Diane-Marie Banks

Service

1. The Panel noted that the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’) provide at paragraph 3(1)(b) that notice may be served on a registrant by sending it to their electronic mail address as it appears in the Register. Paragraph 6(2) of the Rules provides that “The Committee shall not fix a date for the hearing which is before the end of the period of 28 days beginning with the day on which the Committee sent the notice referred to in paragraph (1) to the Registrant”.

2. The Panel reviewed a five-page Service Bundle which contained a Notice of Hearing, sent to the Registrant on 21 April 2026 via email at 4:53 PM, and an extract of the Register showing the contact details provided by the Registrant and held by the HCPC. It also received legal advice from the Legal Assessor, which it accepted and applied, and had regard to the HCPTS Practice Note ‘Service of Documents’. 
 
3. The Panel was satisfied that the Notice of Hearing had been duly served upon the Registrant via her email address more than twenty-eight days prior to the hearing.

4. The Panel determined that good service of notice of the hearing had been effected. It was content that the HCPC had discharged its duty to ensure that the Registrant had been afforded an opportunity to appear before it and be heard, as set out at Article 31(15) of the Health Professions Order 2001 (‘the Order’).

Proceeding in Absence

5. The Presenting Officer invited the Panel to proceed with the hearing in the absence of the Registrant. She set out the steps taken to make the Registrant aware of the hearing and noted that the Registrant did not request an adjournment or to be represented at the hearing. In the circumstances, the Presenting Officer submitted that the Panel was entitled to find that the Registrant had voluntarily absented herself from the proceedings and therefore that the hearing should proceed in her absence.

6. The Panel received advice from the Legal Assessor, which it applied, and had regard to the practice notes provided by the HCPTS in relation to proceeding in the absence of the Registrant. It noted that the Registrant was informed that the substantive order would be reviewed prior to expiry via emails on 31 October 2025, 9 January 2026, 6 February 2026, 2 April 2026 and 7 May 2026. The Registrant has not responded to any of the communications sent to her.

7. Having determined that good service of notice of the hearing had been effected by the HCPTS, the Panel carefully considered all of the circumstances of the case to inform its assessment of the fairness to the HCPC, the public and the Registrant in respect of whether to proceed with the hearing in the absence of the Registrant. It noted that the notice of hearing specifically informed the Registrant that the hearing could proceed in her absence if proper notice was given of the hearing.

8. The Panel was satisfied that the Registrant was aware of the date, time, location and purpose of the meeting as required by the Rules. It was also satisfied that the HCPC had taken all reasonable steps to engage the Registrant in the proceedings to no avail.  The notice of hearing also provided the Registrant with links to a variety of guidance documents, including those relating to adjournments and substantive review hearings. 

9. The Registrant had, in the Panel’s view, comprehensively disengaged from the regulatory process. She had not requested an adjournment or to be represented at the hearing and there was no indication that the Registrant would attend the hearing on a future date if it was adjourned. 

10. In considering fairness to the HCPC and the public when making its decision whether to proceed with the hearing or not, the Panel noted that the HCPC attended the hearing and was in a position to proceed, having taken reasonable steps to secure the Registrant’s attendance.

11. The Panel gave careful consideration to the prejudice that may be caused to the Registrant by the matter proceeding in her absence but was content that it could mitigate any disadvantage as much as possible. It was mindful of the practice note issued by the HCPTS in respect of ‘Unrepresented Registrants’ and the fact that registrants should not be able to frustrate the efficient administration of regulatory matters by simply not engaging in the proceedings.

12. In the circumstances, the Panel determined that the public interest favoured the proceedings continuing in the absence of the Registrant. The hearing had been convened to undertake a mandatory review of an order imposed following a substantive hearing. The HCPC was in attendance and ready to proceed with the matter while the Registrant had not requested to be represented or sought an adjournment. The Panel was satisfied that the hearing could fairly proceed in the absence of the Registrant.

Background

13. The Registrant is a qualified Hearing Aid Dispenser, registered with the HCPC.

14. The Registrant was employed by Specsavers as a receptionist in November 2010, qualifying as a Health Care Assistant (HCA) in July 2014. Specsavers sponsored the Registrant’s training at De Montfort University as a Hearing Aid Dispenser and she qualified in June 2016. Once qualified, she worked for Specsavers as a Registered Hearing Aid Dispenser until she was dismissed on 22 October 2020. Her job description included taking case histories, otoscopy (examining the structures of the ear), taking impressions, audiometry (testing the ability to hear sounds), fitting hearing aids, programming hearing aids, and making medical referrals. 

15. During her employment as a Hearing Aid Dispenser, the Registrant’s line manager, KC, was concerned regarding the Registrant’s ability to identify the need for and subsequently carry out ‘masking’, which is an essential component of some hearing tests, along with testing air conduction audiometry thresholds and bone conduction audiometry thresholds.

16. Hearing tests are conducted in accordance with the British Society of Audiology Recommended Procedure 2018 (the BSA Recommended Procedure) and can include:

     a.    Air conduction audiometry, measured using either headphones placed over the external ear or insert earphones placed at the entrance to the ear canal. Air conduction audiometry measures the response of the entire hearing pathway and are measured before bone conduction thresholds. If a hearing loss is recorded with air conduction thresholds, it could be due to a blockage in the ear canal or middle ear, or due to damage to the inner ear (cochlea). The hearing loss is termed ‘conductive’ if it is due to blockage in the ear canal or middle ear and ‘sensorineural’ if it is due to damage to the inner ear or central auditory nerves. Sometimes conductive and sensorineural losses are present in the same person, in which case the hearing loss is termed ‘mixed’;

     b.    Bone conduction audiometry, measured by a small bone vibrator being placed on the mastoid bone behind the ear.   Bone conduction audiometry helps to determine whether a hearing loss is conductive or sensorineural and is carried out when hearing loss is identified by air conduction. It is not possible to be certain which cochlea is responding without bone conduction masking;

     c.    Masking, where a masking noise is presented to the better hearing ear to stop it from responding, which allows accurate testing of the worse hearing ear. Masking is not always necessary; for example, if there is no significant difference between the air and bone conduction thresholds in either ear, or if both ears have a significant conductive hearing loss. The BSA Recommended Procedure sets out three rules when masking is necessary to determine whether the hearing loss is conductive or sensorineural, and to be sure that the thresholds belong to the correct ear. The BSA Recommended Procedure refers to these as the three masking rules: 

        “Rule 1 – Masking is needed at any frequency where the difference between the left and right not-masked a-c (air conduction) thresholds is 40 dB or more when using supra- or circum-aural earphones or 55 dB when using insert earphones;

         Rule 2 – Masking is needed at any frequency where the not masked b-c (bone conduction) threshold is better that the air conduction threshold of either ear by 10 dB or more. The worse ear (by air conduction) would then be the test ear and the better ear       would be the non-test ear to be masked;

         Rule 3 – Masking will be needed additionally where Rule 1 has not been applied, but where the b-c threshold of one ear is more acute by 40 dB or more (if supra or circum-aural earphones have been used) or 55 dB or more (if insert headphones have been used) than the not-masked a-c threshold attributed to the other ear.”

17. The British Academy of Audiology has issued guidance for when referrals should be made for a medical or other professional opinion. It is entitled “Guidance for Audiologists: Onward Referral of Adults with Hearing Difficulty Directly Referred to Audiology Services”, published in November 2021. The Guidelines list a number of conditions which indicate when onward referral should be made, including:

     a.    sudden hearing loss or sudden deterioration of hearing in one or both ears; 

     b.    persistent tinnitus; 

     c.    conductive hearing loss; and 

     d.    unilateral or asymmetrical sensorineural hearing loss. 

18. During the Registrant’s time at Specsavers, she was subject to three sets of disciplinary proceedings. The first disciplinary investigation led to a disciplinary hearing on 7 July 2017 and related to Service User 20 and Service User 21. The second disciplinary investigation led to a disciplinary hearing on 24 August 2017 and related to Service User 24. 

19. The final disciplinary investigation arose out of an audit by the Registrant’s line manager, KC, of the Registrant’s records. KC became concerned that the Registrant appeared not to be undertaking air conduction and bone conduction masking, or, when it had taken place, it did not appear to comply with the BSA Recommended Procedure and follow the masking rules. As part of her investigation, KC interviewed the Registrant on 24 June, 28 July, 18 August, and 10 September 2020, seeking to explore the Registrant’s knowledge and clinical judgement. The third set of disciplinary proceedings led to the Registrant ultimately being dismissed from her employment on 22 October 2020.

20. Following the disciplinary proceedings, KC referred the Registrant to the HCPC in December 2020. 

21. As part of its regulatory investigation, the HCPC instructed an expert in audiology, Ms McKinney, to consider the clinical allegations. The Registrant faced clinical allegations in respect of:

     a.    Performing pure-tone audiometry which was not compliant with the Recommended Procedure in respect of 11 Service Users; 

     b.    Prescribing or providing inadequate or incorrect hearing aids in respect of 11 Service Users; 

     c.    Not managing earfittings for Service User 13 effectively; 

     d.    Not taking adequate aural impressions for new earmoulds for earplugs and hearing aids for Service User 20; 

     e.    Not making appropriate onward referrals for five Service Users in order for them to obtain further medical investigation, diagnosis, and treatment. 

22. The Registrant also faced allegations of fabricating audiograms in respect of 10 Service Users and doing so dishonestly. 

23. On 25 January 2021, the Registrant sent an email to the HCPC in response to its enquiry about whether she was at that time working as a Hearing Aid Dispenser. In the email the Registrant stated that the allegations had been implemented as a malicious vendetta by KC and the supposed evidence had been gathered illegally as she had been on furlough the entire time.

24. The Registrant did not attend, and was not represented at, the substantive hearing. The substantive hearing panel found some facts proved and that they amounted to misconduct. It determined that the Registrant’s fitness to practise was impaired on the public and private aspect of impairment but that the misconduct was, in principle, remediable. However, the Registrant’s lack of engagement and absence of information as to her insight, remediation and maintenance of skills since leaving Specsavers in October 2020 led the substantive panel to conclude that the Registrant had not remedied her practice and that there was a high risk of ongoing harm to patients. 

25. The substantive hearing panel observed that service users were exposed to harm as a consequence of the Registrant’s failures and that, by failing to follow the BSA Recommended Procedures, particularly in relation to the masking rules, the Registrant obtained inaccurate results. It was mindful of Ms McKinney’s expert opinion that, as a consequence of the Registrant’s inaccurate audiometry, the Registrant had:

     a.    missed onward referrals for further medical opinion with potentially serious risk of harm to the service users involved; 

     b.    caused in inappropriate and inaccurate hearing aid fittings, which either did not provide sufficient amplification or too much amplification to service users and therefore determined her to be impaired on the personal aspect of impairment.

26. In respect of the public component, the Panel was mindful of its responsibility to protect service users, maintain public confidence in the profession and uphold professional standards, concluding that public confidence in the profession would be undermined if no finding of current impairment were made in respect of a Hearing Aid Dispenser who repeatedly failed to comply with the profession’s recommended procedures for conducting hearing tests, prescribing appropriate hearing aids and making appropriate onward referrals. The Panel concluded that the Registrant was also impaired on the public component of fitness to practice. 

27. The substantive hearing panel imposed a Suspension Order for a period of 12 months and suggested that the Registrant provide to a reviewing panel: 
28    
     a.    evidence of her engagement with the HCPC;

     b.    any plan to return to safe practice, including:
 
       i. evidence of reflection on the Panel’s findings and the impact of her actions on Service Users and the reputation of the profession; 

       ii. evidence of training; 

       iii.testimonials; 

     c.    evidence of any relevant health matters.

29. The Suspension Order imposed by the substantive hearing panel for a period of 12 months was reviewed on 22 May 2025. The Registrant did not attend the hearing or provide information to the reviewing panel, which determined that her fitness to practise remained impaired on both the personal and public components of impairment. The reviewing panel carefully considered the nature of the order to impose upon the Registrant and decided that the appropriate and proportionate order was to extend the suspension for a further period of 12 months. 

Submissions

30. The Presenting Officer adopted the submissions set out in the skeleton argument provided for the Panel and invited the Panel to find that the Registrant’s fitness to practice remains impaired and impose a Striking Off Order. She confirmed that the Registrant had not responded to any correspondence sent to her in relation to the regulatory proceedings since the last review and submitted that, in the absence of insight or remediation since the substantive hearing, the Panel could not be satisfied that the impairment identified had been addressed. 

31. In addressing the issue of the appropriate sanction, the Presenting Officer submitted that extending the current suspension order would serve no useful purpose given the Registrant’s “complete failure to engage with these proceedings at any stage, or to provide any explanation for her failure to do so, indicates that she is unwilling to address or remedy her failings”. Therefore, there was in her submission “no basis upon which the Panel could be satisfied that a further period of suspension would achieve anything the current order has not.”

32. No information by or on behalf of the Registrant was provided to the Panel. 

Decision    

33. The Panel noted, accepted and applied the advice of the Legal Assessor and had careful regard to the documentation and submissions it received. It also had regard to the practice notes issued by the HCPTS and the HCPC’s Sanctions Policy. It was mindful that the purpose of the review was not to go behind the findings of a previous panels but to determine whether the Registrant’s fitness to practise remains impaired, and if so, to determine what action would be appropriate to address that impairment. The key issue for the Panel to determine is what, if anything, has changed since the current order was imposed.  The factors to be taken into account include: 

     a)  the steps which the Registrant has taken to address any specific failings or other issues identified in the previous decision;

     b)    the degree of insight shown and whether this has changed;

     c)    the steps which the Registrant has taken to maintain or improve her professional knowledge and skills; 

     d)    whether any other fitness to practise issues have arisen; 

34. The Panel must consider whether the concerns which led to a finding of impairment at a hearing in April 2024 remain. As the decision in Abrahaem v GMC [2008] EWHC 183 (Admin) indicates, in practical terms this places a “persuasive burden” on the Registrant to demonstrate that she has fully acknowledged the issues which led to the original finding and has addressed them sufficiently “through insight, application, education, supervision or other achievement...”.

35. The Panel reminded itself that when reviewing sanctions under Article 30 of the Order, the Reviewing Panel may:

     a)    confirm the order; 

     b)    extend, or further extend, the duration of the order;  

     c)    reduce the duration of the order; 

     d)    replace the order with any other order which the Panel could have made (to run for the remaining term of the original order); or 

     e)    revoke the order or revoke or vary any condition imposed by it.

36. The decision reached by the Panel must be proportionate, striking a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection. In determining whether fitness to practise is currently impaired, panels must take account of a range of issues which, in essence, comprise two components: 

    a) the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and 

    b) the ‘public’ component: the need to protect service users, declare and uphold professional standards and maintain public confidence in the profession. 

    The personal component includes the risk of repetition and to what extent any misconduct has been remedied. In respect of the public component the Panel has to consider public policy issues, which include the need to maintain confidence in the profession and to declare and uphold the HCPC standards of proficiency.

37. Both the substantive hearing panel and the first reviewing panel produced comprehensively detailed determinations, which the Panel accepted and endorsed. It particularly noted the substantive hearing panel’s findings that: 

    a.the Registrant’s “acts and omissions in respect of particular 1 fell far below the standards expected” of her in respect of nine service users; 

    b.four service users were impacted by the Registrant’s failure to obtain accurate results for the pure-tone audiometry, leading her to prescribe or provide incorrect or inadequate hearing aids (Particular 3); 

    c. the Registrant failed to make appropriate referrals for medical investigation in respect of four service users, contrary to the guidance issued by the British Academy of Audiology, placing service users at risk of significant harm (Particular 6);  

    d. the following HCPC Standards of Conduct, Performance and Ethics (2016) had been breached:

     i.    1 -  Promote and protect the interests of service users and carers;

     ii. 3.2 – You must refer a service user to another practitioner if the care, treatment or other services they need are beyond your scope of practice; 

    iii. 3.3 – You must keep your knowledge and skills, up-to-date and relevant to your scope of practice through continuing professional development; 

    iv.    3.4 – You must keep up-to-date with and follow the law, our guidance and other requirements relevant to your practice; 

    v.    6.1 – You must take all reasonable steps to reduce the risk of harm to service users… as far as possible.

    e.    “the Registrant appeared to have issues with her competence, in particular in not appearing to fully understand the principles underpinning audiology and pure-tone audiometry. However, given the seriousness of the facts found proved, and the consequent risk of harm to service users, in the Panel’s judgement, they were more properly characterised as misconduct”.  
 
38. The Panel was satisfied that there is no evidence before it that the Registrant has remediated the concerns identified by the substantive panel and endorsed by the reviewing panel, despite being given two opportunities to do so. It also noted that the Registrant had been prompted about the information she was expected to provide on a number of occasions but failed to respond at all. In all the circumstances, the Panel was content the Registrant remains impaired on both the personal and public components of impairment.  

39. The Panel therefore considered how to address the impairment, bearing in mind the provisions of the HCPTS Sanctions Policy and the relevant practice notes. It determined that taking no further action, mediation, imposing a caution or conditions of practice would not be sufficient to protect the public or be in the public interest in the circumstances of this case. 

40. Given the Registrant’s total lack of engagement in the regulatory process and her failure to take advantage of the opportunity provided to her to remediate her practice by both the substantive and reviewing panels, the Panel concluded that a Suspension Order is no longer the appropriate and proportionate sanction to address the risk to the public. The Registrant has not supplied any evidence to the Panel which suggests that she has made any attempt to remediate her practice or evidence insight into the concerns identified by the previous panels.  Further, given the time elapsed since the Registrant last occupied a regulated role, the Panel was also conscious that she had not provided any information in relation to the maintenance and development of her professional learning and skills. 

41. The Panel was mindful that the Sanctions Policy provides that a striking off order is likely to be appropriate “where the registrant:

     •    lacks insight; 
 
     •    continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence (for example, due to not attempting to engage with any remediation); or  

     •    is unwilling to resolve matters.”

42. The Panel was satisfied that revoking the Suspension Order and replacing it with a Striking Off Order was the most appropriate way of concluding the concerns identified in detail by the substantive panel and endorsed by the reviewing panel. In reaching this decision, the Panel was mindful that the Registrant may be significantly impacted by the decision, but it did not consider that a less restrictive sanction was appropriate. 

43. The Panel therefore directs that the Registrant be struck from the Register.  

That the Registrar is directed to strike the name of Diane-Marie Banks from the Register on the date this order comes into effect.

The Order imposed today will apply from 23 May 2026

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 Diane-Marie Banks