests of Service User B, Ms Hughes submitted that there was evidence that Service User A’s communication with the Registrant impacted upon Service User A’s ability to engage with treatment at the Unit and ultimately led to him being refused further treatment and returned to prison. Ms Hughes said that as a Registered Psychologist, who had worked with Service User A for almost 2 years, it was reasonable to conclude that the Registrant would have been aware of the impact her extensive contact with Service User A was having on his treatment.
65. With regards to Allegation 5, Ms Hughes said there was clear evidence from the video of the purple visit on 16 May 2022 supporting the course of conduct reflected in Schedule C. She submitted that given the vulnerability of Service User A and the key position of trust and responsibility held by the Registrant between October 2019 and July 2021, she was in breach of professional boundaries notwithstanding the fact that there was no active professional relationship at the time.
66. Allegation 7 related to the sending of the birthday card containing the words set out in Schedule D. Ms Hughes submitted that, as with the purple visit, this was a breach of professional boundaries by virtue of the duration of their prior professional relationship, the acute vulnerabilities of Service User A and the abuse of a position of trust by the Registrant.
67. In conclusion, Ms Hughes submitted there was sufficient evidence of a case to answer in respect of each the Allegations and the application of no case to answer should be rejected.
The Panel’s Decision
68. The Panel considered the application with care and accepted the advice of the Legal Assessor, who referred to the test laid down in the case of R v Galbraith [1981] 1 WLR 1039, namely:
“If there is no evidence that the facts alleged have been committed by the Registrant then the Panel should stop the case in so far as it relates to those facts.
Where there is some evidence but it is of a tenuous character, for example, because of inherent weakness or vagueness or because it is inconsistent with other evidence and a submission is made to stop the case, the Panel should consider whether the Council’s evidence taken at its highest is such that the Panel properly directed could not, on the balance of probabilities find those facts proved. If it does so conclude then the Panel should stop the case in relation to those facts.
Where, however, the Council’s evidence is such that its strength or weakness depends on the view to be taken of a witness’s reliability, or other matters which are generally speaking within the province of the fact finding function of the Panel and where on one possible view of the facts there is evidence on which the Panel could properly come to the conclusion that the facts could be found proved, then the Panel should not stop the case, in relation to those facts.”
69. The Panel considered in turn each of the Allegations where Ms Fletcher-Smith submitted there was no case to answer. It bore in mind that it was not making any findings of fact, but rather was deciding whether the Council, who had the burden of proving the case, had adduced sufficient evidence on each of the relevant Allegations to satisfy the test in Galbraith.
Allegation 1
70. The Registrant accepted that between October 2019 and 12 July 2021 Service User A was assigned to her in her professional capacity as a Psychologist, whilst at HMP Isle of Wight, she denied entering into an emotional and/or romantic relationship with Service User A during that time. To prove to the contrary the HCPC relied on the evidence that emanated from Service User A, as recorded in various Intelligence Reports and from comments he made to his Probation Officer, A-LW. None of the other witnesses called by the HCPC ever spoke to Service User A.
71. Service User A did not provide a witness statement and did not attend the hearing. Accordingly, the entirety of this evidence was hearsay. Some of it was first-hand hearsay, in that they were comments made to A-LW. The majority of this evidence was, however, multiple hearsay in that it was recorded in Intelligence Reports, from many different sources and the authors were unknown. It was not known through how many people the comments passed before finding their way into the Intelligence Reports. None of those responsible for completing the Intelligence Reports provided statements or attended the hearing. It was thus not possible for the reliability of those reports to be tested.
72. In some instances, the Intelligence Reports consisted of overheard telephone conversations. This might be thought to be a more reliable source of evidence. However, it was not possible to test this without the authors of the reports attending to give evidence. During this case, the only opportunity to assess the accuracy, and thus reliability, of any contact between Service User A and the Registrant was during the Skype purple visit on 16 May 2022, when he was at HMP Frankland. Whilst not relevant to this Allegation, it served as an example of the dangers of relying on those overhearing or summarising calls making an accurate record.
73. On 8 August 2022, SW, the Supervising Officer and Intelligence Analyst at HMP Frankland, reviewed the footage of the purple visit and produced a statement detailing his observations. In that statement he said “I have detailed the relevant parts of the conversation” and he recorded this: “[Service User A] asks her to show him his side of the bed. She smiles and shows him her bed and his side.” From that extract, the HCPC included in Schedule C(ii), as part of Allegation 5, the following: “After Service User A asked you what side of the bed was his, you demonstrated the side of the bed to him.”
74. However, when the video of the purple visit was played during the hearing it was apparent that this was an inaccurate account (the actual video was in the possession of the HCPC, but they had not been relying on it. However, once it was discovered (during the hearing) that they had the video, it was decided to play it as it clearly represented the best evidence). It was apparent that SW had conflated several comments made during the recording and put them together when in fact at no time did the Registrant show Service User A “his side of the bed”.
75. Accordingly, the Panel approached any reports of overheard conversations with a degree of caution.
76. The Panel thus had to decide the extent to which it could rely on the hearsay evidence of Service User A. There was evidence before the Panel from a number of sources that Service User A had a history of developing attachments to women he worked with and indicating relationships when none existed. It was agreed evidence that Service User A had one, if not two, personality disorders, was narcissistic and manipulative. For example, when on the Oswin Unit staff there recorded him as “having stated outright that he uses manipulation to get what he wants from staff”.
77. The evidence from the Intelligence Reports said to have come from Service User A provided inconsistent accounts of how long he was saying the relationship had been in place, how long he had known the Registrant and whether there was a relationship at all.
78. For example, when on the Oswin Unit it was noted in the electronic records of therapy sessions (the system called RIO), that “there have been a number of concerns in relation to [Service User A] forming a sexual relationship with a professional involved in his care and treatment whilst in custody.” The record goes on to say that Service User A “has a book which he has hand written which suggests this relationship started prior to him entering custody and may have also involved the person’s sister.”
79. The evidence from A-LW also demonstrated the unreliability of the information she was provided with by Service User A:
[p49] ‘Lisa and Dale then met with him Wednesday and he denies any feelings towards Lisa and said it all got a bit confused.’
[p50] ‘He started to ask me about the process if he were to have relationship on 30/06/21. Over the coming weeks he then drip fed information to me about this relationship often giving me a little more information each time we spoke and slightly changing his story.’
[p50] ‘On 08/07/21 he disclosed that the lady he was talking to was someone who used to work for the psychology department within a prison and assessed him once but no longer works within the prison establishment and now works for the NHS. At this point he was still working with Lisa Forgione at HMP IOW.’
[p50] ‘On 15/07/21 SUA called to discuss the contact he is having with the lady again. This time he told me that she does work for the prison but that she works in a different prison to the one he is in at the moment.’… ‘He was clear in saying that they do not have a professional relationship at present.’… ‘He is very vague with information so hard to give him the answers he wants.’
[p50] ‘On 22/07/20 SUA called me to discuss his relationship with the female’… ‘He proceeded to tell me that the female he had been talking to was in fact Lisa.’
80. However, shortly after the disclosures made by Service User A to A-LW on 27 July 2021, he disclosed to another Psychology staff member that he had “made up the rumours of the alleged relationship to punish and hurt Lisa for leaving him. He stated that he felt bad and that she did not deserve this as she was a good person.”
81. The possibility of there having been an emotional and/or romantic relationship between Service User A and the Registrant is, to some extent, undermined by the HCPC’s own evidence that Service User A was on 2:1 contact whilst at HMP Isle of Wight. The only evidence of that having been breached came from the Registrant herself when she raised this with A-LW. On 19 March 2021, the Registrant phoned A-LW to tell her that during a meeting with Service User A the previous week, the Prison Officer who was meant to be overseeing the meeting had to step out. The Registrant told A-LW that while the Prison Officer was gone, Service User A said to her “If you met me in a bar and I told you that I had been in prison for rape would you be turned off” or words to that effect. The Registrant informed A-LW that she was confident that this interaction had been role play.
82. On the face of it the Registrant appeared to have acted professionally and may have done the right thing when she became concerned that Service User A might be forming an attachment to her.
83. The investigation carried out by HMPPS into the alleged relationship concluded with a request that Service User A be spoken to and advised that “… from a prison perspective it is likely that this relationship was fabricated with there being no evidence to corroborate that Lisa was either in contact with [Service User A] directly or indirectly as [Service User A] has stated.” The Prison Service treated the information as “malicious” and Service User A was “strongly recommended” to stop “spreading these rumours”. The Panel accepted that it did not know the parameters of this investigation and that it was important not to give too much weight to it. However, it was further evidence that pointed away from there having been an emotional and/or romantic relationship between Service User A and the Registrant during his time at HMP Isle of Wight.
84. The Panel considered it important not to fall into the trap of post-dating the relationship. In other words, just because it was apparent (and admitted) that at a later stage the two of them did enter into an emotional and romantic relationship, this did not mean they must have been in one whilst at HMP Isle of Wight.
85. For all the reasons above, the Panel considered the hearsay evidence of Service User A to be vague, inconsistent, weak and wholly unreliable. The Panel noted that it was all ‘one-way traffic’, in that all the information about there being a relationship between Service User A and the Registrant came from him. The Panel had not seen any evidence of reciprocation by the Registrant during this period. When asked by the Ministry of Justice why she thought Service User A had disclosed that he was in a relationship with her, the Registrant said:
“I have not worked with A since before this happened and, although I have been tempted to find out more about all this, have not spoken to anybody who has so at this stage I only have hypotheses and speculations. My guess is that this may be linked to his personality difficulties, which make it difficult for him to regulate his emotions and deal with perceived rejection and abandonment. This combined with his own sense of victimisation and high levels of vengeful thinking may have led him to behave in this way in an attempt to harm me and cause me distress for leaving him/my job and letting him down. There is also a possibility that this is a learnt behaviour, which he displayed in an attempt to be moved to a different establishment or to be treated differently, receive attention and feel special. But as I said these are only educated guesses at this point that come from my understanding of his psychological functioning and formulation and would constitute possible offence paralleling behaviours.”
86. Applying the test from the case of Galbraith, the Panel accepted there was some evidence in support of Allegation 1, but concluded that because of its tenuous character by virtue of its inherent weakness, vagueness and inconsistency, the HCPC’s case, taken at its highest was not such that the Panel could, on the balance of probabilities, find this allegation proved.
87. Since the Panel was unable to rely on the evidence emanating from Service User A and since that was essentially the only evidence the HCPC had to prove Allegation 1, the Panel concluded that there was no case to answer in relation to Allegation 1.
Allegation 8 insofar as it relates to Allegation 1
88. Having found no case to answer in respect of Allegation 1, it followed that there was no case to answer in respect of Allegation 8, insofar as it related to Allegation 1.
Allegations 2 and 3
89. Allegations 2 and 3 were very much predicated on there being an emotional and/or romantic relationship between Service User A and the Registrant during his time at HMP Isle of Wight. The Registrant left HMP Isle of Wight on 12 July 2021 and moved into the South Central Psychology team, with a base at HMP Winchester. There was no evidence of her contacting Service User A between 12 July 2021 and 6 September 2021, the date she completed her responses to the security questions from the Ministry of Justice.
90. Accordingly, Allegations 2 and 3 relied on the exact same evidence as Allegation 1. There is evidence of disclosures made by Service User A in July and August 2021, but the same reasoning as applied in relation to Allegation 1, applies here. That is to say, the evidence is all ‘one-way’, it all emanates from Service User A, whose evidence is wholly unreliable.
91. For these reasons, the Panel concluded that the HCPC’s case, taken at its highest, was not such that the Panel could, on the balance of probabilities, find these allegations proved.
92. The Panel therefore finds no case to answer in relation to Allegations 2 and 3.
Allegation 9 insofar as it relates to Allegations 2 and 3
93. Allegation 9, insofar as it relates to Allegations 2 and 3, is predicated on there being a case to answer on Allegations 2 and 3. The Panel having found there to be no case to answer on Allegations 2 and 3, it follows that there can be no case to answer on Allegation 9, insofar as it relates to Allegations 2 and 3.
Allegation 4
94. Allegation 4 alleges a breach of professional boundaries and not acting in Service User A’s best interests during the course of conduct set out in Schedule B. Ms Fletcher-Smith submitted that as the professional relationship between them had ended in July 2021, the Registrant could not be in breach of any professional boundaries in her interactions between December 2021 and February 2022. She indicated that the contact referred to in Schedule B was generally accepted, although there was some dispute about the number and duration of some of the calls.
95. The Panel had regard to paragraph 16 of the HCPTS Practice Note, which makes it clear that the mere fact that a personal or sexual relationship between a registrant and a service user began after the registrant had stopped treating the service user in question does not necessarily mean that there is no breach of professional boundaries. It is said that Panels should consider:
(a) the nature of the previous professional relationship; and
(b) the length of time since the Registrant stopped treating the service user; and
(c) whether any of the aggravating factors listed above are present along with any other factors which appear to be relevant on the particular facts of the case.
96. The nature of the previous professional relationship, based on the Council’s evidence, was that from October 2019 to July 2021, a period of some 21 months, the Registrant was assigned to Service User A as his Psychologist. She was part of a Multi-Disciplinary Team responsible for Service User A’s psychological care and, whilst she did not carry out the actual assessment that resulted in his move to the Oswin Unit, she was instrumental in the process.
97. It is undisputed evidence that contact between Service User A and the Registrant resumed on 25 December 2021 and continued on a regular basis for the whole time Service User A was on the Oswin Unit, until 15 February 2022. That is a period of between five and seven months after the professional relationship had ended.
98. Other relevant factors to include would be that Service User A was very vulnerable as a result of his mental health conditions, which included at least one personality disorder and a history of suicide attempts and self-harm. Service User A was also vulnerable by virtue of being an IPP prisoner with very limited access to anyone on the outside world. There was also evidence that there continued to be a significant power imbalance between the Registrant and Service User A, by virtue of the recent professional relationship.
99. The Panel was satisfied that, taking into account the HCPTS guidance, the HCPC’s case, taken at its highest, could establish, on the balance of probabilities, that the Registrant could have been in breach of professional boundaries between 25 December 2021 and 15 February 2022. The Panel also considered that, if it were possible to find the Registrant was still in a position whereby, she could act in breach of professional boundaries then it followed that she would almost certainly be duty bound to act in Service User A’s best interests.
100. The Panel was also satisfied that there was evidence within the therapy session records at the Oswin Unit that demonstrated repeated and frequent contact with a person it could reasonably be inferred was the Registrant (and much of this contact is not disputed by the Registrant, particularly the Skype calls), during the relevant period. In the same records there is evidence that the calls were interfering with Service User A’s treatment.
101. Dr EL at the Oswin Unit gave evidence as follows:
“…it is noted in the RIO entries that Service User A’s extensive use of the ward telephone had an impact on his engagement in activities and relationships with both staff and patients.
As a result of having such long telephone calls on a regular basis, Service User A did not have the time to spend on the therapeutic activities that were being planned to support him and his mental health. He also seemed to prioritise his time speaking with Ms Forgione over building connections and relationships with his fellow patients and/ or staff members, which forms a large part of treatment/ recovery work at the Unit.”
102. Accordingly, the Panel was satisfied that the HCPC’s case, taken at is highest, is such that the Panel could, on the balance of probabilities, find these facts proved.
103. The Panel thus rejected the submission of no case to answer in relation to Allegation 4.
Allegation 5
104. The Panel’s reasoning about the possibility of there still being a professional duty on the Registrant to avoid breaching professional boundaries and to act in Service User A’s best interests in relation to Allegation 4 relates equally to Allegation 5, which was only a few months later.
105. The Panel accepts that item (ii) in Schedule C is no longer supported by the evidence. However, the rest of Schedule C is supported by the video evidence that the Panel has seen and the Panel is of the view that such behaviour could be considered to be in breach of professional boundaries and not in the Registrant’s best interests.
106. Accordingly, the Panel rejected the submission of no case to answer in relation to Allegation 5.
Allegation 8 insofar as it relates to Allegation 5
107. Allegation 8, insofar as it relates to Allegation 5 is predicated on there being a case to answer on Allegation 5. The Panel having found there to be a case to answer on Allegation 5, it follows that there is a case to answer on Allegation 8, insofar as it relates to Allegation 5.
Allegation 7
108. The Panel’s reasoning about the possibility of there still being a professional duty on the Registrant to avoid breaching professional boundaries and to act in Service User A’s best interests in relation to Allegation 4 relates equally to Allegation 7, which was only a few months later.
109. The Panel was satisfied that, taking into account the content of the birthday card, the HCPC’s case, taken at is highest, is such that the Panel could, on the balance of probabilities, find these facts proved.
110. The Panel thus rejected the submission of no case to answer in relation to Particular 7.
Adjournment
111. There was insufficient time within the initial listing period to conclude the case and the hearing was therefore adjourned until 15-23 October 2025.
Resuming Hearing
112. The case resumed on Wednesday 15 October 2025. The same persons were present, save for change of Presenting Officer to Mr Alexander Barnfield and a further change of Hearings Officer (as detailed on page 1).
113. The Registrant was called to give evidence. She maintained that she had not at any stage breached professional boundaries or acted against Service User A’s best interests. She remained adamant that she had not entered into any kind of a relationship with Service User A until after she sent the letter to the HCPC on 20 May 2022 and so was being truthful in that letter. She accepted that sometime between 20 May 2022 and 24 July 2022 she did enter into a romantic relationship with Service User A, a relationship that continues to this day.
Decision on Facts
114. The Panel accepted the advice of the Legal Assessor. The Panel had in mind that the burden of proof is on the HCPC and that the standard of proof is the balance of probabilities. The Panel noted the evidence as to the Registrant’s good character, which may be relevant to the assessment of credibility, propensity, and to any inferences to be drawn as to the Registrant’s state of mind.
Allegation 4
Between 25 December 2021 and 15 February 2022, you breached professional boundaries and/or did not act in the best interests of Service User A by carrying out the course of conduct set out in Schedule B.
115. The Panel had first to decide whether the Registrant had breached professional boundaries by carrying out the course of conduct set out in Schedule B.
116. At the outset of the hearing, Ms Fletcher-Smith indicated that: “The Registrant disputed breaching professional boundaries and disputed not acting in the best interests of Service User A. The Registrant accepted the general course of conduct reflected in Schedule B, but not the entirety of that conduct. She is unable to pick out specific dates but disputes the volume and length of some of the calls as recorded in the Schedule.”
117. From her oral evidence it was also apparent that the Registrant accepted much of the conduct set out in Schedule B. This was supported by her own phone records that she produced to assist the Panel, which in fact showed far more contact than that recorded in Schedule B.
118. In order to decide whether by such conduct she had breached professional boundaries, the Panel made reference to the HCPTS Practice Note on Professional Boundaries. The Practice Note is based on the HCPC Standards of Conduct, Performance and Ethics, which states that a registrant must keep their relationship with service users and carers professional.
119. The Practice Note makes it clear that the mere fact that a personal or sexual relationship between a registrant and a service user began after the registrant had stopped treating the service user in question, does not necessarily mean that there is no breach of professional boundaries. The Panel had first to consider:
(a) the nature of the previous professional relationship;
(b) the length of time since the Registrant had stopped being in a professional role with Service User A; and
(c) whether any of the aggravating factors listed in the Practice Note are present, along with any other factors which appear to be relevant on the particular facts of the case.
120. With regards to (a), the nature of the previous professional relationship, the Registrant commenced working at HMP Isle of Wight as a Trainee Forensic Psychologist, in September 2017. She qualified and was registered with the HCPC on 3 March 2021 as a Forensic Psychologist. Her last day of employment with HMPPS was 30 September 2021. However, her last day at work at HMP Isle of Wight was 12 July 2021 and that marked the end of her professional involvement with Service User A.
121. The Registrant was first assigned Service User A in or around October 2019, when still a Trainee Forensic Psychologist. She said she was allocated to “case manage” Service User A, not to treat or engage in therapy with him. JB, Head of Psychology at HMP Isle of Wight, referred to the Registrant as Service User A’s allocated health professional, describing Service User A as a vulnerable adult with a range of presenting issues. A-LW, Service User A’s Probation Officer, referred to the Registrant as Service User A’s “psychologist”. She added, “In her capacity as a psychologist who was having contact with Service User A, I had frequent contact with Ms Forgione as her role was to support him in transferring to a hospital where he could receive treatment for his personality disorders.” The Registrant accepted in evidence that she played a part in Service User A’s subsequent transfer to the Oswin Unit. Whilst her precise role is unclear, what is clear, and not disputed, is that she worked with Service User A in a professional capacity and continued in that role up until 12 July 2021, a period of around 23 months.
122. The Registrant was always employed as a Psychologist, some of it as a trainee and, from March 2021 onwards, as a registered Forensic Psychologist. Her role was part of a Multi-Disciplinary Team (MDT) looking after the care and pathway for Service User A. She thus had the same responsibilities as anyone else on that team to Service User A. The Panel accepted that the Registrant was not in a therapeutic relationship in that she was not treating Service User A, however she was part of the MDT looking after his care and pathway, part of which was the provision of treatment. Accordingly, the Panel considered it did not matter that she was not personally carrying out therapeutic work with him, she still, in a professional capacity, played an important role in his care.
123. In her role, the Registrant had access to Service User’s files, and she completed a targeted file review in order to write a report for the Parole Board in May 2020. She knew a lot about Service User A, which the Registrant would not have known had she not been the Psychologist on the MDT assigned to Service User A. She first met him face-to-face in August 2020 and thereafter met him approximately once a month, seeing him (on her account) about 12 times up to July 2021. In addition, there was other contact by phone and letter where she was offering Service User A support. This was referred to by the Registrant in a questionnaire she completed that had been sent by HMP Isle of Wight, when investigating the allegation (the subject matter of allegation 1). The Panel was left with the impression that in her evidence the Registrant had attempted to play down her professional role with respect to Service User A.
124. When Service User A contacted the Registrant in December 2021, she was alert to the fact that he had formed an attachment to her (and to others in the past), in her written submissions she said:
“Despite the limited involvement I had in his case and the firm boundaries I had set in our working relationship, there were a few instances, in particular between February 2021 and April 2021, when I noticed that SUA had developed an attachment towards me. During a couple of meetings that took place over that time, and in spite of the presence of other staff members, SUA had made some attempts to push boundaries through inappropriate questions and gifts.”
125. The Registrant was also aware of Service User A’s manipulative nature and aware of his complex character. In addition, she was aware that there was a staff alert that Service User A was a risk to females, as she herself acknowledged in the HMP Isle Of Wight questionnaire. The Registrant was also alert to the potentially destabilising effect of her moving on. As A-LW said:
“On 30 April 2021, Ms Forgione said that she was concerned about the impact her proposed job move would have on Service User A as they had built a good working relationship. She said that she was worried the change might be quite destabilising for him.”
126. Notwithstanding all this knowledge and the fear and panic the Registrant said she experienced when the contact from Service User A’s brother came “out of the blue”, she nonetheless decided to call Service User A. The Registrant was asked by the Panel what had motivated her to make that call to Service User A around Christmas 2021. The Registrant said, “A few things motivated me to make that call, some about me. I felt the need to make that noise, that worry, that preoccupation stop. I was trying to understand what would help me now and the only thing was just to hear what he had to say, to make peace with this and close it there. On the other hand I wanted to give him the opportunity to say it: things that happened since I moved from the Isle of Wight, the allegations and investigation had left a lot of unanswered questions for both of us. I didn’t see the request as a threat and thought maybe he is trying to find some closure for himself. So maybe it was going to help him as much as me and maybe we could both have some closure and move on, those are the reasons.” She added that she felt sorry that he was having to spend Christmas on his own and a part of her felt it was a “good deed” and “something that could help and maybe I could stop feeling so awful and maybe help him too.” In her written submissions, she also referred to talking with Service User A in that initial call on or around Christmas Day 2021, about his unresolved feelings towards her. She said: “We also talked about his unresolved feelings towards me and how he had felt unable to work with professionals to overcome these, ending up fantasising about being in a relationship with me.”
127. The Panel considered this explanation lacked credibility. There was nothing the Registrant said that explained why, as a professional Psychologist, she would make contact with Service User A, a very vulnerable service user with such a complex history, including suicide attempts and self-harming. That history also included forming inappropriate attachments to females and the Registrant knowing that he had feelings towards her. She also knew that steps were put in place when she left her role at HMP Isle of Wight to avoid destabilising him and yet despite all that she still called him.
128. With regards to (b) and the length of time since the Registrant had stopped being in a professional role with Service User A that was from 12 July 2021 to 25 December 2021, a period of just over five months. This was not a long period, in the Panel’s view. There remained a question mark over whether in fact there had been no contact between the Registrant and Service User A for the entirety of that period, but even allowing for the Registrant’s case that the December 2021 contact with her came “out of the blue”, it was still not a long period.
129. When considering (c) whether any of the aggravating factors listed in the Practice Note are present, along with any other factors which appear to be relevant on the particular facts of the case, the Panel noted the following.
130. Service User A was in prison for serious sexual offences and was serving an IPP sentence (Imprisonment for Public Protection). IPP is an indeterminate sentence for those considered dangerous, with a minimum term, potentially unlimited detention, with release on licence a possibility if they can satisfy the parole board that they are no longer a threat.
131. Steps had been taken to arrange for Service User A to be transferred to the Oswin Unit, including a referral that contained, inter alia, the Registrant’s professional opinion that he should be moved. The Oswin Unit is based within the Secure Care at the Bamburgh Clinic in Newcastle Upon Tyne. The unit is designed for offenders who are serving sentences of imprisonment and who have personality disorders or are high-risk offenders with additional personality needs, which can sometimes result in difficulties with impulse control and relationships. Offenders stay on the Oswin Unit as in-patients during their treatment.
132. It was clear from the records provided to the Panel, and not disputed, that Service User A was vulnerable by virtue of being a prisoner on an IPP, he also had a number of mental health and personality issues and there was reference to self-harming and multiple suicide attempts.
133. As well as vulnerability, other relevant aggravating factors in this case include the following:
• power imbalance
• covering up boundary breaches
• failing to set clear boundaries with Service User A
134. The Panel concluded that between 25 December 2021 and 15 February 2022, the Registrant continued to owe a duty of care to service User A. Her professional relationship had ended only five months earlier. It was a professional relationship that lasted some 23 months, with relatively regular contact with service User A for just under a year, in her role as a Psychologist, even if there was no therapeutic content. Service User A was particularly vulnerable for the reasons given above and there was clearly a power imbalance between them as the Registrant had had access to his personal records, she was the professional and he the incarcerated prisoner. From the evidence of their contact from 25 December 2021 onwards, it was apparent that having made contact, the Registrant had failed to set clear boundaries with service User A.
135. In the Panel’s view in making the decision, in such prevailing circumstances, to rekindle contact with Service User A, the Registrant breached professional boundaries in making that call on or around 25 December 2021.
136. The Panel was also satisfied, on the balance of probabilities, that the Registrant had breached professional boundaries by carrying out the rest of the course of conduct, as set out in schedule B.
137. Schedule B consists of: nine dates when the two of them were on the phone for many hours, often into the early hours of the morning; eight Skype calls; and the sending of a Valentines card.
138. There were several very lengthy phone calls from the Registrant to Service User A, as seen from the Registrant’s phone records, for example:
• on 4 January 2022, there were 11 calls between 8am and 10pm, with a total duration of around four hours;
• on 16 January 2022, the first call was at midnight and there were nine calls, the last being at 8pm, with a total duration of around seven hours;
• on 22 January 2022, the calls started at 10.15pm and finished at 3.48am the following day, seven calls with a total duration of approximately five hours;
• on 29 January 2022, the first call was at 9.35am and the last call was at 3.55am on 30 January 2022, 17 calls, with a total duration of over ten hours.
139. The Panel noted that, although not in Schedule B, the Registrant’s own phone records show she rang Service User A every day from 30 December 2021 to 11 February 2022, amounting to approximately 400 calls in 35 days. That was, in any view, an extraordinary amount of contact, particularly with someone the Registrant claimed she was not having any sort of relationship with. Furthermore, although not part of Schedule B, the Panel also noted that on 11 January 2022, so just days after they had resumed contact “out of the blue”, Service User A received from the Registrant a package comprising:
• a Christmas card;
• a teddy bear;
• a pair of leather gloves;
• seven pairs of boxer shorts;
• 11 pairs of socks;
• a pair of tracksuit bottoms;
• three hoodies;
• three shirts; and
• eight T-shirts.
140. All this from someone who had been in a professional relationship with Service User up until five months previously, had then heard nothing from him until Christmas and then contacted him on Christmas day, ostensibly to help them both “have closure”.
141. With reference to the Skype calls in Schedule B, one of them included the Registrant showing Service User A photographs of herself in a bikini and topless with her arms across her breast (pictures she was later to include in a birthday card to him). The Registrant claimed the pictures were simply to show her weight loss. The Panel did not consider this to be credible. The picture of her in a bikini is not showing weight loss, it is just showing the top half of her body and is focused on her breasts. The same was true of the topless picture. From her own evidence the Registrant was aware that Service User A had developed an attachment towards her when she was working with him at HMP Isle of Wight and continued to have feelings towards her. She was also aware that he was in a very restrictive environment and would have been acutely aware of the impact of showing pictures of that nature to Service User A. In the Panel’s view this was wholly inappropriate.
142. In another Skype call she showed photos of other men, and it was recorded in the RIO notes that she asked Service User A to rate them. The Panel did not have the benefit of the pictures and this assertion relied on anonymous hearsay evidence. The Registrant said she did show pictures of men but not exclusively of men and denied that she asked Service User A to rate them. In all the circumstances, the Panel did not consider this assertion to be supported by reliable evidence, and therefore gave it no weight.
143. With reference to the Valentines card, that was not retained so the Panel had not seen it. Such a card is usually an expression of love between two people, but the panel accepts it can have a broader application than just that and can be sent in other contexts. However, if Service User A was just wanting a card from the Registrant, she could have sent a normal card at any point, it did not need to have been a Valentine’s card.
144. It was apparent that Schedule B was not a comprehensive account of all the contact between the Registrant and Service User A. From her own phone records, which the Registrant said she provided so that there could be complete transparency, it was clear that in fact they had far more contact than is recorded in Schedule B.
145. However, focusing on Schedule B, as alleged, the Panel considered this conduct did amount to a breach of professional boundaries. The first call, on 25 December 2021, the Panel has already said amounted to a breach of professional boundaries. That was then compounded by making calls over the next 35 days for long periods of time, until Service User A ended up in seclusion. It was clear to the Panel that they dominated each other’s lives for that 35-day period, given the amount of time they spent on the phone together. Whilst the Panel did not know the content of the calls, it did know that by 4 February 2022 the Registrant was in a position whereby she was happy to show alluring photos of herself in a bikini and topless (albeit with her arm across her breasts). The Panel considered it reasonable to draw the inference that by 4 February 2022 they had grown sufficiently close for her to feel comfortable showing such intimate pictures.
146. Having decided that the Registrant had breached professional boundaries by carrying out the course of conduct set out in Schedule B, the Panel next considered whether she had not acted in Service User A’s best interests.
147. From extensive records kept during his time on the Oswin Unit, it was possible to glean that, certainly from Service User A’s perspective, he and the Registrant were in some form of a relationship. However, the Panel approached those records with a degree of caution and some scepticism, as much of the information was essentially coming from one, already deemed unreliable, source - Service User A. The fact that the Registrant and Service User A entered into a relationship is not disputed, indeed they are still in one at the time of this hearing. The issue is when that relationship started. The Registrant is adamant that it was not until after 20 May 2022 (by which time Service User A had been transferred to HMP Frankland). As will be seen below, 20 May 2022 is a date of some significance because it is the date that the Registrant wrote a letter to the HCPC stating she was not in a sexual, financial or emotional relationship with Service User A. This is dealt with in more detail below, when considering allegation 6.
148. What was essentially not in dispute either, was that the Registrant and Service User A spent a significant amount of time on the telephone talking to each other during his time at the Oswin Unit, as referred to above.
149. The evidence of the staff at the Oswin Unit was that the phone calls were impacting Service User A’s treatment. GM, Lead Consultant Psychologist at the Oswin Unit, said in her referral to the HCPC:
“The ongoing communication between [the Registrant] and [Service User A] has influenced his referral pathway, presentation and ability to engage with our service and it has impacted negatively on his treatment plan. This has resulted in his being placed in seclusion in order to safely manage the emerging risks to himself and others. This has impaired his ability to form therapeutic relationships with our staff team which is essential to our being able to offer him meaningful intervention. Indeed, the impact has been so marked as to make ongoing care in our service impossible such that his placement with us has now ended and he has been returned to prison. … We have concerns that his contact with [the Registrant] has been one significant factor preventing him from engaging at this time and potentially in future which could have a negative impact on his pathway through the prison service towards release.”
150. EL, Consultant Psychologist at the Oswin Unit said:
“As a result of having such long telephone calls on a regular basis, Service User A did not have the time to spend on the therapeutic activities that were being planned to support him and his mental health. He also seemed to prioritise his time speaking with Ms Forgione over building connections and relationships with his fellow patients and/ or staff members, which forms a large part of treatment/ recovery work at the Unit.”
151. The Registrant said she was completely unaware of the impact of her contact with Service User and neither Service User A, nor any member of staff communicated that to her.
152. The clear evidence from the professional witnesses called in relation to the Oswin Unit was that, whether she knew about it or not, the Registrant’s frequent and significant contact with Service User A during his brief time on the Oswin Unit had a detrimental impact on his treatment. It resulted in him having to be placed in seclusion and ultimately being returned to prison without having had any benefit from the Unit. Accordingly, the Panel was satisfied, on the balance of probabilities, that the Registrant had not acted in Service User A’s best interests by carrying out the course of conduct set out in Schedule B.
153. The Panel thus found allegation 4 proved in its entirety.
Allegation 5
On 16 May 2022, you breached professional boundaries and/or did not act in the best interests of Service User A during the purple visit by carrying out the course of conduct set out in Schedule C.
154. At the outset of the hearing, Ms Fletcher-Smith indicated that: “The Registrant accepted she went on the purple visit with Service User A, but disputed anything she did was a breach of professional boundaries or was not in the best interests of Service User A. The Registrant accepted the entirety of the content of Schedule C” (although this was later amended after the video of the call was watched for the first time - during the hearing - and the Panel found that C(ii) was not in fact supported by the evidence).
155. The Panel was of the view that by May 2022, the Registrant’s duty of care arising from the professional relationship with Service User A was still ongoing. This was a continuing course of conduct. The professional relationship ended approximately ten months previously and this was still a relatively short period of time. In the meantime, they had had contact, which the Panel had found breached professional boundaries. Service User A remained a vulnerable adult, the imbalance of power remained, and it was incumbent on the Registrant to have continued to maintain professional boundaries. This she failed to do during the purple visit.
156. Although focusing on the conduct in Schedule C, the Panel did not approach that conduct in a void as the whole visit provided context to the conduct selected by the HCPC in Schedule C.
157. From the transcript of the call the language used suggests the Registrant and Service User A saw each other as a couple and at least in an emotional relationship - indeed they appeared to be besotted with each other. The Registrant said Service User looked nice. When he referred to wearing the same clothes, she responded with “I wasn’t talking about the clothes”. When he said, “How do you tell someone that you love that they’re hurting you?”, the Registrant said nothing to rebut the declaration of love and instead responded with “Am I hurting you?” Service User A made reference to the teddy (sent by the Registrant) he sleeps with and how he had made something for the Registrant to sleep with. Service User A expressed concern that they were “drifting apart” and the Registrant reassured him that they were not: in other words they were still together. They talked about seeing each other in two weeks and the Registrant said she was really excited. When Service User A talked about being stuck in prison and nothing was going to change, the Registrant said “I told you I’m with you until the end and you better believe me, I mean it.” The Registrant said to Service User A that she really missed him and could not wait to see him.
158. The Panel considered the actual video footage of the purple visit to be even more illuminating than the transcript of the visit, due to the many non-verbal communications between the two of them. These non-verbal communications suggested a much more intimate relationship than admitted by the Registrant. It was, the Panel concluded, far more than simply flirtatious, as suggested by Ms Fletcher-Smith. The comments made by both, together with their non-verbal communications, consisting of blowing kisses, tilting her head, fluttering her eyelids and giving him coquettish looks, the making of heart shapes and the references to love, all pointed in one way. He had a locket with “I [heart shape] you”. The Registrant also had a necklace from Service User A that she said she wore all the time, even in the shower. That was a very intimate thing to say to somebody.
159. The content of Schedule C, clearly seen on the video and admitted by the Registrant, included the Registrant saying to Service User A that he made her happy, she missed his face, she was seeing him in less than two weeks and was really excited. She also said she was with him to the end. She agreed to send photos of herself to Service User A. When Service User A asked to see her “peach”, the Registrant stood up, turned around and showed him her (clothed) bottom. It was clear from the video that she was more than happy to do this and her claim in evidence that she was embarrassed and was only doing it to show her weight loss, was unconvincing. The reason she was showing him her bottom was because he asked to see it and she was happy to show it - it had nothing to do with weight loss, that was just a comment from her. This behaviour went far beyond professional boundaries.
160. The Panel was thus satisfied, on the balance of probabilities, that the Registrant had breached professional boundaries during the purple visit by carrying out the course of conduct in Schedule C.
161. The Panel next considered whether the Registrant had not acted in the best interests of Service User A during the purple visit, by carrying out the course of conduct in Schedule C. The Panel found that the Registrant’s behaviour towards service User A, who was a highly vulnerable prisoner with whom she had a professional relationship only 10 months previously, was not in his best interests. The Panel therefore found this proved.
162. Accordingly, the Panel found the entirety of allegation 5 proved.
Allegation 6
On 20 May 2022, you wrote a letter to the HCPC in which you stated that you were not in a sexual, financial or emotional relationship with Service User A when this was not the case.
163. At the outset of the hearing, Ms Fletcher-Smith indicated that: “The Registrant accepted writing the letter to the HCPC and stating she was not in sexual, financial or romantic relationship with Service User A, but disputed that this was not in fact the case.”
164. As stated earlier, the fact that the Registrant and Service User A are now in a relationship is not disputed. Indeed, she accepts that they were in a relationship when she sent the birthday card to Service User A in July 2022, but she denied there being any kind of relationship when she sent the letter to the HCPC on 20 May 2022. The Panel found this untenable. The Registrant went from apparently having no contact with Service User A in the five months between ending her professional relationship with him in July 2021, to contacting him extensively every day for 35 days, sending him gifts and a Valentine's card, showing him alluring photos of intimate parts of her body and then behaving in the way described above during the purple visit, just four days before writing to the HCPC.
165. The Panel rejected the Registrant’s account that her conduct showed nothing more than friendship as implausible.
166. The Panel was in no doubt that the Registrant was in some form of deep emotional, romantic, sexualised relationship with Service User A by the time she wrote that letter. The Panel considered there was insufficient evidence to say it was actually a sexual relationship. Whether it was also financial in less clear, although she had been very generous with the Christmas package sent to Service User A within days of speaking to him for the first time in five months and out of the blue on Christmas day. The Panel concluded, however, that this could be seen as simply a gift and there was insufficient evidence to conclude that there was a financial relationship.
167. Accordingly, the Panel was satisfied that the Registrant had been untrue when saying to the HCPC that she was not in an emotional relationship with Service User A on 20 May 2022. The Panel could not say precisely when the relationship commenced, but it was clearly before 20 May 2022, and it was certainly emotional.
168. Accordingly, the Panel found allegation 6 proved.
Allegation 7
On 24 July 2022, you breached professional boundaries and/or did not act in the best interests of Service User A by sending him a birthday card detailed in Schedule D.
169. At the outset of the hearing, Ms Fletcher-Smith indicated that: “The Registrant accepted sending a birthday card to Service User A and accepted the contents of Schedule D (i) and (ii), but denied a breach of professional boundaries and denied not acting in the best interests of Service User A.”
170. By 24 July 2022 and the sending of the intimate birthday card, the Registrant admitted that she was in a relationship with Service User A. Indeed, she gave evidence that she continued to be in a relationship with Service User A to this day. The question for the Panel was whether this was a breach of professional boundaries and/or not in the best interests of Service User A.
171. With regards to professional boundaries, by July 2022 it had been over a year since the Registrant’s professional role had ended. They were clearly in a relationship at this time, and the Registrant admits as much. The Panel acknowledged that at some stage the duty of care giving rise to professional boundaries must fall away. It may well be the case that now, three to four years later, those boundaries might have fallen away. However, the Panel did not consider a year after the end of a professional relationship that lasted 23 months to be a long period of time, given the nature of her professional involvement and given his vulnerability and position as an IPP prisoner. This was not a case where they had been completely apart for a year and then met. Their evolving relationship had been building for some time from Christmas 2021. In those circumstances, the Panel considered the duty of care remained and accordingly the Registrant had breached professional boundaries by sending the birthday card. In the card she professed her love for him, referred to him as her lover and attached the intimate photos that focused on her breasts. This was all inappropriate, in the Panel’s view.
172. The Panel next considered whether the Registrant had not acted in the best interests of Service User A by sending the birthday card. In the Panel’s view, if one is in breach of professional boundaries that cannot be acting in someone’s best interests, and it therefore found this proved.
173. Accordingly, the Panel found allegation 7 proved.
Allegation 8
Your conduct in relation to allegations 4, 5 and/or 7 was sexual in nature.
174. At the outset of the hearing, Ms Fletcher-Smith indicated that: “The Registrant denied that her conduct was sexual in nature with regards to Allegations 1, 4 and 5, but accepted sending the birthday card, referred to in Allegation 7, was sexual in nature.”
175. In relation to allegation 4, the Panel was satisfied that the photographs the Registrant showed Service User A of her in a bikini, taken at such an angle as to focus on her breasts and the other photo of her topless, albeit with an arm covering her breasts, were clearly sexual in nature and had nothing to do with weight loss. On this basis, the Panel found allegation 8 proved in relation to allegation 4.
176. The Panel did not consider the evidence of phone sex referred to in the RIO notes was sufficiently reliable. It relied on multiple hearsay without any corroboration and thus was not taken into account.
177. In relation to allegation 5 the Panel was satisfied that the Registrant’s conduct had, in part, been sexual in nature during the purple visit. Reference has already been made to the Registrant’s coquettish behaviour, as seen on the video, and in particular the showing of her bottom, albeit clothed, was, in the Panel’s view, sexual in nature. He wanted to see her bottom and she showed it to him. He responded with “Oh my days” and she was clearly pleased with his response. She was demonstrating that they were physically attracted to each other.
178. In relation to allegation 7, the birthday card contained the same two photographs referred to in allegation 4 and thus, for the same reasons, the Panel found allegation 8 proved in relation to allegation 7. Furthermore, the Registrant admitted the birthday card was sexual in nature.
179. In conclusion, the Panel found allegation 8 proved in relation to allegations 4, 5 and 7.
Allegation 9
Your conduct in relation to allegation 6 was dishonest.
180. The Registrant denied acting dishonestly, because she claimed she was being honest in that letter to the HCPC. The Panel had already found that not to be the case and concluded that she deliberately lied in that letter. For all the reasons referred to above, the Panel was satisfied that the Registrant knew at the time that she was in, at the very least, a deep emotional and quite intimate relationship with Service User A. The Panel considered why she had lied to the HCPC about that and concluded that it was because she effectively wanted permission from the HCPC to allow her to communicate with Service User A. She must have been concerned about breaching professional boundaries and therefore lied about the status of their relationship. The Panel was satisfied that the ordinary decent person would find such conduct to be dishonest.
181. The Panel therefore found allegation 9 proved in relation to allegation 6.
Decision on Grounds
182. The Panel heard submissions from Mr Barnfield. He invited the Panel to find that the statutory ground of misconduct had been established. He submitted that the Registrant’s conduct in the facts found proved by the Panel fell far short of what would be proper in the circumstances and what the public would expect.
183. Ms Fletcher-Smith made no submissions on misconduct, save to say that the registrant did not dispute the allegation that her conduct amounted to misconduct.
184. The Panel accepted the advice of the Legal Assessor and was aware that in respect of misconduct there was no burden or standard of proof and that it was a matter for the Panel’s own professional judgment. It bore in mind that breaches of the Standards did not automatically result in a finding of misconduct.
185. The Panel considered that the Registrant’s conduct fell significantly below the standards to be expected of a Registered Psychologist. In particular the Panel considered that the Registrant was in breach of the following standards:
HCPC Standards of conduct, performance and ethics [2016]:
1. Promote and protects the interests of service users and carers
Maintain appropriate boundaries
1.7 You must keep your relationships with service users and carers professional.
9. Be honest and trustworthy
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
186. The Registrant repeatedly breached professional boundaries in her conduct towards a very vulnerable service user over a protracted period of seven months and did not act in his best interests in the ways described above. Of particular note was that her conduct whilst Service User A was at the Oswin Unit had a detrimental impact upon his treatment and therapy. It resulted in him being placed in seclusion and ultimately removed, back to the prison system, thereby getting no benefit from having attended the Oswin Unit. It had taken over a year to arrange for him to be transferred to that Unit and all that effort was wasted as a result of him not engaging with the staff whilst he was there. That lack of engagement was said to have been significantly impacted by the amount of time he spent on the phone to the Registrant. The Registrant’s own phone records showed that she called him every day and often multiple times and into the early hours of the morning, over a 35-day period, making approximately 400 calls in that time.
187. The Panel was therefore satisfied that this behaviour was sufficiently serious to amount to misconduct.
188. The Panel also considered that the Registrant’s dishonest conduct was in breach of a fundamental tenet of the profession. Dishonesty is a very serious matter which has a significant impact on public confidence in the profession. Telling a lie to her Regulator in order to conceal the status of her relationship with Service User A, is entirely contrary to the requirement for registrants to behave ethically and to act with integrity, honesty, and openness. Furthermore, at the time of telling the lie, the Registrant was under investigation for breaching boundaries by being in a relationship with Service User A and this appeared to have been an attempt to mislead the investigation. Thus, even though an isolated incident, such deliberate, premeditated, dishonest behaviour is particularly serious. It was misleading and intentionally so.
189. The Panel considered that members of the profession and members of the public would consider the Registrant’s dishonest conduct to be deplorable and sufficiently serious to amount to misconduct.
190. In all the circumstances, the Panel concluded that the Registrant’s conduct, individually and collectively, fell far below the standards of a Registered Psychologist and was sufficiently serious to amount to misconduct.
Decision on Impairment
191. Having found the statutory ground of misconduct to be well founded, the Panel went on to consider whether the Registrant’s current fitness to practise was impaired as a result of that misconduct. In doing so it took into account the oral evidence of the Registrant, given at the facts stage and again at this stage together with the submissions made and all the relevant documents provided. The Panel accepted the advice of the Legal Assessor.
192. Mr Barnfield invited the Panel to find that the Registrant’s current fitness to practise is impaired. Ms Fletcher-Smith submitted that, notwithstanding the misconduct, the Registrant’s current fitness to practise is not impaired.
193. The Panel had regard to the positive testimonials provided from friends and colleagues, who were aware of the allegations the Registrant faced. The Panel did not consider the testimonials to be of particular assistance at this stage of the proceedings. [Redacted].
194. The Legal Assessor advised the Panel to have regard to the case of The Council for Healthcare Regulatory Excellence v Nursing and Midwifery Council and Grant [2011] EWHC 927 (Admin), which referred to the approach in determining the issues of impairment as follows:
(a) has the registrant in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or
(b) has the registrant in the past brought and/or is liable in the future to bring the profession into disrepute; and/or
(c) has the registrant in the past breached and/or is liable in the future to breach one of the fundamental tenets of the profession; and/or
(d) has the registrant in the past acted dishonestly and/or is liable to act dishonestly in the future.
195. The Panel considered all four of these limbs were engaged in this case when looking at what had happened in the past. With regards
(a), by breaching professional boundaries in the ways described above and by not acting in Service User A’s best interests, again as described above, the Registrant acted in a way that caused him unwarranted harm. It brought an unsatisfactory end to his time on the Oswin Unit and significantly contributed to the failure of that placement. Service User A was sent to the Oswin Unit to be assessed and treated for his mental health and personality issues that were preventing him from being released from prison. In the event, that did not happen, in no small part because of the behaviour of the Registrant. She says she was unaware of the impact of her behaviour at the time because nobody told her. However, as a professional Forensic Psychologist she ought to have known that calling Service User A around 400 times on the telephone over a critical 35-day period in his time at the Oswin Unit, was bound to have a detrimental impact.
196. With regards to (b) and (c), the Panel also considered the Registrant’s actions brought the profession into disrepute and breached fundamental tenets. Observing professional boundaries, acting in the best interests of a service user and behaving honestly are all fundamental tenets of the profession and all had been breached by the Registrant. Such behaviour clearly brought the profession into disrepute.
197. With regards to (d), the Registrant was found to be dishonest in relation to the sending of the letter to the HCPC, in May 2022. In oral evidence to the Panel the answers she gave to questions about that appeared to be minimising her culpability and not really accepting she had been dishonest. She repeatedly said she should have been clearer and yet she sought legal advice before sending the letter, so one might have expected clarity of her thought process at the time. The closest the Registrant came to admitting dishonesty was when she said, “… it is really difficult to accept I lied intentionally because I don’t think it was my intention to do so, but I recognise that in failing to give open and transparent answers I undermined myself and ended up not being fully honest or transparent.” However, it was a somewhat grudging, reluctant admission and came very late on in her evidence after repeatedly being given the opportunity to say whether she admitted her dishonest behaviour.
198. The Panel was advised by the Legal Assessor that an important factor when considering current impairment is whether the conduct which led to the allegation is remediable, that it has been remedied and that it is highly unlikely to be repeated. Also, the level of insight shown by the Registrant is an important factor when considering current impairment.
199. The Panel considered this behaviour, although attitudinal, was in theory remediable. The Panel then considered whether it had been remedied.
200. The Panel accepted the Registrant’s evidence that she is deeply ashamed, embarrassed and genuinely remorseful for both her actions and for ending up before her Regulator.
201. With regards to the breaching of professional boundaries and not acting in the best interests of Service User A, the Registrant has said she accepts the findings of the Panel and that she did indeed breach professional boundaries and not act in Service User A’s best interests. She has reflected on her behaviour and recognised a number of factors that influenced the way she conducted herself with regards to Service User A. She referred to her time at HMP Isle of Wight as particularly challenging. She said she was bullied, not properly supported by colleagues [redacted]. The Registrant has worked hard to understand why she behaved as she did and told the Panel that in hindsight, she should not have made the call in December 2021, that was the catalyst for this whole chain of events. If ever faced with a similar situation she said she would reflect and seek advice before taking any action. She referred to how she was “hyper-sensitive” a “people pleaser”, she cares too much and she crossed a line. She also said she used to find it hard to say “no”, but that she was in a much better place now, had the tools to prevent a recurrence and was able to say “no” when necessary.
202. [Redacted].
203. The Panel could see that, as a young, idealistic, trainee and then newly qualified Forensic Psychologist, with the upbringing she had described and her overwhelming desire to care and help people, the harsh environment in a prison was perhaps not best suited to the Registrant’s skill set; she simply did not have the resilience needed for such an environment. That, together with being bullied, treated harshly and the particular challenges of managing a manipulative prisoner with complex mental health and personality disorders on an IPP sentence, resulted in what was probably a unique set of circumstances. The Registrant has since learned, at a much deeper level, about her own boundaries both professional and personal and has re-established those. She had wanted to make Service User A happy and did not like to say “no”. She now knows she can be a stronger individual and will step back, get support and say “no” if that is the response called for. In light of the insight, she has now shown when giving evidence at this stage of the proceedings, her acknowledgment that she was too relaxed when it came to professional boundaries, her extensive reflection and therapeutic intervention, the Panel was satisfied that the Registrant had remedied her conduct and that she was highly unlikely to repeat it.
204. Accordingly, the Panel was satisfied with regards to the breaches of professional boundaries and the failure to act in Service User A’s best interests that a finding of current impairment on public protection grounds was not made out in this case.
205. With regards to the dishonesty and notwithstanding the late, begrudging acceptance of guilt, the Panel is satisfied the Registrant recognises the seriousness of what she has done and the impact of her conduct and the need to be clear, transparent and honest. In oral evidence, the Registrant gave a very detailed explanation of the impact of dishonesty on the profession, colleagues, service users and the public. The Panel considered the Registrant had learnt a very hard, salutary lesson and was unlikely to put herself in similar situation in the future. This was an isolated, albeit serious, act and there was no evidence of her being dishonest in any other way, before or since. Furthermore, the testimonial evidence demonstrates that it was very much out of character for her to behave in such a way.
206. Accordingly, the Panel was satisfied with regards to the dishonesty that a finding of current impairment on public protection grounds was not made out in this case.
207. The Panel went on to consider whether this was the type of case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and the Regulator and to uphold professional standards. The Panel was satisfied that a fully informed member of the public, who was aware of all the background to this case, would have their confidence in the profession and the Regulator undermined if a finding of impairment were not made. The Panel considered that a member of the public would be most concerned if the Regulator took no action in a serious case where a Psychologist had repeatedly breached professional boundaries with a very vulnerable service user, not acted in his best interests and had then lied about her relationship in a letter to her Regulator.
208. The Panel therefore determined that the Registrant’s fitness to practise is currently impaired on public interest grounds and that the allegation of impairment is well founded.
Sanction
HCPC’s submissions
209. Ms Bass referred to the HCPC’s Sanctions Policy (March 2019) (“SP”), making reference to the sanctions available to the Panel and the approach to be adopted. She stated that she was not making any particular ‘sanction bid’ and that it was a matter for the Panel to exercise its own judgment.
210. She reminded the Panel of the need to impose a sanction that was proportionate and appropriate. She stated that any sanction may have a punitive effect but reminded the Panel of the need to protect the public and the public interest to ensure confidence in the profession and in the regulatory process. She also reminded the Panel to have regard to the need for a deterrent effect on other members of the profession.
211. In terms of aggravating features, she submitted that the Registrant’s dishonesty was deliberate and repeated, and that her misconduct had a detrimental impact on Service User A, a vulnerable Service User. In addition, the breaches of professional boundaries were repeated and continued over many months.
212. Ms Bass referred the Panel to the various paragraphs of the SP that related to conduct towards vulnerable individuals, dishonesty and sexual misconduct.
213. In relation to sanction, she submitted that the misconduct found proved was too serious for no further action to be taken or for the imposition of a caution.
214. Ms Bass submitted that conditions of practice were less likely to be appropriate in dishonesty and sexual misconduct cases. She then identified the circumstances in the SP where a suspension order or a striking off order would be appropriate.
Submissions on behalf of the Registrant
215. Ms Fletcher-Smith initially accepted on behalf of the Registrant that whilst this was a case involving sexual misconduct with a vulnerable service user, his vulnerability was not a factor in the Registrant pursuing her relationship with him. She accepted however, that the Registrant’s conduct impacted on Service User A.
216. In relation to the sexual misconduct, Ms Fletcher-Smith submitted that it was extremely minor in nature. She submitted that it occurred after the Registrant had entered into an emotional relationship with Service User A. She further submitted that the comments made to Service User A did not have a negative impact on him.
217. Ms Fletcher-Smith reminded the Panel that it was not obliged to impose a sanction. She submitted that whilst imposing no order was only appropriate in exceptional circumstances, it may be appropriate in cases where impairment was solely found on public interest grounds and where a registrant had shown insight and remediated their misconduct such that there was no risk of repetition of it.
218. She reminded the Panel that it had concluded in its determination on impairment that the Registrant had shown insight, that she had extensively reflected on her failings [redacted]. As a result, she submitted, the Panel had found that the Registrant had remedied her misconduct and was highly unlikely to repeat it.
219. In relation to the Registrant’s dishonesty, she submitted that, as the Panel had concluded, the Registrant had learned a hard lesson and that she was unlikely to put herself in a similar situation again. She submitted that the Registrant’s dishonest behaviour was isolated and out of character.
220. Ms Fletcher-Smith submitted that whilst the Panel had found that it would be inappropriate not to make a finding of impairment in such circumstances, it was a different position when it came to taking no action at the sanction stage. She therefore submitted that the Panel could conclude that this was an appropriate course of action to take.
221. In relation to a possible caution order, Ms Fletcher-Smith submitted that such an outcome may be appropriate where the misconduct was isolated, limited or relatively minor. She submitted that the Registrant’s dishonesty was isolated, and that the sexual misconduct was limited in nature. She further submitted that the Panel had found a low risk of repetition of her misconduct, that the Registrant had shown good insight ,and that she had taken effective remedial action.
222. She invited the Panel to take a nuanced approach to dishonesty. She submitted the Registrant’s dishonest conduct related to a single act and that no harm had been caused as a result of it. In the circumstances she submitted that a caution order could adequately mark the Registrant’s misconduct and was a proportionate outcome. Such an outcome, she submitted, provided an effective balance between protecting the public interest and the Registrant’s interests.
223. Ms Fletcher-Smith reminded the Panel that the Registrant has already been the subject of a significant period of suspension on an interim basis and in the circumstances, a further period of suspension would be disproportionate.
224. She submitted that imposing a conditions of practice order would not be appropriate as such an order was not relevant to the particular facts of this case.
225. Finally, her firm submission was that a striking off order would also be disproportionate.
Decision on Sanction
226. The Panel accepted the advice of the Legal Assessor who referred it to the SP. He reminded the Panel that it should consider any sanction in ascending order, and to apply the least restrictive sanction necessary to protect the public and the public interest. It should also consider any aggravating and mitigating factors and bear in mind the principle of proportionality. He reminded the Panel that the primary purpose of imposing a sanction was protection of the public and the public interest and that there was a need to balance those interests with the interests of the Registrant.
227. In reaching its decision on whether to impose a sanction, and if so, which one, the Panel has reminded itself of its conclusions and rationale in relation to the seriousness of the Registrant’s misconduct as set out in its determination on impairment. The Panel has concluded that the Registrant continues to pose an ongoing risk to the public interest which includes the reputation of the profession and the need to declare and uphold standards for members of the profession. As such, any sanction should reflect the need to uphold the public interest and mark the seriousness of the misconduct found proved.
228.NThe Panel has had due regard to paragraphs 56-58 of the SP, noting the impact of dishonesty on public confidence.
229. It has also had due regard to paragraph 69 in relation to inappropriate relationships, 73-75 in relation to vulnerability, and 76-77 of the SP, noting the impact of sexual misconduct on public confidence.
230. In considering sanction, the Panel first identified the following aggravating factors:
a) That the Registrant’s dishonesty was a deliberate lie to her regulator to conceal her relationship with Service User A when it was undertaking an investigation into her relationship with him;
b) The Registrant’s breaches of professional boundaries were repeated over a period of approximately six months from December 2021 until May 2022;
c) Service User A was a particularly vulnerable individual, identified with complex issues about which the Registrant would have been acutely aware at the time of the events in question; and
d) As identified earlier in this determination, the Registrant’s conduct had a significantly detrimental impact on Service User A, including the treatment he received.
231. The Panel identified the following mitigating factors:
a) The Registrant has shown a high degree of insight and has taken significant steps to remediate her misconduct as a result of which the Panel was able to conclude that she was highly unlikely to repeat her misconduct;
b) The Registrant had made some admissions at the outset of this hearing, but noted that they were limited in nature and therefore, it attached little weight to this as a mitigating factor;
c) The Registrant has provided a number of positive references and whilst these attest to her good character, the Panel has attached limited weight to them in light of the seriousness of the misconduct proved.
232. The Panel considered the SP in relation to the overall seriousness of the Registrant’s sexual misconduct. It concluded that her relationship with Service User A was consensual rather than threatening or intimidating, and was not initiated by the Registrant. The Panel concluded that the inappropriate nature of her sexual misconduct arose not principally from the nature of the sexual behaviour itself, but from the circumstances in which it occurred, namely in relation to Service User A being a highly vulnerable individual. The Registrant was aware, because of her role, of Service User A’s complex issues, that he had a history of forming inappropriate relationships and the nature of his vulnerabilities. The Panel noted, however, that there was no evidence before the Panel that the Registrant demonstrated predatory behaviour. As such, the Panel concluded that, whilst wholly inappropriate, her sexual misconduct was at the lower end of the scale of seriousness of sexual misconduct.
233. In relation to the Registrant’s dishonesty, the Panel was mindful that the Registrant had been dishonest to her regulator during the course of its investigation into her conduct. As a result, her conduct had the potential to undermine the HCPC’s regulatory function. However, it has also borne in mind that the Registrant’s dishonesty reflected a one-off incident and similarly, was not demonstrative of the Registrant displaying entrenched attitudinal issues generally.
234. The Panel noted that it had not found that the Registrant had entered into an emotional and/or romantic relationship with Service User A while he was assigned to her at HMP Isle of Wight. However, the Panel had found that the Registrant had breached professional boundaries by forming such a relationship with the Registrant in the period between December 2021 and May 2022. The Panel considered that this was a very serious breach of professional boundaries particularly given the vulnerabilities of Service User A, which the Registrant knew about.
235. The Panel approached the issue of sanction starting with the least restrictive first, bearing in mind the need for proportionality and to take into account the Registrant’s interests. Having done so, it concluded that taking no further action would not reflect the nature and gravity of the misconduct. The Panel concluded that taking no action would not be adequate to protect the wider public interest in upholding standards, ensuring a deterrent effect on other registrants and maintaining confidence in both the profession and the regulatory process. Such an outcome was therefore neither appropriate nor proportionate in the circumstances.
236. The Panel then considered whether to impose a Caution Order and had regard to paragraphs 99-102 of the SP. The Panel concluded that this was also not an appropriate outcome because of the reasons set out in its determination on misconduct in relation to sexual misconduct, dishonesty, breach of professional boundaries and current impairment. The Panel did not consider the Registrant’s misconduct to be minor in nature.
237. The Panel next considered whether a Conditions of Practice Order was appropriate. It had regard to paragraphs 105-109 of the SP. It has concluded that such a sanction would neither be appropriate nor proportionate to address the public interest concerns identified. The Panel concluded that workable and appropriate conditions could not be formulated that would meaningfully address the concerns identified in relation to the Registrant’s sexual misconduct, dishonesty and breach of professional boundaries. In reaching that conclusion, the Panel reminded itself that it had already concluded that the Registrant had remediated her misconduct such that it had concluded that the Registrant was highly unlikely to repeat her misconduct. In any event, the Panel concluded that the nature of the misconduct found proved was too serious for such a sanction.
238. In the circumstances, the Panel concluded that imposing a Conditions of Practice Order was not an appropriate sanction to impose.
239. The Panel next considered the sanction of suspension. It had regard to paragraph 121 of the SP. The Panel has borne in mind that this would be an appropriate sanction to impose where, even though the allegation is serious, the conduct was not fundamentally incompatible with the Registrant remaining on the register, the Registrant had insight and that the issues were unlikely to be repeated, factors that the Panel concluded were present in this case.
240. In concluding that this was the appropriate sanction to impose, the Panel identified that:
• The matters found proved, as set out in the Panel’s determination on misconduct, represented serious breaches of the Standards of Conduct Performance and Ethics;
• As identified above, the Registrant has demonstrated a high level of insight into her misconduct and has taken appropriate steps to remediate her failings. The Panel in its determination on impairment concluded that the Registrant was therefore highly unlikely to repeat her misconduct;
• The Panel was mindful that a striking off order was appropriate for the most serious cases of dishonesty. It considered that the Registrant's failing was not so serious that it was fundamentally incompatible with remaining on the register. In reaching that conclusion, it had regard to paragraph 121 of the SP which states that a Suspension Order may be appropriate where “there is evidence to suggest that the Registrant is likely to be able to resolve or remedy their failings” which she has satisfied the Panel that she has done. As indicated above, the Panel was satisfied that the dishonesty was not the product of entrenched attitudinal issues. Similarly, it concluded that her sexual misconduct was at the lower end of the scale of seriousness.
241. To reassure itself that a Suspension Order was the appropriate and proportionate sanction to impose, the Panel considered whether a Striking-off Order was justified. It had regard to paragraph 130 of the SP which states that: “A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts” whilst setting out a non-exhaustive list of applicable circumstances.
242. The Panel was satisfied that the facts of this case were not of such gravity so as to merit such a restrictive sanction. It concluded that the public interest concerns could be adequately met by the imposition of a Suspension Order which would restrict the Registrant’s ability to practise as a Practitioner Psychologist until such time as a reviewing panel determined that she was fit to do so. In reaching that decision, the Panel was mindful that the Registrant was otherwise regarded as a competent and effective practitioner who had demonstrated a high level of insight and had satisfied the Panel that she had addressed her failings.
243. The Panel therefore determined to impose a Suspension Order. In considering the length of the Suspension Order, the Panel was mindful that the Registrant has been the subject of an interim suspension order for approximately three years, and that this hearing has taken approximately 10 months to conclude through no fault of the Registrant. Applying the principle derived from the case of Kamberova v Nursing and Midwifery Council [2016] EWHC 2955 (Admin), the Panel concluded that it was therefore proportionate to reduce the length of the Registrant’s suspension to reflect the lengthy period of time that she has been subject to an interim suspension. Having done so, the Panel concluded that it was proportionate and appropriate to reduce what otherwise would have been a sanction of a 12 month suspension order, to one of 9 months.
244. The Panel concluded that that period of time effectively balanced the Registrant’s interests with the need to impose a sanction that marked the unacceptability of the Registrant’s conduct and still met the public interest limbs of the overarching objective.
245. Given that the Panel has only made a finding of impairment on public interest grounds alone, the Panel makes no recommendations as to what evidence a future reviewing panel will be assisted by, save for the fact that the Registrant will no doubt recognise the need to satisfy that reviewing panel that she is fit to return to unrestricted practice.
246.The Panel accordingly determined to impose a Suspension Order for a period of 9 months.
Order
ORDER: The Registrar is directed to suspend the registration of Miss Lisa Forgione for a period of 9 months from the date this order comes into effect.
Notes
Interim Order
Application
1. Ms Bass applied for an Interim Suspension Order for a period of 18 months in light of the Panel’s substantive findings on the grounds that it was otherwise in the public interest to cover the appeal period.
2. She submitted that, given the possible length of time it may take an appeal to be heard and given the Panel’s reason for imposing a suspension order by way of a substantive sanction, an 18 month interim suspension order was appropriate. She submitted that the failure to impose an interim sanction would be inconsistent with its determination on sanction if the Registrant were allowed back into unrestricted practice during the appeal period. She submitted that imposing an interim conditions of practice order would not be sufficient or proportionate given the rationale for the Panel’s substantive sanction.
3. Ms Fletcher-Smith opposed the application. She submitted that, given that impairment was found on public interest grounds alone, the threshold for the making of an interim order had not been met. She reminded the Panel that imposing an interim order should not be made as a matter of course.
4. She submitted that the sanction imposed was intended to mark the fact that the Registrant’s conduct fell below the standard expected of her. If the Registrant were to appeal against the decision, the public would not be concerned if the Registrant were allowed to continue to practise during the appeal period where she does not pose a risk to the public. In the circumstances, she submitted that imposing an interim order was neither necessary nor appropriate.
5. The Panel was mindful that when a substantive sanction is imposed, a Registrant’s entitlement to practise is unrestricted whilst their appeal rights against the substantive sanction remain outstanding.
6. The Panel had regard to its rationale for imposing the substantive sanction of a suspension order. It concluded that failing to impose an interim order to cover the appeal period would be inconsistent with its earlier reasoning for restricting the Registrant’s right to practise. The Panel therefore concluded that the threshold for imposing an interim order on public interest grounds alone had been met. It therefore decided to impose an interim order under Article 31(2) of the Health Professions Order 2001, it being otherwise in the public interest, which outweighed the Registrant’s own interests.
7. It first considered an Interim Conditions of Practice Order. The Panel concluded that such an interim order would not be appropriate given its rationale for its earlier determination on sanction. It considered that in light of that determination, an Interim Suspension Order was otherwise in the public interest. It would be wholly incompatible with the Panel’s findings and its decision as to sanction not to impose an Interim Suspension Order.
8. The Panel concluded that the appropriate length of the Interim Suspension Order should be 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event that the Registrant submits a Notice of Appeal within the 28-day period. This Interim Suspension 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) on the final determination of that appeal, subject to a maximum period of 18 months.
Decision
9. The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being otherwise in the public interest.
10. 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.
Hearing History
History of Hearings for Lisa Forgione
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 10/12/2025 | Conduct and Competence Committee | Final Hearing | Suspended |