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.
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:
- Breaching the relevant Codes of conduct and ethics. See the HCPC standards of conduct performance and ethics, HCPC guidance on conduct and ethics for students and BPS DCP “Professional Practice Guidelines 1995”.
- Demonstrating a behaviour that poses a threat to the reputation of the profession
- An ongoing behavioural concern or suggesting a lack of the necessary character to practise as a student clinical psychologist safely and effectively
- Demonstrating a lack of capability to achieve the necessary standards of proficiency for the profession. See the HCPC Standards of proficiency and BPS Accreditation through partnership handbook.
- Presenting a health and safety risk or presenting a potential risk to service users or staff members
- Breaching programme specific attendance requirements.
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.
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.
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 member from 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 defense 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 defense 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)