Sabreen Qureshi-Hitchens

Preliminary Matters

Service

1. The Notice of Hearing (Notice) was sent to the Registrant by email on 18 June 2025 at the correct address held on the Register as evidenced by the certificate of Registration records dated 18 June 2025. The Notice had details of the date and time of the hearing, that it would be conducted remotely by video conference, and a reference to the relevant papers and to the powers available to the Panel including the power to proceed in the Registrant’s absence. The Notice observed that the hearing bundle had been served with less than the conventional 42 days’ allowed.

2. The Registrant’s representatives responded to the Notice on 2 July 2025 waiving the Registrant’s right to the formality of 42 day’s service of the bundle (‘This is fine’).

The Panel’s decision

3. The Panel observed that the service bundle included a certificate proving the Registrant’s correct registration details and registered email address. The Panel accepted the Legal Assessor’s advice, and having had regard to rule 3 of The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the rules), the Panel concluded that the Notice of Hearing had been served effectively under the rules. Any informality of service regarding the hearing bundle had been consciously and voluntarily waived on behalf of the Registrant.

4. Accordingly, good service had been effected.

Proceeding in the Registrant’s absence

5. Ms Collins, on behalf of the HCPC, invited the Panel to hear this case in the Registrant’s absence. Ms Collins reminded the Panel of its powers to do so under rule 11 and the guidance from the Court of Appeal in the case of GMC v Adeogba [2016] WLR (D) 156. The Panel should prioritise fairness to the Registrant and consider the fair and expeditious disposal of this case to protect the public.

6. Ms Collins reminded the Panel that the Registrant’s representatives had said in their response email of 2 July 2025:
‘This is fine. I just want to make it abundantly clear however, that this is an agreed CPD Hearing, not final Hearing. I have also previously confirmed the Registrant does not oppose the CPD and therefore will not be attending the Hearing, nor will a legal representative.
If upon review of the late service of the HCPC Bundle this includes documents which have not previously been disclosed to the Registrant and/or cannot be agreed, the Registrant reserves the right to oppose such material and attend the CPD Hearing and/or make an application to adjourn.’

7. Ms Collins said that:

• the Registrant’s representatives had waived the Registrant’s right to attend on her behalf, and that
• no application to attend or to adjourn had been received on service of the bundle.

8. Ms Collins said that in all of the circumstances, including the Registrant’s waiver and consent to the proposed CPD, there was no information to suggest that an adjournment would serve any real purpose. If the Panel was unable to accept the proposed CPD, the matter would be referred for further procedure in any event. Proceeding in the Registrant’s absence would promote the public interest in resolving cases at the earliest point available, without any material disadvantage for the Registrant.

The Panel’s decision

9. The Panel accepted the Legal Assessor’s advice and paid careful attention to the guidance provided by the Court of Appeal in GMC v Adeogba which incorporated earlier guidance from the House of Lords in R v Hayward (1908) 21 Cox CC 692 and adapted for professional regulation settings. The Panel must ensure that any hearing is fair and should proceed without the Registrant only with care and caution having balanced the risk of prejudice to the Registrant with the public interest in resolving cases at the first reasonable opportunity.

10. The Panel observed that the Registrant’s representatives appear to have slightly misunderstood the nature of this hearing. The hearing was intended to dispose of a proposed CPD but it did not fall outside of the scope of the rules relating to substantive hearings into a special category of substantive hearing. The Panel considered, however, that this did not create any issue of unfairness for the Registrant or procedural impropriety.

11. The Panel observed that if the CPD was not resolved today as both parties intended, the matter would be referred for further procedure. Accordingly, there was reason to conclude that any delay would result in the Registrant’s attendance or participation at a substantive hearing convened to dispose of a CPD. The Registrant’s representatives had expressly said that the Registrant would not attend nor be represented at the hearing dealing with the CPD.

12. The Panel paid close attention to the Practice Note (PN) Proceeding in the Absence of the Registrant dated June 2022. It recognised that fairness to the Registrant was a prominent factor in its decision making. Considering all matters, the Panel decided that it would be fair and proper to move forward in the Registrant’s absence.

Application for parts of the hearing to be heard in private

13. Ms Collins invited the Panel to conduct part of the hearing in private. She said that it may be necessary to discuss matters which touched on the Registrant’s health and family life. Ms Collins reminded the Panel that, ordinarily, these matters would not be heard in public even where the Registrant had attended. That may not, in fact, be necessary, but she made the protective application to guard against that possibility. Ms Collins said that the open justice principle mandated that hearings should always be open to the public where possible. However, the Panel had power to depart from that principle within the limited exceptions permitted under rule 10.1.

14. Ms Collins said that the Registrant had a right for respect for her private and family life, and that could be managed by
• reference to the Panel’s powers to do so under rule 10 and
• the factors set out in the PN Conducting Hearings in Private dated February 2025.

15. Ms Collins submitted that conducting only part of the hearing in private for this reason would still conform to the open justice principle as fully as possible. She submitted that conducting the parts of the hearing in private would protect the Registrant’s right to a private life.

The Panel’s decision

16. The Panel accepted the Legal Assessor’s advice and had close regard to the discretion provided to it under rule 10 and the factors set out in the PN referred to by Ms Collins.

17. The Panel was satisfied that the Registrant’s health should be heard in private to maintain the Registrant’s right to respect for her private life. The Panel was satisfied, having considered the matter carefully, that the Registrant may suffer an invasion of privacy in matters that are subject to a right for respect for privacy under Article 8 of the European Convention on Human Rights. Accordingly, the Panel accepted Ms Collins’s application on behalf of the HCPC. The limited departure necessary from the open justice principle would not result in an unreasonably redacted determination being published.

18. The Panel decided that the matters about the Registrant’s health and family life would be heard in private.

19. In the event, it was unnecessary to discuss in open session the personal and private matters referred to by the Registrant’s representatives. Accordingly, the entire hearing was conducted in open session.

Documents list

20. The Chair confirmed that the Panel had received the following documentation:
Ms Collins skeleton argument on behalf of the HCPC (not exhibited)
Exhibit 1 – consensual disposal hearing bundle 147 pages
Exhibit 2 – Service bundle of 6 pages
Exhibit 3 – draft consent order of 1 page
Exhibit 4 – email from Registrant’s representatives dated 16 June 2025 of 4 pages

Background

21. The Registrant is a registered Physiotherapist. The allegations against her, which the Registrant accepts, arose after a member of the public who is also a registered Physiotherapist found social media posts (tweets) made by the Registrant on 29 December 2020. The Registrant’s publicly accessible ‘twitter bio’ linked to her posts identified her as ‘#CharteredPhysiotherapist’.

22. The Tweets expressed views regarding, among other things, the World Health Organisation. The member of the public then searched the Registrant’s Twitter account profile and found that the Registrant described herself as a Chartered Physiotherapist.

23. On or around 29 December 2020, the member of the public contacted the Chartered Society of Physiotherapy’s complaints team directly and copied the HCPC into this email alerting them to the Registrant’s Twitter account and tweets. The complainant alleged that the Registrant had made public statements via their Twitter account which could be seen as bringing the reputation into disrepute.

24. The Director of Practice and Development at the Chartered Society of Physiotherapy, NB, looked into the Registrant’s Twitter account, including the tweets posted and shared by the Registrant.

25. On 15 January 2021, Ms NB contacted the Registrant by email to notify her that a complaint had been made to the Chartered Society of Physiotherapy and that a referral had been made to the HCPC. Ms NB asked the Registrant to stop using the title “Chartered Physiotherapist” in future tweets and to remove the reference to her being a member of the Chartered Society of Physiotherapy from her Twitter biography.

26. The Registrant responded to Ms NB on that same day, and stated that she understood the concerns raised and that she had
• removed the title of Chartered Physiotherapist from her Twitter biography and
• deleted any posts referring to her being a Chartered Physiotherapist.

The case history

27. Ms Collins, on behalf of the HCPC, told the Panel that on 18 August 2021, an Investigating Committee Panel determined there was a case to answer against the Registrant and referred an allegation to the Conduct and Competence Committee.

28. An investigation was undertaken, beginning with the legal firm Kingsley Napley LLP which obtained witness statements as follow:

• Witness Statement of CT
• Witness Statement of NB
• Production Statement of OA and
• The associated exhibits for the statements.

29. Ms Collins referred the Panel to the content of the statements and exhibits in the bundle in amplifying her submissions.

30. Ms Collins informed the Panel that following a preliminary hearing which took place between 13 and 14 June 2022, the allegation against the Registrant was drafted as follows:
As a registered physiotherapist (PH45498) your fitness to practise is impaired by reason of misconduct. In that:
1. On your Twitter account, where in your Twitter Bio you had #CharteredPhysiotherapist, you publicly shared inappropriate and irresponsible tweets in relation to Covid-19. In that:
1.1 On 29 December 2020 you tweeted that the MHRA (Medicines and Healthcare products Regulatory Agency), a UK government regulatory agency had been paid off by Bill and Melinda Gates to approve the safety of a covid vaccine.
1.2 On 29 December 2020 you tweeted about a “very insightful video” which you said “puts into context the Global Criminal Elite Deathwish roll out for Control and Depopulation under the guise of “Sustainable Development Goals” bs -sorcery at its finest”
1.3 On 29 December 2020 you retweeted the comment, “The Who is a band. The World Health Organization is a criminal enterprise.”
2. The matters set out in allegations 1.1 to 1.28 above constitute misconduct.
3. By reason of your misconduct your fitness to practise is impaired.

31. Between 15 August 2022, and 25 November 2022, Kingsley Napley LLP and the Registrant’s representatives exchanged correspondence which agreed that the allegations were admitted in full and that a one year caution order would be an appropriate and proportionate sanction for the matter to be concluded of consent.

32. This case was then allocated to a case manager at a successor legal firm, Blake Morgan LLP in or about August 2023. On 8 February 2024, the Registrant’s representative informed the HCPC that owing to the time that had elapsed since an agreement was reached to conclude the case by imposition of a caution order for a period of one year, the caution order was effectively ‘spent.’ The HCPC disagreed with that analysis since the matter had not been formally resolved and so nothing could be ‘spent’. However, the HCPC confirmed that a caution order was still considered to be a proportionate sanction and an appropriate way of disposing of the case. The issue became the subject of correspondence extending between the parties, which resulted in a letter from the Registrant’s representatives dated 2 October 2024 stating that the Registrant confirmed that she would be willing to conclude the case on the basis of a CPD with a one year caution order.

33. Further correspondence concluded with the Registrant’s completed Consensual Disposal Request Pro-Forma together with written confirmation that she accepts the proposed sanction on 3 October 2024. The Panel was taken by Ms Collins to the signed Consensual Disposal Request Pro-Forma in the bundle.

34. Ms Collins accepted and apologised to the Registrant on behalf of the HCPC for the extended period of time that has elapsed since the disposal was first agreed between the parties. On 5 December 2024, the steps necessary to initiate the scheduling process for the consensual disposal hearing was submitted to the HCPC.
Guidance on Disposal of Cases by Consent

35. Ms Collins invited the Panel to have regard to the PN in relation to Disposal of Cases by Consent last updated in March 2018 (the PN). The PN reminded the Panel that the HCPC’s overarching statutory objective is the protection of the public and that a Panel should not agree to resolve a case by consent unless they are satisfied that:
• the appropriate level of public protection is being secured; and
• doing so would not be detrimental to the wider public interest.
• the Panel can conclude the case on an expedited basis upon the terms of the proposed Caution Order put before it or reject that proposal and set the case down for a full, contested hearing.

Submissions

36. Ms Collins, on behalf of the HCPC, invited the Panel to exercise its discretion to dispose of the matter by way of consent. She said that in doing so, the Panel could be satisfied that the public was fully protected and that an appropriate and proportionate sanction had been imposed which reflected the Registrant’s insight and reflection.

37. Ms Collins said that the proposed agreed disposal was supported by the Registrant having admitted the substance of the allegation and that her fitness to practise is currently impaired by reason of her misconduct.

38. On that basis, a one year Caution Order on the Registrant’s registration with effect from the date of the hearing would sufficiently mark the seriousness of the Registrant’s departures for the Standards expected of her. That outcome was the least restrictive but equally effective sanction which would serve to fully protect and to reassure the public that it had taken the matter seriously and that there will be no repetition by the Registrant. Public confidence in the profession and in the Standards expected to be upheld would be fully supported.

39. Ms Collins said that the HCPC was satisfied that the Registrant had demonstrated sufficient insight into her failings by fully reflecting on her actions. When the Registrant had been contacted by the Chartered Society of Physiotherapy on 15 January 2021, she took immediate action to address the concerns raised. The Registrant immediately removed the words Chartered Physiotherapist from her Twitter Biography and deleted her posts mentioning Chartered Physiotherapist. The Registrant emailed the Chartered Society of Physiotherapy on 15 January 2021 to confirm the same. In this email she also stated that she was the author of the tweets referred to and would

40. “…not want to damage the reputation of the Chartered Physiotherapy title and mis-construe its values to the public.”

41. Ms Collins also told the Panel that on 12 December 2021, the Registrant had emailed the HCPC apologising for any offence that she had caused to her professional colleagues by her actions and for any misrepresentation of her profession to the public.

42. Ms Collins invited the Panel to have regard to the Registrant’s statement dated 5 August 2021 which was produced in the bundle. The Registrant said that she had extensively reflected on her actions and had accepted that, as a registered practitioner, she should use all forms of communication including social media appropriately and responsibly.

43. The Registrant confirmed that she is aware that her communications need to justify the public’s trust and confidence in her as a registered physiotherapist. Furthermore, the Registrant has confirmed that she no longer uses Twitter or any other form of social media as a method for expressing personal or political views.

44. Finally, the Registrant said that she had reviewed the HCPC guidance and standards in relation to communication and conduct.

The wider public interest

45. Ms Collins said that the second limb of the test for disposing of the case by way of consent, is that the disposal would not be detrimental to the wider public interest.

46. Ms Collins reminded the Panel what was said in the High Court in the case of Cohen v GMC [2008] EHWC 581 (Admin). The guidance from that case was that the public component test for impairment must be considered; specifically:
• the need to protect service users,
• declare and uphold proper standards of behaviour, and
• to maintain public confidence in the profession.

47. Ms Collins said that in this case, the Panel could be satisfied that the wider public interest is sufficiently protected by the Registrant agreeing to the one year Caution Order. This was an isolated incident and because of the insight the Registrant has shown into
• her actions
• the impact on the public and the profession more widely, and
• the immediate steps taken to correct her failings
there was a low risk of repetition. Further, Ms Collins said, the admitted misconduct occurred over a very short period of time and occurred during a time when the Registrant was going through a particularly difficult time in her personal life as she explained in her statement. There was, Ms Collins said, no evidence that the Registrant has repeated the misconduct since the allegations came to light.

48. Ms Collins said that in the event that this matter were to be decided at a substantive hearing, the likely outcome in all of the circumstances would be a one year Caution Order. That outcome was proportionate in that it adequately protects the public and is proportionate given the circumstances of the case.

49. Ms Collins invited the Panel to give effect to the draft Consent Order that had been provided by her.

The Registrant

50. On 16 June 2025, the Registrant’s representatives sent an email to the HCPC in the following terms:
‘I write with reference to your correspondence below. I would be grateful if the below responses could be provided to the CPD Panel:-
Please find attached a further copy of the signed consent of the Registrant which was filled with the HCPCs legal representatives (Blake Morgan) on 3 December 2024.
I would also be grateful if it could be brought to the Panel's Decision that the Registrant had previously agreed in writing to CPD of a I year Caution Order on 25 November 2022.However, due to the HCPC withdrawing their work from their previously instructed legal representatives (Kingsley Napley), the Registrant has been waiting some 2.5 years for newly appointed HCPC legal representatives in order for the matter to be resolved and listing of the CPD Hearing. Disappointingly, it is clear to see therefore, that had the I year Caution Order become effective closer to the time it was agreed between the parties, this would have now passed.
We confirm that since 25 November 2022 no further referrals had been made regarding the Registrant’s practise.
The HCPC have confirmed however it is their view that a I year Caution Order is still the appropriate sanction.
That said, to save any further distress, anxiety and delay, the Registrant consents to the proposed CPD and does not oppose the agreement Consequently, the Registrant does not intend to attend the CPD Hearing nor that of a legal representative and is content for the matter to be dealt with at a meeting/ on papers.’

Decision on the Facts

51. The Panel accepted the Legal Assessor’s advice. It had regard to the PN referred to, which permitted the Panel to dispose of the case by consent as an efficient and effective means to fully protect the public without the need for a formal substantive hearing. The Panel recognised that in considering this application, it was not bound to accept the proposed determination. Although the Registrant had made admissions, if the proposed consent order was not agreed to, those admissions would be treated as having been made without prejudice in pursuit of an agreed outcome. Any substantive panel would only become aware of the admissions if they were voluntary reproduced by the Registrant in that process.

52. The Panel’s primary focus is the statutory overarching objective which was to protect the public. Three objectives are subsumed under the overarching objective which are:
• the need to protect service users,
• declare and uphold proper standards of behaviour, and
• to maintain public confidence in the profession.

53. The Panel has to be satisfied that the facts are proved by voluntary, and comprehensive admissions. The Panel must also be satisfied that the Registrant’s fitness to practise is impaired. Her admissions are helpful but the Panel must approach the matter independently and objectively. Finally, if the Panel is satisfied regarding impairment, the Panel must independently consider what is the appropriate and proportionate sanction in this case. If that coincides with the agreement between the parties, then the Panel can give effect to the proposed agreement. If not, then the matter will be referred for further procedure.

54. The Panel had regard to the PN Admissions dated October 2024. The Panel recognised that the Council had the burden of proving disputed facts to the civil law standard of balance of probabilities. The Registrant had no burden of proof. However, a panel can find a fact proved by virtue of an admission without receiving further evidence, which is consistent with the overarching objective and Article 32(3) of the Health Professions Order 2001 to ensure that '…each stage in proceedings…shall be dealt with expeditiously'.

55. The Panel had regard to the relevant exhibits which included extracts of the social media posts made by the Registrant. The Panel was satisfied that the posts were reflected accurately what had been particularised by the HCPC in the allegations against the Registrant. The Statements made available to the Panel supported the Registrant’s position that she accepted having made the social media posts and that in the circumstances, that this was contrary to the Standards expected of her as a registrant. Further, the Registrant had apologised and taken immediate action to remove the posts, which was all verified in the exhibits and the statements.

56. In all of the circumstances, that Panel is satisfied that the facts in head of charge 1 of the allegation were proved.

Decision on Grounds

57. The Panel went onto consider particular 2; whether misconduct as the statutory ground of impairment under Article 22.(1)(a) of the Health and Care Professions Order 2001is made out.

58. The Panel understood that this issue was one for its own professional judgement as was not approached on the basis of any evidential gateway considerations. The Panel had to be satisfied that the social media posts amounted to serious misconduct in the sense that other registrants might find the posts to have been ‘deplorable’ and capable of bringing the Registrant and the wider professional into disrepute.

59. The Panel took into account the guidance found in the familiar cases of
• Roylance v GMC [2000] 1 AC 311,
• Nandi v GMC [2004] EWHC 2317 (Admin), and
• Calheam v GMC [2007] EWHC 2606.
Taken as a whole, the Panel was satisfied the Registrant’s behaviour individually was sufficiently serious to amount to misconduct and so satisfy the statutory ground for a decision on impairment to follow. The Registrant had acted, albeit briefly and in a way that she now regrets, in such a way which fell far short of what would be proper in the circumstances and what the public would expect of a HCPC registered Physiotherapist. The Panel observed that one fellow professional had been so exercised by coming across the posts in association with the Registrant’s professional status, that complaints were made by that person to two separate bodies including the HCPC.

60. In considering grounds, the Panel that there is no statutory definition of misconduct, but the Panel had regard to the guidance of Lord Clyde in the case of Roylance:
‘Misconduct is 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… practitioner in the particular circumstances.”

61. The conduct must be serious in that it falls well below the required standards. The Panel recognised that breaches of standards in and of themselves might not necessarily amount to misconduct.

62. The Panel considered that the Registrant had breached the following 2016 Standards of the HCPC Standards of Conduct, Performance and Ethics 2016 (the 2016 Standards) which were in force at the relevant time:
2. Communicate appropriately and effectively
Communicate with service users and carers
2.1 You must be polite and considerate.
2.5 You must work in partnership with colleagues, sharing your skills, knowledge, and experience where appropriate, for the benefit of service users and carers.
6. Manage risk
Identify and minimise risk
6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers, and colleagues as far as possible.
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 Be honest and trustworthy
Personal and professional behaviour
9.1 You must make sure that your conduct justifies the public's trust and confidence in you and your profession.
63. The Panel considered that the Registrant had acted in a way which potentially could impact on a service user, patient or their carers to hesitate before seeking the services of a Physiotherapist based on having read the Registrant’s posts. The Panel does not make any judgement in relation to the content which is a matter for others. However, the social media posts were undoubtedly alarmist in nature, controversialist in character and openly challenging of the commitment held by other professionals to act in the public interest.

64. In all of the circumstances, the Panel was satisfied that the Registrant’s actions were serious and amounted to misconduct.

Decision on Impairment

65. Having found that the statutory ground of misconduct had been made out, the Panel moved on to consider the question of impairment.

66. The Panel had regard to the HCPTS PN Fitness to Practise Impairment updated in February 2025. A Registrant’s impairment if any has two aspects, personal impairment and impairment in the wider public interest. The Panel was reminded that whether the Registrant’s fitness to practise was impaired was a matter for the Panel’s professional judgement, judged against what was known today and taking account of the Registrant’s apology and her immediate remedial action in taking down the social media posts.

Personal impairment

67. The Panel had regard to the PN Fitness to Practise Impairment last updated in February 2025. The Panel also took into account what was said by the court in the case of Meadow v General Medical Council [2006] EWCA Civ 1390; that the Panel is entitled to form a view of the likelihood of repetition of misconduct by having regard to what had been done in the past.

68. The Panel also referred to what was said by Silber J in the Cohen case already referred to, that any
“…approach to the issue of whether a [relevant professional’s] fitness to practise should be regarded as ‘impaired’ must take account of ‘…the need to protect the individual patient, and the collective need to maintain confidence [in the] profession as well as declaring and upholding proper standards of conduct and behaviour of the public in their doctors and that public interest includes amongst other things the protection of patients, maintenance of public confidence in the profession’.
The judge went there on to say that
“it must be highly relevant in determining if a [practitioner’s] fitness to practise is impaired that first his or her conduct which led to the charge is easily remediable, second that it has been remedied and third that it is highly unlikely to be repeated.”

69. The Panel recognised that the public interest in maintaining trust and confidence in the profession of Physiotherapist was a centrally important element of any determination of current fitness to practise.

70. In this case, the Registrant had acted immediately and properly to remove the social media posts which had caused the complaint be made and had prompted her professional association to seek reassurances that the identified breaches of its code would not be repeated. The Panel considered that the Registrant had acted creditably and with grace in removing the posts and offering apologies for her actions to the HCPC, her professional association and to her fellow practitioners. She recognised that the posts had fallen short of the Standards expected of her. She had given an instant undertaking not to associate her views with her professional registration and had removed herself from public facing social media.

71. All of those actions were sufficient to satisfy the Silber test taken from the Cohen case, except in relation to the wider public interest. The Registrant had placed herself in a difficult dilemma in making the social media posts. She had removed them but had not, as was open to her, taken steps to publish the fact that any view expressed were private views and not those which were made because of any insights or training stemming from her professional practice or registration.

72. Taking this step might foreseeably expose the Registrant to the risk of becoming a target for ‘trolls’ who might publicly round on her as an unreliable ally or even someone hostile to the view that the trolls advanced. That would be personally unpleasant, but it also raised the potential for the now deleted posts to adopt a currency and prominence that would defeat the purpose of the qualifications that might have been posted by the Registrant.

73. In all of the circumstances, the Panel did not criticise the Registrant for not taking such action. However, the dilemma was helpful in illustrating the hidden and not immediately apparent dangers of posting on social media, posts which associated personal views with professional registration. That also assisted the Panel in coming to the view that the reasonable and informed member of the public would expect the regulator to take action since other alternatives may not be effective and might perhaps be counter-productive.

74. The Panel was satisfied that in this case; a reasonable and informed member of the public would be troubled if a finding of current impairment were not made.

Public impairment

75. The Panel then considered the public aspect of impairment. In that regard it referred to the approach formulated by Dame Janet Smith in the Fifth Shipman Report and adopted as a test for current impairment in the case of CHRE v NMC & Grant [2011] EWHC 927 (the Grant case). The Panel recognised that impairment is decided based on the present circumstances and is a forward-looking exercise. However, where impairment in the past can be identified, the focus can be on what current information is available to displace or lessen impairment. The Panel considered that on any reasonable measure of impairment, the Registrant had shown a full grasp of the important issues and the potential for harm to the public in her actions and in her apologies. The HCPC case is that there has been no repetition.

76. The Panel considered that despite all of the good work done by the Registrant and evidence of a clear commitment which had been followed through, not to repeat the conduct, nevertheless the Registrant’s fitness to practise was impaired on grounds of the wider public interest.

77. In the Panel’s view, the need to support public trust and confidence in the profession of Physiotherapist and in its regulator made it necessary that a finding of impairment be made. An informed member of the public would be troubled to learn that no finding of impairment had been made in a case like this in social media posts had been made. The impact of the posts on the public mind was, in a sense, made more evident by the Registrant’s creditable quick and decisive apologies and actions to take down the posts.

78. The Panel considered that, objectively, certain parts of the Grant test had been met in the past.
“Do our findings of fact in respect of the [Registrant's] misconduct, … show that …her fitness to practise is impaired in the sense that s/he:
….; and/or
has in the past brought and/or is liable in the future to bring the [Registrant’s] profession into disrepute; and/or

79. The Panel came to the view that the discreditable social media posts were in violation of the Registrant’s obligation to not act so as to bring the profession of Physiotherapist into disrepute.
The Registrant had acted on the realisation that this was so and removed the posts and had apologised. Her impairment was therefore confined solely to the need to maintain the trust and confidence of the public going forward by marking the misconduct with such a finding.

80. The Panel therefore found that the Registrant was impaired for reasons of the wider public interest.

Decision on Sanction

81. Ms Collins, on behalf of the HCPC invited the Panel to exercise its discretion to dispose of the matter by way of the proposed agreed Consent Order.

82. Ms Collins said that disposing of the matter by way of consent would be an appropriate and proportionate method of concluding this case. The Registrant had admitted the substance of the allegation and that her fitness to practise is currently impaired by reason of her misconduct.

83. The proposal to impose a one year Caution Order on the Registrant’s registration with effect from the date of the hearing was on the basis that the Registrant has admitted that her fitness to practise is currently impaired by reason of her misconduct. That Order would represent the minimum action required to protect the public and public confidence in the profession.

84. Ms Collins said that the Registrant has also demonstrated insight by fully reflecting on her actions. She had taken urgent action to remove the posts. She recognised the potential impact on the profession of her posts. She had clearly stated that this was an unwanted consequence. The Registrant had made good on her undertaking not to repeat her misconduct.

85. In all of these circumstances, Ms Collins submitted, a one year Caution Order was an appropriate and proportionate disposal.

The Panel’s decision

86. The Panel accepted the advice of the Legal Assessor. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Collins on behalf of the HCPC and those on behalf of the Registrant. It took account of by the HCPC Indicative Sanctions Policy (ISP) and noted the need for proportionality.

87. The Panel also referred to the ISP and held in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and to maintain proper standards of conduct and performance.

88. The Panel found the following mitigating factors:
• Prior to this matter no previous disciplinary history with the HCPC.
• The Registrant had engaged immediately with her professional association and the HCPC. She had acted swiftly and decisively to remove the social media posts.
• The misconduct was of limited duration and there had been no repetition.
• The Registrant had made full admissions in this case.

89. The Panel found the following aggravating factors:
• These were serious departures from the standards expected of a Physiotherapist.

90. The Panel considered that this case did not fall within the definition of a serious case as set out in the ISP. The misconduct was not insignificant and did have the potential to harms the interests of patients and the profession. However, the Registrant’s swift remediative actions spurred by her instant grasp of the issues and full insight made this a case which did not indicate a need for a disposal which called into question any need to preclude the public from having access to an otherwise valuable member of the profession.

91. There had been regrettable (and regretted) social media posts which had reflected poorly on the Registrant’s wider professional judgement. There was a potential risk for patient safety. In all of these circumstances, the Panel did not consider this was an appropriate case in which either mediation or taking no further action had any merit.

92. The Panel next considered whether a Caution Order would adequately reflect the seriousness of the conviction. The Panel’s role, as indicated by the ISP, was not to punish the Registrant, but solely to
• protect the public,
• to maintain high standards amongst registrants and
• to maintain public confidence in the profession.
For all of the reasons already set out, the Panel was satisfied that a Caution Order would adequately mark the seriousness of the Registrant’s behaviour. The Panel considered that a one year period beginning immediately was the appropriate and proportionate duration of the Order.

93. The Panel gave careful consideration to the potential for any other more restrictive sanction. However, there was nothing to suggest that these would be any more protective. There was a real risk that they would be perceived as being solely punitive.

94. In all of the circumstances, the Panel considered that the agreed one year Caution Order was the appropriate and proportionate outcome in this case.

The Registrar is directed to annotate the Register entry of Ms Sabreen Qureshi-Hitchens with a caution which is to remain on the Register for a period of one 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 Sabreen Qureshi-Hitchens