Fitness To Practise Annual Report 2020-21

Statistical summary:

Number of concerns

The total number of concerns raised in 2020-21 decreased by 45% from the previous year. This decrease was caused for the most part by the transfer of the regulation of around 90,000 social workers in England from the HCPC to Social Work England in December 2019, significantly reducing the number of registrants on our Register. The nationwide lockdowns, which restricted public interaction with healthcare professionals, are also likely to have had an impact on the number of concerns raised.

 

2019-20	2,284
2020-21	1,266

 

Source of concerns

Members of the public are the main source of concerns raised. This is followed by self-referrals, and employer referrals.

Source of concern	No. of cases	Percentage
Anonymous	22	2%
Article 22(6)[1]	3	0%
Employer	227	18%
Other	145	11%
Other registrant	76	6%
Police	14	1%
Professional Body	19	2%
Public	475	38%
Self-referral	285	23%
Total	1,266

 

Concerns by profession

The profession with the highest number of concerns raised against them in this period were paramedics, followed by practitioner psychologists and physiotherapists.

Profession	No. of cases	% of registrants subject to concerns
Arts therapist	10	0.2%
Biomedical scientist	45	0.2%
Chiropodists / Podiatrist	66	0.5%
Clinical scientist	10	0.2%
Dietitian	17	0.2%
Hearing aid dispenser	35	1.0%
Occupational therapist	123	0.3%
Operating department practitioner	111	0.8%
Orthoptist	3	0.2%
Paramedic	321	1.0%
Physiotherapist	160	0.3%
Practitioner psychologist	235	1.0%
Prosthetist / Orthotist	1	0.1%
Radiographer	97	0.3%
Speech and language therapist	32	0.2%
Total	1,266

 

Outcomes

In 2020 -2021, 427 concerns were closed as they did not meet our threshold.

341 cases were closed by an Investigating Committee Panel, as there was no case to answer. 

	No. of cases
Initial assessments (cases closed at Threshold)	427
Cases closed at ICP (NCTA)	341

Cases where an ICP decided there was a case to answer were referred to a Conduct and Competence Committee or Health Committee, depending on their nature.

 

Conduct and Competence Committee panels

Conduct and Competence Committee panels consider allegations that a registrant’s fitness to practise is impaired by reason of misconduct, lack of competence, a conviction or caution for a criminal offence, or a determination by another regulator. Some allegations contain a combination of these reasons.

Misconduct

The majority of cases heard at a final hearing relate to allegations that the registrant’s fitness to practise is impaired by reason of their misconduct. Some of these cases relate to allegations about a lack of competence or a conviction. Misconduct allegations could include:

• failure to provide adequate service user care or
• accurate assessment;
• failure to maintain accurate records;
• failure to complete adequate reports;
• dishonesty (for example, falsifying records, fraud or false claim of sick leave);
• undermining public confidence in the profession;
• breach of confidentiality through inappropriate use or misuse of patient information;
• breach of professional boundaries with colleagues, service users or service user family members;
• assault or abuse;
• bullying and harassment of colleagues;
• failure to report incidents;
• driving under the influence of alcohol;
• failure to communicate properly and effectively
• with service users and / or colleagues;
• acting outside scope of practice; and
• unsafe clinical practice.

Lack of competence

Lack of competence allegations could include:

• a failure to provide adequate service user care;
• inadequate professional knowledge; and
• poor record-keeping.

 

Health committee

Panels of the Health Committee consider allegations that registrants’ fitness to practise is impaired by reason of their physical and / or mental health. Many registrants manage a health condition effectively and work within any limitations their condition may present. However, we can take action when the health of a registrant is considered to be affecting their ability to practise safely and effectively.

Our presenting officer at a Health Committee hearing will often make an application for proceedings to be heard in private. Sensitive matters regarding registrants’ ill-health are often discussed and it may not be appropriate for that information to be discussed in a public session.

163 cases were concluded at final hearings where 109 sanctions were imposed.

Concluded outcome	No. of cases
Struck off	28
Removed by consent	15
Suspended	33
Cautioned (inc. 6 by consent)	17
Conditions of practice (inc. 2 by consent)	16
Not well founded, discontinued or no further action	54
Total	163

 

Consent process

Our consent process is a means by which we, and the registrant concerned, may seek to conclude a case without the need for a contested hearing.

In such cases, both parties consent to conclude the case by agreeing an order. The order is of a type that the panel would have been likely to make had the matter proceeded to a fully contested hearing. Both parties may also agree to enter into a

Voluntary Removal Agreement. By Voluntary Removal Agreement, we allow the registrant to remove themselves from the Register. This is on the basis that they no longer wish to practise their profession and admit the substance of the allegation that has been made against them.

Voluntary Removal Agreements are made on similar terms to those that apply when a registrant is struck off the Register. Cases can only be disposed of in this manner with the authorisation of a panel of a Practice Committee. In order to ensure that we fulfil our obligation to protect the public, we would not ask a panel to agree to resolve a case by consent unless we were satisfied that:

• public protection was being secured properly and effectively; and
• there was no detrimental effect to the wider public interest.

To ensure a panel can be satisfied on those points, we present evidence to demonstrate that the registrant understands the impact on their registration if they agree to a sanction. We will only consider resolving a case by consent:

• after an ICP finds that there is a case to answer, so that a proper assessment has been made of the nature, extent and viability of the allegation;
• where the registrant is willing to admit the substance of the allegation (a registrant’s insight into, and willingness to address failings are key elements in the FTP process and it would be inappropriate to dispose of a case by consent where the registrant denies liability); and where any remedial action agreed between the registrant and us is consistent with the expected outcome if the case were to proceed to a contested hearing.

The process of disposal by consent may also be used when existing conditions of practice orders or suspension orders are reviewed. This enables orders to be varied, replaced or revoked without the need for a contested hearing.

Voluntary removals	No. of cases
Number of applications for voluntary removal	14
Applications granted	14
Applications rejected	0

 

Appeals against decisions

Appeals	No. of cases
Upheld and outcome substituted	0
Upheld and case remitted to regulator for re-hearing	0
Settled by consent	3

 

Restoration to the register

 

A person who has been struck off our Register and wishes to be restored can apply for restoration under Article 33(1) of the Health and Social Work Professions Order 2001. A restoration application cannot be made until five years have elapsed since the striking-off order came into force.

In addition, if a restoration application is refused, a person may not make more than one application for restoration in any twelve-month period. In applying for restoration, the burden of proof is upon the applicant. This means that the applicant needs to prove that they should be restored to the Register, but we do not need to prove the contrary.

The procedure is generally similar to other FTP proceedings. However, as the applicant has the burden of proof, they will present their case first, after which our presenting officer makes submissions. If a panel grants an application for restoration, it may do so unconditionally or subject to the applicant:

• meeting our ‘return to practice’ requirements; or
• complying with a conditions of practice order imposed by the panel.

In 2020 – 21, three applications for restoration were heard. All three were restored.

Restoration to the register	No. of cases
Total restoration applications received	3
Applications accepted	3
Applications rejected	0

 

Outcomes summary

The total number of cases closed, or concluded at final hearing in 2020-21 was 35% fewer than the previous financial year. This reflects the fact that there were also 45% fewer complaints raised during this period of time, caused for the most part by the transfer of the regulation of social workers in England to Social Work England, as well as restricted public interaction with healthcare professionals, due to Covid-19 restrictions.

Proportionally, the number of cases concluded at final hearing in 2020-2021 fell compared to the last financial year because a large number of in-person FTP hearings had to be postponed due to Covid-19 restrictions. The proportion of cases closed at ICP rose in 2020-2021 compared to 2019-2020, as these meetings could be conducted remotely throughout the pandemic.

Outcome	2019-20	2020-21
Case closed pre-ICP[2]	639	457
Case closed at ICP	389	341
Case concluded at final hearing	355	163
Total	1383	961

 

Interim orders

HCPTS panels hear and determine cases. Panels may impose interim suspension or interim conditions of practice while an investigation is ongoing. These interim restrictions are to protect the public, to protect the registrants from harm to themselves, or are otherwise in the public interest.

The panels considered 94 applications for interim orders. 69 were granted and 25 were not.

Decision	No. of cases
Conditions of Practice - Interim Order	22
IO not granted	25
Suspension - Interim Order	47
Total	94

 

Average^[3] length of time to conclude cases at the ICP and final hearings

 

Conclusion	2019-20	2020-21 (months)
From receipt to ICP	16	14
From receipt to final hearing	26	32

 

[1] Article 22(6) of the Health and Social Work Professions Order 2001 is important in self-referral cases. Article 22(6) allows us to investigate a matter even where a concern has not been raised with us in the normal way. For example, when registrants self-refer, in response to a media report or where information has been provided by someone who does not want to raise a concern formally.

This is an important way we can use our legal powers to protect the public. We encourage all registrants to self-refer any issue which may affect their fitness to practise.

[2] This includes cases closed at Triage and at Threshold.

[3] Median.