Miss Sarah Allinson

: Speech and language therapist

: SL20967

: Review Hearing

Date and Time of hearing:10:00 29/06/2017 End: 12:00 29/06/2017

: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Voluntary Removal agreed

Allegation

During the course of your employment as a Speech and Language Therapist with The Children’s Trust between July 2009 and July 2012, you did not:

 

1. a. Establish clinical hypotheses and then plan assessments from available materials for service users, in particular for:

i. Child 1

ii. Child 4

iii. Child 12

iv. Child 14

 

b. Not proved.

 

c. Plan adequate and/or appropriate therapy goals for service users, in particular for:

i. Child 1

ii. Child 2

iii. Child 3

iv. Child 7

v. Child 10

vi. Not proved.

vii. Not proved.

 

d. Deliver therapy for service users by using and modifying a hierarchy to achieve goals, in particular:

i. Not proved.

ii. Child 3

iii. Not proved.

 

2. Did not complete accurate, timely and contemporaneous file notes on service users, in particular:

i. Child 13

ii. Child 14

 

3. Did not write comprehensive and/or accurate reports on service users, including summaries and recommendations. In particular:

i. Child 1

ii. Child 2

iii. Not proved.

iv. Child 5

v. Child 6

vi. Not proved.

vii. Not proved.

 

4. Did not meet deadlines for the provision of professional reports, in particular:

i. Child 1

ii. Child 4

iii. Child 7

 

5. Left confidential service user case notes on your desk overnight.

 

6. Did not provide adequate cover within the School for Profound Education in that you:

a. Did not carry out all designated sessions within child’s programme in particular:

i. Not proved.

b. Did not set up a communications programme as requested by the lead speech and language therapist in the school in particular:

i. Child 10

c. Carried out minimal self-directed work to develop knowledge of dysphagia in particular:

i. Not proved.

d. Not proved.

 

7. The matters described at paragraphs 1 -6 constitute a lack of competence.

 

8. By reason of your lack of competence your fitness to practise is impaired.

Finding

Preliminary matters:

Service

1. The Panel is satisfied on the basis the documentation which it has been shown, that the Registrant has been served with notice of today’s hearing in accordance with the Rules.   The Panel has seen (i) a letter dated 26 May 2017 which was sent by first class post to the Registrant at her registered address and also by e-mail on the same date;  this letter gave notice of a mandatory substantive review hearing to be heard today; (ii) a letter dated 27 June 2017 which was sent by first class post to the Registrant at her registered address, and also to her email address on the same date;  this letter gave notice of a hearing to consider a Voluntary Removal Agreement to be heard today.

Proceeding in the absence of the Registrant

2. The Panel heard an application by Ms Nadarajah for the hearing to proceed in the Registrant’s absence.   She referred the Panel to an email sent by the Registrant’s solicitor to the HCPC dated 28 June 2017 in which it is stated that the Registrant will not be attending the hearing, and that she is content for the hearing to proceed in her absence.   Ms Nadarajah submitted that this demonstrated that the Registrant has voluntarily waived her right to be present, has not sought to send anyone to represent her interests and has not sought an adjournment.   She also submitted that it was in the interests of the Registrant for this hearing to proceed in her absence.

3. The Panel has decided to proceed in the absence of the Registrant.   In reaching this decision, the Panel was mindful that it should exercise utmost care before doing so.  It took into account the matters set out in the HCPTS’s Practice Note on Proceeding in the Absence of the Registrant, and also received and accepted legal advice. 

4. The Panel is satisfied that the Registrant is not only aware of today’s proceedings but has given informed consent for it to proceed in her absence.   In these circumstances, the Panel is satisfied that the Registrant has voluntarily waived her right to be present.   The Panel noted that she has not sought an adjournment and is satisfied that an adjournment would not result in her future attendance.   The Panel also takes the view that there is a clear public interest in notified hearings being heard expeditiously and at the allotted time.  

Background:

5. Between July 2009 and July 2012, the Registrant was employed as a Speech and Language Therapist (SLT) by The Children’s Trust (the Trust).   The post had initially been advertised at a highly specialised Band 7 but the Trust decided to appoint the Registrant as an SLT on Band 5.   At the beginning of her employment, the Registrant worked in the Brain Injury Community Team (BICT) but she also worked in the Trust’s In-Patient Unit.  

6. In September 2010, the Registrant applied for a vacancy as an SLT on a higher graded Band 6 post within the In-Patient Unit.   Despite some concerns about her limited or absent past-experience of independent working and specialist experience and post-graduate training in dysphagia, the Registrant was appointed to the advertised position in December 2010.  However, the job title “Developing Specialist SLT-Band 5” was specifically created for her.   As part of her role, the Registrant was given targets to meet to gain further experience and knowledge.   Her appointment was subject to a six-month probationary period. 

7. In May 2011, the Registrant had a Personal Development Review (PDR) of her ability and performance.   This was part of the Trust’s standard practice for its employees.   At that time, the Trust took the view that the Registrant had not achieved a satisfactory PDR.   At the end of the six-month probationary period, the Registrant was placed on the Trust’s Capability Procedure.   At the same time, an Informal Stage Disciplinary Hearing took place on 6 July 2011.   The Registrant was issued with a First Written Warning for poor performance.  A Performance Improvement Plan (PIP) was set up.  However, as it was considered that the Registrant was not meeting expectations within the PIP process, a Capability Hearing took place on 29 September 2011.   The Registrant was given a Final Written Warning and she was moved onto Stage 2 of the Trust’s Capability Policy and a new PIP was set up.

8. At about the same time, the workload within the Trust reduced, including the individual caseload of the Registrant.   It was noted by the Trust that with a reduced caseload, the Registrant’s performance improved.   A Capability Review meeting took place on 9 December 2011 at which it was agreed that the Registrant had met the targets for performance set for her.  It was made clear at that meeting that the Registrant remained subject to certain action points, and that the Final Written Warning of September 2011 would remain in place.

9. After that meeting, the Trust’s caseload increased.   At the time of the Registrant’s next PDR in June 2012, there was renewed concern as to her performance.   She was made subject to a further PIP.   On 3 July 2012, the Registrant resigned from her employment with the Trust.  

10. The Trust referred its concerns to the HCPC.   At a substantive hearing which concluded on 3 July 2014, the Registrant’s fitness to practise was found to be impaired on grounds of lack of competence, and a Conditions of Practice Order was imposed for a period of 3 years.   In imposing the Order, that panel noted the substantial steps that the Registrant had taken to reflect on and remedy her past shortcomings.   The panel set out in its determination the information and evidence it had received from the Registrant’s then employers as to the clinical supervision she had been receiving.    It based its decision as to the Registrant’s fitness to practise at that time, on the basis that the Registrant was still in need of a significant level of support in her practice.   It concluded that because of the extent of her shortcomings and the time over which they had occurred, there was still a significant level of risk of harm to service users.   In imposing a Conditions of Practice Order, that panel was satisfied that the Registrant’s lack of competence was capable of being remedied.

11. This Panel has noted that since that Order was imposed in July 2014, the Registrant was only able to secure employment as an SLT for a 10-month period between January and October 2015, and has not worked as an SLT since then.   In June 2017, the HCPC received a request that the Registrant be considered for voluntary removal from the Register.    This has been considered by the HPCP and the parties have signed a Voluntary Removal Agreement.   The substantive review hearing set down for hearing today is now also a hearing to consider disposing of the case by consent on the basis of the signed Voluntary Agreement.

Decision: 

12. The Panel has decided it will first make due enquiry into the appropriateness of Voluntary Removal in this case.   If, it concludes that this is appropriate, the Panel will revoke the current Conditions of Practice Order.   If the Panel concludes that Voluntary Removal is not appropriate in this case, it will then review the Conditions of Practice Order in the usual way.

Voluntary Removal:

13. In reaching its decision, the Panel has taken account of the HCPTS’s Practice Note on “Disposal of Cases by Consent” (Voluntary Removal).   It has received and accepted legal advice.  It has reviewed the terms of the proposed Voluntary Removal Agreement.  It has had regard to the submissions of Ms Nadarajah for the HCPC and to the fact that the Registrant has signed the proposed Voluntary Removal Agreement.   

14. It has taken into account all the information put before it, including :

(i) the determination of the substantive hearing panel,

(ii) documentation evidencing the Registrant’s compliance with the conditions imposed on her practice.    This included notes of supervision sessions, notes of meetings with her mentor, certificates of attendance at training courses and the Registrant’s Continuing Professional Development activity (CPD), and a list of jobs which the Registrant has applied for during the period of the current Order, 

(iii) the Registrant’s stated wish for her name to be removed from the Register.

15. The Panel is mindful that it should only agree to revoke the existing Conditions of Practice Order if it is satisfied that voluntary removal of the Registrant’s name from the Register would secure an appropriate level of protection for SLT service users and that it would not undermine public confidence in the SLT profession or in its regulatory body.

16. The Panel has carefully considered all the material before it.  It is satisfied that the Registrant has reflected long and hard with her mentor into her lack of competence.   The Panel is also satisfied that  in so far as she was able to do so the Registrant has complied with the conditions imposed on her registration.  The Panel noted the difficulties that she has experienced in finding suitable employment as an SLT since October 2015.     It is reassured that the Registrant did not take up the offer of one SLT position where she decided that the caseload would be too big for her to cope with.  This demonstrates that she has a good level of insight into her lack of competence.  The Panel also noted that the Registrant has taken legal advice before signing the proposed Voluntary Removal Agreement.     

17. The Panel accepts that the Registrant no longer intends to practise as a SLT.   It also accepts that the Registrant is aware that if, after 5 years, she did apply for re-admittance to the Register, her application would be considered by the HCPC on the basis that she had been struck off the register as a result of the Allegation.  

18. The Panel has decided that it would be appropriate to permit the Registrant to voluntarily remove her name from the Register.  The Panel is satisfied that service users will be adequately protected as (i) any application by the Registrant for re-admittance to the Register cannot be made for 5 years from the date that her name is removed from the Register and (ii) her application will be treated, as if she had been struck off the Register on the basis of the Allegation, and will be made in light of the findings at the substantive hearing.

19.  The Panel is also satisfied that an informed member of the public would not consider that public confidence in the SLT profession would be undermined in any way by allowing the Registrant to remove her name from the Register.   The fact that she has been subject to proceedings brought by her regulator has already served to maintain public confidence in the SLT profession, and sent out a message as to the standards it expects of its practitioners.

20. In these circumstances, the Panel has decided to approve the Voluntary Removal Agreement and to revoke the Conditions of Practice order with immediate effect.

Order

The Registrar is ordered to revoke the Conditions of Practice imposed on the registration of Miss Sarah Allinson with immediate effect.

Notes

If the Registrant seeks to return to the HCPC Register at any time the application would be treated as if the registrant had been struck off as a result of that allegation

Hearing history

History of Hearings for Miss Sarah Allinson

Date Panel Hearing type Outcomes / Status
29/06/2017 Conduct and Competence Committee Review Hearing Voluntary Removal agreed
25/06/2014 Conduct and Competence Committee Final Hearing Conditions of Practice