Zoe L Heeks

Preliminary Matters

Service and Proceeding in Absence

1. The Panel was satisfied on the basis of the documents before it that the Registrant had been properly served with Notice of this hearing. It had sight of the email sent to the Registrant’s registered email address on 21 August 2025 informing her of the date and time of the remote hearing. The Panel was aware in view of the legal advice it received, that 28 days’ notice is required and that all that is required of the Regulator is to evidence that notice has been sent to the Registrant’s address as held on the register. The Health and Care Professions Council (Coronavirus) (Amendment) Rules 2021 allow for the service of documents by email. The Panel had sight of the email delivery receipt and the Registrant’s Certificate of Registration, which confirmed her email address.

2. Ms Khaile made an application to proceed in the Registrant’s absence. She submitted that the Panel could be satisfied that the Registrant was aware of this hearing and that she has voluntarily absented herself. She referred the Panel to the more recent correspondence sent to the Registrant and copied to her husband, since his request to act as her representative on 12 April 2024. She referred the Panel to the related practice note and invited the Panel to exercise its discretion to proceed in the Registrant’s absence.

3. The Panel was aware that, in accordance with rule 11 of the Conduct and Competence Committee Procedure Rules, it had discretion to proceed in the Registrant’s absence. In determining whether in all the circumstances it was fair to do so, the Panel took into account the HCPTS Practice Note on Proceeding in Absence. It was aware, in view of the legal advice it received, of the factors which should inform its decision, as set out in R v Jones [2003] UKPC 34. It had regard to the case of GMC v Adeogba [2016] EWCA Civ 162 where the judge summarised the position as follows: “Where there is good reason not to proceed the case should be adjourned; where there is not however, it is only right that it should proceed”.

4. The Panel noted that since the Notice of Hearing was served, more recent correspondence from Blake Morgan to the Registrant had been copied to her husband, as he requested in April 2024. This included notice of the amended allegation following a preliminary hearing in October 2025 and an updated version of the hearing bundle sent on 25 November 2025. The HCPC’s case summary had been emailed on 3 December 2025 to both the Registrant and her husband. The Panel further took into account that initially the Registrant engaged with correspondence from the HCPC. Whilst there was reference to her having been unwell in April 2024, no updates on her health had been provided and there was no information to suggest she remained unwell.

5. As such, the Panel was satisfied that the Registrant was aware of the hearing and had waived her right to attend. She had not requested an adjournment and there was no indication that an adjournment would secure her attendance at a future date. There was inevitably some disadvantage to the Registrant in not being able to give her account to the Panel, however this was outweighed by the public interest in hearing and disposing of the matter at this time, given that the alleged misconduct dated back to June 2021. The Panel determined that it was fair and proportionate to proceed in the Registrant’s absence.
Application for parts of the hearing to be conducted in private

6. In view of the Registrant’s explanation for her actions, which included treating a health condition, the Panel invited a privacy application. Ms Khaile made an application for any references to the Claimant’s health or private life be heard in private, so as to protect her privacy.

7. The Panel accepted the Legal Assessor’s advice and was aware that, whilst hearings are generally conducted in public, with a view to maintaining public trust and confidence in the regulatory process, health and private life are areas where an exception is routinely made. This is reflected in rule 10 of the Conduct and Competence Committee Procedure Rules. The Panel considered that the Registrant’s right to privacy in respect of her health and private life outweighed the public interest in those matters being heard in public. Any such references were likely to be discrete and easily separable from the majority of the evidence going to alleged misconduct/impairment. As such, the Panel determined that the hearing would go into private for any references to the Registrant’s health or private life.
Application to admit hearsay evidence

8. Ms Khaile made an application for the statement and exhibits of Mila Ragi, Associate Solicitor at Blake Morgan, to be admitted as hearsay evidence. She was the previous case manager, and had returned to New Zealand. As such, calling her to give evidence was impractical due to the time difference. Ms Khaile submitted that the exhibits to the statement were documents (emails) that the Registrant herself had provided. Indeed, the Allegation had been amended in view of the information she provided. The emails gave the Registrant’s response to the original Allegation. As such, there was, in Ms Khaile’s submission, no unfairness in admitting them. The Registrant had received ample notice of the HCPC’s intention to rely on these; they had formed part of the evidence at the preliminary hearing in October 2025, which the Registrant had been invited to attend.

9. The Panel was aware that rule 10 of the Conduct and Competence Committee Procedure Rules permitted hearsay evidence to be admitted subject to the general principles of relevance and fairness. The Panel had regard to the factors to take into account when assessing fairness, as set out in Thorneycroft v NMC [2014] EWHC 1565 (Admin). The Panel determined that the statement of Ms Ragi was a record of evidence that had been obtained; the author did not have direct knowledge of the underlying facts. The Panel considered that the emails from the Registrant appended to the statement were directly relevant to the allegations. As the Registrant was not in attendance, fairness required that the accounts and explanations she had given in correspondence were admitted in evidence. These emails were not the sole and decisive evidence as the Panel additionally had sight of the prescriptions that the Registrant admitted to having written, and the evidence of Mr D Aujla from the pharmacy. The Panel admitted the statement and exhibits. It would determine weight when assessing the evidence as a whole and making findings of fact.

Amendment to Schedule A to the Allegation

10. The Panel drew Ms Khaile’s attention to what appeared to be a typographical error in a date in Schedule A. Ms Khaile confirmed that there was indeed an error; reference to 17 September 2021 should in fact have been 19 September 2021. She applied for this minor amendment to be made.

11. The Panel accepted the Legal Assessor’s advice and was aware that the HCPC had a duty to bring a case which accurately reflected the evidence. It was satisfied that there was no unfairness to the Registrant in allowing the amendment, notwithstanding that she had not had notice. This was because the amendment was very minor, the correction of a date, to reflect one of the prescriptions that the HCPC relied on, and which the Registrant did not appear to dispute she had written. The amendment was made and is reflected in the Schedule to the Allegation as set out above.

Background

12. The Registrant is a registered Chiropodist/Podiatrist. On 4 January 2022 the HCPC received a referral from a Pharmacist, Manni Shergill, who worked in an online aesthetics pharmacy (Acre Pharmacy). She had checked the credentials of a prescriber from whom the pharmacy had received a private prescription. On checking the HCPC website, the Registrant did not have an independent prescribing qualification, only annotations POM-A and POM-S. The Registrant had prescribed Botox on three previous occasions.

13. On 15 November 2022, in response to a request from the HCPC for further information, Manni Shergill provided the prescriptions written by the Registrant. These were:
- Prescription dated 29.06.2021. Both the patient and prescriber are Zoe Heeks. The prescription is for Botox 50 units x 2; 50 units per vial and TOR-BAC 5ml x 10.
- Prescription dated 12.07.2021. The patient and prescriber are Zoe Heeks. The prescription is for 1 pack of Botox 50 units.
- Prescription dated 12.07.2021. The patient is Person A and the prescriber is Zoe Heeks. The prescription is for 1 pack of 50 units of Botox.
- Prescription dated 19 September 2021. The patient is Person B. The Prescriber is Zoe Heeks. The prescription is for 1 pack of 50 units of Botox.
- Prescription dated 04.02.2022. The patient is Person B. The prescriber is Zoe Heeks. The prescription is for 1 pack of 50 units of Botox.
Although there were two prescriptions for the 12 July 2021, only the prescription for Person A was dispensed.

14. Ms Shergill said in her email that it was only on receipt of the prescription dated 4 January 2022 that it was realised that the Registrant did not have prescribing rights. The earlier prescriptions had been dispensed.

15. In correspondence with the HCPC in November and December 2022 the Registrant said she used Botox.

16. On 19 January 2023, the Registrant spoke to the HCPC’s case manager. She said she had not worked for four years. She had left the NHS to start a family. With regard to the prescriptions, the Registrant said that during Covid, the Practitioner from whom she had previously obtained prescriptions had stopped practising. She called the pharmacy and was told she simply needed to write the prescription and send it through. The Registrant had said that she did not have a prescription pad and was advised she could handwrite the prescription and send a picture of it to the pharmacy. This was what she did. She said she did not make any false representations or claim to hold qualifications which she did not have. She confirmed she did not hold an independent or supplementary prescriber qualification.

17. The Registrant’s GP provided the information requested by the HCPC on 20 January 2023.

18. By email of 10 November 2023 the Registrant provided a response to the HCPC’s concern. She said she had contacted the nurse prescriber who had previously prescribed her Botox. She would confirm that it was not for cosmetic reasons. She had never made false claims about her qualifications or treated anyone other than herself. The names and addresses on the prescriptions for others were fictitious. She said she called the pharmacy and enquired about obtaining Botox, and was told to write a prescription. The Registrant had said that the prescription was for herself, and that she had been advised to put another name and details.

19. On 18 December 2023 a Panel of the Investigating Committee determined that there was a case to answer. Blake Morgan was instructed and obtained a witness statement from Dalbir Aujla, the Superintendent Pharmacist and Responsible Person at Acre Pharmacy.

Witness Evidence

20. Mr Aujla appeared to give evidence at the hearing and confirmed his statement dated 10 September 2024. Within that he confirmed that three of the four prescription orders made by the Registrant were fulfilled by the pharmacy, and then her prescribing rights were checked. He could not give evidence as to the process for checking prescriptions at the time, but only the current process.

21. The Panel heard no other live witnesses, but had regard to the hearsay statement of Ms M Ragi, former Associate at Blake Morgan, and also carefully considered the Registrant’s written representations made via various emails and the telephone note.

22. With regard to the weight to give to the hearsay statement, the Panel determined that Ms Ragi, as a professional witness, with no knowledge of the Registrant, had no reason to give anything other than an honest and accurate account. Indeed, her statement was provided in order to put before the panel the Registrant’s evidence, such as it was, in the form of emails and a phone conversation on 19 January 2023. The Panel would assess the reliability of the Registrant’s account in relation to each particular of the Allegation, when making its findings of fact.

Submissions

23. Ms Khaile submitted that the Panel could be satisfied on the balance of probabilities that the Registrant had acted as alleged and had been dishonest as set out in the allegation. She invited the Panel to make findings accordingly.

Legal advice at the facts stage

24. The Legal Advisor provided the following advice to the Panel:

25. The burden of proof is on the HCPC. The standard of proof is the civil standard, the balance of probabilities.

26. The Panel must make a separate finding on each particular. In doing so it should take into account the entirety of the evidence; its reliability, accuracy and credibility. It is for the Panel to decide what evidence to accept/reject and what conclusions to draw.

27. The court in Dutta v GMC [2020] EWHC 1974 referenced the fallibility of human memory and advised panels to start with unchallenged documentary evidence.

28. The test for dishonesty is that stated in Ivey v Genting Casinos UK Ltd [2017] UKSC 67, and made up of a subjective and objective element.

Decision on Facts

1. Between 29 June 2021 and 4 January 2022, you wrote one or more prescriptions for Botox as set out in Schedule A, without holding an Independent Prescriber (IP) or Supplementary Prescriber (SP) entitlements from another institution or profession - PROVED

29. The Panel noted from the original referral that the Registrant has annotations POM-A and POM-S on the Register. This means she has a licence for the administration, sale and supply of the Royal College of Podiatry approved list of prescription medications. Within her email correspondence, the Registrant had made reference to working in the NHS under a Patient Group Directive (PGD). This means that she could prescribe specified medicines to a particular group of patients as and when needed.

30. Prescribing in such limited circumstances would either have formed part of the Registrant’s degree, or she would have undertaken additional courses. This education and training would have included the limits on prescribing that the Registrant was able to undertake, and likely included the ethical aspects of prescribing.

31. When the Registrant was asked by the case manager at the HCPC, in a call on 19 January 2023, whether she was an Independent or Supplementary Prescriber, the Registrant stated she was not. She explained that she was trained and qualified to administer local anaesthetics and antibiotics, but during her time in the NHS she worked under a PGD. The record of this call, which was agreed by the Registrant as being accurate, was appended to the statement of Ms M Ragi.

32. In the same call, the Registrant was asked about the process she used to obtain Botox. She said she had called the pharmacy and was told that she simply needed to write a prescription. The Registrant says that she informed the pharmacy that she did not have a prescription pad, and was advised she could hand-write a prescription, photograph it, and send it through to the pharmacy.

33. The Registrant appears to admit that she wrote all the prescriptions, because she says that initially they were dispensed without issue. However, when she sent the last one (4 January 2022), the pharmacy told her that the process had changed, and she would need to have the Botox prescribed by an Independent Prescriber.

34. The Panel had sight of the prescriptions listed in Schedule A. These all gave the Registrant’s name as the prescriber and were signed by her. The Registrant has at no time stated that she did not write one or more of the prescriptions.

35. The Panel found that the Registrant wrote each of the prescriptions set out in Schedule A. She was clear in her call with the HCPC that she did not hold an Independent or Supplementary Prescriber qualification. As such, the Panel found this particular proved.
2. In respect of particular 1 you knowingly worked beyond the scope of your practise - PROVED

36. In the call on 19 January with the HCPC, the Registrant having stated she was told by the pharmacy to write a prescription when she asked how to obtain Botox, said she felt profoundly let down by the pharmacy, because they failed to give her appropriate guidance.

37. The Panel found that the Registrant would have been aware of the distinction between being an Independent or Supplementary Prescriber, and prescribing under a PGD, because she confirmed, when asked that she was not an Independent or Supplementary Prescriber. The Registrant would have known that Botox was not in her approved POMs medication list and neither was she working under a PGD. Indeed, she did not seek to assert, in any of her emails, that she believed such prescribing to be within her scope of practice. The Registrant in fact stated that she originally received prescriptions from a nurse prescriber, and at the time of the call in January 2023, she was seeing a different practitioner, who prescribed and administered her Botox.

38. The Panel concluded that the Registrant would have been aware that prescribing Botox was beyond the scope of her practice, and she wrote the prescriptions knowing this. The Panel did not accept the Registrant’s explanation that she was misled by the advice she says she received from the pharmacy, because as a regulated professional, with knowledge of the limitations on her license to prescribe, the Registrant knew that such prescriptions were beyond the scope of her practice.

3. You wrote one or more prescriptions containing false information in that:

a. On 12 July 2021, you wrote a prescription which contained the name and address of Person A, identifying that person as the patient, when the prescription was for you;

b. On 19 September 2021, you wrote a prescription which contained the name and address of Person B, identifying that person as the patient, when the prescription was for you;

c. On 4 January 2022, you wrote a prescription which contained the name and address of Person B, identifying that person as the patient, when the prescription was for you - PROVED

39. In her email to the HCPC on 10 November 2023, the Registrant stated that she had:

“…never treated anyone else other than myself with botox. The names, DOB and address were fictitious, although I do know the address and postcode as I used to live on Thornhill Road.”

40. The Registrant, in the same email, when outlining a call that she says took place with a ‘girl’ at the pharmacy:

“I said “its for myself” she said your [sic] not supposed to put its for yourself, so put another name and details, then you can just take a photo of it and send it as an attachment to my [sic] email, I can then process it and send it to the pharmacist… I did the same process again until I was informed by phone call one day by a different pharmacist from Acre that I could not purchase it this way, and that the previous pharmacist should not of [sic] done this and should of [sic] cross-checked by HCPC number.”

41. The Panel, taking these parts of the email together found that the Registrant was accepting that she wrote the names and addresses of fictitious patients on the prescriptions, which were in fact for her own use. The Panel noted that at no time has the Registrant disputed that any of the prescriptions relied on by the HCPC were written by her; indeed her name and signature appears as the prescriber. Therefore the Panel found that the Registrant wrote false information relating to Person A and Person B on prescriptions which were for her own use, as alleged.
4. Your conduct as set out at particular 1 was dishonest in that you knew you did not hold an Independent Prescriber (IP) or Supplementary Prescriber (SP) entitlement from another institution or profession - PROVED

42. The Panel found, in view of the Registrant’s admission in the call of 19 January 2023 referred to above, that she does not hold such an entitlement, and that her subjective state of mind at the time she wrote the prescriptions was that she knew she did not hold an Independent Prescriber or Supplementary Prescriber qualification. She has at no time asserted that she did. Rather, she appears to rely on an assertion that she did not expressly tell the pharmacy that she held such a qualification.

43. As no evidence of the asserted call with the pharmacy has been provided save for the Registrant’s account, the Panel only has the Registrant’s word as to what may or may not have been said. However the Panel finds there is some inconsistency in the Registrant’s evidence, because her account suggests that she spoke to the pharmacy prior to putting in the first prescription. This is because the Registrant said she called the pharmacy and asked how to obtain Botox and was advised she simply needed to write a prescription. However the Registrant in her subsequent email of November 2023 elaborates on this and says she was told to write a patient’s name and address, as she should not prescribe for herself. Had this call taken place at the outset, as the Registrant describes, she would not have written the first two prescriptions naming herself as the patient.

44. The Registrant’s account appears to have changed over time, the Panel found, with a view to trying to justify her conduct, and seek to blame others. The Panel found that subjectively the Registrant was aware that she was not permitted to prescribe Botox in the absence of an Independent or Supplementary Prescriber entitlement. Irrespective of advice she said she may have been given by the pharmacy, the Registrant, as a regulated professional, knew the rules and limitations around prescribing. She nevertheless wrote prescriptions for Botox, initially naming herself as the patient, and then using fictitious patient details, likely to seek to give validity to the prescriptions she was writing for herself.

45. The Panel asked itself whether ordinary decent people would consider this conduct to be honest or dishonest. It considered that such people would consider the conduct dishonest, because the Registrant was aware that she was not permitted to prescribe Botox, not having the necessary qualification, and yet she wrote prescriptions with a view to obtaining the medication.
5.Your conduct as set out at particular 3 was dishonest in that you knowingly provided false information about the identity of the patient - PROVED

46. As noted above, the Registrant has stated that she provided fictitious patient details. She subjectively knew that Person A and Person B did not exist, and that the details she provided were false information. Objectively, ordinary decent people would find this conduct dishonest, because the prescription was written to appear that the medication was for another person, when in fact it was for the Registrant herself.

Decision on Misconduct

47. Ms Khaile submitted that in view of its findings as to the facts, the Panel could properly find misconduct. In her submission, the Registrant’s actions fell far short of the expected standards. She invited the Panel to find that the following standards of the HCPC’s 2016 Standards of Conduct, Performance and Ethics had been breached:
13
3.1 You must keep within your scope of practice by only practising in the areas you have appropriate knowledge, skills and experience for.
3.4 You must keep up to date and follow the law, our guidance and other requirements relevant to your practice.
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
9.2 You must be honest about your experience, qualifications and skills.

48. In addition, Ms Khaile submitted that standards required by the HCPC’s (Pre-2023) Proficiency Standards for Podiatrists were engaged:
3.1 Understand the need to maintain high standards of personal and professional conduct.
3.3 Understand both the need to keep skills and knowledge up to date and the importance of career-long learning.

49. As to impairment, Ms Khaile submitted that the Registrant’s fitness to practise is currently impaired. The misconduct was so serious that the wider public interest required a finding of impairment, even if the Committee did not consider that a finding of impairment is necessary to protect the public.

Legal Advice

50. The Panel accepted the Legal Assessor’s advice:
• Misconduct is a matter for the Panel’s independent judgment, there is no burden or standard of proof.
• There is no statutory definition of misconduct, but guidance is given by the caselaw, including Roylance v GMC (No 2) [2000] 1 AC 31 where Lord Clyde said “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.....in the particular circumstances”.
• Doughty v General Dental Council [1988] AC 164 described it as conduct that has 'fallen short, by omission or commission, of the standards of conduct expected among dentists, and that such falling short as is established should be serious”;
• In Nandi v General Medical Council [2004] EWHC 2317 it was considered as 'conduct which would be regarded as deplorable by fellow practitioners
• The Panel should have regard to the HCPC’s Standards when determining the matter of misconduct.
• If misconduct is found, the Panel should then decide whether the Registrant is currently impaired. Impairment is a matter for the Panel’s independent judgement;
• In assessing current impairment, the Panel is looking at the past to assess the present; Meadow v GMC [2007] 1 QB 462;
• The Panel is likely to be assisted the guidance provided in CHRE v NMC and Grant [2011] EWHC 927 (Admin), as formulated by Dame Janet Smith in the report into the Fifth Shipman Inquiry. In doing so, it should consider whether a finding of impairment is required to protect the public, and also whether the public interest requires such a finding to be made;
• When assessing the personal component of impairment, The Panel may be assisted by the three-fold test set out in the case of Cohen v GMC [2008] EWHC 581 (Admin): Is the conduct remediable? Has it been remedied? Is it highly unlikely to recur?
• Finally, when addressing the public component, the Panel should consider the public interest, and whether the need to uphold professional standards and maintain public confidence in the profession would be undermined if a finding of impairment were not made in the circumstances of this case.

Decision on Grounds

51. The Panel began by reviewing the HCPC’s 2016 Standards as referred to by Ms Khaile. In respect of 3.1, it had found that the Registrant had knowingly worked beyond the scope of her practice. As to 3.4, the fact that the Registrant had considered it was permissible to write prescriptions for herself satisfied the Panel that she had disregarded ethical guidance relating to prescribing or had been unaware of it. Her conduct had fallen far short of both these standards because the Registrant had repeatedly written prescriptions for Botox when she knew she did not have authorisation to prescribe it. She further demonstrated in her emails that she was aware that she should consult an appropriately qualified health care professional to prescribe this treatment for her.

52. Standards 9.1 and 9.2 go to the public’s trust and confidence in registered professionals, and to honesty. The Panel had found the Registrant acted dishonestly. Such conduct will always undermine the public’s trust and confidence, not only in the professional concerned, but damage the profession more broadly, since it is fundamental to the therapeutic relationship that registered professionals are trustworthy. As such the Panel determined that the Registrant’s conduct had fallen far below the expected standards.

53. Moving to the HCPC’s (Pre-2023) Proficiency Standards for Podiatrists, the Panel agreed with Ms Khaile’s submission that 3.1 and 3.3 were engaged. For the reasons given above, the Registrant had failed to maintain high standards of personal or professional conduct. Indeed, she had used her professional status to further her personal interests in a dishonest manner. It appeared that she had failed to keep her knowledge up to date, given her self-prescribing. The Panel further considered that standard 2.5 had been breached. This requires registrants to “know about current legislation applicable to the work of their profession”.

54. The Panel found that the breach of these standards, in the context of self-prescribing medication outside the scope of podiatry practice, and using dishonest means to secure it, namely using fictitious patient details, would be considered deplorable by fellow practitioners. It follows that the Registrant’s conduct as set out in each particular of the allegation, and the conduct taken as a whole, was very serious and amounted to misconduct.
Decision on impairment

55. Moving to impairment, the Panel was aware that its role was not to seek to punish the Registrant for past failings, but to assess whether she is currently impaired. The Panel had no recent information from the Registrant. She had not provided any sort of reflective statement or evidence of continuing professional development. Indeed, in her correspondence with the HCPC in 2022 the Registrant had said that she was not working at that time, and was focusing on her family. The Panel had no information as to whether the Registrant has worked since that time.

56. The Panel began by assessing the personal component of impairment and asking itself whether the Registrant’s conduct is remediable, has been remedied and whether there remains a risk of repetition. In so far as the misconduct related to poor prescribing practice, this was something that was in principle remediable through education and training. Prescribing outside the scope of practice was more concerning in view of the Panel’s finding that the Registrant had knowingly done so. It took into account the unusual circumstances during the Covid pandemic, and the Registrant’s assertion that the prescriber who had previously treated the Registrant had seemingly stopped practising. The Registrant’s dishonesty was however an aspect of her misconduct which would be very difficult to remediate, given the inherent intention to deceive. The Panel also noted that her dishonesty was not isolated but sustained over a period of time. That was not to say that remediation was not possible.

57. As to whether the Registrant had remediated, the Panel looked for evidence that she understood the nature and seriousness of her misconduct and any steps taken to put matters right. It was unfortunate that the Registrant had not attended the hearing, as this would have given her opportunity to demonstrate insight. The most recent contact from her had been in 2023. At that time, the Registrant had referred to assisting a colleague who had been in trouble for administering local anaesthetic to herself while on duty. That colleague, the Registrant said, had been removed from the Register. This demonstrated to the Panel that the Registrant had failed to learn from the mistake of her colleague, or consider parallels between that conduct and her own. This was a concern to the Panel. The Panel also noted that the Registrant sought to blame the person she had spoken to at the pharmacy for “misleading” her rather than taking responsibility for her own actions.

58. In the absence of evidence of any relevant continuing professional development (CPD) courses, character references, remorse or insight demonstrated by the Registrant into what she had done, why it was wrong and the impact of such misconduct on the public and the profession, the Panel had no option but to conclude that the Registrant has failed to remedy her misconduct. Also, there had been repeated dishonesty in writing Botox prescriptions. In the Panel’s view, this would likely have continued had the Pharmacy not picked up on and reported the matter. The Panel therefore concluded that there was a high risk of repetition. As such the Registrant is currently impaired on the personal component.

59. The Panel then directed itself to the nature of the Registrant’s impairment in line with the formulation set out in the case of CHRE v NMC and Grant. The Panel accepted that the prescriptions had all been for the Registrant’s personal use, and that there was no evidence that she had treated patients or members of the public such as friends. As such, there was no evidence that the Registrant’s misconduct had placed patients at an unwarranted risk of harm. There was no basis for the Panel to find she was liable to do so in the future. As such, the protection of the pubic did not require a finding of impairment.

60. However, the Panel considered that the Registrant’s conduct had brought the profession into disrepute and that she had breached fundamental tenets of the profession. In the Panel’s view, both fellow practitioners and members of the public would take an extremely dim view of a practitioner who had acted as the Registrant had. Fellow healthcare professionals would, in the Panel’s view, be likely to have a good understanding of why there are strict rules around prescribing, and the potential for harm if these are not adhered to. Members of the public understand that certain medications can have harmful side effects and that professional advice is needed, from a person trained to prescribe, before prescription medicines can be obtained. Breach of those rules, in the circumstances of this case, brings the profession into disrepute because it demonstrates a disregard for the law, disregard for ethical prescribing and a serious lack of judgment.

61. The Registrant put her own interests before that of the profession, and used her limited knowledge of prescribing to her personal advantage. She sought to blame the pharmacy when caught out. This abuse of the status that her registration gave her meant that the Registrant had breached a fundamental tenet of the profession.

62. Such conduct is likely to significantly undermine the trust of members of the public and fellow professionals in the profession. Further, both groups would expect a responsible regulator to take action to uphold professional standards.

63. Additionally, the Registrant acted dishonestly. This is particularly serious because members of the public need to be able to trust healthcare professionals and may put their own health at risk by not seeking treatment if that trust is lost. The fact that the dishonesty here was repeated led the Panel to conclude that it was attitudinal in nature. The Registrant may act dishonestly in other circumstances where that suited her personal interests, without considering the wider implications.

64. As such, the Panel determined that a finding of current impairment is required in the public interest, to mark the wholly unacceptable nature of the Registrant’s misconduct and to restore public trust and confidence in the profession. Such finding and the message it sends will help ensure that proper professional standards are maintained going forwards.

Decision on Sanction

65. Ms Khaile submitted that the Panel should have regard to the Sanctions Policy and work through the available sanctions in ascending order. With regard to conditions of practice, she submitted that such an order was unlikely to be appropriate in circumstances, as here, where the conduct was attitudinal and there has been a lack of insight or remediation. Ms Khaile submitted that there were no mitigating factors present, and invited the Panel to find that aggravating factors were the Registrant’s lack of remediation, limited insight or remorse, the seriousness of the allegations and potential harm to service users. She also took the Panel to the section on dishonesty contained within the Sanctions Policy.

Legal Advice

66. The Panel accepted the advice of the Legal Assessor, that it should:
• Have regard to the sanctions policy and begin by considering whether there are any particular mitigating or aggravating features;
• Bear in mind that the attitude of the Registrant to the allegations is something which can go in their favour or against them at the stage of determining sanction - Nicholas-Pillai v. General Medical Council [2009] EWHC 1048 (Admin)
• Have regard to the HCPC’s over-arching objective of protecting the public, maintaining public confidence in the profession and upholding proper professional standards
• Impose the minimum sanction necessary to meet the regulator’s overarching objective, bearing in mind that the purpose of sanction is not to punish; Meadow v GMC [2007] 1 QB 462;
• Ensure that any sanction is proportionate, whilst noting that the interests of the profession take precedence; Bolton v Law Society (1994) 1 WLR 512, endorsed in the context of health regulation in The Council for the Regulation of Health Care Professionals v General Dental Council (Fleischmann) [2005] EWHC 87 (Admin):
• In cases of dishonesty, there is generally considered to be a ‘scale of dishonesty’ and there is not an automatic presumption of strike-off; Hassan v GOC [2013] EWHC 1887 (Admin);

67. The Panel began by considering whether there were any mitigating features. It identified the following:
• The Registrant has no prior FTP history and the events took place during Covid;
• The Registrant accepted that she wrote the prescriptions and that she created fictitious patient details

68. As to aggravating features the Panel considered the following to be matters making the case more serious:
• The Registrant had abused her position of trust as a registered professional to gain access to medication;
• She had sought to blame others;
• There had been a pattern of behaviour over some six months;
• The Registrant had demonstrated very limited remorse, shown no insight and taken no steps towards remediation;
• The Registrant had not engaged with the Regulatory process since 2023.

69. The Panel did not accept Ms Khaile’s submission that there was a potential for harm to service users, in view of its previous findings. Nor did it find that the seriousness of the allegations was an aggravating feature, since aggravating features are matters which increase the seriousness.

70. The Panel then considered the ‘Dishonesty’ section of the Sanctions Policy. It noted that there are different forms of dishonesty. It had regard to the factors which can assist in determining the seriousness of dishonesty in a particular case. The Panel had found that the Registrant’s dishonest conduct occurred on multiple occasions over a period of six months. The Registrant took a very active role, she wrote the prescriptions and invented patients. The Registrant had not engaged with the HCPC since the Allegation was amended to include dishonesty. That said, in the material available there was a denial of an intention to mislead. In the call on 19 January 2023 the Registrant said she did not make false representations or claim to hold a qualification that she did not have. This was, in the Panel’s view a denial of dishonesty. The Panel therefore considered that the Registrant’s dishonesty was towards the higher end of the scale.

71. The Panel then worked through the available sanctions in ascending order. Given the basis for its finding of impairment, taking no action was wholly in appropriate.

72. As to a caution order, the Panel determined that such an order was insufficient to mark the seriousness of both the misconduct and its impact on public trust and confidence in the profession. The Panel had found that the Registrant had brought the profession into disrepute, abused her professional position and that there was a high risk of repetition.

73. The Panel then considered whether a conditions of practice order could deal with the impact on the public interest of the Registrant’s dishonesty. The Panel’s starting point was that the conduct took place outside professional practice, which indicated that conditions of practice were unlikely to mitigate against the risk of repetition. Further, and more importantly, the Panel had found that the Registrant’s dishonesty was attitudinal in nature, rather than practice based, and the deception inherently involved in dishonesty meant that conditions of practice would not be an appropriate way of addressing it. Conditions require a registrant to work openly with those supervising and supporting them. The Panel had no basis upon which it could be assured that the Registrant would do this, and indeed, had serious concerns as to her willingness to engage, due to her lack of participation in the hearing. In any event, the seriousness of the dishonesty as noted above led the Panel to conclude that a conditions of practice order would be insufficient to meet the public interest. Informed members of the public would expect a responsible regulator to take more restrictive action, particularly in view of the Registrant’s lack of insight and remediation.

74. The Panel moved to consideration of a suspension order. It noted from the Sanctions Policy that such orders may be appropriate where a registrant has insight, the conduct is unlikely to be repeated and there is evidence to suggest that the registrant is likely to be able to remedy their failings. None of these were applicable in this case. There was nothing before the Panel that indicated it may be appropriate to depart from the HCPC’s guidance. The serious nature of the Registrant’s dishonesty combined with her attitude to these proceedings led the Panel to conclude that a suspension order was insufficient to meet the public interest.

75. As such, the Panel was left with no option but to impose a striking-off order. The Panel considered that the circumstances outlined in the Sanctions Policy as to when such an order may be appropriate were consistent with its findings in this case. The dishonesty had been serious, persistent and deliberate. There had been no attempt to address it. The Registrant had demonstrated no insight into the impact of her misconduct on the public or the profession. Her dishonesty was attitudinal in nature and likely to be repeated. Repeated dishonesty involving an abuse of a professional position was not, in the Panel’s view, compatible with continued registration.

76. As such, the Panel determined that no other sanction would be sufficient to uphold public confidence in the profession and the regulatory process. Trust had been seriously undermined to the extent that the Regulator would not be acting properly if it permitted the Registrant to remain on the Register.

Interim Order Application

77. In light of its findings, the Panel next considered an application by Ms Khaile for an interim suspension order to cover the appeal period before the final order becomes effective.

78. Ms Khaile submitted that an interim order should be made to cover the appeal period in light of the Panel’s decision that the Registrant should be struck-off in order to meet the public interest. She submitted that the seriousness of the misconduct warranted an interim order to uphold the public interest pending any appeal.

79. The Legal Assessor advised the Panel that it could make an interim order if doing so was necessary for protection of the public, otherwise in the public interest or in the interests of the Registrant. The Panel should bear in mind its previous findings and consider whether it is necessary to place any restriction on the Registrant’s practice immediately. The Panel was reminded of high threshold for imposition of an order in the public interest in accordance with Davey v General Dental Council 8 Oct 2015 unreported. If an order is required the Panel should determine the appropriate form and duration of any interim order.
Decision

80. The Panel considered whether to impose an interim order. It was mindful of its earlier findings. It had found that the Registrant had abused her position as a registered professional to obtain prescription medication, and that there was a high risk of repetition. As such, for as long as the Registrant remains on the Register she is able repeat her dishonest conduct, further undermining the trust and confidence that members of the public and fellow professionals place in registrants. The damage to the public interest in the circumstances of this case was significant, and failing to impose an immediate order, hence allowing repetition, would further and avoidably harm the reputation of the profession and undermine the Regulator. The Panel decided that it would be incompatible with its earlier findings if no interim order were imposed.

81. Accordingly, the Panel concluded that an interim suspension order is necessary to meet the public interest.

82. The Panel made the interim order for 18 months, to allow for any appeal to be dealt with. When the 28-day appeal period expires this interim order will come to an end unless an appeal has been filed with the High Court. If there is no appeal, the final order shall take effect when the appeal period expires.

The Registrar is directed to strike the Registrant off the Register with immediate effect.

The Panel makes an Interim Suspension Order for a period of 18 months and will be reviewed by 21 April 2026.

History of Hearings for Zoe L Heeks