Lisa Forgione

Preliminary Matters

Privacy application

1. Ms Fletcher-Smith on behalf of the Registrant invited the Panel to hear the matter partly in private to protect information about the health and / or private life of the Registrant from being in the public domain where such matters were to be referred to. The application was supported by Ms Khorassani on behalf of the HCPC. 

2. The Panel was referred to the HCPTS Practice Note on ‘Conducting Hearings in Private’, which states that as a general rule hearings are to be in public in accordance with the ‘open justice’ principle. However, in certain circumstances it is in the interests of justice for the hearing to take place wholly or partially in private.

3. The Panel considered the representations made and determined that it was appropriate for the hearing to be heard partly in private in the interests of justice to protect information about the health and / or private life of the Registrant where such matters were referred to. It considered that the concerns were not so inextricably linked to the Registrant’s health or private life that it was possible to hold only part of the hearing in private.

Background

4. The Registrant is a HCPC registered Practitioner Psychologist who, between October 2019 and July 2021, conducted psychology sessions with Service User A, who was serving an indeterminate prison sentence. 

5. At some stage between October 2019 and July 2021, when the Registrant was conducting sessions with Service User A at HMP Isle of Wight, it was alleged that the Registrant and Service User A developed an emotional and/or romantic relationship. 

6. The HCPC case was that this alleged relationship amounted to a breach of professional boundaries by the Registrant and was sexual in nature. This was the basis of Allegation 1. 

7. In around March 2021, HM Prison and Probation Service (HMPPS) Corruption Team received an Intelligence Report via their intelligence management tool, Mercury, which suggested that Service User A had informed a member of prison staff at HMP Isle of Wight, that he had proposed going on a date with the Registrant. She allegedly told him that she would accept his offer of a date. A further Intelligence Report was received in July 2021, which said that Service User A had informed his Probation Officer, A LW, that he was in a romantic relationship with the Registrant. 

8. It was alleged that the Prison Service also became aware, on 23 July 2021, that Service User A had disclosed that the Registrant had made and sent greetings cards and romantic messages to him. On a separate occasion, though after the Registrant had resigned from HMPPS, Service User A disclosed that he had asked his grandmother to send messages to the Registrant via Facebook on his behalf. In August 2021, the Prison Service received information that Service User A had asked his brother to facilitate contact with the Registrant via mobile phone. The Prison Service was aware that the Registrant had responded to messages from Service User A’s grandmother and brother, as this was captured as part of the routine telephone monitoring of Service User A’s PIN phone account, although those records were no longer available. 

9. On 12 July 2021, the Registrant was promoted to the role of Registered Psychologist in HMPPS and moved into the South Central Psychology team, with a base at HMP Winchester. She formally resigned from HMPPS on 24 August 2021, although her managers were aware of her intention to leave prior to that date. Her final date of employment was 30 September 2021, although she was on sick leave for some of August and all of September 2021. 

10. Prior to her resignation, in around July/August 2021, HMP Isle of Wight opened an investigation into allegations of an improper relationship between the Registrant and Service User A. The Registrant was not interviewed as part of that investigation but did provide written answers to a number of questions. In those written answers, which were provided on 06 September 2021, the Registrant denied that she was in a relationship with Service User A and speculated as to why he may have made statements that they were in a relationship. It was the HCPC case that those answers were untrue and dishonest. This formed the basis of Allegations 2, 3 and 9. 

11. It was ultimately determined by the Police that there was insufficient evidence to commence a criminal investigation into the contact between the Registrant and Service User A’s family. 

12. The investigation carried out by HMPPS into the alleged relationship, between Service User A and the Registrant, concluded with a request that Service User A be spoken to and advised that “… from a prison perspective it is likely that this relationship was fabricated with there being no evidence to corroborate that [the Registrant] was either in contact with [Service User A] directly or indirectly as [Service User A] has stated.” The Prison Service treated the information as “malicious” and Service User A was “strongly recommended” to stop “spreading these rumours”. 

13. In December 2021, Service User A was transferred to the Oswin Unit, following a referral that contained, inter alia, the Registrant’s professional opinion that he should be moved. The Oswin Unit is based within the Secure Care at the Bamburgh Clinic in Newcastle Upon Tyne. The unit is designed for offenders who are serving sentences of imprisonment and who have personality disorders or are high-risk offenders with additional personality needs, which can sometimes result in difficulties with impulse control and relationships. Offenders stay on the Oswin Unit as in-patients during their treatment. 

14. On arrival at the Oswin Unit Service User A provided the Registrant’s details as his next of kin, reporting to staff that “they are together”. Concerns were raised by staff on the Oswin Unit who recognised the Registrant’s name from Service User A’s admission paperwork. They contacted HMP Isle of Wight, who confirmed that they were already aware of concerns regarding an alleged inappropriate relationship between Service User A and the Registrant. 

15. It was alleged that during his time on the Oswin Unit, between December 2021 and February 2022, Service User A and the Registrant spoke frequently and for long periods of time either on the phone or via Skype (see Schedule B above). In addition, on 03 February 2022, an incident was recorded as Service User A said he was only able to receive a photocopied version of a Moonpig Valentine’s Day card sent by the Registrant and there had been delays in him receiving a parcel he said she had sent. 

16. The following day, on 04 February 2022, a SKYPE session between Service User A and the Registrant took place during which, it was alleged, the Registrant was observed to share photographs of herself in a bikini and topless with her arms across her breasts. The interactions between the Registrant and Service User A, whilst he was on the Oswin Unit, are detailed in the course of conduct alleged in Allegation 4 and Schedule B. 

17. The HCPC case was that this course of conduct amounted to a breach of professional boundaries by the Registrant and/or that she had not been acting in the best interests of Service User A. It was also alleged that the course of conduct was sexual in nature. 

18. On 08 February 2022, the Registrant was contacted by the HCPC in relation to concerns about her fitness to practise and requesting further information about her current employment status and details of her Line Manager. The Registrant responded to this letter on 14 February 2022, providing the information requested. 

19. On 24 February 2022, Service User A was relocated from the Oswin Unit to HMP Frankland. His contact with the Registrant continued, and it was alleged that they would speak at length over the phone. 

20. On 16 May 2022, the Registrant participated in a purple (video-link) visit with Service User A, whilst he was a prisoner at HMP Frankland. It was alleged that the following exchanges were recorded during the visit and they form the basis of Allegation 5: 

(i) The Registrant told Service User A “You make me happy. I will miss your face. I’m seeing you in less that two weeks I’m really excited. I’m with you to the end” or words to that effect. 

(ii) After Service User A asked the Registrant what side of the bed was his, she demonstrated the side of the bed to him. 

(iii) The Registrant agreed to send photographs of herself to Service User A. 

(iv) When Service User A spoke about her ‘peach’, the Registrant stood up and showed him her clothed buttocks. 

21. The HCPC case was that this visit amounted to a breach of professional boundaries by the Registrant and/or that she had not been acting in the best interests of Service User A. It was also alleged that the visit was sexual in nature. 

22. The Registrant subsequently visited Service User A in person on 29 May 2022, however that visit was not monitored. 

23. On 20 May 2022, the Registrant sent a follow up letter to the HCPC regarding the concerns raised in February 2022 about her fitness to practise. In the letter, the Registrant stated “I would like to confirm that I am not in a professional relationship with the prisoner, nor in a sexual, financial or emotional relationship with him and never have been.” The HCPC case was that this statement was untrue and dishonest, as reflected in Allegations 6 and 9. 

24. On 24 July 2022, the Registrant sent a birthday card to Service User A. The cover of the card contained an image of the Registrant in a bikini and a second image in which the Registrant was topless (with an arm across her breasts). The card contained the message detailed in Schedule D above. It was the HCPC’s case that the sending of this card represented a breach of professional boundaries by the Registrant and/or that she was not acting in his best interests. It was also alleged that her conduct in sending the card was sexual in nature.

25. At a substantive hearing the Registrant made some partial admissions. After hearing the evidence, the panel determined that Particulars 4, 5, 6, and 7 proved. It also found Particular 8 proven insofar as it related to Particulars 4, 5 and 7, and Particular 9 proven insofar as it related to allegation 6.

26. The panel found that the matters found proven amounted to misconduct and that the Registrant’s fitness to practise was impaired on the public component only. The panel imposed a 9-month suspension order with an 18-month interim suspension order.

27. This is the first review of that Order.

Submissions

28. Ms Khorassani on behalf of the HCPC submitted that the Registrant’s fitness to practise remained impaired and invited the Panel to impose a 12-month conditions of practice order to support the Registrant in a safe return to practise.

29. Ms Khorassani reminded the Panel that it should not go behind the decision of the previous panel and invited the Panel to consider whether the concerns identified had been addressed. Ms Khorassani acknowledged that the Registrant had engaged with the HCPC in a manner which may assist the Panel. It was identified that the previous panel had not made any recommendations as to what evidence would assist this Panel due to the finding of impairment on public interest grounds alone.

30. Ms Khorassani identified that the conduct which had led to the original finding of impairment was in breach of the following 

Standards of Conduct, Performance and Ethics (2024):-

• 1.9 You must take action to set and maintain appropriate professional boundaries with service users, carers and colleagues.

• 1.12 You must not abuse your position as a health and care practitioner to pursue personal, sexual, emotional or financial relationships with service users, carers or colleagues.

• 6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues, as far as possible.

• 6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.

• 9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

31. Ms Khorassani highlighted parts of the Registrant’s reflections where she had indicated that she had not practised since August 2022 and required updating, supervision and support to ensure a safe return to practise.

32. Ms Fletcher-Smith on behalf of the Registrant invited the Panel to consider that the Registrant was no longer impaired. However, should the Panel not agree, she submitted that a conditions of practice order or a suspension order were not necessary or proportionate.

33. It was submitted that due to insight, remediation and reflection the Registrant had demonstrated that the public would not be concerned if she was permitted to return to unrestricted practise. It was highlighted that the previous panel were not concerned with any risk of repetition, had considered the sexual misconduct to be at the lower end of the scale, were not persuaded that there were any entrenched attitudinal issues, and had concluded that the Registrant’s actions were not fundamentally incompatible with continued registration.

34. Ms Fletcher-Smith indicated that there were no concerns around the competence or effectiveness of the Registrant as a practitioner, and that she had addressed the failings identified. Ms Fletcher-Smith highlighted that the Registrant had been subject to an interim suspension for around 3 years and that the hearing had taken around 10 months to conclude.

35. On behalf of the Registrant, it was submitted that there had been no new fitness to practise concerns and the Registrant had ended her relationship with Service User A. Additionally, she had [redacted] developed a structured plan to return to practise.

36. It was submitted that the Suspension Order had served its purpose and that any restriction was no longer necessary or proportionate. Ms Fletcher-Smith indicated that despite the previous panel not requiring any additional work to be undertaken by the Registrant that she had continued to undertake reflections, continuing professional development and had developed a plan to return to professional practice.

37. Ms Fletcher-Smith submitted that the Registrant was in no worse position than a registrant who had taken a career break. 

38. Ms Fletcher-Smith submitted that a conditions of practice order would restrict the ability of the Registrant to find employment, and that she had done everything she could to increase public confidence in her as a professional and uphold professional standards.

Legal Assessor’s Advice

39. The Legal Assessor advised that this is a Review under Article 30(1) of the Health Professions Order 2001, and the Panel should consider the HCPTS Practice Notes on ‘Review of Article 30 Sanction Orders’, ‘Fitness to Practise Impairment’ and the ‘Sanctions Policy’. The Panel was reminded that Article 30(1) of the Health Professions Order 2001 provides Panels with a power to:

- extend, or further extend the period for which the order has effect; 
- make an order which could have been made when the order being reviewed was made; or 
- replace a suspension order with a conditions of practice order. 

40. The Panel was reminded that the review process is not a mechanism for appealing against or ‘going behind’ the original finding that the Registrant’s fitness to practice is impaired. The purpose of the review is to consider:-

• Whether the Registrant’s fitness to practise remains impaired; and
• If so, whether the existing order or another order needs to be in place to protect the public.

41. The key issue which needs to be addressed is what, if anything, has changed since the current order was imposed. The factors to be taken into account include:

• the steps which the Registrant has taken to address any specific failings or other issues identified in the previous decision;
• the degree of insight shown and whether this has changed;
• the steps which the Registrant has taken to maintain or improve their professional knowledge and skills; and
• whether any other fitness to practice issues have arisen.

42. The reviewing Panel’s task “is to consider whether all the concerns raised in the original finding of impairment...[have] been sufficiently addressed”. Abrahaem v GMC [2008] EWHC 183 (Admin). There is a ‘persuasive burden’ on the Registrant to demonstrate at a review hearing that he has fully acknowledged the deficiencies which led to the original finding and has addressed that impairment sufficiently “through insight, application, education, supervision or other achievement...”. 

43. The decision reached must be proportionate, striking a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection.

44. In determining fitness to practise, Panels must take account of two broad components: the ‘personal’ component: the current competence and behaviour of the registrant concerned; and the ‘public’ component: those critically important public policy issues.

45. In making proportionate decisions on sanction, panels need to strike a balance between the competing interests of the registrant and the HCPC’s overriding objective to protect the public. Therefore, decisions should deal with the concerns raised, but be fair, just and reasonable. Sanctions are not intended to be punitive. Panels should only take the minimum action necessary to ensure the public is protected. This means considering the least restrictive sanction available to them first and only moving on to a more restrictive sanction if it is necessary to protect the public.

Decision on Impairment

46. In reaching its’ decision the Panel considered all of the information before it. The Panel first considered whether the Registrant’s fitness to practise remains impaired. The Panel was aware that the persuasive burden is upon the Registrant to demonstrate that her fitness to practise is no longer impaired. The Panel had regard to the decision of the substantive panel. However, it comprehensively reviewed the matter and exercised its own judgment in reaching a decision.

47. The Panel had regard to the HCPTS Practice Notes ‘Review of Article 30 Sanction Orders’ and ‘Fitness to Practice Impairment” and accepted the advice of the Legal Assessor. The Panel had sight of the HCPC bundle of 88 pages and the Registrant’s bundle of 49 pages.
48.    The Panel noted that Ms Khorassani had referred it to the Standards of Conduct, Performance and Ethics applicable from 2024. The Panel should have been referred to the Standards which were in force at the time of the misconduct found, which were those valid from 2016.

49. The Panel first of all considered whether the Registrant’s fitness to practise is currently impaired. The Panel was aware that it could not go behind the findings of the substantive hearing panel and so focussed its discussion on the public component, as there had been no finding of impairment on the personal component. The Panel acknowledged the comments of the panel who heard the substantive matter in its decision and the submissions of the parties. The HCPC has not advanced any information to suggest that there has been any change to the risk that the Registrant posed to the public, or that the risk of repetition has changed. 

50. The Panel was impressed with the work the Registrant had undertaken since the conclusion of the substantive hearing, despite that panel saying that none was required. Whilst it was previously acknowledged that the Registrant had remediated, she has gone further and her reflections now demonstrate an awareness of what would be required to enable her to safely return to practise. The Panel considered the insight shown to have deepened and developed further, and the quality of her reflections was excellent.

51. The Registrant has focussed her learning on the concerns which were identified, has engaged in the regulatory process, has demonstrated a commitment to return to the profession, and there have been no further fitness to practise concerns. The Panel was of the view that the Registrant had taken the regulatory process seriously and had reflected to develop herself sufficiently to be able to recognise when she has the knowledge, skills and ability to return to safe autonomous practise. The Panel has confidence in the Registrant in that she has already developed a plan for safe return to practice and are persuaded that she can be entrusted to follow this plan herself.

52. The Panel was satisfied that the Registrant presents as a motivated, intelligent, and capable professional who can be trusted to manage her own development and reintegration into practice.

53. In considering whether the Registrant remains impaired on the public component the Panel was satisfied that there was no risk of repetition which could result in a risk of harm. It relied upon the conclusions reached by the substantive hearing panel and took account of the remediation and detailed reflections demonstrating full insight into the actions which led to the misconduct.

54. In considering the requirement to maintain and uphold proper professional standards and public confidence in the profession, the Panel was satisfied that the current Suspension Order was sufficient to mark the misconduct, to satisfy public confidence in the profession and its regulation. The Panel considered that a member of the public aware of the full circumstances, and the work undertaken by the Registrant, would have confidence that the regulatory process had worked. Accordingly, the Panel was not able to find impairment on the public component.

55. As the Panel found that the Registrant is no longer impaired on either the personal or public component the current Suspension Order shall be allowed to lapse upon expiry on 08 October 2026.

ORDER: The Suspension Order imposed on 11 December 2025 shall be allowed to lapse upon expiry on 08 October 2026.

The Order imposed today will apply from 08 October 2026.

No notes available

History of Hearings for Lisa Forgione