Mrs Deborah Ruscillo

1. The Registrant attended and was represented by her Solicitor.  The Panel was satisfied that no issue arose regarding service.

 

2. At the outset of the hearing, Ms Dixon applied to the Panel to amend the Allegation to change the date in Particular 1 of the allegations from 2 September 2022 to 3 September 2022.

 

3. She submitted that the amendment was necessary to reflect the evidence, which showed that the Registrant accessed Patient A's records on 3 September 2022. She told the tribunal that the proposed amendment had been notified to the Registrant on 30 January 2026 and had been agreed in the Agreed Statement of Facts signed by the Registrant’s representatives on 10 March 2026. 

 

4. Mr Jolliffe did not object to the amendment, on the Registrant’s behalf.

 

5. The Panel heard and accepted the advice of the Legal Assessor, which it has followed in the decision set out below.

 

6. The Panel noted that there is no specific provision in The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the Rules) dealing with amendment but accepted the advice of the Legal Assessor that it has the power to amend if such amendment is necessary to protect the public and can be made without injustice to the Registrant.

 

7. The Panel was satisfied that the proposed amendment did not affect the fairness of the hearing as the Registrant had been aware of the proposed amendment for a considerable time and had agreed to it in writing. In addition, there was no material change to the Allegation. Accordingly, the Panel allowed the amendment. 

 

8. Ms Dixon applied to the Tribunal to hold in private:

a. those parts of the evidence and submissions which could lead to the identification of Person A (the person whose records the Registrant had accessed) and Person B.

b. Those parts of the evidence which related to the health of the Registrant and that of Person A.

 

9. She submitted that, despite anonymization they could be identified by reference to their relationship to the Registrant.

 

10. Mr Jolliffe did not object to the application and submitted that the whole of the hearing should be heard in private because it would be impractical to move from public to private session in the way envisaged by Ms Dixon.

 

11. The Panel accepted the advice of the Legal Assessor, which it followed in the decision set out below.

 

12. The Panel took into account the HCPTS Practice Note entitled “Conducting Hearings in Private” and had regard to Rule 10(1)(a) of the Health and Care Professions Council (Health Committee) (Procedure) Rules 2003, which provides that “proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice or for the protection of the private life of the Registrant, the complainant, any person giving evidence or of any patient or client, the public should be excluded from all or part of the hearing.”

 

13. The Panel also had careful regard to the importance of open justice and of imposing a restriction on that principle which is no more restrictive than necessary to protect the private lives of individuals and promote the interests of justice.

 

14. The Panel concluded that it was in the interests of justice to protect the identities of the people mentioned above in order to ensure that people were not discouraged from bringing complaints to the HCPC. It was also satisfied that it was appropriate to make such order as was necessary to hear in private evidence relating to the health of the people mentioned above.

 

15. Nevertheless, the Panel was satisfied that it would be practical to hold the bulk of the hearing in public because experienced advocates would be able to isolate those parts of the evidence which needed to be heard in private.

 

16. Accordingly, the Panel ordered that it would hear in private those parts of the evidence and submissions relating to the health of the Registrant and those people mentioned above. It would also hear in private evidence and submissions, which identified Person A and Person B by reference to their relationship to the Registrant. It ordered that the rest of the hearing would be heard in public.

 

Admissions and finding Particular 1 found proved by reason of the Registrant’s admission

17. After those preliminary matters had been dealt with, the Hearings Officer read the Allegation to the Registrant. Mr Jolliffe indicated that the Registrant admitted Particulars 1 and 2 (although he recognised that misconduct and impairment were both matters for the Panel’s own judgement).

 

18. The Panel also saw a document headed Statement of Agreed Facts, signed by Mr Jolliffe on behalf of the Registrant on 9 March 2026 and on behalf of the HCPC on 10 March 2025.

 

19. The Panel observed that the second paragraph of that document stated “The Registrant admits Particular 1 of the proposed amended allegations in full. She admits the factual conduct alleged in that, on the 3 September 2022, on one or more occasions, she accessed the records of Person A without a reason and/or consent to do so.”

 

20. Both Ms Dixon and Mr Jolliffe submitted that the Panel should accept the Registrant’s admissions and announce that Particular 1 of the Allegation was admitted and found proved.

 

21. The Panel also heard and accepted the advice of the Legal Assessor, which it has followed in its decision set out below.

 

22. The Panel had regard to the HCPTS Practice Note entitled Admissions and dated January 2026. The Panel acknowledged that the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (as amended), (the Rules) do not provide for matters to be proved by admission. However, the Panel observed that the rules do not prohibit this, and the above practice note provides that 

 

23. The Panel took into account the following matters:

a. The Registrant was present and represented by her solicitor;

b. Her admission was consistent with the statement of facts set out above and which was also signed by her solicitor;

c. The Admission was also contained in her signed witness statement;

d. Her admission was also consistent with her early admission when confronted with the allegation in a workplace investigation;

e. The admission was of a simple statement of fact, and no issue arose regarding her understanding of what she had admitted.

 

24. Accordingly, the Panel accepted the Registrant’s submissions and announced that Particular 1 was proved by virtue of the Registrant’s admissions.

 

25. The Registrant is a Physiotherapist registered with the HCPC. She qualified in 2011 with a first-class degree from the University of Central Lancashire. She started work with the University Hospitals of Morecambe Bay NHS Foundation Trust (“the Trust’) in November 2014, obtained a permanent Band 6 job within the stroke team at the Royal Lancaster Infirmary in 2016 and remains employed by the Trust. 

 

26. In August 2022, Person A, was admitted to hospital as a result of a heart attack.  He was discharged from hospital on 1 September 2022 and on medical advice downloaded the GP access app in order to keep track of his medication. Having looked at his own records, he became aware that they had been accessed after he had left hospital by somebody who did not appear to be part of the team caring for him.

 

27. He suspected that this had been done by the Registrant and contacted the Trust. The Trust conducted an investigation and on 6 March 2023, the investigator interviewed the Registrant via Microsoft Teams. The Registrant admitted that she had accessed Person A's records with no professional reason to do so. She told the investigator that she had done this in what she described as a moment of stupidity because she wanted to know whether patient A had had a heart attack. 

 

28. The Panel saw that the investigation report showed that the Registrant had denied accessing patient A's records on any other occasion and also denied sharing the information she had found with anyone. 

 

29. Person A referred the Registrant to the HCPC on 10 February 2023.

 

30. Having found the Particular 1 of the Allegation proved by virtue of the Registrant’s admission, the Panel considered whether the matters found proved amounted to serious misconduct and, if so whether the Registrant’s fitness to practise is currently impaired.

 

31. The Panel had regard to all the documents put before the Panel by the HCPC and the Registrant:

a. HCPC case summary dated 25 March 2026;

b. HCPC hearing bundle, 289 pages;

c. Registrant’s Bundle 152 pages;

d. Registrant’s Addendum bundle 54 pages;

e. A statement of Tasmin Kind dated 9 April 2026;

f. Statement of Agreed facts signed 9 and 10 March 2026;

 

32. The Panel also heard evidence from the Registrant and 3 testimonial witnesses who gave evidence of the quality of the Registrant’s work and the contribution she made to colleagues and the patients under her care.

 

33. The Panel deals with the Registrant’s evidence under the individual matters that it has to decide. Nevertheless, the Panel made a number of general observations about the Registrant’s evidence, which it records here.

 

34. The Registrant’s evidence comprised her oral evidence, a signed witness statement, and a number of reflections and documents she had prepared. The Panel was satisfied that the Registrant’s oral evidence was entirely consistent with her written evidence and the documentation she had prepared. 

 

35. The Panel also observed that the Registrant was carefully and skilfully cross-examined. During that cross-examination she acknowledged that she had been fully trained in her employer's confidentiality policies and understood when she did it that it was wrong to access the records of somebody without clinical justification. She also acknowledged that her admissions to the Trust investigation were made some four months after her accessing of Person A's records and only when she was confronted with the allegation.

 

36. Taking all these matters together the Panel concluded that the Registrant’s evidence was honest and reliable, and it accepted what she told the tribunal in the ways set out below.

 

37. On the issue of misconduct, Ms Dixon reminded the Panel of the relevant law and guidance, which the Panel has set out in its decision below.

 

38. Ms Dixon also drew the Panel’s attention to the relevant provisions of the HCPC standards of conduct, performance and ethics in force in September 2022 (the Code), which the Panel also refers to in its decision set out below.  She acknowledged that the Registrant had accessed Person A's records at a time of significant personal stress for herself. Nevertheless, she submitted that, while that may afford her some mitigation, her actions amounted to serious misconduct in all the circumstances. 

 

39. Mr Jolliffe reminded the Panel that the Registrant had admitted that her actions amounted to misconduct and acknowledged that this was a decision for the Panel alone.

 

40. The Panel heard and accepted the advice of the Legal Assessor, which it has followed in its approach and decision set out below.

 

41. The Panel reminded itself of the decision of the High Court in Roylance v General Medical Council (No.2) [2000] 1 AC 311 “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 medical practitioner in the particular circumstances.”

 

42. It also had regard to the decision of the High Court in Solicitors Regulation Authority v. Day and others [2018] EWHC 2726 (Admin) which gave the following guidance to Panel: “We do not, we emphasise, say that there is a set standard of seriousness or culpability for the purposes of assessing breaches of the core principles in tribunal proceedings. It is a question of fact and degree in each case. Whether the default in question is sufficiently serious and culpable thus will depend on the particular core principle in issue and on the evaluation of the circumstances of the particular case as applied to that principle.”

 

43. The Panel was satisfied that the Registrant’s actions breached the following provisions of the Code.

 

 

44. The Panel acknowledged that not every breach of the code will amount to serious misconduct. Therefore, it examined the seriousness and culpability of the Registrant’s actions.

 

45. The Panel accepted the Registrant’s evidence that she acted out of character under significant personal stress. 

 

46. In her evidence the Registrant acknowledged that at the time she was simply “not thinking straight”.  The Panel also accepted that the Registrant had not shared the information she found with anyone else.

 

47. The Panel concluded that this evidence did reduce the Registrant’s culpability but was not sufficient to extinguish it. The Panel observed that the Registrant had recently been retrained in the importance of preserving the confidentiality of service users' records and knew at the time that she should not access them for family reasons.

 

48. The Panel also found that, the Registrant had caused Person A significant anguish and distress by accessing his records and her actions risked making him reluctant to seek help from medical professionals in the future.  The Panel also found that the Registrant’s actions risked undermining the confidence of other members of the public who needed to be able to trust that their medical records were confidential and secure.

 

49. Taking all those matters together the Panel was satisfied that the matters admitted and found proved in Particular 1 of the Allegation amounted to serious misconduct.

 

50. The Panel then went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of the misconduct it has found.

 

51. Ms Dixon reminded the Panel of the relevant law and guidance to which the Panel refers below in its decision.

 

52. She reminded the Panel that impairment should be considered under both the personal and public component. She reminded the Panel that the personal component related to the risk that the Registrant would repeat her misconduct and the public component was focused upon the need to maintain public confidence in the profession and uphold standards of conduct for the profession.

 

53. With regard to the personal component, Ms Dixon reminded the Panel that the Registrant’s misconduct was an isolated incident and there is no evidence of repetition since September 2022, although the Registrant has been working without restriction since then.

 

54. She reminded the Panel that the Registrant had not started to develop insight and begun her remediation until she was confronted with her misconduct, some four months after it occurred. Nevertheless, she acknowledged the evidence that the Registrant had undertaken significant reflection and remediation since then. She submitted that the HCPC was neutral on the issue of impairment by reason of the personal component.

 

55. Turning to the public component of impairment, Ms Dixon reminded the Panel of the serious impact of the Registrant’s misconduct and submitted that a finding of impairment was necessary to promote and maintain public confidence in Physiotherapists and to promote and maintain proper standards of conduct.

 

56. Mr Jolliffe reminded the Panel of the insight that the Registrant had displayed in her written reflections and oral evidence. He also drew the Panel’s attention to the Registrant’s action plan, well-being plan, and stress plan, all of which he submitted, showed that the Registrant had taken exceptional steps to ensure that there was no longer a risk of repetition.

 

57. Turning to the public component of impairment, in particular the wider public interest in promoting and maintaining confidence in the profession and upholding standards, he submitted that a finding of impairment was not necessary.  

 

58. He submitted that an informed member of the public, fully aware of the circumstances in which the Registrant had committed misconduct, the exceptional efforts she had made to ensure that there was no risk of repetition, and the time that had elapsed since her misconduct would not be shocked or concerned if there were no finding of current impairment.

 

59. The Panel heard and accepted the advice of the Legal Assessor, which it has followed in its approach and decision set out below.

 

60. The Panel reminded itself that impairment of fitness to practise is a separate question from misconduct and reminded itself of the guidance given in Cohen v GMC [2008] EWHC 581 (Admin)

 

61. Impairment is a question for the Panel’s own judgement, and there is no question of there being a burden or standard of proof.

 

62. The Panel considered current impairment. That is particularly important where a considerable period of time has elapsed since the misconduct and the Registrant has adduced significant evidence that they have developed insight and learned how to avoid misconduct in the future.

 

63. The Panel had regard to the HCPTS practise note on Fitness to Practise Impairment, dated August 2025 and in particular:

 

64. When determining fitness to practise, a Panel should take account of two broad components:

a. the ‘personal’ component: the current competence, behaviour etc. of the Registrant concerned; and

b. the ‘public’ component: those critically important public policy issues of

a. protecting, promoting and maintaining the health, safety and well-being of the public

b. promoting and maintaining public confidence in the professions it regulates

c. promoting and maintaining proper professional standards and conduct for members of those professions.

 

 

65. When considering the personal component the Panel asked:

a. are the acts or omissions which led to the allegation remediable?

b. has the Registrant taken remedial action?

c. are those acts or omissions likely to be repeated?

 

66. An important factor is the Registrant’s insight into those acts or omissions, the extent to which the Registrant:

a. accepts that their behaviour fell below professional standards, understands how and why it occurred and its consequences for those affected; and

b. can demonstrate they have taken action to address that failure in a manner which remedies any issue and avoids any future repetition.

 

67. The Panel also bore in mind the guidance given that it should assess the seriousness of the misconduct at this stage by reference to the following matters, including both aggravating and mitigating features:

a. the extent of the departure from expected professional conduct and standards

b. The extent of the impact on maintaining public confidence in the profession

c. the risk of harm to patients, service users, colleagues and the public, irrespective of the actual harm caused

d. the effect of the conduct or failings on the delivery of care and safe practise

e. whether the conduct or failings were repeated or isolated

f. whether the conduct was directed at or involved vulnerable service users

g. whether the Registrant abused their professional position

h. whether the conduct involved any dishonest, sexual misconduct or predatory behaviour

i. the degree of insight shown by the Registrant

j. the effect, if any, of the denial by the Registrant of the allegation

k. any remediation that the Registrant can demonstrate and its effect on the risk of repetition

 

68. The Panel reminded itself of the test of impairment adopted by the High Court in NMC v Grant (CHRE v NMC and P Grant [2011] EWHC 927 (Admin)

 

69. Finally, the Panel reminded itself that although it must consider carefully the risk of repetition in this case it must not lose sight of the “important public policy issues” set out above.

 

70. The Panel first, considered the seriousness of the misconduct it had found.

 

71. The Panel concluded that accessing patient records for essentially personal reasons represented a significant departure from expected professional conduct and standards and an abuse of the Registrant’s professional position, which gave her access to the records. 

 

72. The Panel also concluded that this was conduct that had an impact on maintaining public confidence in the profession because patients and service users were concerned that their records should remain private and not be accessed for personal reasons. 

 

73. The Panel found that the Registrant’s misconduct had caused significant distress to Person A, who was a vulnerable service user (albeit not of the Registrant) by reason of his ill health and personal circumstances.  The Panel observed that the Registrant acknowledged this and offered a public apology to Person A in the hearing.  

 

74. The Panel found that the Registrant’s misconduct had no direct effect on the delivery of care and safe practise but had the potential to discourage patients, in particular Patient A, from seeking help for fear that their records would be accessed.

 

75. Having examined all the evidence in this case, the Panel was satisfied that the Registrant’s misconduct was a truly isolated incident. It occurred on a single day against the background of an unblemished career. The Panel reached this conclusion for the following reasons:

a. There have been no other adverse findings made against the Registrant either before or since September 2022.

b. The Panel accepted the positive evidence of the Registrant’s colleagues that they are satisfied she has not accessed patient records improperly either before or since.

c. The Panel observed that many colleagues and patients wrote and spoke favourably of the Registrant.

d. The Panel saw that in October 2022 the Registrant was nominated by the trust for which she worked, for the "Unsung Hero of the Year". She was runner-up in that award category.

e. In 2024 she became involved in a research clinical trial organised by the University of Sheffield to look into upper limb recovery after stroke, after being nominated by Team Leads, out of various volunteers within her team.

f. She has served as an external physiotherapy examiner at undergraduate and master's level.

 

76. The Panel was satisfied that the Registrant’s conduct falls significantly short of the most serious forms of misconduct listed in the guidance, namely dishonesty, sexual misconduct, or predatory behaviour. 

 

77. The Panel recognised that, far from denying her misconduct, the Registrant admitted it as soon as she was confronted by her employers.

 

78. Having examined both the written and oral evidence in this case, the Panel is satisfied that the Registrant’s level of insight is genuinely exceptional. The Panel has read the Registrant reflections and observed her giving evidence.

 

79. The Panel accepted that the Registrant has understood the effect of what she has done on patient A, her colleagues, the reputation of the hospital where she works, and public confidence in her profession. She has demonstrated consistently that she understands not only that what she has done is wrong, but why it is wrong and (most encouragingly) its effect on others. She has also demonstrated a good understanding of what she has to do to prevent any repetition.

 

80. Against this background the Panel observed that the Registrant has undertaken a programme of remediation from 2023 until this year. The Panel was particularly reassured by the Registrant’s "well-being and stress management plan".

 

81. The Panel found that this plan and the materials surrounding it are important because they demonstrate not merely that the Registrant understands why she behaved as she did, but what she needs to do to prevent it happening again. The Panel accepted that the Registrant behaved as she did in a period of exceptional stress leading to her needing medication. In many cases a Panel is left concerned that a Registrant may well behave in the same way if she experiences a stressful period in her life again. In this case the Registrant has demonstrated that she has developed effective strategies to avoid that level of stress and is able to stop and reflect before doing things so that the risk of impulsive behaviour, leading to misconduct, is greatly reduced.

 

82. The Panel accepted the Registrant’s evidence that recently a person known to the Registrant, admitted as a patient in the Trust in her department. The Panel accepted the Registrant’s account of how, on this occasion, she resisted any temptation to look at notes, because she was able to reflect on how wrong that would be.

 

83. The Panel concluded that this is convincing evidence that the Registrant has reduced the risk of repetition to the point where it is no longer significant.

 

84. The Panel was also reassured that the Registrant’s understanding and remediation were underpinned by written evidence of CPD from 2023 until 2026, focused on the relevant concerns in this case.

 

85. The Panel then considered the four questions set out in the Grant case, referred to above.  The Panel was satisfied that the Registrant had put a service user at risk of harm by causing him distress and making it less likely that he would seek treatment. It also concluded that she had brought the profession into disrepute and breached a fundamental tenet of the profession by breaching patient confidentiality.

 

86. The Panel then asked itself whether she was liable to do so in the future. The Panel had careful regard to the insight and remediation presented by and on behalf of the Registrant and concluded that there was not a significant risk of that.

 

87. For the sake of completeness, the Panel observed that there is no suggestion that the Registrant has been dishonest.

 

88. For these reasons the Panel concluded that the personal component of impairment was no longer engaged, because of the level of insight and remediation that the Registrant had demonstrated reassured the Panel that there was not a significant risk of the repetition of her misconduct.

 

89. The Panel reminded itself of Mr Jolliffe's submission that, a finding of impairment under the public component was no longer necessary because an informed member of the public would be reassured by all that the Registrant had done since the misconduct.

 

90. Nevertheless, the Panel reviewed carefully its findings about the seriousness of the misconduct in this case and its impact upon public confidence in the profession. The Panel concluded that if there were no finding of impairment in this case, it would appear, even to a fully informed member of the public, that the Panel did not regard the misconduct in this case with the seriousness that it merits.  In those circumstances the Panel would be failing in its duty to promote and maintain public confidence in the profession and uphold standards of conduct for the profession.

 

91. For those reasons, despite the insight and remediation that the Registrant has demonstrated, the Panel found that the Registrant’s fitness to practise is currently impaired under the public component alone.

 

92. Having found the Registrant’s fitness to practise impaired, for the reasons set out above, the Panel considered, what, if any sanction it should impose on the Registrant.

 

93. The Panel heard submissions from Ms Dixon who drew the Panel's attention to the Sanctions Policy, dated 2 March 2026.

 

94. She submitted that the Panel should have careful regard to the Registrant's culpability and to the aggravating and mitigating factors in this case. She submitted that the Registrant was an experienced practitioner who knew she was breaching both Trust policies and HCPC standards. She also acknowledged that the Panel had accepted that the Registrant had committed her misconduct in exceptionally difficult circumstances and had not intended to cause harm.

 

95. She drew the Panel's attention to paragraph 68 of the Sanctions policy which highlights that there are some the concerns which are so serious, that activities intended to remediate the concern cannot sufficiently reduce the risk to the public or public confidence in the profession. Despite the steps the Registrant has taken to attempt to remediate the concerns, the Panel may still feel it necessary to impose a more restrictive sanction. Such cases might include those involving:

a. conduct which represents a serious breach of professional boundaries towards service users, carers, colleagues and other people;

 

96. She submitted that, although the misconduct in this case may not be the most serious example of that, it did cause significant distress to Person A.

 

97. She submitted that taking no action would be inappropriate in the light of the Panel's findings.

 

98. She drew the Panel's attention to the paragraphs of Sanctions policy dealing with a Caution Order and invited the Panel to consider carefully whether the misconduct in this case was not too serious for a Caution Order to be sufficient to uphold public confidence in the profession and the regulator.

 

99. She submitted that conditions were neither appropriate nor practical in this case and invited the Panel to consider whether suspension was the appropriate sanction.

 

100. Mr Jolliffe reminded the Panel that the misconduct in this case was a truly isolated incident and that there was very significant mitigation available to the Registrant.

 

101. He reminded the Panel of its findings regarding the extent of the Registrant's insight and remediation and it’s finding that she had reduced the risk of repetition to the point where it was no longer significant. 

 

102. He submitted that it would be appropriate to take no action in this case. He submitted that a Suspension Order would be wholly disproportionate in this case and submitted that if the Panel did not agree with him about taking no action, the most restrictive sanction it should impose was a Caution Order for the minimum period of 12 months.

 

103. The Panel heard and accepted the advice of the Legal Assessor, which it has followed in its approach and decision set out below.

 

104. The Panel reminded itself that sanctions are not intended to punish registrants, but to ensure the public is protected and maintain standards and confidence in the profession. Inevitably, a sanction may be punitive in effect but should not be imposed for that purpose.

 

105. Accordingly, the Panel must have regard to:

• any risks the Registrant might pose to those who use or need their services;

• the deterrent effect on other Registrants;

• public confidence in the profession we regulate; and

• public confidence in the regulatory process.

 

106. The Panel also had regard to the principle of proportionality, which is set out in paragraph 24 of Sanctions policy in the following terms: “In making proportionate decisions on sanctions, Panels need to strike a balance between the competing interests of the Registrant and the HCPC’s overriding objective to protect the public. Furthermore, there is a public interest in retaining Registrants on the Register and allowing them to practise, but only where the Panel is satisfied that they can do so safely without restriction (or with conditions where required) and where the public interest does not require a Registrant to be suspended or struck off.”

 

107. The Panel reminded itself that it must have careful regard to the Registrant's culpability, the seriousness of her misconduct and evidence of insight, remediation, remorse, and apology.

 

108. The Panel reminded itself that the correct approach to selecting the appropriate and proportionate sanction is to start with the least restrictive sanction and consider each sanction in turn until it finds a sanction that is sufficient to satisfy the purpose of imposing a sanction.

 

109. The Panel reminded itself that it had dealt with the seriousness of the misconduct and the aggravating and mitigating features between paragraphs 70 and 84.

 

110. The Panel had already concluded that it was more appropriate to regard the Registrant's misconduct as an abuse of professional position or breach of trust rather than a breach of professional boundaries. 

 

111. It had already concluded that this was inevitably a serious matter but fell significantly short of the most serious matters. The Panel observed that a breach of trust could cover a very wide range of situations and in this case, it was an isolated incident which was not intended to either benefit the Registrant or cause harm to anyone. 

 

112. The Panel was satisfied that the misconduct was not so serious that it was incompatible with continued registration, in circumstances where a Registrant displayed sufficient insight and evidence of remediation.

 

113. With regard to the Registrant's culpability, the Panel has already found that her culpability was reduced but not extinguished by the difficult personal issues which impacted upon her at the time of her misconduct.

 

114. With regard to the Registrant's insight and remediation, the Panel reminded itself that it had already found and explained between paragraphs 78 and 84 the extent of the Registrant's developed insight and remediation, which was sufficient to satisfy the Panel that there was no longer a significant risk of repetition and hence of harm to the public in the future.

 

115. The Panel heard evidence from the Registrant of her shame at what she had done and accepted that evidence for the reasons it has already explained. It was satisfied that the Registrant had displayed genuine remorse and that the apology she offered to Person A during the hearing was sincerely meant, in the context of her early admission to the Trust and the evidence of her reflection and remediation.

 

116. The Panel then considered in turn each of the sanctions available to it.

 

117. The Panel first considered taking no action. It concluded that this would not be appropriate in light of the findings it had already made about the seriousness of the misconduct in this case. Furthermore, it would not satisfy public confidence in the profession and the regulator’s requirement to promote and maintain standards. 

 

118. The Panel then considered whether it was appropriate to impose a Caution Order.

 

119. The Panel had regard to paragraphs 146 to 149 of the Sanctions policy.

 

 

120. The Panel reminded itself of its findings that the misconduct in this case was not minor but was isolated.

 

121. It also reminded itself of its findings that there was no significant risk of repetition because the Registrant had shown exceptional insight and undertaken appropriate remediation.

 

122. It also had careful regard to paragraph 148 above which provides that it would be appropriate where "there is no risk to public protection…meaningful practice restrictions cannot be imposed, but a suspension order would be disproportionate.”

 

123. For these reasons the Panel was satisfied that a Caution Order would be a sufficient sanction to protect the public due to the low risk of repetition identified. Nevertheless, it gave anxious consideration to the question of whether the sanction was sufficiently restrictive to fulfil its duty to maintain public confidence in the profession and uphold standards for the profession.

 

124. The Panel considered whether a Conditions of Practice Order was appropriate. However, it was satisfied that both advocates were correct when they said that there were no appropriate or workable conditions that could be imposed in this case. Further, the Registrant has been the subject of extensive supervision with reflective practice. 

 

125. The Panel then considered whether a Suspension Order was necessary in order to promote and maintain public confidence in the profession and send a sufficient message that the Registrant's conduct was unacceptable.

 

126. The Panel has decided it is appropriate to record that this was a very finely balanced decision.  The Panel wished it to be clear that the misconduct in this case is unacceptable and only concluded that a caution order was sufficient in this case because of the following factors, taken together:

a. There has been a delay of over three years since the Registrant admitted her misconduct;

b. The Registrant has worked without restriction for the three years since then;

c. The Registrant has used the time exceptionally well to develop insight and remediate to the point where she has eliminated any significant risk of repetition;

d. A number of colleagues took the time and trouble to attend this hearing to tell the Panel how she would be missed from the team in which she worked if she were suspended. This is likely to be to the detriment of both colleagues and patients.

 

127. With regard to the fourth point, the Panel reminded itself that when deciding the public interest paragraph 24 of Sanctions Policy provides: “there is a public interest in retaining Registrants on the Register and allowing them to practise, but only where the Panel is satisfied that they can do so safely without restriction (or with conditions where required) and where the public interest does not require a Registrant to be suspended or struck off”.

 

128. The Panel observed that it is exceptional for all these factors to be present.

 

129. Nevertheless the Panel is satisfied that they are present in this case and for those reasons it is possible to protect not only service users but the wider public interest by the imposition of a caution order, which the Panel reminded itself will be recorded on the Registrant's record and would be likely to be taken into account if there were any further incidents of misconduct.

 

130. The Panel then considered the appropriate length of the Caution Order, reminding itself that the minimum period is 12 months and the maximum is five years.  The Panel concluded that the appropriate period is 1 year because of the time that has elapsed since the Registrant's misconduct and the exceptional use to which she has put that time.

 

131. Accordingly, the Panel imposed a Caution Order for a period of 12 months.

 

 

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.