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Fitness to practise report 2020

Our Fitness to practise report highlights key insights from the year, explains how we protect the public and shows how we help registrants meet our standards

The report is written for informational and educational purposes only, and covers the period between April 2019 and March 2020 inclusive.

Key facts and figures

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  • 2,284 new concerns were raised in 2019–20
  • 0.6% of registrants were subject to a concern, with only 0.06% subject to a sanction
  • The largest amount of concerns, 46%, were raised by members of the public
  • Employers raised 22% of concerns
  • 18% of concerns came via registrants self-referring
  • 22% of concluded concerns* were classified as matters concerning registrants’ professional practice
  • 20% of concerns were classified as matters not for HCPC’s further investigation and could not be classified otherwise
  • 15% of concerns were classified as matters concerning registrants’ behaviour
  • 13% were classified as matters concerning communication issues
  • 11% were classified as criminal, or conduct matters
* Concluded between February 2019 and January 2020, 12-month period and excluding social workers. The classifications summary (at the end of this report) sets out what issues are included in each category.
  • 909 concerns were assessed and closed as they did not meet our threshold test for investigations
  • 1,062 cases were concluded by the Investigating Committee Panel
  • 338 cases were concluded at final hearings
  • Cumulatively, it took us on average 12 months from receipt to conclude cases. The timescale for each case will vary, depending on complexity, seriousness or other circumstances

 

As a result of our work, we:

  • Concluded 973 public hearings;
  • Concluded 338 cases at final hearings and imposed 232 final sanctions on registrants including caution, conditions of practice, suspension, or removal from the Register;
  • Considered 121 cases at interim order hearings and imposed 98 interim sanctions on registrants including interim suspension or interim conditions of practice;
  • Reviewed 198 final orders on registration and 312 interim orders; and
  • Restored 2 registrants to the Register and rejected 2 applications for restoration.

These actions were required to protect the public, reputation of the professions, or registrants themselves.

 

Concerns raised with us

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2,284 concerns were raised

Although this is 6% fewer concerns compared to the previous year, it is worth noting that we stopped receiving concerns about social workers in December 2019. This is because the regulation of social workers transferred to Social Work England.

As in previous years, the proportion of registrants who had concerns raised about their fitness to practise remained relatively low, at 0.6%, and only 0.06% were subject to a sanction imposed at a final hearing.

46% of the concerns we received this year were raised by members of the public, compared to 47% last year. Registrants’ employers continue to be the second largest source of concerns, at 22%.

Registrants have an obligation to tell us about events that might raise a concern about their fitness to practise. This year, 430 registrants notified us of such concerns, which constituted 19% of concerns and is similar to the previous years.


Concerns raised by referrer

Referrer Number raised Percentage of total
Public 1,059 46%
Employer 508 22%
Self-referral 430 19%
A fellow professional 97 4%
Other 85 4%
Anonymous 51 2%
Professional body 37 2%
Police 17 1%
Total 2,284 100%

 

Concerns raised by profession

Profession Number of cases % of registrants subject to concerns
Arts therapists 15 0.31
Biomedical scientists 57 0.25
Chiropodists / Podiatrists 53 0.41
Clinical scientists 8 0.13
Dietitians 24 0.24
Hearing aid dispensers 33 0.99
Operating department Practitioners 134 0.93
Orthoptists 81 5.44
Occupational therapists 4 0.01
Paramedics 322 1.11
Physiotherapists 203 0.35
Practitioner psychologists 241 0.97
Prosthetists / Orthotists 3 0.28
Radiographers 96 0.27
Social workers in England* 973 0.26
Speech and language therapists 37 0.22
Total 2,284 0.60
* The regulation of social workers was transferred to Social Work England on 2 December 2019.

 

How we manage our cases

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We take a proportionate and risk-based approach when considering new concerns against our threshold policy for fitness to practise investigations.

In 2019-2020, 909 concerns were closed as they did not meet our threshold.

Investigating Committee Panel (ICP)

After the threshold is met, we will draft allegations and put them before an ICP.

Before that, we will share evidence with the registrant and ask for their observations.

1062 cases were concluded by an ICP.

488 cases were closed as there was no case to answer. 

In 574 matters there was a case to answer and they were referred for a hearing.

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.

338 cases were concluded at final hearings where 232 sanctions were imposed.

7% of cases considered at final hearings were dealt with by the Health Committee.

93% of cases considered at final hearings were dealt with by the Conduct and Competence Committee.

The sanctions of suspension and conditions of practice must be reviewed before they expire.

The registrants, for example, may want to raise difficulties with complying with conditions or new evidence may come to light. 

In 2019-20, 198 cases were concluded at review hearings.

The independent panels , who hear and determine cases, 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 121 applications for interim order. 98 were granted and 23 were not.

We have to review the interim order within the six month periods after it was first imposed and then within the period of three months from the date of the immediately preceding review, for as long as the order continues in force. In 2019-20, we reviewed 312 orders.

In 2019-20, the median time it took for a panel to consider whether an interim order was necessary was 19 weeks from receipt, and less than 3 weeks from the time we received information and we thought there was a risk to the public, registrants themselves or otherwise in the public interest.

 

Nature of allegations

We reviewed our approach to case classification and started classifying concerns by their nature in January 2019. This helped us to build up intelligence for our prevention initiatives.

Within the 12-month period (and excluding cases involving social workers), cases were classified as follows*:

Cases closed pre-ICP because they did not meet our threshold:

  • 15% - communication and information sharing;
  • 13% - registrants’ behaviour;
  • 13% - professional practice; and
  • 43% - classified as matters not for further investigation and could not be assigned to any of the areas on our classification.

 

Cases closed with a 'no case to answer' outcome by the ICP:

  • 30% - professional practice;
  • 17% - criminal matters or conduct;
  • 16% - registrants' behaviour;
  • 13% - record keeping; and
  • 12% - communication and information sharing.

 

Cases taken to a final hearing (cases with a case to answer):

  • 28% - registrants’ professional practice, mostly concerns about patient care or treatment;
  • 19% - criminal matters or conduct for example violence, motoring or financial offences; and 
  • 17% - behaviour (for example not being open and honest).
* 12 month period between February 2019 and January 2020 inclusive. In this period we classified cases at the point of their closure. In February 2020 we started classifying allegations at receipt of the case. We will present data for that period in our next annual report.



Nature of allegations broken down by when case was closed* 

Type of allegation Total closed %
Behaviour 207 15%
Communication and information sharing 180 13%
Criminal matters or conduct 149 11%
HCPC / regulatory issues 16 1%
Health 61 4%
Matters not for further investigation 273 20%
Other 1 0%
Professional boundaries 27 2%
Professional practice 299 22%
Raising concerns, complaints, safeguarding 51 4%
Record keeping 119 9%
TOTAL 1,383 100%
Type of allegation Closed pre ICP %
Behaviour 83 13%
Communication and information sharing 97 15%
Criminal matters or conduct 15 2%
HCPC / regulatory issues 6 1%
Health 20 3%
Matters not for further investigation 273 43%
Other 1 0%
Professional boundaries 10 2%
Professional practice 82 13%
Raising concerns, complaints, safeguarding 23 4%
Record keeping 29 5%
TOTAL 639 100%
Type of allegation Closed at ICP %
Behaviour 62 16%
Communication and information sharing 47 12%
Criminal matters or conduct 67 17%
HCPC / regulatory issues 4 1%
Health 17 4%
Matters not for further investigation 0 0%
Other 0 0%
Professional boundaries 9 2%
Professional practice 118 30%
Raising concerns, complaints, safeguarding 16 4%
Record keeping 49 13%
TOTAL 389 100%
Type of allegation Closed at final hearing %
Behaviour 62 17%
Communication and information sharing 36 10%
Criminal matters or conduct 67 19%
HCPC / regulatory issues 6 2%
Health 24 7%
Matters not for further investigation 0 0%
Other 0 0%
Professional boundaries 8 2%
Professional practice 99 28%
Raising concerns, complaints, safeguarding 12 3%
Record keeping 41 12%
TOTAL 355 100%

 

*This classification is for the cases closed between February 2019 and January 2020 inclusive. In this period we classified cases at the point of their closure. In February 2020 we started classifying allegations at receipt of the case. We will present data for this period in our next annual report.
 

Time to conclude a concern

We continue to ensure that cases are progressed in a timely manner. The time may differ from case to case. It may depend on various factors including ongoing criminal investigations, vulnerability or availability of parties, requests for adjournment or legal arguments.

We have initiated a Fitness to Practise Department transformation programme which includes an ongoing improvement initiatives framework to address this area.

Average length of time to conclude cases at the ICP and final hearings 

Conclusion 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20
From receipt to ICP 9 11 10 12 16 16
From receipt to final hearing 19 23 25 26 25 25

 

Hearing outcomes and sanctions

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As a result of our regulatory work, the independent Conduct and Competence Committee or Health Committee panels have considered 338 cases at final hearings.

They imposed 232 final sanctions on registration including caution, conditions of practice, suspension and strike-off. These sanctions were necessary to protect the public, reputation of the professions, or registrants themselves.

Out of the 338 cases concluded at final hearings, 31% (106 cases) of those that went for a final hearing did not result in a sanction. This is similar to the previous year.

As we mentioned in our last report, we continue to monitor these cases. We review our approach, provide stakeholder guidance and encourage registrant engagement throughout the fitness to practise process to minimise the impact of public hearing on the parties involved.

 

Breakdown of hearing outcomes 

Outcome Total Proportion
Struck off (inc. 12 removals by consent) 92 27%
Suspended 65 19%
Cautioned (inc. 5 by consent) 49 15%
Conditions of practice (inc. 1 by consent) 26 8%
Not well founded, discontinued or no further action 106 31%
Total 338 100%

 

Hearing outcomes by complainant

Source Sanction No sanction Total
Article 22(6) / anonymous 6 2 8
Employer 131 39 170
Other 12 7 19
Other registrant 5 3 8
Police 5 3 8
Professional body 2 0 2
Public 13 14 27
Self-referral 58 38 96
TOTAL 232 106 338

 

Hearing outcomes by each committee

Almost 7% of cases (23) that went for a hearing were considered by a Health Committee.

This is an increase from 3% (11 cases) in the previous year.

Outcome Conduct and Competence Health Investigating Total
Caution 44 0 0 44
Conditions of practice 19 6 0 25
No further action 1 0 1 2
Not well founded / discontinued 101 3 0 104
Removed by consent 5 7 0 12
Caution - consent 5 0 0 5
Conditions of practice - consent 0 1 0 1
Struck off 79 1 0 80
Suspension 60 5 0 65
Well-founded 0 0 0 0
Total 314 23 1 338

 

Hearing outcomes by representation at final hearing

Similar to last year, in 55% of all cases concluded at final hearing, the registrants were either represented by a representative or represented themselves.

Of the cases which did not result in a sanction, 86% were for matters in which there was representation at the hearing.

We encourage registrants to seek representation early in the process.

Outcome Self-represented Represented Not represented Total
Caution 9 26 8 44
Conditions 6 11 8 25
No further action 0 2 0 2
Well founded 0 0 0 0
Not well founded / discontinued 30 59 15 104
Register entry amended – removed 0 0 0 0
Struck off 11 7 62 80
Suspended 8 15 42 65
Consent – removed 0 0 12 12
Consent – caution 2 1 3 5
Consent – suspension 0 0 0 0
Consent – conditions 0 0 1 1
Total 66 121 151 338

 

Appeals against decisions

The Professional Standards Authority, which oversees regulatory bodies’ work, can challenge and refer our final decision to the High Court (or in Scotland, the Court of Session) if it considers that the decision is not sufficient for public protection.

In 2019-20, the PSA challenged us on nine cases. At the time of writing, three cases were settled by consent, one was dismissed by the High Court and five cases are still under consideration.

A registrant may also appeal against the panel’s decisions if they think it is wrong or unfair. In 2019-20 four registrants challenged our decisions and sought to appeal. One appeal was dismissed, one appeal was settled by consent and two, which were about social workers, were transferred to the new regulator, Social Work England.

Classifications summary

  • Concerns about a registrant’s behaviour, (the way in which they act and conduct themselves). We expect registrants to make sure that their conduct justifies the public’s trust and confidence in them and their profession.

  • Concerns about the use of inappropriate or offensive language and about professional communication skills.

  • Concerns about criminal convictions, cautions and conduct that would or could be unlawful if proved to be true.

  • Concerns about a registrant’s compliance with HCPC registration requirements and with our fitness to practise processes.

  • Concerns about a registrant’s health.

  • Concerns that have been closed as they fell under the Threshold Policy types of cases suitable for closure, unless an exception applies.

  • Concerns where it is alleged that a registrant has breached professional boundaries with a service user or carer.

  • Concerns about a registrant’s professional practice. It is particularly concerned with registrants’ proficiency, care and treatment decisions and team working skills.

  • Concerns where it is alleged that a registrant has failed to appropriately raise and handle concerns and manage risk to service users.

  • Concerns around a registrant’s record keeping.

Page updated on: 23/07/2021
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