Category: Values & behaviours

Data storage, information governance and ethics

Last updated 20/04/23

When collecting data from human participants you need to ensure that the data you collect are handled and stored securely and in accordance with legislative frameworks governing data protection, organisational information governance requirements, and research ethics and governance. The procedure outlined below has been developed with these frameworks in mind, and is designed to provide a clear, consistent approach that can be used for all trainee data (unless there are particular reasons why your data require a different approach).

What constitutes data?

The data you need to think about storing includes:

  • Clinical recordings made on placement
  • Research data e.g. interview recordings, questionnaires, transcripts, coded/analysed data
  • Personal information collected during a study i.e. consent forms, expression of interest forms, email addresses

These data may be in paper form, or electronic (or both), so you need to think about storage of both formats. You also need to distinguish between how you will store data whilst the study is taking place and how it will be stored after the study has finished.

Clinical recordings

As the information governance of trusts can differ, methods of data collection, transfer, and storage may vary from placement to placement. Trainees should check with their supervisor regarding local policy when they first arrive on placement and contact the relevant assignment co-ordinator in the event of any issues. Clinical recordings should be stored on secured university file stores. Portable storage media (such as SD card, encrypted USB) should be used for data transportation ONLY and considered insecure with appropriate care taken to ensure data security. Details on the management of recordings can also be found in the guidance for specific assignments.

Storing data during a research study

Whilst the study is taking place you (the trainee) will be responsible for the data. You need to explain how you will store all data in a way that keeps it secure e.g.  electronic data in password protected file space on the University server, and/or on encrypted electronic devices (see below).

As chief investigator for the study, the thesis supervisor is the named data custodian on the ethics application and must therefore be able to access the data throughout your study. This process needs to be described in your participant facing documents so that participants know how data will be managed. We advise that you store all of your data electronically. This can be achieved for all participant facing documents by using university approved digital platforms, such as Qualtrics, to share your information sheet(s) and collect completed assent and consent forms, and demographic questionnaires. If you do use paper documents, e.g. consent forms, these need to be scanned to create a digital copy and the hard copy should then be destroyed. At the outset of the study, you will need to create a OneDrive folder for the storage of the data and share this with your thesis supervisor. You should encrypt all your data to ensure that it is stored securely. You will need to share the password for the documents with your thesis supervisor so that they are able to access these.

We recommend that data containing personal details that would lead to the identification of participants (e.g. participants’ email addresses, expression of interest forms BUT NOT consent forms) should be deleted/destroyed as soon as possible. If people provide you with their contact details in order to be contacted about taking part in your study, these should be retained only until they have participated in the study, or until they have informed you that they do not wish to take part. However, if a participant says they would like to receive a summary of the research at the end of the study, it would be appropriate to retain their contact details until this summary has been sent out. Once the study is completed, contact details should be deleted and you should confirm in writing (by email) that this action has been completed with your supervisor.

We advise that, as far as possible, data are stored electronically in your personal file space on the University server, rather than on laptops, PCs or other devices. If you do store data on any devices other than the server, it must be encrypted. The server is secure, so any files stored there do not need to be encrypted. However, where you are storing data containing sensitive material or identifiable personal information, individual files should also be password-protected as an additional security measure.

Encryption

If identifiable data are stored on a portable device, e.g. a laptop or USB drive, the University advises that encryption should be used. More information on how to do this is available from the ISS page on encryption. If it is not possible to encrypt the data at a particular stage (such as while on a video camera’s storage), there needs to be confirmation that any identifiable data will be transferred and then deleted from the device as soon as possible. If you are using digital recording devices for research, the encryption capabilities of the devices or a process to mitigate a lack of such should be mentioned in any ethics application.

Long-term storage of research data

You also need to explain what will happen after the study has been completed i.e. what data will be stored, where they will be stored and who will be responsible for them. Long-term data will be stored by the DClinPsy admin team and can be shared with your thesis supervisor on request. If your supervisor also wishes to store the data after the study ends, you will need to discuss this with them before and indicate this on your ethics application, participant information sheet and consent forms. In the past, most data have been stored in paper form. For practical and safety reasons, we advise trainees to keep data for storage after the end of the study in electronic form, unless there is a particular reason for keeping paper documents. The data that should be retained for storage includes the consent forms, all raw data (e.g. interview transcripts and completed questionnaires) and any coded data produced during analysis.

Once the final version of your thesis has been submitted, you will need to share your research data with the Research Coordinator for long-term storage. We would recommend that you do so by sharing the OneDrive folder you use to store the data in during the study. The data will then be saved on a password protected file space on the server. You will also need to confirm the password that has been used to encrypt the documents and the period of time that the data needs to be stored for. On your ethics form, you will need to state that your data will be transferred electronically using a secure method that is supported by the University.

Applying for ethical approval

To gain ethical approval for your project, you will need to develop an application on REAMS. REAMS is the Research Ethics Application Management System for Lancaster University. Once completed by you and signed off by your supervisor, your REAMS application will be reviewed by the Faculty Research Ethics Committee. The system can be accessed remotely via the web. You do not have to be on site or connected to the Lancaster University VPN. We recommend using a desktop PC, laptop or tablet for the best user experience. The REAMS form will adapt as you progress so that you are provided with questions relevant to your study. You can share your REAMS application with your supervisor through the platform. You should expect a REAMS review to take between 4 and 10 weeks, depending upon the level of approval you need and REC availability. Make sure the detail you provide is as clear and accurate as possible to help the committee fully consider your plans, and proof read all participant facing documents extremely carefully prior to submission. For questions regarding sponsorship please discuss these with your supervisor in the first instance. If you need to contact the sponsorship office directly their email address is sponsorship@lancaster.ac.uk.

If you think you may need ethical approval from the Health Research Authority for a study conducted within the NHS and/or social care, complete the decision tool checklist and discuss your plans with your supervisor. HRA applications are submitted through IRAS. Your approved application will then need to be processed through REAMS. You should expect a HRA ethics review to take between 8 and 16 weeks, depending upon the level of approval you need and REC meeting availability. We recommend you attend the REC review meeting to address the panel’s queries or questions, either in person or via a digital platform.


Faculty Ethics Committee
REAMS
How to submit an application in REAMS
IRAS website
Health Research Authority
NHS tutorial video
NHS decision tool
Qualtrics
ISS page on encryption

DClinPsy policy on use of mobile devices whilst driving

Using mobile phones in any capacity whilst driving leads to dramatically increased number of driver errors, andresults in a four-fold increase in the likelihood of being involved in a road traffic accident (e.g. Violanti & Marshall, 1996). The Royal Society for the Prevention of Accidents (ROSPA – 2004)  assessed the risk of using  mobile phones whilst driving and concluded that using hands free technology impaired  driving performance and that “the risk of being involved in a collision was four times higher when using a…hands-free phone than when not using one”. A more recent review of the research also suggests that a driver’s performance whilst using a mobile phone with hands-free technology is rarely any better than when holding the device (Lipovac, Ðeric, Tešic, Andric & Maric, 2017). The evidence indicates that use of a mobile phone whilst driving is more dangerous than holding a conversation with someone who is present in the car (e.g. Ishigami & Klein, 2009).

Lancaster University policy states that staff must not use hand-held mobile phones and similar devices whilst driving, including whilst in a stationary vehicle with the engine running. In line with the research evidence this DClinPsy policy goes further, and directs all staff and trainees during their working day not to either initiating or respond to calls on hand-held devices whilst driving even if a hands-free function is available, except in exceptional circumstances.

Furthermore, staff and trainees should not participate in phone conversations with another party who is driving, even if hands-free technology is in use. If when making or receiving a mobile phone call a trainee or staff member is informed or suspects the other party may be driving, then they should clarify this and immediately suspend any call which would breach this policy until the other party is no longer driving.

Ishigami, Y., Klein, R. (2009). Is a hands-free phone safer than a handheld phone?, Journal of safety research 40 (2), 157-164, ISSN 0022-4375.

Krsto Lipovac, Miroslav Đerić, Milan Tešić, Zoran Andrić, Bojan Marić (2017). Mobile phone use while driving-literary review. Transportation Research Part F: Traffic Psychology and Behaviour (47), 132-142.

Royal Society for the Prevention of Accidents (2004). The Risk of Using a Mobile Phone While Driving. Birmingham: ROSPA Retrieved from www.rospa.com/rospaweb/docs/advice-services/road-safety/drivers/mobile-phone-report.pdf

Violanti, J., Marshall, J. (1996). Cellular phones and traffic accidents: an epidemiological approach. Accident, analysis & prevention 28 (2), 265-70.

Other useful references  from the charity ‘Brake

Asbridge M1, Brubacher JR, Chan H., Cell phone use and traffic crash risk: a culpability analysis, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada

Briggs et al. (2016) ‘Imagery-inducing distraction leads to cognitive tunnelling and deteriorated driving performance’, Transportation Research Part F, 38: 106-117.

Gaspar, J. et al (2014), Providing views of the driving scene to driver conversation partners mitigates cell-phone-related distraction

McEvoy, P. et al (2005), Role of mobile phones in motor vehicle crashes resulting in hospital attendance: a case-crossover study, University of Western Australia

Strayer, D. et al (2015), Measuring cognitive distraction in the automobile III, University of Utah, for AAA Foundation for traffic safety, 2015

TRL (2008) The effect of text messaging on driver behaviour: a simulator study

Plagiarism

The term ‘plagiarism’ relates to the ‘unacknowledged use of someone else’s work, usually in coursework, and passing it off as if it were his/her own’ (Dealing with plagiarism by students; an institutional framework; p.3). It includes collusion, commission, duplication of the same work for more than one assessment, inappropriate acknowledgement of text from another source and submission of another student’s work (regardless of that student’s consent). Fabrication of results relates to the presentation of data or results which have not actually been collected.

This document has been produced to dovetail with the university’s existing framework.

Background

Cases of plagiarism by trainees are rare, but given the programme’s status as a postgraduate professional doctorate, plagiarism has implications  in terms of fitness to practise. It is also important that inadvertent plagiarism can occur through a lack of knowledge of appropriate referencing devices.

Teaching

E-learning on what constitutes plagiarism (and why it is important not to engage in it knowingly or accidentally) is included in the induction to the programme. If trainees at any stage in their training need advice on whether text which they are producing constitutes plagiarism or not, they can discuss this informally with a member of staff. Trainees are also encouraged to use the university’s resources on avoiding plagiarism. The programme is committed to providing every opportunity for uncertainties and ambiguities to be clarified before the formal assessment stage. Consequently, this does mean that, should plagiarism be detected in a trainee’s work, lack of knowledge or uncertainty about whether this constituted plagiarism will not be considered an adequate or mitigating justification.

The university makes use of a number of practices  to detect plagiarism:

  1. Turnitin plagiarism detection software is routinely used to check all written submissions before they are sent to markers. This software checks both against published work and past coursework submissions so that any reliance on work submitted by previous trainees can be detected. This includes trainees or students on other programmes nationally.
  2. Guidance on plagiarism is sent to all markers of assessed work. This includes advice on what to do if plagiarism is suspected. It is the markers of assessed work who have the primary responsibility to detect plagiarism;
  3. Plagiarism is discussed at marker training workshops;
  4. Suspected plagiarised texts will also be checked using other databases such as Google Scholar and, if necessary, hand searching through relevant articles.

Where there are concerns around falsification of data, trainees must be willing to provide evidence of appropriate data collection.

Investigation process and sanctions

Where plagiarism is believed to be present in any piece of work authored by a trainee then a concern will be raised regarding this behaviour. The result of the concern meeting may be a referral to the the Division of Health Research’s Academic Officer for scrutiny. Should this happen, the Academic Officer will call a meeting with the trainee to discuss the alleged plagiarism. The trainee will be informed that a representative from either the LU students’ union or a colleague is welcome to attend this. The Academic Officer will then decide whether plagiarism has occurred. If it has, then a letter attesting to this will go to the registry and will be attached to the trainee’s file. The trainee will then be asked to respond to this letter to indicate how they will work to ensure that future work does not contain plagiarism. This letter will also be kept on file.  The Academic Officer may also recommend to the programme that a further concern or Fitness to Practise procedure be considered with respect to the trainee as a result of the plagiarism.

Guidelines for trainee professional behaviour

Background

Trainee clinical psychologists work in a variety of different contexts and are subject to many, sometimes conflicting, demands in terms of their roles and responsibilities. It is acknowledged that the role of the ‘developing professional’ on placement both in the NHS and elsewhere can jar with trainees’ expectations of holding a student-type identity within the university. The purpose of the document is to clarify expectations. It is not meant to serve as a commentary on trainees’ current behaviour. However, if an individual repeatedly acts in an unprofessional manner this will be recorded and the appropriate measures taken (see monitoring section below). As a general standard, it is important to acknowledge that the training programme functions best when all individuals, both staff and trainees, adopt a cooperative and respectful approach.

It is also important for trainees to note that as employees of Lancashire and South Cumbria Foundation NHS Trust, they are subject to the levels of professional behaviour outlined in this Trust’s policy documents. Ultimately, trainees must consider themselves as employed to train and behave as if they were within an NHS context regardless of their physical location.

Behaviour at University

  • The aim of our carefully thought out teaching programmes is to help you gain your core competencies and develop into qualified practitioners. To help achieve this, your attendance at all teaching sessions is expected in the same way as attendance at work would be required. Unauthorised absences are always followed up and poor time keeping will be acted upon. If you need to take annual leave, please arrange this with the administration office team in advance. A record of this will be kept and a request may be refused if it is recognised that significant levels of teaching are being missed. Obviously, some teaching sessions will be missed due to illness or exceptional circumstances but frequent one-day illnesses on teaching days will be noted (please see the absence from work policy).
  • If you are aware there will be a need to leave teaching early on a particular day you must make a request to discuss this with your clinical tutor or the Clinical Director in advance. This leave will need to be authorised by the Clinical Director. There are legitimate reasons for needing to leave early such as medical appointments and attending interviews. If you suddenly become aware you will need to leave teaching unexpectedly you need to try and discuss this in person with your clinical tutor or the Clinical Director. If no one is available you must follow the absence procedure and report that you have had to leave work unexpectedly. It is not permitted to leave teaching early without seeking authorisation. Authorisation cannot be given by individuals facilitating the teaching session. Where teaching is being delivered remotely, i.e. via Microsoft Teams or equivalent and trainees are having to contend with conflicting demands, such as carer responsibilities, this should be discussed with your clinical tutor and appropriate adjustments can be made.
  • Teachers work hard to prepare and deliver the curriculum. Please respect this and engage in the session. Your feedback regarding teaching is sought in a number of ways and we are always attempting to improve the quality and coherence of the teaching programmes. If you are unhappy about components of a session, this can be acted upon at a later date; please do not express your dissatisfaction through disengagement. Question asking, participation in exercises, comments and debate, all make for a richer learning experience for those involved. Some examples of not being engaged are being late, being otherwise engaged and remaining silent/not contributing to the chat function during virtual sessions. This list is not exhaustive; please monitor your own behaviour to make sure it communicates your engagement to the teacher(s). As stated above, where teaching is being delivered remotely, i.e. via Microsoft Teams or equivalent and trainees are having to contend with conflicting demands, such as carer responsibilities, this should be discussed with your clinical tutor and appropriate adjustments can be made. However, there will still be an expectation of ongoing engagement with teaching sessions when in attendance.
  • It is the trainee’s responsibility to check the teaching timetable when it is published to identify any days which may be problematic with regards to caring responsibilities. If any teaching days are identified as likely to be problematic–trainees are asked to raise and discuss with their clinical tutors as soon as possible and in advance of the day(s) as to how to best manage them. Options available are as follows:
    • Taking annual leave – this can be booked in hours rather than full days
    • Making a request to leave teaching early for a proportionate and reasonable amount of time (for example leaving teaching in time to meet the usual nursery pick up if on a 7.5 hour placement day). This needs to be explicitly agreed in advance with the clinical tutor
    • Where teaching is being delivered remotely, i.e. via Microsoft Teams or equivalent and trainees are having to contend with conflicting demands, such as carer responsibilities, this should be discussed with your clinical tutor and appropriate adjustments can be made.
  • It is important that any request is made in advance and explicitly agreed before the teaching day. The trainee is responsible for organising any agreements. If a trainee is absent without an agreement being in place then the trainee could be considered to be in breach of their contract as technically they are working for less hours than they are being paid for.
  • If a trainee needs to leave teaching (or placement) early because of an urgent need (e.g. child becomes ill) then trainees can request carers leave at short notice. This needs to be made via the absence phone.
  • Laptops, mobile phones and other devices must only be used for the purposes of the learning experience, for example accessing PowerPoint slides and note taking. Any use of electronic devices not related to the learning experience could lead to a concern form being submitted.
  • Each individual begins the course with different levels of experience and confidence. Everybody has something unique to offer their colleagues and this should be valued and respected. Listening to each other’s thoughts, questions and comments is important and mostly beneficial.
  • There may be some days when you are expected to be somewhere other than Health Innovation One for teaching. The teaching timetables, available on Moodle, detail where you should be and when. You will have electronic access to the annual plan via Outlook. It is your responsibility to check the timetables and get all the relevant dates in your diary. If you are not where you are supposed to be, it will be noted and you will be asked to provide an explanation. You will have to take unauthorised absence as annual leave.
  • After consultation with trainees and staff the following guidance for the use of cameras during remote teaching have been agreed. Trainees should have their cameras on for small group discussion, larger group feedback and certain exercises when requested by the teacher. Cameras can be turned off (if preferred) for PowerPoint and other types of presentations. If trainees are having technological issues that is fine, just let the teacher(s) and your cohort know via the chat. We really encourage contributions in all our teaching sessions. We are happy if that comes in the form of a verbal contribution but also happy for people to use the chat function. We recognise how difficult it can be to communicate on Teams and want to facilitate ways that people can contribute in a way that they are comfortable with.

Behaviour on placement

Generally, trainees are expected to adhere to the HCPC’s guidance on conduct and ethics for trainees, the BPS Code of Ethics and Conduct  (2018), the BPS Code of Human Research Ethics (2021), and also to bear in mind that the needs of clients are paramount at all times. Trainees are encouraged to familiarise themselves with all these documents before going on placement; however, it is imperative that trainees read the HCPC’s guidance thoroughly.

  • Clinical tutors monitor trainees’ progress and the experiences provided by the placement through mid-placement visits. It is important to note that the trainee’s professional behaviour and attitude relating to the above issues are reviewed and discussed, as well as their clinical competencies.
  • The Placement Contract (drawn up between trainee and supervisor) maps onto the core competencies in the Supervisor’s Assessment of Trainee (SAT) form. Supervisors complete the SAT form prior to placement visits and this forms the basis of discussions in this meeting. The form is then updated and completed, and submitted long with a log of placement experience and the placement audit form (PAF) as a formal evaluation of the trainee’s performance near the end of the placement. Again, personal and professional skills are among the ‘core competencies’ being evaluated.
  • Trainees are accountable to their clinical supervisor whilst on placement. Consequently, trainees must keep their supervisor informed (and the course via the absence phone) if they are off sick. Please refer to the guidance on sick leave procedures and reporting absences.
  • It is the trainees’ responsibility to inform their supervisor of any teaching that falls on a placement day. Supervisors must be informed promptly, i.e. as soon as the trainee is informed of the teaching dates or any changes to teaching dates. If a problem arises through a change in teaching date, this needs to be brought to the attention of both placement supervisor and the trainee’s clinical tutor. Trainees should inform supervisors at the start of training of any teaching which is scheduled to fall on a day usually reserved for placement activity.
  • Adjustments to hours on placement: requests to work outside of the typical 9-5 working pattern can usually be made (e.g. working 8-4) but they still need to cover the hours the trainee is contracted to do. They also need to fit with times when the service is open and be in negotiation with the placement supervisor and clinical tutor. Where all, or the majority, of a trainee’s placement activity is being undertaken remotely (i.e. at home), then flexible working patterns must still be negotiated with the placement supervisor and the clinical tutor.
  • The course staff do recognise the competing demands of the programme and the importance of supporting trainees’ personal and professional development. There are many different ways in which trainees can gain support during the course. However, it is the trainees’ responsibility to access and take up this support and to let somebody know if they are experiencing difficulties.
  • Given that the needs of clients are paramount at all times, if the trainee experiences any difficulties on placement, s/he should, if possible, approach their supervisor in the first instance or their individual clinical tutor for advice and support.

Contact with all staff involved in the provision of training

  • The overarching aim of the programme is to help trainees develop during training so that they meet the HCPC’s standards of proficiency. The role of staff is to help make this happen. Much is invested in supporting trainees through the many demands of the programme. This works best when all interactions are professional, respectful and courteous.
  • If you decide to contact a member of staff by e-mail, s/he will normally respond as soon as they are able. Some staff members work full time on the programme and will often be able to respond promptly. Other staff members have other professional commitments and do not have daily access to their e-mails. Please practise patience and direct any truly urgent queries to an appropriate member of staff; telephone contact, rather than email contact, may be more appropriate.
  • If you receive an e-mail from any member of staff that requires a response, it is expected that you respond promptly. Much important information is communicated this way and those trainees who do not respond put extra stress on programme systems. Every trainee has a Lancaster university e-mail account that can be accessed easily both whilst on campus and via the internet. The programme also maintains a Moodle e-learning web resource which trainees are expected to access regularly. Any trainees who consistently fail to respond to e-mails will be considered to be acting unprofessionally.
  • Staff do try to be as available and friendly as possible. Often, impromptu meetings are possible and staff will try to help trainees with any queries/difficulties. However, staff are not always available for many reasons and, where possible, trainees should try and arrange an appointment with the appropriate member of staff in advance.
  • The administration team are extremely busy and this needs to be respected. They are consistently helpful and friendly but this should not be abused – for example they are not able to provide you with administrative support for tasks you can complete yourself. If you have a query, make sure it is something that you really cannot find out yourself before asking them.
  • Please make sure you cannot find the answer to a query yourself before asking a member of staff. No member of the research team has memorised the APA guidelines. They have to look things up as well!

Monitoring

These guidelines exist to aid the smooth running of the programme and help all trainees to progress steadily. We hope everyone involved with the course is committed to promoting a culture of good communication, respect and courtesy, on which many of these guidelines are based. After reading this document trainees should be clear what they can expect from staff and what is expected of them in terms of their professional behaviour across different contexts. It is not expected that these guidelines will be regularly transgressed. However, the following procedures are in place should they be required:

  • Concern about trainee behaviour process
  • Persistent and/or major examples of unprofessional behaviour would be dealt with through the programme’s Fitness to Practise process

Absence from work policy and annual leave procedure
Concern about trainee behaviour
Fitness to practise
HCPC guidance on conduct and ethics for students
BPS code of ethics and conduct
BPS code of human research ethics
LSCFT code of conduct for employees
LSCFT disciplinary policy
LSCFT disciplinary guidance
LSCFT Managing unsatisfactory work performance policy

Fitness to practise

Being fit to practise is a prerequisite for an applied psychologist to deliver a service to the public. The following extract is taken from the Health and Care Professions Council’s brochure entitled “The Fitness to Practise Process”:

What is fitness to practise?
When we say that someone is ‘fit to practise’ we mean that they have the skills, knowledge and character to practise their profession safely and effectively. However, fitness to practise is not just about professional performance. It also includes acts by a registrant which may affect public protection, or confidence in the profession or the regulatory process. This may include matters not directly related to professional practice.

What is the purpose of our fitness to practise process?

Fitness to practise proceedings are about protecting the public. They are not a general complaints-resolution process. They are not designed to deal with disputes between registrants and service users. Our fitness to practise process is not designed to punish registrants for past mistakes. It is designed to protect the public from those who are not fit to practise. If we decide that a registrant’s fitness to practise is ‘impaired’, it means that there are concerns about their ability to practise safely and effectively. This may mean that they should not practice at all. Or that they should be limited in what they are allowed to do. We will take appropriate action to make this happen. Sometimes registrants make mistakes that are unlikely to be repeated. This means that the registrant’s fitness to practise is unlikely to be impaired. People sometimes make mistakes or have a one-off instance of unprofessional conduct or behaviour. We will not pursue every isolated or minor mistake. We are responsible for handling fitness to practise cases. These are known as ‘allegations’ and question whether professionals who are registered with us are fit to practise.”

Whilst students (also known as trainees) of the Doctoral Programme in Clinical Psychology (DClinPsy) at Lancaster University are not registrants of the HCPC, they are involved in providing a service to the public under supervision on their practice placements. It is therefore incumbent on the programme to ensure that students are fit to practise as student / trainee clinical psychologists, to provide the same safeguards to the public as the above HCPC processes do with respect to qualified clinical psychologists. It is also a responsibility of the programme to inform the HCPC of a student’s eligibility to register as an applied psychologist practitioner, so the programme is therefore required to have an assurance process of its own with respect to ensuring that when students are awarded the DClinPsy, they are also fit to practise and therefore eligible to register (it must also be noted that the HCPC make their own assessment of an applicant’s fitness to practise upon application to the register; this will be informed by our assessment but not limited by it, in that the HCPC may seek further information to make any determination). This is why we have instituted the following fitness to practise procedures.

The Trainee Advocate is a qualified clinical psychologist, independent from the Programme, who is available to offer advice and support to any trainee who is in a position where successful completion of the programme is in question, such as being subject to a fitness to practise investigation or having reached the criteria for academic failure. The Trainee Advocate/trainee discussions are confidential with the usual limitations to confidentiality when safeguarding issues arise. The Trainee Advocate is a member of the fitness to practise panel/committee which meets twice a year to review procedures and is therefore familiar with FtP processes and can offer objective guidance. The FtP committee is a separate entity from FtP panels which are convened specifically when individual fitness to practise concerns are raised. The Trainee Advocate is able to offer assistance throughout the FtP process, including appeals and is also able to signpost trainees to other available sources of support.  The Trainee Advocate position is currently vacant and we are actively seeking someone to fill this role. While it remains vacant we are offering support on a bespoke basis.

Procedures to Address Concerns about Fitness to Practise

Beginning Fitness to Practise Procedures

1.0 These procedures should be followed when a report/correspondence is received by a member of staff of the Doctoral Programme in Clinical Psychology relating to the fitness to practise of a student on the programme or a prospective student who has been offered a post of student clinical psychologist on the programme. These procedures will also be followed if a member of staff of the programme considers a verbal report from a practice placement provider or another stakeholder to raise sufficient concerns about the fitness to practise of a student, or encounters behaviour that gives such sufficient concern. The Request for Investigation Form provides a structure for reporting concerns about fitness to practise.

1.1 Assessment of whether the report or correspondence potentially requires a referral to the Fitness to Practise panel will be made by the member of staff receiving the report in discussion with another member of staff (working in the domain where the concerns originated e.g. research / clinical or general behaviour). This assessment will be presented to the Clinical Director and will be based on one or more sources of evidence as follows:

  • Written reports by University academic or clinical staff and/or practice staff from placement areas relating to unsuitable or unprofessional behaviour by a student. These reports can come from any area within the programme (clinical, academic, research etc.).
  • Concerns about fitness to practise raised within written examiner reports or feedback on assignments.
  • Allegations from a member of the public relating to unsuitable or unprofessional behaviour by a student or a prospective student who has been offered a post of trainee clinical psychologist on the programme.
  • Reports from other disciplinary procedures or panels where evidence raising concerns about fitness to practise has come to light.
  • Reports received of criminal convictions, cautions or police allegations/investigations (for example, as a result of mandatory DBS [Disclosure and Barring Service] check as a condition of employment).
  • Information from the Lancashire and South Cumbria NHS Foundation Trust Self Declaration Form A, regulated or controlled positions, completed as a condition of employment.
  • On rare occasions someone raising a concern may wish to remain anonymous. On these occasions it is challenging for us to fully and fairly investigate and may prevent us from being able to assess the concern at all. This circumstance limits the ability of the trainee concerned to respond, it limits our ability to offer support to those raising a concern and it limits our ability to keep an open dialogue. If someone expressing a concern wishes to remain anonymous, we prefer an initial contact with a member of the staff team so that ongoing dialogue can be maintained. Where possible, we aim to support those raising a concern to disclose their identity. We will undertake a preliminary assessment, including the motivation for anonymity, which can, rarely, be malicious. This assessment will also include the potential seriousness of the concern (i.e., breach of any of the HCPC standards of proficiency, or standards of conduct, performance, and ethics). This would be conducted by a member of staff who has completed Fitness to Practise training.

This list is indicative, not exhaustive.

The Clinical Director will determine whether this assessment constitutes a prima facie case within 5 working days. As part of this decision-making process, the Clinical Director will identify whether any previous concerns relating to fitness to practise have been documented in the student’s personal file. If a prima facie case is determined the Clinical Director will appoint an Investigating Officer to conduct further investigation, which will potentially result in a referral to the FTP panel. Should a situation arise whereby the Clinical Director has identified a potential FTP issue, then a senior member of the Clinical Psychology Programme team, who has sufficient FTP experience will be appointed by the Chair of the FTP Panel to fulfil this function.

The investigation process must be fair, robust, and timely. Due to the dynamic and unpredictable nature of investigations a time constraint will not be set upon this process. It will be completed as quickly as possible: in most instances this will be within 6 weeks but may be longer. The student will be informed that an investigation has started and may be involved in this process.

Following the completion of the investigation, the Investigating Officer will consult with at least one other FTP trained member of the faculty to determine whether the concerns reach the threshold for referral to the FTP panel. The Investigating Office will then make the referral if necessary, FTP referral form. A referral will be made if a threshold is reached in relation to any of the following criteria:

The Programme will inform the student in writing that he or she has been referred to the panel, identifying the area of concern on which this referral is based, and explaining the process. Should the Investigating Officer determine that none of the above threshold criteria has been reached, then no referral will be made to the Fitness to Practise panel, but those involved will consider any measures necessary to address the concerns raised. This is because, whilst the Fitness to Practise process may not be appropriate, concerns may still mean that disciplinary or capability processes would still be appropriate, or the concern in question may contribute to considerations of placement or assignment failure. Should such measures be necessary, these will follow other established procedures either within the University (e.g. academic issues) or within the employer, Lancashire and South Cumbria NHS Foundation Trust (e.g. conduct on placement). The Programme will record all decisions about any concerns made at this stage, whether or not they meet the criteria for a referral to be made to the fitness to practise process. All such records will be maintained and made available to the student.

It should be noted that issues highlighted above could lead to dismissal from employment in Lancashire and South Cumbria NHS Foundation Trust as a trainee clinical psychologist. The Programme specification highlights that in these circumstances trainees cannot continue to be registered on the Programme and their studies will be discontinued. Therefore, there would be no need for a fitness to practice investigation to take place. However, because staff dismissed from the Trust have a right of appeal, de-registration from the programme would only occur once the appeal had been resolved. In the meantime, registration on the Programme would be suspended, until resolution of the appeal. In the event of a successful appeal against dismissal, a fitness to practice investigation could be instigated in line with the criteria described above.

1.2 Should a fitness to practise concern requiring referral to the fitness to practise panel be identified, at this stage, those making the referral, in conjunction with the Clinical Director, will decide whether it is necessary for the student to be temporarily withdrawn from their practice placement, have their studies suspended within the University and placed on study leave (within the context of their employment within LSCFT). This is in cases where it is felt to be necessary to protect the public and/ or the student until the alleged case of fitness to practise can be heard and a decision ratified by the examination board.

1.3 As part of the programme’s duty of care to the student, where there are sufficient concerns relating to his/her health, a student will be asked to undertake an occupational health review prior to any formal hearing taking place. A student may refuse to undertake such a review, but will be made aware that if they do so not only would the panel be unable to access any mitigating factors that might be identified by such a review, but also that the panel may be concerned that the student was reluctant to ensure that their health was not impeding their fitness to practise. Depending on the outcome of any occupational health review, a decision will be made by the chair of the FTP panel as to what evidence from the occupational health review should be forwarded to a formal hearing. This decision will be made in full consultation with the HR representative from the employing trust. The student will always receive a full copy of the occupational health report.

1.4 It is possible that the programme is advised against instigating a fitness to practise process in case potential legal proceedings against a student are compromised. This situation could potentially be at odds with the panel’s duty to public safety. In this, or a similar situation, a panel shall be convened in order to consider the dilemma and relative risks, take legal advice if appropriate, and decide whether the fitness to practise process should proceed. This is to ensure the ongoing preservation of public safety.

1.5 All correspondence to the student, witnesses and panel members relating to a Fitness to Practise referral, panel meeting or outcomes of a panel will be sent electronically and in accordance with data protection requirements.

Fitness to Practise Panel: Composition & Process

2.0 The panel membership should comprise of:

  • An appointed chair of the FTP Panel, who will be a practising Consultant Clinical Psychologist appointed for a 2-year term. This term may be renewed for further 2-year terms of office as agreed by the FTP Panel.
  • There will be an appointed Deputy Chair or an appointed Deputy Chair Elect who work actively with the Chair with a view to succeeding as Chair in due course.
  • Chair of the DClinPsy programme Examination Board.
  • Another senior staff member of the DClinPsy.
  • An expert by experience appointed to the panel.
  • A qualified and appropriately registered member of a statutorily registered profession employed as a trainer in that profession within the University.
  • A representative from LSCFT Human Resources Department as employing body.
  • A member of Professional services from Lancaster University will be available to the panel but will not necessarily be present on the panel.
  • A Trainee Advocate, a Clinical Psychologist, independent from the programme.

All the above members or their nominated deputies must be present (in person or virtually) for a panel hearing to be quorate, with the exception of the trainee advocate and a member of professional services. In circumstances where a member of the panel is not present, the hearing will be rearranged. A member of the DClinPsy administrative team will also be present to assist with the administration of the panel. All members will have nominated deputies, to be available in case a member is already involved with the expression of concern in question, or unavailable for the panel. The chair of the FTP panel may also co-opt other members to the panel as necessary to review fully the issues of concern in the specific case (for example, an occupational health practitioner or a practice placement provider).

The student has the right to be accompanied by a person of their choice to support them through the process, and they will be advised of this in their letter inviting them to the hearing. This person will be present to support the student during the hearing and will be able to address the panel or represent the student. The panel may direct questions to all parties.

2.1 Hearings will be arranged on a formal basis. A panel will be convened within 40 working days of a referral being made. To aid scheduling, a provisional panel date will be scoped once the investigation has commenced. The hearing will be scheduled to last for a minimum of one day, but some hearings will require additional days to be scheduled. The student will be given a minimum of 20 working days’ notice of the hearing.

2.2 The evidence available to be presented to the panel will be sent to the student to consider a minimum of 15 working days before the hearing is scheduled to begin. The information sent to the student may need to be restricted in light of information governance requirements (e.g. data protection, confidentiality of NHS service users etc.), in which case amended information (e.g. using pseudonyms) which gives sufficient detail to allow the student to defend themselves without contravening the relevant information governance regulations will be provided. Any further evidence that is gathered for presentation to the Fitness to Practise panel subsequent to this will also be shared with the student as soon as it is administratively possible to do so.  The student is also permitted to provide their own written evidence to the hearing. This must be received by the FTP administrator at least 5 working days before the start date of the hearing. In exceptional circumstances, and on provision of a reason deemed satisfactory by the chair of the FTP panel, a student may request the rearrangement of the panel.

2.3 Prior to the hearing process the panel will consider all the written documentation made available to it regarding the referral and described in section 1 above. The panel will have read the documentation in advance of the hearing. A copy of all evidence available to be presented to the panel will be retained in the student’s personal file.

2.4 Both the chair of the panel and the student can request the attendance of witnesses at the panel hearing. The Chair of the panel may request the attendance of those individuals who have been involved in bringing the concerns to the attention of the programme, with comments invited from them to clarify any of the documentation. All witnesses attending will have submitted written statements to the panel, according to the timelines outlined in 2.1 above. Not all individuals who have submitted written statements will necessarily be asked to attend the panel hearing. Witnesses will be invited to attend at least 3 working days prior to the panel hearing. Failure by a witness to attend is not sufficient grounds for a panel not to reach a conclusion.

2.5 Hearings begin with the presentation of the case by the investigating officer. All panel members, the investigating officer, the student and the student’s representative (if applicable) will be present for this part of the hearing. The panel will have the opportunity to seek clarification and ask questions of the investigating officer. Following this, the student and/or their representative will have the opportunity to seek clarification and ask questions of the investigating officer.

2.6 The second part of the hearing is the presentation of the case of the student, in mitigation or defence of the expressed concern about their fitness to practise.

2.7 Following this, the chair of the panel will invite the individual witnesses to join (in person or virtually) the hearing. The panel will have the opportunity to seek clarification and ask questions of each witness.  The student and/or their representative will have the opportunity to seek clarification and ask questions of each witness. Each witness will only be in attendance for the section of the hearing when they are being specifically questioned.

2.8 The content of the entire hearing is confidential and professional rules will be observed. If the content of the meeting involves discussion of clinical practice, then any service users or third parties will be referred to by pseudonyms to preserve anonymity.

2.9 The student would usually be required to attend a fitness to practise panel hearing, though the chair may consent to them being absent if they judge them to have a reasonable explanation for such absence. Whether or not he/she is in attendance, the student may make written submissions in their defence and/ or in mitigation, according to section 2.2 above. This evidence will be considered at the Fitness to Practise hearing.

2.10 In the event that a student, who has been required to attend a hearing under these regulations, fails to do so at the appointed time without reasonable explanation, then he/she may be subject to disciplinary action under University regulations or in the context of LSCFT regulations. The fact of their non-attendance may also be included in the consideration of their fitness to practise, if it is relevant to the case being made.

2.11 Where a student fails to attend, then the Chair of the panel may decide that the panel will hear the case in the absence of the student. If the panel believes that the evidence is sufficiently clear, a decision and subsequent recommendations to the exam board will be made and notified to the student in the usual way. When the student is notified that they have been referred to the exam board, it will be drawn to their attention that the panel can act in this way if he/she does not appear.

2.12 At the conclusion of the hearing the Panel will determine the outcome and the extent and seriousness of the case and make a recommendation regarding any penalty or course of action to the Examination Board.. The student will normally be advised verbally of the recommendation of the hearing at the conclusion of the panel’s deliberations. They will then be sent a letter detailing the recommendation of the panel, including the rationale for this recommendation, within 15working days of the formal hearing. An audio recording of the hearing can be sent to the student on request. In the letter the student will be advised of their right to make a submission to the Examination Board (see 3.1 below).

2.13 The recommendations possible following a Fitness to Practise hearing are as follows:

  • There are no fitness to practise issues and the student is able to progress on the programme. This outcome does not require ratification by the examination board.
  • The student is able to progress on the programme, although fitness to practise concerns remain and are noted and recorded on the personal file. In any future referrals through the regulations these will be taken into account. An action plan and additional requirements to support the student will be put in place if deemed appropriate. This plan will describe in detail the targets that the student has to meet to provide evidence that the concerns have been addressed and progress has been made. This will be considered within a developmental context, e.g., an action plan may be more demanding for a student close to finishing the programme, in comparison to a student at the start of their training. The programme also has a responsibility to communicate these concerns and the attendant action plan with all practice placement providers contributing to the training of the student in question.
  • The student is not deemed fit to practise at this stage. The student may be required to interrupt their studies and/or be required to repeat/restudy an element of the programme to establish their fitness to practise.
  • The case is proven and the student is deemed unfit to practise. The student cannot redeem the situation and is unable to progress on the programme.

All decisions, with the exception of ‘no action’ need to be ratified by the Exam Board.

After a Fitness to Practise Hearing

3.0 The outcome of the hearing and the recommendation of the fitness to practise panel will be considered at the next appropriate Examination Board (allowing time for submission of information by the student (see 3.1 below). However, if an Examination Board is not scheduled within 11 weeks of the hearing, an extraordinary Examination Board will be convened within that time.

3.1 The student will be given at least 20 working days’ notice of the date of the Examination Board. The student can submit any new, relevant information to be considered by the Board alongside the submission of the Fitness to Practise Panel.  Any such submission must be received a minimum of 5 working days before is the Board is scheduled to meet.

3.2 The Examination Board will consider the recommendation of the Fitness to Practise hearing together with any new/relevant information provided by the student. The role of the Examination Board is to consider and ratify the recommendation made in respect of the student’s progress, including any outcomes for the student. The Board must also confirm, to its satisfaction, that due process has been followed at the hearing and that all relevant information has been fully considered.

3.3 If the Board either fails to ratify the recommendation of the fitness to practise panel or considers there to be additional information available that would potentially impact on the recommendation made by that panel, the Board can request that the original Fitness to Practise hearing is reconvened.

3.4 The student should receive formal notification of the Examination Board’s decision and the rationale of this decision. The examination board will also decide how best to communicate this decision, although it must be communicated promptly and within 5 working days of the Board meeting. A copy of any written correspondence will be retained in the student’s personal file.

3.5 Where the Examination Board ratifies a decision indicating that a student is not fit to practise and cannot redeem the situation, the student will be required to withdraw from the programme and will not be eligible for the full final award nor be eligible to apply for professional registration as a Practitioner Clinical Psychologist.

3.6 This set of procedures is consistent with Lancaster University’s own procedures, as set down in the Manual of Academic Regulations and Procedures (MARP). Please see the link for the postgraduate Examination Board Regulations

3.7 In the case of a student lodging an appeal against the decision of the Examination Board requiring him/her to withdraw from the programme on the grounds of fitness to practise, the appeal will be dealt with under the University’s Assessment Review Regulations (MARP E6.5). If the student appeals on the basis of the consequent termination of their contract of employment with the LSCFT, then this will be dealt with by the relevant procedures within LSCFT.

Summary of FTP procedures
FTP Request for investigation Form
FTP Referral Form
HCPC standards of conduct performance and ethics
HCPC guidance on conduct and ethics for students
The HCPC Standards of Proficiency for practitioner psychologists
BPS Accreditation through partnership handbook
Manual of Academic Regulations and Procedures (MARP)

Concern about trainee behaviour

From time to time staff/service users who come into contact with DClinPsy trainees may have concerns about an individual trainee’s conduct and behaviour. There are already a number of formal DClinPsy, Lancashire & South Cumbria NHS Foundation Trust (LSCFT) and Lancaster University policies and procedures which can be applied in the case of serious concerns. The key policies and procedures are available in our programme handbook and are: –

There are also a number of professional standards documents which DClinPsy trainees are expected to adhere to: –

The programme has also developed its own guidelines for professional behaviour.

The Concern Form has been adapted from a similar form developed by the Lancaster University Medical School in order to complement our existing policies and procedures. The aim of the concern form is three-fold: –

  1. To document ‘low level’ concerns in order to guide trainees to the appropriate standards of professional behaviour prior to conduct issues escalating to a more serious level
  2. To document the accumulation of ‘low level’ concerns, where support and guidance has not been sufficient to establish appropriate standards of professional conduct and it has become necessary to issue a formal warning
  3. To standardise documentation with regards to very serious concerns prior to the appropriate route(s) of referral being taken

The process (outlined on the flowchart on the form) is intended to be supportive to students. Our aim is to intervene at an early stage with trainees who are finding it difficult to meet appropriate professional standards, work with the trainees to establish what the obstacles to meeting those standards are and attempt to establish new patterns of conduct.

These forms, once completed, are confidential. The information will only be disclosed to those concerned with the DClinPsy who have a direct need to know. Concern forms for a trainee will be retained on the trainee file and will be kept during their period on the DClinPsy and for six years from the date of graduation / formal withdrawal (this is a university requirement).

The expected standards of appropriate professional behaviour outlined below are from the HCPC guidance on conduct and ethics for students. Any failure to meet one or more of these standards should be registered on a concern form and submitted to the Programme Administrator.

  1. Promote and protect the interests of service users and carers

    • You should treat service users and carers as individuals, respecting their privacy and dignity.
    • You should make sure that you have consent from service users or other appropriate authority before you provide any care, treatment or other services.
    • You should follow your education provider’s or practice placement provider’s policy on consent.
    • You should make sure that before you provide any care, treatment or other services, the service user is aware that you are a student.
    • You should respect a person’s right to have their care, treatment or other services carried out by a professional and not a student.
    • You should treat everyone equally and not discriminate against anyone because of your personal views.
    • You should keep relationships with service users and carers professional.
  2. Communicate appropriately and effectively

    • You should be polite and considerate to service users, other students and staff at your education provider and practice placement provider.
    • You should listen to service users and carers and take account of their needs and wishes when carrying out any care, treatment or other services.
    • You should take all reasonable steps to make sure that you can communicate appropriately and effectively with service users and carers.
    • You should communicate effectively and co-operate with members of staff at your education provider and practice placement provider to benefit service users and carers.
    • If you are experiencing any difficulties or other issues which may affect your learning or ability to successfully participate in your programme, you should tell your education provider and practice placement provider.
    • You should use all forms of communication appropriately and responsibly, including social media and networking websites.
  3. Work within the limits of your knowledge and skills

    • You should make sure that you are appropriately supervised for any task that you are asked to carry out.
    • You should ask for help when you need it.
    • You should be aware of any restrictions which apply to you in carrying out certain tasks and follow any relevant policies of your education provider or practice placement provider.
    • You should recognise that opportunities for carrying out any unsupervised tasks will vary during your programme and may depend on your knowledge, understanding, skills and experience.
    • You should only carry out an unsupervised task if you feel that you have the appropriate knowledge and skills to do so safely and effectively.
    • You should take responsibility for your own learning.
    • You should be aware of and follow any guidance issued by your education provider or practice placement provider for working with service users and carers.
    • You should ask for, listen to, think about and respond proactively to feedback you are given.
  4. Delegate appropriately

    • You should recognise that the opportunities for delegation will vary during your programme depending on your knowledge, understanding, skills and experience.
    • You should discuss the delegation of tasks with an appropriate member of staff at your education provider or practice placement provider before you take any action.
    • You should follow local policies or guidelines on delegation and working with others produced by your education provider or practice placement provider.
    • If you give tasks to another person to carry out on your behalf, you should make sure that they have the knowledge, skills and experience to carry out the tasks safely and effectively. The education provider or practice placement provider should support your decision to delegate.
    • If you give tasks to another person to carry out on your behalf, you should make sure that they have the appropriate information to carry out the tasks safely and effectively.
    • You should explain to service users and carers when you have asked another person to provide any care, treatment or other services.
  5. Respect confidentiality

    • You should keep information about service users and carers confidential, and only use it for the purpose for which it was given.
    • You should follow local policies or guidelines on confidentiality produced by your education provider or practice placement provider.
    • You should remove anything that could be used to identify a service user or carer from information which you use in your assessments or other academic work related to your programme.
    • If any confidential information raises concerns about the safety or wellbeing of someone, you should discuss this promptly with an appropriate member of staff at your education provider or practice placement provider.
  6. Manage risk

    • You should make sure that you take all appropriate steps to limit the risk of harm to service users, carers and others.
    • You should not do anything that you think will put someone in danger or at unacceptable risk.
    • You should follow your education provider’s or practice placement provider’s policy on managing risk.
    • You should be aware that you may put your service users or yourself at risk if your performance or judgement is affected by your physical or mental health.
    • You should ask for appropriate support and adapt your study or stop studying if your performance or judgement is affected by your physical or mental health and could put service users, yourself or others at risk.
    • You should get advice from a doctor or other appropriate professional if you are worried about your physical or mental health.
  7. Report concerns about safety

    • If you are worried about the safety or wellbeing of service users, carers or others, you should speak to an appropriate member of staff at your education provider or practice placement provider promptly.
    • You should put the safety and wellbeing of service users before any personal concerns, for example, about assessments, marks, other work related to your programme, employment prospects or other personal gain.
  8. Be open when things go wrong

    • You should tell an appropriate member of staff at your education provider or practice placement provider if something has gone wrong in any care, treatment or other services you have carried out involving a service user.
    • You should co-operate with members of staff at your education provider and practice placement provider if something has gone wrong in any care, treatment or other services you have carried out involving a service user. You should learn from this experience.
    • You should tell an appropriate member of staff at your education provider or practice placement provider if a service user or carer wants to raise concerns about any care, treatment or other services they have received.
  9. Be honest and trustworthy

    • You should make sure that your conduct and behaviour does not damage public trust and confidence in your profession.
    • You should be aware that your conduct and behaviour outside of your programme may affect whether or not you are allowed to complete your programme or register with us.
    • You should not claim that you have knowledge, skills, qualifications and experience which you do not.
    • You should be honest about your role with service users, carers and others.
    • You should make sure that your personal appearance is appropriate for your practice placement environment.
    • You should follow your education provider’s or practice placement provider’s policy on attendance.
    • You should follow your education provider’s policies on ethics when carrying out research.
    • You should make sure that all attendance, achievement and assessment records are completed accurately and truthfully.
    • You should reference other people’s work appropriately and not pass it off as your own.
    • You should provide constructive feedback on the quality of your teaching and learning experience in both the education and practice placement setting.
    • You should provide, as soon as possible, any important information about your conduct, competence or health to your education provider and practice placement provider.
    • You should tell your education provider, as soon as possible, if you are charged with, convicted of, or accept a caution for, any offence.
    • You should co-operate with any investigation into your conduct or competence.
  10. Keep records of your work with service users and carers

    • You should make sure that the records you keep are clear and accurate.
    • You should help to protect records from being damaged, lost or accessed by someone without permission.
    • You should follow your education provider’s or practice placement provider’s policy on record keeping.

© 2024 DClinPsy Handbook

Theme by Anders NorenUp ↑

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close