Lady Deborah Knight Griffiths

Preliminary Matters
Service
1. The Panel was satisfied on the papers that the Registrant had been properly served with notice of today’s hearing by email dated 18 December 2025 in accordance with the Health and Care Professions (Conduct and Competence Committee) (Procedure) Rules 2003, as amended. Service of notice was confirmed on the same date.

Proceeding in absence
2. Ms Sampson made an application for the hearing to proceed in the Registrant’s absence on the grounds that she had voluntarily absented herself and waived her right to attend, as evidenced by the following documents in the hearing bundle:
• on 1 December 2025, the Registrant’s representative from the Royal College of Podiatry advised the HCPC that, due to her health, the Registrant would not be attending the hearing in person but would submit a written response to the Panel;
• on 2 January 2026, the Registrant’s representative sent written submissions on behalf of the Registrant and advised that, as the Registrant would not be attending the hearing, the Royal College of Podiatry would not be providing representation; and
• On 8 January 2026, the Registrant’s representative sent the HCPC written submissions for the Panel’s consideration at today’s hearing.

3. The Panel had regard to the HCPTS Practice Note on “Conducting Hearings in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Registrant’s representative had not applied for an adjournment. The Panel inferred that the Registrant had voluntarily absented herself and waived her right to attend. Today’s hearing is a mandatory review which must take place before the expiry of the Suspension Order on 14 February 2026.The Panel was satisfied that the Registrant would be unlikely to attend a hearing at any future date. The Panel concluded that no useful purpose would be served by an adjournment and that it was in the public interest and in the Registrant’s interests to proceed with the hearing in her absence.

Hearing in private
4. Ms Sampson made an application for any reference to the Registrant’s health to be heard in private.

5. The Panel had regard to the HCPTS Practice Note on “Conducting Hearings in Private” and accepted the advice of the Legal Assessor. The Panel decided that any reference to the Registrant’s health should be heard in private on the grounds advanced by Ms Sampson but that the hearing should otherwise be conducted in public.

Background
6. The Registrant is registered with the HCPC as a Podiatrist and at the time of the events she practised through her podiatry practice named First Steps Podiatry (“First Steps”).

7. At the relevant time the Registrant provided podiatric services to prisoners at HM Forest Bank Prison (“the prison”).

8. On 15 December 2020, the Registrant was referred to the HCPC by Sodexo Justices Services (“Sodexo”) which operated HM Forest Bank Prison. For some time before the relevant events, there had been an agreement in place between Sodexo and First Steps that the Registrant would provide podiatric services to prisoners at the prison.

9. The Allegation considered by the panel at the final hearing concerned the Registrant’s treatment of Service User 1 who was a prisoner at HM Forest Bank Prison. Service User 1 was in poor health and suffered from diabetes. Prior to the relevant events he had already had his big toes amputated.

10. The Registrant attended and was represented at the final hearing on 18-25 March 2024, and 15- 17 July 2024. At that hearing the panel found that:
• the Registrant had undertaken a partial amputation of Service User 1’s right second toe and that this was a procedure that should only have taken place in a hospital setting or as part of a hospital’s Diabetes Multidisciplinary Team;
• she omitted eleven specific pre-operative actions as particularised in 1(b) of the Allegation;
• she failed to maintain accurate and complete records for Service User 1 as detailed in Particular 3;
• she inappropriately sutured Service User 1’s wound and did not obtain a tissue sample or wound swab prior to the procedure;
• she had acted beyond the scope of her practice in performing a partial amputation and in suturing Service User 1’s wound in circumstances where she had not maintained or developed the skills to do so.

11. The panel found that the proven facts amounted to misconduct on the basis that:
• the Registrant had performed an invasive procedure outside the scope of her practice upon an individual who was acutely vulnerable and thereby placed him at real risk of harm; and
• her conduct was in breach of several of the HCPC Standards of conduct, performance and ethics and the Standards of Proficiency for Chiropodists/Podiatrists.

12. The panel found that the Registrant’s fitness to practise was impaired by reason of her misconduct having regard to the following:
• whilst the Registrant’s shortcomings were capable of being remedied, the Registrant had not in fact remedied them;
• the Registrant’s reflection was superficial and did not demonstrate having been embedded in practice;
• there was no evidence of Personal Development Plans, audits, peer supervision, or mentoring of her practice;
• there was an absence of recognition by the Registrant about what had happened in the past and why, and the panel had little confidence that the misconduct would not be repeated in the future;
• the panel acknowledged that the Registrant believed that she was acting in Service User 1’s best interests, but there was a risk that in the future the Registrant would act impulsively in a misguided attempt to aid a service user.

13. The panel therefore concluded that the Registrant’s fitness to practise was impaired on the basis of the personal component.
14. The panel also considered that the misconduct was so serious that a finding of current impairment was required to declare and uphold proper professional standards and to maintain public confidence in the profession of Podiatry.

15. The panel imposed a Suspension Order for a period of 12 months on the grounds that such an order would protect the public, reflect the seriousness of her misconduct and give the Registrant sufficient opportunity to remediate her failures. The panel declined to make any recommendations as to what steps the Registrant might take to satisfy a future reviewing panel that her fitness to practise was no longer impaired.

The substantive review hearing on 14 July 2025
16. The Registrant did not attend the substantive review hearing on 14 July 2025, having unsuccessfully applied for an adjournment on the grounds of ill health. She did not provide any evidence that she had addressed any of the failings in her practice identified by the substantive hearing panel.

17. Accordingly, the reviewing panel found that the Registrant’s fitness to practise remained impaired in respect of both the personal and public components by reason of her misconduct.

18. The reviewing panel decided to impose a Suspension Order for a period of 6 months on the expiry of the original Suspension Order, having regard to the information and evidence provided by the Registrant about her health, which might explain to some extent her limited engagement and limited instructions to her representative.

Case updates
19. In recent correspondence with the HCPC, the Registrant’s representative explained that the Registrant is now medically retired and “She is not able to practise safely in any capacity, nor is she able to undertake meaningful remediation or CPD”.

20. The HCPC discussed with the Registrant’s representative whether voluntary removal might be an option but this was discounted because the Registrant was unwilling to accept all the allegations against her.

Today’s hearing
21. On behalf of the HCPC Ms Sampson adopted her skeleton argument, in which she submitted that, in the absence of any evidence of remediation, the Panel should conclude that the Registrant’s fitness to practise remains impaired in respect of both the personal and public components.

22. Ms Sampson further submitted that in circumstances where the Registrant, by her own admission, will be unable to remediate or practise safely due to her health condition, and where voluntary removal is not suitable, the only proportionate and appropriate option would be a Striking Off Order.

23. Ms Sampson referred in support of her submission to the Registrant’s written submissions emailed to the HCPC by her representative on 8 January 2026, in which it is acknowledged that a Striking Off Order might be the most appropriate disposal.

24. Ms Sampson therefore invited the Panel to impose a Striking Off Order to take effect on the expiry date of the current Suspension Order.

25. The Panel was provided with written submissions from the Registrant’s representative emailed to the HCPC on 8 January 2026 to the following effect:
• The Registrant accepts that she should not have sutured the patient’s toe on 13 November 2020 and that her clinical records were not sufficiently detailed. She does not accept all remaining factual allegations but does not seek to challenge the findings of the panel at the substantive hearing;
• her fitness to practise remains solely impaired by reason of her health;
• that impairment is permanent and irreversible and there is no prospect of remediation;
• she does not present a risk to the public because she will never practise as a Podiatrist again; and
• she requests a “health-based disposal”, bringing this matter to a conclusion in a manner that is fair, proportionate, and consistent with the HCPTS Sanctions Policy.

26. The written submissions conclude as follows:
“[the Registrant] regrets that her health prevents her from attending the hearing and engaging further with the regulatory process.

She is deeply saddened that her career has had to end in this way and she has been prevented due to her health from showing she was a good clinician and with extra support and CPD she would have been able to show the panel her learning from this concern.

She thanks the Panel for considering her circumstances and this written submission and understand the likely outcome will be strike off due to her health”

Decision
27. The Panel took into account the submissions on behalf of the HCPC and the Registrant respectively.

28. The Panel had regard to the HCPTS Practice Notes “Review of Article 30 Orders” and “Fitness to Practise Impairment” and accepted the advice of the Legal Assessor.

29. The Panel first considered whether the Registrant’s fitness to practise remains impaired by reason of her misconduct as determined by the panel at the substantive hearing.

30. The Panel took into account the decision of the High Court in Abrahaem v GMC [2008] EWHC 183 [Admin] where it was stated that in practical terms there is a “persuasive burden” on the Registrant to demonstrate at a review hearing that she has fully acknowledged the deficiencies which led to the original findings and has addressed her impairment sufficiently “through insight, application, education, supervision or other achievement”.

31. The Panel found that the Registrant had failed to take any steps to discharge this burden by addressing the fitness to practise concerns identified at the substantive hearing and her insight remains very limited. The Panel acknowledged the impact of the Registrant’s ill health on her ability to take any remedial steps.

32. In the absence of any evidence of remediation, public confidence in the profession and the HCPC as its Regulator would be undermined, and reputational damage would be caused to both, if the Registrant were permitted to practise without restriction.

33. The Panel therefore found that the Registrant’s fitness to practise remains impaired in respect of both the personal and public components.

34. The Panel noted the information provided by the Registrant about her health condition but was unable to treat this review as a hearing about whether the Registrant’s fitness to practise is impaired by reason of her health. The Panel, however, had regard to the Registrant’s contention that she would never be able to practise in the future and would therefore not be able to remediate her practice.

35. With regard to sanction, the Panel took into account the submissions on behalf of both parties. The Panel had regard to the HCPC’s Sanctions Policy and accepted the advice of the Legal Assessor.

36. The Panel considered the need to protect the public, in particular service users, and gave appropriate weight to the wider public interest, which includes the reputation of the profession and public confidence in the regulatory process. The Panel applied the principle of proportionality and considered the available sanctions in ascending order of seriousness.

37. The Panel considered that the concerns about the Registrant’s fitness to practise were too serious to take no further action or for the imposition of a Caution Order.

38. The Panel considered whether to impose a Conditions of Practice Order but decided that this would be inappropriate given the Registrant’s statement that she would never in the future practise as a Podiatrist, given her health condition.

39. The Panel considered whether to impose a further period of suspension but decided that this would serve no useful purpose, given that the Registrant has stated that, by reason of her health condition, she would never be able to remediate her practice.

40. The Panel would have preferred for the Registrant to leave the profession by some means other than a Striking Off Order but, given that voluntary removal was not available, the Panel had no other option available by way of disposal.

41. It follows that the appropriate and proportionate sanction is a Striking Off Order, which will come into effect upon the expiry of the current Suspension Order.

The Registrar is directed to remove name of Lady Deborah Knight-Griffiths from the register upon the expiry of the current Suspension Order.

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 Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

History of Hearings for Lady Deborah Knight Griffiths