Deborah Knight-Griffiths
Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.
Allegation
As a registered Chiropodist/Podiatrist (CH31360) your fitness to practise is impaired by reason of misconduct. In that:
1. On or around 13 November 2020 you:
a. performed a partial right second toe amputation on Service User 1;
b. did not carry out an adequate pre-operative assessment of Service User 1 in that you did not:
i. Take and/or record Service User 1’s blood pressure;
ii. Take and/or record Service User 1’s pulse;
iii. Take and/or record Service User 1’s temperature;
iv. Take and/or record Service User 1’s oxygen saturation;
v. Take and/or record Service User 1’s respiration rate;
vi. Take and/or record Service User 1’s level of consciousness;
vii. Obtain and/or record Service User 1’s medical history and/or drug history and/or allergy status;
viii. Obtain and/or record a vascular and/or neurological assessment;
ix. Perform an up-to-date x-ray on Service User 1’s right foot;
x. Undertake and/or record a venous thromboembolism assessment; and/or
xi. Obtain informed and/or written consent from Service User 1 to perform the procedure.
2. On or around 6 November 2020, you did not obtain a tissue sample and/or wound swab from Service User 1’s right foot which was necessary and/or appropriate.
3. Between 20 December 2019 and 13 November 2020 (inclusive), you did not maintain accurate and complete records for Service User 1, in that you did not:
a. Record the location, dose and/or volume of local anaesthetic block administered to Service User 1 on or around 13 November 2020;
b. Document your clinical notes in the Subjective, Objective assessment, Action taken, Plan of care and (optional) Education ((SOAP) (E)) format;
c. Assess and/or document the dimensions of Service User 1’s foot ulceration;
d. Document and/or undertake an appropriate diabetic assessment of Service User 1’s feet; and/or
e. Adequately, or at all record any post-operative advice provided to Service User 1 on 13 November 2020.
4. On or around 13 November 2020, you sutured Service User 1’s wound when it was not appropriate to do so.
5. In respect of the procedure detailed at Particular 1a above, you did not undertake the procedure in a hospital setting and/or as part of a hospital’s Diabetes Multidisciplinary Team which was necessary and/or appropriate.
6. In respect of particulars 4 and/or 5 you have worked beyond your scope of practice.
7. The matters set out in particulars 1a and/or 1b.i and/or 1b.ii and/or 1b.iii and/or 1b.iv and/or 1b.v and/or 1b.vi and/or 1bv.ii and/or 1b.viii and/or 1b.ix and/or 1b.x and/or 1b.xi and/or 2, and/or 3a and/or 3b and/or 3c and/or 3d and/or 3e, and/or 4, and/or 5 and/or 6 above constitute misconduct.
8. By reason of your misconduct you fitness to practise is impaired.
Finding
Preliminary Matters
Service
1. The Panel was satisfied on the basis of the documents before it that the Registrant had been properly served with Notice of this hearing. It had sight of the letter sent by email to the Registrant’s registered address on 13 June 2025 informing her of the date and time of the remote hearing.
Hearing in private
2. Ms Khorassani made an application for the hearing to be heard in private to protect the Registrant’s private life. She submitted that there would be references to details of the Registrant’s health, including within the Registrant’s application for an adjournment.
3. Having accepted the advice of the Legal Adviser the Panel decided that any part of the hearing which referred to details of the Registrant’s health should be heard in private to protect her private life. The remainder of the hearing was heard in public in accordance with the principle of open justice.
Adjournment or proceeding in the absence of the Registrant
4. The Panel considered the Registrant’s request that the hearing should be adjourned. In an e-mail dated 4 July 2025 the Registrant stated that she requested the hearing is moved to a later date [Redacted].
5. [Redacted].
6. The Registrant was advised in an e-mail dated 9 July 2025 that the request for an adjournment would be considered by the Panel today.
7. [Redacted].
8. Ms Khorassani opposed the application for an adjournment. She submitted that the current order of suspension was due to expire on 14 August 2025 and that a review should take place before its expiry. She submitted that this timeframe would only allow a few more weeks for the Registrant to engage and that it was unclear from the evidence provided in support of the application for an adjournment that she would be able to do so. The evidence provided by the Registrant does not include information on when the Registrant’s health will improve so that she will be able to engage fully. The HCPC also submitted that the review should be dealt with promptly in the wider public interest. Ms Khorassani further submitted that the HCPC might not be able to list a further review hearing before the expiry of the current order due to existing commitments.
9. The Panel accepted the advice of the Legal Assessor. Her advice included reference to the cases of CPS v Picton [2006] EWHC 1108 and General Medical Council v Adeogba [2016] 1 WLR Civ 162. The Panel had regard to the guidance in the HCPTS Practice Notes “Postponement and
Adjournment of Proceedings”.
10. [Redacted]. In these circumstances, the Panel agreed with Ms Khorassani’s submissions that there was no indication that an adjournment to a rescheduled date prior to 14 August 2025 would secure the Registrant’s attendance. The Panel’s primary responsibility is to protect the public and this requires that the current interim suspension order is reviewed before it expires. The Panel concluded that there is insufficient time to enable the Registrant to recover her health and for another review hearing to be scheduled prior to 14 August 2025. The Panel therefore decided to reject the Registrant’s application for an adjournment.
11. Ms Khorassani made an application for the hearing to proceed in the Registrant’s absence. She submitted that the factors drawn from the case of R v Hayward [2001] QB 862 indicated that it would be appropriate for the Panel to exercise its discretion to proceed.
12. The Panel accepted the advice of the Legal Assessor. Her advice included reference to the case of General Medical Council v Adeogba [2016] EWCA 162. The Panel had regard to the guidance in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.
13. In its decision the Panel referred back to the considerations which were relevant to its decision not to grant the Registrant’s application for an adjournment. While the Registrant has indicated that she wishes to participate in the proceedings, she has stated that she is not currently able to do so. As discussed above, the Panel were not of the view that an adjournment to a date prior to 14 August 2025 would be likely to secure the Registrant’s attendance. The Panel considered that any disadvantage to the Registrant in not being able to present evidence or make submission to the Panel was outweighed by the public interest in ensuring that the suspension order is reviewed before it expires.
14. The Panel therefore decided that it was fair and appropriate to proceed with the hearing in the Registrant’s absence.
Background
15. The Registrant is a Podiatrist and at the time of the events she practised through her podiatry practice named First Steps Podiatry (“First Steps”).
16. At the relevant time the Registrant provided podiatric services to prisoners at HM Forest Bank Prison (“the prison”). Service User 1 was a prisoner at the prison and was in poor health, including diabetes and previous amputation of his big toes.
17. The Registrant attended the final hearing on 18-25 March 2024, and 15-17 July 2024. At this hearing the Panel found the Registrant had undertaken a partial amputation of Service User 1’s right second toe and that this was a procedure that should only have taken place in a hospital setting or as part of a hospital’s Diabetes Multidisciplinary Team. The Registrant also omitted eleven specific pre-operative actions as particularised in 1(b). The Registrant failed to maintain accurate and complete records for Service User 1 as detailed in Particular 3. The Registrant also inappropriately sutured Service User 1’s wound and did not obtain a tissue sample or wound swab prior to the procedure. The Panel also found that the Registrant had acted beyond the scope of her practice in performing a partial amputation and in suturing Service 1’s wound in circumstances where she had not maintained or developed the skills to do so.
18. The Final Hearing Panel found that the Registrant’s conduct represented serious breaches of the HCPC Standards of conduct, performance and ethics and the Standards of Proficiency for Chiropodists/Podiatrists. The Registrant had performed an invasive procedure outside the scope of her practice upon an individual who was acutely vulnerable, and he was placed at real risk of harm. The seriousness of the breaches were not lessened by the fact that no tangible harm to Service User 1 was identified. The Panel concluded that the facts found proved amounted to misconduct.
19. The Final Hearing next considered whether the Registrant’s fitness to practise was impaired. It considered that the Registrant’s shortcomings were conceptually capable of being remedied, but it did not find that the Registrant had in fact remedied them. The Panel considered that the Registrant’s reflection was superficial and did not demonstrate having been embedded in practice. There was no evidence of Personal Development Plans, audits, peer supervision, or mentoring of her practice. The Panel was also of the view that there was an absence of recognition from the registrant about what had happened in the past and why, and it had little confidence that the issue will not be repeated in the future. The Panel acknowledged that the Registrant believed that she was acting in Service User 1’s best interests, but it identified a risk that in the future the Registrant would act impulsively in a misguided attempt to aid a service user.
20. The Final Hearing Panel therefore concluded that the Registrant’s fitness to practise is impaired on the basis of the personal component.
21. The Final Hearing Panel was also of the view that the findings were so serious that a finding of current impairment was required to declare and uphold proper professional standards and to maintain public confidence in the profession of Podiatry.
22. The Final Hearing panel decided that the appropriate and proportionate sanction was a suspension order. It considered that it would not be right to remove from the Registrant an opportunity to remediate her failings. The Final Hearing Panel considered whether to make suggestions to the Registrant on the steps that might assist a future reviewing panel, but decided not to do so for the following reasons:
“It has been explained earlier in this determination why the Panel does not accept that the Registrant has remediated her failings to date. If the Registrant choses to seek to persuade the future reviewing panel that she has successfully remediated the failings then it will be for her to decide how she would wish to demonstrate that she has. It will be a matter for the future reviewing panel to determine what information and evidence they would require to be satisfied on the issue, but the Registrant would be well advised to take the view that the future panel might expect not only written material, but also that it might wish to hear directly from her.”
Decision
23. Ms Khorassani outlined the background and submitted that the Registrant’s fitness to practise remains impaired as there was nothing before the Panel to demonstrate that the Registrant has addressed the concerns identified by the Final Hearing Panel.
24. In her submissions Ms Khorassani noted that during the period of the Registrant’s suspension the HCPC had received a concern from Medicash regarding the Registrant practising as a Podiatrist. Ms Khorassani informed the Panel that this is a matter currently under investigation and it is unclear when the appointment in question took place. Ms Khorassani did not submit that this new information was a material factor for the Panel to consider in its review of the suspension order today.
25. Ms Khorassani invited the Panel to consider extending the current suspension order for a period of six months. She submitted that this period would enable the Registrant time to engage and a further opportunity to address her failings as identified by the Final Hearing Panel.
26. The Panel accepted the advice of the Legal Adviser. Her advice included reference to the case of Abrahaem v General Medical Council EWHC 183. The Panel also had regard to the guidance in the HCPTS Practice Notes “Review of Article 30 Orders” and “Fitness to Practise Impairment”.
27. The Panel first considered whether the Registrant’s fitness to practise remains impaired by reason of the allegations found proved at the substantive hearing.
28. The Panel noted that there was no evidence presented by the Registrant to address any of the concerns identified by the Final Hearing Panel. The Panel was therefore not satisfied that the Registrant has addressed any of the concerns. It concluded that there remains a risk of repetition and that service users will be placed at real risk of harm.
29. In view of the risk of repetition and the consequential impact on the reputation of the profession, the Panel decided that the Registrant’s fitness to practise remains impaired in respect of both the personal and public components.
30. In considering the appropriate order the Panel took into account the HCPC’s Sanctions Policy. The Panel considered the need to protect the public and gave appropriate weight to the public interest, which includes the need to maintain and uphold professional standards and the reputation of the profession. The Panel applied the principle of proportionality and considered the available sanctions in ascending order of seriousness.
31. The Panel considered that the concerns about the Registrant’s fitness to practise were too serious to take no further action or for the imposition of a Caution Order.
32. The Panel considered whether to impose a Conditions of Practise Order, but considered that this would be insufficient and inappropriate in circumstances where the Registrant’s engagement has been limited and there is no evidence that her level of insight is developing.
33. The Panel decided that a further period of suspension was appropriate. In reaching this decision the Panel took into account the information and evidence the Registrant has provided about her health, as summarised in the Panel’s decision on the Registrant’s application to adjourn today’s hearing. The information about the Registrant’s health may explain, at least to some extent, the Registrant’s limited engagement and limited instructions she has been able to give to her representative. The Panel was aware that the more restrictive option of a Striking Off Order was available to it, but it considered that this would not be a fair or proportionate outcome in circumstances where the Registrant and her representative have made a request for further time to enable her to provide evidence to a reviewing panel due to ill health.
34. The Panel considered the appropriate length of the suspension order. [Redacted]. The Panel considered that a short period of extension may not be sufficient, but that the maximum period of 12 months would also not be appropriate, given the length of time the Registrant has not been practising as a Chiropodist and the importance of her addressing the issues identified by the Final Hearing Panel as soon as she is able to do so. In all the circumstances the Panel decided that a period of six months is appropriate and proportionate. It gives the Registrant sufficient time for her to recover, prepare her evidence for a reviewing panel, and give instructions to her representative.
35. The Panel takes this opportunity to remind the Registrant of the guidance given by the final hearing panel and in particular the following:
“It has been explained earlier in this determination why the Panel does not accept that the Registrant has remediated her failings to date. If the Registrant choses to seek to persuade the future reviewing panel that she has successfully remediated the failings then it will be for her to decide how she would wish to demonstrate that she has. It will be a matter for the future reviewing panel to determine what information and evidence they would require to be satisfied on the issue, but the Registrant would be well advised to take the view that the future panel might expect not only written material, but also that it might wish to hear directly from her.”
Order
ORDER: The Registrar is directed to suspend the registration of Deborah Knight-Griffiths for a further period of 6 months on the expiry of the existing order.
The Order imposed today will apply from 14 August 2025.
Notes
This Order will be reviewed again before its expiry on 14 February 2026.
Hearing History
History of Hearings for Deborah Knight-Griffiths
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 16/01/2026 | Conduct and Competence Committee | Review Hearing | Struck off |
| 14/07/2025 | Conduct and Competence Committee | Review Hearing | Suspended |
| 15/07/2024 | Conduct and Competence Committee | Final Hearing | Suspended |
| 18/03/2024 | Conduct and Competence Committee | Final Hearing | Adjourned part heard |