Your fitness to practise as a Practitioner Psychologist is impaired by reason of your health.
The HCPC sent the Notice of Hearing dated 21 October 2013 to the Registrant‟s address as it appears on the Register.
Ms Alicea invited the Panel to proceed in the Registrant‟s absence. She submitted that the Registrant was aware of the Hearing and had chosen not to attend.
Ms Alicea referred the Panel to the Registrant‟s email, which was sent to the HCPC on 9 January 2014 at 16.54hrs and which informed the HCPC that he was not intending to attend today‟s hearing. In that email, he stated as follows:
„…. Although you mentioned it is possible to request a postponement, my feeling is that my attached submission adds to the further information of which I would like the panel to be aware, and it seems in everybody’s interests to continue without delay if possible…..’
This email also enclosed additional written representations ("Further Response").
The Legal Assessor advised the Panel that under rule 11 of The Health And Care Professions Council (Health Committee) (Procedure) Rules 2003 (“the Rules”) it had a discretion as to whether it should proceed in the Registrant's absence but that such discretion should be exercised with the utmost care and caution, having regard to all relevant circumstances.
The Panel was satisfied that the Registrant had been served with the Notice of Hearing in accordance with the Rules. In those circumstances it considered that all reasonable steps had been taken to serve the Registrant with the Notice of Hearing.
The Panel noted that in exercising its discretion it had to conduct a balancing exercise having regard to all the circumstances. In the Panel's view, it was relevant that the Registrant was aware of today's hearing, had decided not to attend and had not requested an adjournment. In the circumstances the Panel considered that the Registrant had chosen to waive his rights to attend today's hearing. It also considered that there was no reason to believe that the Registrant would attend any adjourned hearing. The Panel was satisfied that it was in the public interest that these matters be concluded without delay. Further it took into account the fact that the Registrant had provided written representations. In those circumstances it decided that it was appropriate to proceed in the Registrant's absence.
Ms Alicea then invited the Panel to hold the hearing in private in accordance with its powers under rule 10(1) (a) of the Rules. The Panel noted that this was a health case and that the HCPC's Practice Note “Conducting Hearings in Private” contemplated hearing cases involving health allegations in private. The Panel considered that it was necessary to hold this hearing in private so as to protect the Registrant's private life and accordingly it decided that the current proceedings should be held in private.
The Registrant was employed by Cambridgeshire and Peterborough NHS Foundation Trust ("the Trust") as a Psychological Therapist. In 2012, the Trust investigated concerns relating to the Registrant's record keeping. These concerns were referred to the HCPC.
The Registrant admitted that he had failed to keep accurate and timely records for a two-year period. The Investigating Committee noted that these problems were ongoing at the time of consideration of the allegations and therefore it referred the matter to the Health Committee.
Miss Alicea opened and summarised the HCPC;s case.
The Panel heard evidence from the HCPC's witness, Dr Timothy Garvey MBChB FRCPsych LLB. In addition to relying upon Dr Garvey's oral evidence, the HCPC also relied upon the documents contained in its Bundle.
The Panel considered a written response ("Response") that the Registrant had provided to the Investigating Committee and a further response ("Further Response").
The Panel heard Ms Alicea's closing submissions and took advice from the Legal Assessor.
Decision on Facts/Grounds:
The Panel reminded itself that the burden of proving all disputed facts remained on the HCPC, that the Registrant did not have to prove anything and that the relevant fact could only be found to be proven if the Panel was satisfied on a balance of probabilities.
Decision on Impairment:
The Panel took into account, in particular, Dr Garvey's oral and written evidence.
The issue to be determined was whether the Registrant's fitness to practice was impaired as of today's date by reason of his health.
In reaching its decision the Panel took account of the guidance in the HCPC Practice Note "Finding that Fitness to Practise is Impaired".
In considering the issue of impairment, the Panel took into account the fact that the purpose of these procedures was not to punish the Registrant but to protect the public against the acts and omissions of those who are not fit to practice.
In the Panel's judgement, these proceedings had come about as a result of the Registrant's organisational difficulties, specifically his inability properly to manage paper
work and workload. Such deficiencies created a practical risk to patient-safety from which the public needed to be protected. As long as the Registrant was able to practise on an unrestricted basis, there was a risk to patient safety. The Panel accordingly found that the Registrant was impaired as of today's date.
In the circumstances the HCPC's case was well-founded.
Decision on Sanction:
The Panel considered the range of options available and took into account the HCPC‟s Indicative Sanctions Policy (“ISP”). The Panel had a responsibility for the protection of the public, for the maintenance of the reputation of the profession and public confidence in the regulatory process. It considered the various options in ascending order. It recognised that any sanction had to be proportionate.
In considering what sanction if any to impose, the Panel took account of the submissions made by Ms Alicea and the Registrant's representations in the Response and Further Response.
In considering the appropriate sanction in this matter the Panel had regard to its earlier findings.
The Panel first considered whether to take no further action. It was of the view that there would be risks to patients if no further action was taken.
The Panel then considered whether mediation was appropriate. The Panel noted the guidance at paragraph 17 of the ISP which provides that mediation is only appropriate where the Panel was satisfied that no further action was required. Given its view that there would be risks to patient safety if no further action was taken, the Panel considered that mediation was inappropriate.
The Panel then went onto to consider whether a caution was appropriate. The Panel regarded a caution as being insufficient to address the risks to patient safety that it had identified. In those circumstances the Panel considered that a caution was inappropriate.
The Panel proceeded to consider a conditions of practice order. It noted the guidance at paragraph 23 ISP that such conditions had to be appropriate, realistic and verifiable. The Panel noted that in the Further Response the Registrant expressed willingness to comply with any recommendations of the HCPC.
In assessing proportionality the Panel had regard to the more serious sanction of suspension but decided that this was not appropriate as the risks to patients could be adequately mitigated by conditions of practice.
Accordingly the Panel decided that conditions were appropriate. The Panel were keen to impose conditions for as short a period as possible. However it noted Dr Garvey‟s
recommendations that there should be a health review after 12 months. To enable the results of that review and other consequential information to be collated, considered and made available to any Panel reviewing these conditions, the Panel was of the view that the relevant period should be not less than 18 months. The Panel therefore decided that these conditions should be for a period of 18 months.
In formulating the appropriate Conditions, the Panel had regard to the following recommendations of Dr Garvey that:
the Registrant should obtain a mentor outside of the Trust;
he should receive multi-source feedback;
Dr Garvey recognised that turning any of the above recommendations into conditions might be unworkable, inappropriate or unrealistic, particularly having regard to funding problems. Accordingly the Panel decided not to make the matters set out above into additional conditions.
Nonetheless the Panel anticipated that any future Panel conducting a review of these conditions might be assisted with the following:
Details of any mentoring received from a mentor outside of the Trust.
Details of any multi-source feedback received.
A statement from the Registrant's workplace supervisor or line manager explaining his progress to date, including his ability to carry out his duties, details of additional support provided and of reasonable adjustments being made.
The Panel decided the appropriate conditions were in the form set out below. The conditions would be reviewed before the expiry of the operational period.
The Registrar is directed to annotate the Register to show that, for a period of 18 months from the date that this Order comes into effect (“the Operative Date”), you, William Bratby, must comply with the following conditions of practice:
1. You must place yourself and remain under the supervision of workplace supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within one month of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations and you must provide the Review Hearing with a record of the dates and content of such supervision sessions, which document has been signed-off by your supervisor.
2. You must remain under the care of a general practitioner and of an occupational health specialist and inform them that you are subject to these conditions.
3. You must inform your general practitioner and occupational health specialist about these conditions of practice and authorise those persons to provide the HCPC with information about your health and any treatment you are receiving.
4. You must keep your professional commitments under review and limit your professional practice in accordance with the advice of your general practitioner and occupational health specialist.
5. You must cease practising immediately if you are advised to do so by your general practitioner and/or occupational health specialist.
6. You must promptly inform the HCPC if you cease to be under the care of your occupational health specialist or if you cease to be employed by your current employer or take up any other or further employment.
7. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
8. You must inform the following parties that your registration is subject to these conditions:
A. any organisation or person employing or contracting with you to undertake professional work;
B. any agency you are registered with or apply to be registered with (at the time of application); and
C. any prospective employer (at the time of your application).
9. You will be responsible for meeting any and all costs associated with complying with these conditions.
10. Any condition requiring you to provide any information to the HCPC is to be met by you sending the information to the offices of the HCPC, marked for the attention of the Director of Fitness to Practise.
The Registrant has a right of appeal. An interim conditions of practise was imposed to cover the appeal period.
History of Hearings for William Bratby
|Date||Panel||Hearing type||Outcomes / Status|
|05/12/2017||Health Committee||Review Hearing||Conditions of Practice|
|09/06/2017||Conduct and Competence Committee||Review Hearing||Suspended|
|07/06/2016||Health Committee||Review Hearing||Suspended|
|10/03/2016||Health Committee||Review Hearing||Suspended|
|07/07/2015||Health Committee||Review Hearing||Suspended|
|10/01/2014||Health Committee||Final Hearing||Conditions of Practice|