Leo Hare

Preliminary Matters
Application to amend

1. Ms Danti on behalf of the HCPC made an application to amend the Particulars of Allegation as indicated above. The Registrant did not oppose the application.

2. The Panel was satisfied that the proposed amendments did not materially alter the substance of the Allegation and that no unfairness would be caused to the Registrant. Accordingly, the Panel granted the application to amend.

Hearing in private
3. Ms Danti made an application for any reference to the health of the Registrant or any member of his family to be heard in private.

4. The Panel had regard to the HCPTS Practice Note on “Conducting Hearings in Private” and accepted the advice of the Legal Assessor. The Panel granted the application for any reference to health matters to be heard in private for the reasons advanced by Ms Danti.

Background
5. The Registrant is registered with the HCPC as a Dietitian. At the material time, the Registrant was employed in that capacity by Tees, Esk and Wear Valleys NHS Foundation Trust (the Trust) and was based at West Park Hospital, Darlington.

6. On 1 November 2022, the Registrant accessed the medical records of Service User A on the Trust’s electronic patient record system, known as PARIS. It is alleged that the Registrant had no authorisation or clinical justification to access Service User A’s records.

7. On 8 November 2022, following detection of the unauthorised access, Privacy Officer, NB contacted the Registrant by email, asking why he had accessed Patient A’s records and whether or not he was related to Service User A.

8. In the absence of any response, Ms NB sent a reminder email to the Registrant on 17 November 2022.

9. On 21 November 2022, the Registrant responded to Ms NB's emails by stating that he had accessed Service User A’s records in error when searching another service user’s records. He denied any intention to access Service User A’s records.

10. On 29 November 2022, the Registrant gave a different explanation to his line manager, ST. He said that he had come across the records of Service User A, when searching for someone else, and that he had accessed Service User A’s records out of curiosity and concern.

11. The Registrant’s access to PARIS records was consequently suspended.

12. On 2 December 2022, the Registrant provided a statement in which he described viewing Service User A’s PARIS records in a moment of weakness.

13. On 26 January 2023, the Registrant attended an investigatory interview, in which he confirmed that he had intentionally accessed Service User A’s record. The Registrant also acknowledged that his initial response to the Privacy Officer had been dishonest.

14. On 18 May 2023, a Trust disciplinary hearing took place.

15. On 9 June 2023, the Registrant’s access to PARIS was reinstated.

16. On 22 January 2024, a panel of the Investigation Committed determined that there was a case to answer in respect of the Allegation, apart from Particular 3c.

17. On 16 February 2024, the Registrant completed the HCPC’s Response Proforma to the Notice of Allegation, in which he confirmed that the facts were admitted but denied that his fitness to practise was impaired.

Decision on Facts
18. At the outset of the hearing, the Registrant admitted Particulars 1, 2, 3a and 3b of the amended Allegation. Accordingly, each of these facts was found proved without the need for the Panel to hear any evidence.

Decision on Misconduct

19. The Panel went on to consider whether the facts found proved, amounted to misconduct, as alleged in Particular 4 of the Allegation.

20. The Registrant admitted misconduct at the outset of the hearing.

21. The Panel was mindful that this was a matter for the Panel’s professional judgement, there being no standard or burden of proof.

22. The Panel took into account that misconduct was defined in Roylance v General Medical Council (no 2) [2001] 1 AC 311 as:
“a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a (medical) practitioner in the particular circumstances”.

23. The Panel found that the Registrant had been in breach of the following standards in the HCPC Standards of Conduct, Performance, and Ethics, that were in place at the relevant time:

1.1 You must treat service users and carers as individuals, respecting their privacy and dignity.
5.1 You must treat information about service users as confidential.
6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

24. In addition, the Panel found the Registrant to have been in breach of the following standards in the HCPC Standards of Proficiency for Dietitians that were in place at the relevant time:

2.2 understand what is required of them by the Health and Care Professions Council
2.3 understand the need to respect and uphold the rights, dignity, values, and autonomy of service users and their central role in decisions about their health
3.1 understand the need to maintain high standards of personal and professional conduct
7.1. understand the importance of and be able to maintain confidentiality
10.2 recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines

25. The Panel concluded that the Registrant’s conduct fell seriously short of the standards to be expected of him in the circumstances and thereby constituted misconduct.

Decision on Impairment
26. The Registrant denied that his fitness to practise is currently impaired by reason of his misconduct, as alleged in Particular 5 of the Allegation.

27. The Registrant gave evidence on affirmation. He stated at the time when he accessed Service User A’s records, he (the Registrant) accessed the records out of emotional distress caused by his concern. He admitted that he knew at the time that what he was doing was wrong and that it made him feel sick.

28. The Registrant explained that, when he received the email from the Privacy Officer, he panicked because he thought that his job would be “on the line”.

29. The Registrant admitted to his line manager that he had accessed Service User A’s records.

30. The Registrant said that he had been subject to an investigation by the Trust which lasted six months, which resulted in his receiving a final written warning but that it had been determined that he was fit to continue in practice.

31. The Registrant provided the Panel with a statement from Service User A which confirmed the Registrant’s account at the relevant time, of which the Registrant was aware. Service User A stated, “I fully understand the reasons behind his doing this, it has not caused me any issues”.

32. The Registrant informed the Panel that he had continued to work as a Dietitian for the Trust until November 2024, when he took the decision to take time out of work. He said that he was committed to his profession, which he loved, and intended to return to practice as soon as possible.

33. The Registrant provided a supportive testimonial dated 18 September 2024 from Darren Hitching, Lead Dietitian at the Trust and the Registrant’s former line manager. He described the Registrant as a “conscientious, caring, well respected member of TYEWV’s Dietetic Team” and confirmed that no issues had arisen with the Registrant’s practice.

34. The Panel took account of the Registrant’s evidence and carefully considered the submissions on behalf of the HCPC and the Registrant respectively. The Panel accepted the advice of the Legal Assessor.

35. The Panel took into account the HCPTS Practice Note on “Finding that Fitness to Practise is Impaired” and accepted the advice of the Legal Assessor.

36. In determining whether the Registrant’s fitness to practise is impaired, the Panel took into account both the personal and public components of impairment. The personal component relates to the Registrant’s own practice as a Dietitian, including any evidence of insight and remorse and efforts towards remediation. The public component includes the need to protect service users, declare and uphold proper standards of behaviour on the part of registrants and maintain public confidence in the profession and the Regulator.

37. With regard to the personal component, the Panel accepted the Registrant’s expressions of remorse to be genuine. He candidly admitted that he knew at the time that it was wrong for him to access Service User A’s records without authorisation or any clinical need to do so. He did not seek to justify his conduct. The Panel believed his explanation as to why he had acted as he did, which was supported by the statement of Service User A. The Panel was satisfied that the Registrant had insight as to the why his actions had been wrong and unacceptable, the potential risk of significant harm to Service User A and the negative impact on his own professional reputation and the confidentiality of medical records. The Panel noted that there was no evidence of any specific remedial steps taken by the Registrant but was confident that he had learned his lesson from the consequences which followed from his misconduct, including the Trust investigation and the final written warning.

38. The Panel accepted that this was an isolated incident arising from the Registrant’s emotional distress and concern for Service Users A’s welfare. Having regard also to the negative impact of these proceedings on the Registrant, and his reaction to it, the Panel considered that there was minimal likelihood that he would repeat such misconduct in the future.

39. Accordingly, the Panel found that his fitness to practise is not currently impaired having regard to the personal component.

40. With regard to the public component, the Panel took into account the multiple breaches by the Registrant of the professional standards referred to above, the element of dishonesty in accessing Service User A’s records, and the serious departure from professional standards.
41. In the circumstances, the Panel determined that a finding of current impairment on public interest grounds was required both as a deterrent to others and to maintain public confidence in the confidentiality of their medical records and the reputation of the profession.

42. Accordingly, the Panel found that the Registrant’s fitness to practise is impaired on public interest grounds.

Decision on Sanction
43. The Panel had regard to the helpful, fair and balanced submissions by Ms Danti on behalf of the HCPC. The Registrant made no further submissions at this stage.

44. The Panel took into account the HCPC’s Sanctions Guidance (2019) and accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of a sanction is not to punish the Registrant but to protect the public and the wider public interest in upholding proper standards and maintaining the reputation of the profession. The Panel applied the principle of proportionality, balancing the interests of the Registrant with those of the public, and considered the available sanctions in ascending order.

45. The aggravating factor in this case is that the Registrant’s unauthorised access of Service User A’s medical records involved a breach of trust.

46. The mitigating factors are that:
• This was a single isolated incident where the Registrant accessed the medical records of Service User A, out of concern for Service User A’s welfare and at a time when the Registrant was suffering from emotional distress in response to Service User A’s health condition.
• The Registrant has expressed genuine remorse and apology. He has reflected deeply and has insight into the effect and consequences of his misconduct.

47. The Registrant’s misconduct was too serious for the Panel to take no further action

48. Mediation is not relevant.

49. The Panel carefully considered the indicative features for imposing a Caution Order and decided that they apply to a large extent in this case. In particular, this was an isolated incident of misconduct, which is very unlikely to be repeated. The Registrant has expressed remorse and demonstrated appropriate insight. The misconduct did not involve the Registrant’s clinical practice which has received praise. Whilst there has been a finding of dishonesty, the Panel considered it to be at the lower end and did not bring into question the Registrant’s clinical competence or have implications for public safety. The Panel considered that the public interest in this case includes the return to practice of a competent and dedicated Dietitian.

50. In deciding the length of a Caution Order, the Panel sought to balance the need to send a message by way of a deterrent against such misconduct to the profession with fairness to the Registrant and having regard to the wider public interest.

51. In all the circumstances, the Panel considered that the appropriate and proportionate sanction is a Caution Order for a period of one year.

52. For the sake of completeness, the Panel did not consider that a Conditions of Practice Order would be relevant or appropriate as there were, and are, no concerns about the Registrant’s clinical competence. The Panel considered that a Suspension Order would be wholly disproportionate.

ORDER: That the Registrar is directed to annotate the Register entry of Mr Leo Hare with a caution which is to remain on the Register for a period of 1 year from the date this Order comes into effect.

Right of Appeal:
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.
Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

History of Hearings for Leo Hare