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 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 trainees are fit to practise as 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 trainee'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 trainees 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 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 trainee 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 FTP referral form provides a structure for reporting concerns about fitness to practice.

1.1 An assessment of whether the report or correspondence 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 Care NHS Foundation Trust Self Declaration Form A, regulated or controlled positions, completed as a condition of employment.
The Clinical Director will also identify if any previous concerns relating to fitness to practise have been documented in the student's personal file. The clinical director will determine whether or not the concerns reach the threshold for referral to the FTP panel, according to the process described below. Should the clinical director be unavailable or have prior involvement with the expression of concern being made, then a nominated and named deputy would carry out these roles. Should the Clinical Director identify the concerns as reaching any of the above threshold criteria, then referral will be made to the Fitness to Practise panel. The Clinical Director will inform the trainee in writing that he or she has been referred to the panel, identifying the area of concern on which this referral is based, explaining the process. At this stage the student will be given access to all the information which will be presented to the panel, although this information may need to be restricted in the 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 would be provided. This should all be available to the student within ten working days of the decision and a copy of this should be retained in the student's personal file. Any further evidence that is gathered for presentation to the Fitness to Practise panel will also be shared with the student as soon as it is administratively possible (see 1.2 below).

Should the Clinical Director 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 not 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 Care Foundation NHS Trust (e.g. conduct on placement). The clinical director 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 in the student's file and made available to the student.

1.2 Hearings will be arranged on a formal basis. Whilst the Fitness to Practise panel will meet regularly on a bi-annual basis (January and July), fitness to practise issues are likely to demand more immediate attention than a regular schedule would allow e.g. where the case is considered to be of a more persistent or serious nature and where there may be a necessity to withdraw the student from practice placement straight away. Therefore, once such an issue is identified, the panel would be convened within six weeks. The first four weeks of this would be used to gather the necessary evidence (see 1.3 and 2.2 below). This evidence would be sent to the trainee to allow them a minimum 10 days to consider it before the panel sits.

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 would need to be aware that 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 the 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 receive a full copy of the occupational health report.

1.4 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 LCFT). 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. This is to ensure the ongoing preservation of public safety.

1.5 All correspondence to students, witnesses and panel members relating to a Fitness to Practise referral, panel meeting or outcomes of a panel will be sent in the first instance by e-mail and this will be followed up by a hard copy in the post.

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 three year term.
  • Chair of the Examination Board.
  • Another senior staff member of the DClinPsy.
  • A service user 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.
All the above members must be present for the meeting to be quorate. 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. It is also at the discretion of the chair of the FTP panel to 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).

2.1 The first part of the hearing process will involve the panel considering all the written documentation made available to it regarding the referral and described in section 1 above. The chair of the panel may request the attendance of those staff or representatives from practice placements 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.

2.2 The student should be given a minimum of ten days advanced notification of the date of the formal meeting and full details of the nature of the allegation including copies of any relevant statements, correspondence and student records (see 1.2). The student will be given the opportunity to provide any additional written evidence for the hearing. This must be received by the FTP administrator at least two working days before the 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 The second part of the hearing is the presentation of the case for the student, in mitigation or defence of the expressed concern about their fitness to practise. The student has the right to be accompanied by a person of their choice to support them through the process, and they should 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.

2.4 The content of the whole 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 confidentiality.

2.5 The student would usually be required to attend a fitness to practise panel hearing, though the chair may consent to them being absent given what the chair judges to be a reasonable explanation. 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.

2.6 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 the regulations of the employing trust. 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.

2.7 Where a student fails to attend or make any written submission, 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.

2.8 At the conclusion of the meeting 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 details and outcome of the meeting should be recorded and recommendations forwarded 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. The student will be sent a letter detailing the recommendation of the panel, including the rationale for this recommendation, within eight working days of the formal hearing. The student will also be sent the formal minutes of that portion of the meeting pertaining to his or her case. In the letter the student will be advised that he/she can also write to the Examination Board on the matter if he/she wishes also enclosing any relevant new information such as correspondence/medical notes.

2.9 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 trainee close to finishing the programme, in comparison to a trainee 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.

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 28 days of the hearing an extraordinary Examination Board will be convened within that time.

3.1 The student can submit any new/ relevant information to be considered by the Examination Board alongside the submission of the Fitness to Practise Panel. The student will be given at least 10 days notice of the examination board, within which to submit any such information for consideration. Such information can be submitted to the administrator of the Examination Board up to 2 working days before it 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 new/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. If a further recommendation is not ratified then the student will be deemed to have been cleared of that fitness to practise concern.

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 maximum. A copy will be retained in the student's personal file.

3.5 Where the Examination Board determines that a student is not fit to practise, the student may be required to withdraw from the programme and will not be eligible for the full final award and the eligibility that confers to apply for professional registration.

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). A specific stipulation (E3.2.1) to note here is that to be quorate, an Examination Board has to have at least one external examiner present to participate in the meeting.

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 employing trust, then this will be dealt with by the relevant procedures within that trust.

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)