Further Written Submission from the Health and Care Professions Council (HCPC) (HCP0013)

1. Introduction

1.1               This evidence submission provides further information for the Committee on the approach the HCPC takes to fitness to practise and the time scales it takes to deal with cases.             

2. Approach to Fitness to Practise

2.1              The purpose of our fitness to practise proceedings is to protect the public, not to punish registrants. They are not a general complaints resolution process and they are not designed to resolve disputes between registrants and service users.

2.2              Finding a registrant’s fitness to practise is “impaired” means that there are concerns about their ability to practise safely and effectively. It is not just about professional performance; it also includes acts by a registrant which may have an impact on public protection or confidence in the profession or the regulatory process.

2.3              Registrants sometimes make mistakes that are unlikely to be repeated. This may mean that the registrant’s fitness to practise is not impaired. We do not pursue every isolated or minor lapse. Our processes are designed to be non-punitive although the sanction imposed when fitness to practise is found to be impaired may be punitive in effect.

2.4              The process provides a range of opportunities for registrants to respond to the allegation that has been made against them and to assist a panel considering the case. Firstly, in determining whether there is a realistic prospect that a final hearing panel will find that a registrant’s fitness to practise is impaired, and secondly, at a final hearing, whether that is the case.

2.5              We take a case-by-case approach. This means that every case has to be judged, assessed and investigated on its merits. This is based on the general principles of fairness and proportionality and recognises that we operate a fitness to practise process which differs from any criminal justice or disciplinary process.  It is our view that where there is no information or evidence that raises concern, it would appear to be disproportionate to attempt to find information about the registrant that had not previously warranted a referral to the regulator.

2.6               Nevertheless, a registrant’s fitness to practise is likely to be impaired if there is evidence to show one or more of the following:

• serious or persistent failure to meet standards;
• reckless or deliberate acts;
• hiding mistakes or trying to block their investigation;
• sexual misconduct or indecency (including any involvement in child pornography);
• improper relationships with service users;
• failure to respect the autonomy of service users;
• violence or threatening behaviour;
• dishonest, fraud or an abuse of trust;
• exploitation of a vulnerable person;
• substance abuse or misuse;
• health problems which the registrant has not addressed , and which may affect the safety of service users; and
• other, equally serious, activities which undermine public confidence in the relevant profession.

2.7              In deciding whether a registrant’s fitness to practise is impaired we also take account of whether the registrant has:

• ignored previous warnings;
• has taken action to correct their behaviour;
• has insight; or
• has not met HCPC’s standards of conduct, performance and ethics

3. Disposal by consent

3.1              In recent years we have looked at a range of ways in which we can ensure justice whilst at the same time remaining transparent and open in the delivery of that justice. 

3.2              Our process to dispose of cases via consent is one example of this. It is a means by which the HCPC and the registrant concerned can seek to conclude a case without the need for a contested hearing. This works by putting before a Panel an order of the kind which the Panel would have been likely to make in any event.

3.3              We will only consider resolving a case by consent:

• after an Investigating Committee has found 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 allegation in full. A registrant’s insight into, and willingness to address, failings are key elements in the fitness to practise process and it would be inappropriate to dispose of a case by consent where the registrant denied liability; and
• where any remedial action proposed by the registrant, and to be embodied in the Consent Order, is consistent with the expected outcome if the case was to proceed to a final hearing

3.4              All such hearings take place in public and the consent process is not a mechanism to avoid regulatory proceedings. It is a process by which the registrant and the HCPC can propose an appropriate outcome to the case and ask the Panel, assuming that it is content with that outcome, to conclude the case on that basis. There also may be cases where it is in the public interest to hold a contested hearing.

4. Timescales

4.1               The expeditious resolution of fitness to practise cases is one of our core aims and one which is continuously pursued.

4.2              In order for a case to proceed to an investigation it has to meet our standard of acceptance for allegations. This standard provides a proportionate threshold before HCPC will deal with a case. It is often necessary to seek further information or ask for clarity and it can take time for responses to be received. We track and monitor this through our case management system and through regular meetings reviewing the progress of cases.

4.3              On receipt of all of the relevant information we have to provide the registrant with an opportunity to respond to the allegation before it is considered by the Investigating Committee Panel.

4.4              Once a case to answer determination is made, the case will be prepared for final hearing and arrangements made to fix the case. In listing a hearing, a range of logistical factors have to be taken into account – including the availability of the parties and witness availability.  We have standard case directions in place to resolve some of the common issues that can occur in advance of a hearing.

4.5              In 2012-13 the length of time taken for a matter to be considered by an Investigating Committee Panel from the standard of acceptance being met is a mean of six months and a median of four months. For those cases which were referred to a final hearing, the mean and median average from receipt of allegation to consideration by an Investigating Committee Panel was seven and five months respectively.

4.6              In 2012-13 the total length of time for a case to conclude from receipt of allegation to conclusion at final hearing was a mean average of 16 months and a median average of 14 months.  27 cases took in excess of 24 months from receipt of allegation. The mean and median length of time from the date of the Investigating Committee Panel to conclusion at final hearing was a mean average of nine months and a median average of eight months.

4.7              In 2012-13, the total length of time to close all cases from the point a case was received to case closure at different points (closure without consideration by an investigating committee panel, closure by an investigating committee panel, closure at final hearing) was a mean average of nine months and a median average of six months.

4.8              At the end of December 2013 the break-down of cases open awaiting an Investigating Committee Panel and awaiting a hearing was as follows:

January 2014