Umalini Kathirgamanathan

Preliminary Matters

Service

1. The Panel was satisfied on the papers that the Registrant had been properly served with notice of today’s hearing on 27 March 2026 in accordance with the Health and Care Professions (Conduct and Competence Committee) (Procedure) Rules 2003, as amended. 

Proceeding in absence

2. Ms Khorassani made an application for the hearing to proceed in the absence of the Registrant on the grounds that she had voluntarily absented herself and waived her right to attend.

3. The Panel had regard to the HCPTS Practice Note on “Proceedings in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel noted the email from the Registrant to the HCPC dated 21 April 2026 wherein the Registrant stated that she would not be attending due to the impact the hearing would have on her health. She confirmed that she had accessed the bundle but would not be submitting any documents. [redacted]. The Panel concluded that the Registrant had voluntarily absented herself and waived her right to attend. Today’s hearing is a mandatory review and must be heard before the expiry of the Suspension Order on 13 May 2026. The Panel had no reason to think that the Registrant would attend if the hearing were adjourned to a later date or that any useful purpose would be served by an adjournment. The Panel therefore decided that it was in the public interest, and not unfair to the Registrant, to proceed with the hearing in her absence. 

Background to original Allegation and outcome of Application for Restoration

4. The Registrant began working for Mid-Yorkshire Community Rehabilitation and Intermediate Care Service at Mid-Yorkshire Hospital NHS Foundation Trust in August 2009. The Registrant was employed as a rotational Occupational Therapist and worked with community rehabilitation patients who were medically stable providing generic rehabilitation for a wide range of conditions. 

5. Concerns regarding the Registrant’s capability arose in the induction period which was initially extended. The Registrant was then placed on an informal capability process for a month but by October 2009 the Registrant had not met her objectives. In November 2009, the Registrant was moved to a bedded unit. However, by December 2009, whilst the Registrant had made improvements, she was still failing to perform at the level expected of a Band 5 Occupational Therapist.

6. Between January 2010 and May 2011, the Registrant was subject to a formal capability process. However, on 18 May 2011 it was determined that the Registrant had failed to meet her objectives and she was dismissed on the grounds of capability.

7. A hearing before the HCPC’s Conduct and Competence Committee (‘CCC’) took place between 3 and 5 September 2012 which considered a number of allegations arising from the Registrant’s employment at Mid-Yorkshire NHS Foundation Trust.

8. The CCC found allegations proved which related to the following areas of practice:

•    Failures to adequately manage a caseload; 

•    Poor assessment skills;

•    Failures to communicate clearly and appropriately with staff members, patients and family members;

•    Failures in clinical competence; including failures to provide clinical reasons for actions, failures to consistently respond in a timely manner to situations, and failures in respect of prescribing and fitting equipment as well as failures to identify plans of intervention;

•    Failure to complete patient notes.

9. The CCC determined that the Registrant’s conduct amounted to lack of competence and that her fitness to practise was impaired. A 12-month Suspension Order was imposed by way of sanction.

10. The first review of the Suspension Order took place on 3 September 2013. The Registrant did not attend, and the Order was extended for a further 12 months.

11. The second review took place in September 2014 and the Suspension Order was further extended for a period of 12 months.

12. On 15 December 2014, the Registrant applied for voluntary removal from the Register which was granted.

13. On 1 March 2022, the Registrant applied for restoration to the Register. [redacted]. The Registrant stated that between 2011 and 2020 she had worked as a support worker for people with disabilities and that specifically between 2021 and 2022 she had worked within an Occupational Therapy (OT) team, undertaking a variety of interventions. The Registrant had also undertaken research and training and had reflected on her practice.

14. The CCC found that the Registrant had shown genuine remorse for her previous failures and that she had shown significant insight into what had caused those issues. However, the CCC was not persuaded at that time that the Registrant had fully remediated her failings and/or that she did not continue to pose a risk to the public despite the efforts that she had made. The CCC was, however, satisfied that these risks could be addressed through a Conditions of Practice Order. The Registrant was therefore restored to the Register with conditions.

15. On 27 November 2022, the Registrant informed the HCPC that she had secured work at the Leeds and York Partnership Foundation Trust (‘the Trust’) to start in January 2023 and provided the details of her manager, in line with Condition 1 of the Conditions of Practice Order. The Registrant also updated the HCPC with the details of her manager once she began work.

16. The Trust provided detailed reports to the HCPC on the Registrant’s progress and performance dated 1 April 2023, 13 July 2023, January 2024 and April 2024.

The Substantive Order Review on 24 April 2024

17. The Substantive Order Review on 24 April 2024 was attended by the Registrant.

18. On the basis of the reports from the Trust, the panel found that there were continuing concerns about the Registrant’s communication skills with patients and relatives, her clinical reasoning skills and record-keeping. These had necessitated an extension to the Registrant’s preceptorship as well as her placement on a formal performance improvement plan. The Registrant acknowledged these concerns and that she was not yet ready to practise without restriction.

19. In light of these reports, the panel concluded that the Registrant’s fitness to practise remained impaired in respect of both the personal and public components.

20. The panel decided to impose a further Conditions of Practice Order for a period of 12 months but varied the conditions to provide as follows:

1. You must notify the HCPC within 7 days of any professional appointment whether paid or unpaid, which requires your registration and provide the contact details of your employer;

2. You must allow the HCPC to exchange information with your employer and/or supervisor referred to in these conditions;

3. You must place yourself and remain under the supervision of a workplace supervisor registered with the HCPC, and, if you have not already done so, supply details of your supervisor to the HCPC within 14 days of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations;

4. You must meet with your supervisor on a monthly basis to review your performance and your progress in your Preceptorship and/or Performance Improvement Plan;

5. You must allow your supervisor to provide a report to the HCPC as to your progress every 3 months and at least 14 days prior to any review;

6. You must inform the HCPC within seven days of becoming aware of
any:

• patient safety issues that you are involved in;

• investigation started against you; and

• disciplinary and/or competency proceedings.

7. You must provide a written copy of these conditions, within 7 days from the Operative Date to any organisation or person employing or contracting you to undertake Occupational Therapy work, whether paid or unpaid, which requires your registration;

8. You must not work as an Occupational Therapist for an agency or as a locum or undertake out-of hours work or on call duties without the prior written agreement of your workplace supervisor;

9. You must confine your professional practice to working for one employer; and

10. You will be responsible for meeting any and all costs associated with complying with these conditions.

11. Within six months of the Operative Date you must complete further training in the following areas:

• Communication skills

• Record-Keeping.

The Substantive Order Review on 17 April 2025

21. At the Substantive Order Review on 17 April 2025, the Registrant was in attendance. 

22. The Panel had concluded that the Registrant’s fitness to practise remained impaired on both the person and public components of impairment. It specifically noted the absence of any evidence of the Registrant remediating her practice.

23. The Panel imposed a Suspension Order for 12 months and noted that this timeframe ‘should give the Registrant time to show a willingness and ability to make progress towards becoming an autonomous and safe practitioner’.

24. The Panel further stated that a reviewing panel was likely to be assisted by:

•    the Registrant’s attendance at the hearing; 

•    up-to-date medical evidence as to the Registrant’s current state of health and her fitness to return to work; 

•    references and testimonials in respect of any work, whether paid or unpaid, carried out by the Registrant since 17th April 2025;

•    Evidence of any steps taken by the Registrant to improve her communication and record keeping skills; and

•    Evidence of any Continuing Professional Development undertaken.

25. The Panel also noted that the previous panel gave serious consideration to a Striking Off Order but decided that such an order would have been disproportionate. However, the previous panel also stated that ‘the Registrant should be in no doubt that this would be an option for a future reviewing panel’.

26. On behalf of the HCPC, Ms Khorassani submitted that there has been no meaningful change since the last review. She said that other than the email of 21 April 2026 there has been no engagement by the Registrant. She further said the issues in respect of competence had not been addressed and there was no evidence of insight or remediation and there was a risk of repetition. She submitted that the Registrant's fitness to practise was impaired on personal grounds. She further submitted that the Registrant's fitness to practise was also impaired on public grounds and outlined multiple breaches of the Standards of conduct, performance and ethics. Ms Khorassani informed the Panel that in the circumstances of this case the HCPC considers that a Striking-off Order was the appropriate sanction.

Decision    

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

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

29. The Panel first considered whether the Registrant’s fitness to practise is currently impaired by reason of her lack of competence, having regard to both the personal and public components of impairment.

30. The Panel noted the absence of any evidence that the Registrant has addressed the failings and issues identified by the previous review on 17 April 2025. From her email of 21 April 2026 it appears the Registrant has not been in work. The same email also stated that the Registrant has not completed any voluntary work or training. The Panel further noted that there has not been any evidence submitted in respect of insight notwithstanding that the Registrant has significant and longstanding issues in respect of competency. Similarly, there is no evidence that the Registrant has taken any steps to address the deficiencies with her knowledge and skills. Whilst the Panel accepts that the issues are remediable there is no evidence of any remediation. Accordingly, if the Registrant was found not to have impaired fitness to practise, there would be a high risk of repetition of previous competency failings and this would put service users at risk of harm. The Panel concluded that the Registrant’s fitness to practise was impaired on personal grounds.

31. The Panel had regard to the HCPC Standards of conduct, performance and ethics. The Panel concluded that the Registrant is currently in breach of the following standards:

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

6.1 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. 

32. In breaching the above standards, the Registrant has brought the profession into disrepute. By not keeping her skills and knowledge up to date she has breached a fundamental tenet of the profession. Public confidence in the profession would be undermined if no finding of impairment was made. Accordingly, the Panel concluded that the Registrant’s fitness to practise was also impaired on public grounds. 

33. With regard to sanction, the Panel took into account the HCPC’s Sanctions Policy (March 2026) and accepted the advice of the Legal Assessor.

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

35. A Caution Order would not protect the public from the Registrant’s lack of competence and was therefore not appropriate.

36. The Panel next considered a Conditions of Practice Order. Given that the Registrant has been off sick since June 2024 and she has not addressed the issues identified by previous panels, the Panel concluded that she is unlikely to comply with any conditions. In addition, given the deficiencies with her practice combined with being out of work, it was not possible to identify appropriate, proportionate and realistic conditions. The Panel therefore considered that a Conditions of Practice Order would not be appropriate in this case. 

37. The Panel considered a Suspension Order. It noted that a Suspension Order would adequately protect the public. However, as detailed above there has been no evidence provided to the Panel in respect of insight or remediation and the risk of repetition is high. The Registrant has not put any evidence before the Panel to indicate that she is, or even that she could, remediate the competency issues and address the significant concerns relating to her practice.  

38. The Panel had specific regard to paragraphs 176-181 of the Sanctions Guidance. It considered that the deficiencies in respect of the Registrant’s practice are persistent. The previous Suspension Order has not resulted in any meaningful progress in respect of the concerns and there is no evidence to indicate that any further Suspension Order would be any more likely to see the said concerns addressed.  In the circumstances, the Panel concluded a Striking-Off Order was the appropriate sanction. It was mindful that this would likely have a detrimental impact on the Registrant both personally and financially in the future, however this was outweighed by the need to protect the public, maintain confidence in the profession and maintain the standards and conduct expected of members of the profession.

ORDER: The Registrar is directed to Strike-off the Registrant from the Register on expiry of the current order.

The Order imposed today will apply from 13 May 2026 when the Suspension Order expires.

History of Hearings for Umalini Kathirgamanathan