What should do you do if you get a fitness to practise complaint? What can you expect from the process? How long does it take, what are the possible outcomes, and where can you go to get support?

To answer these questions Paula spoke with Nicholas Stöckling, who works with psychologists and other health professionals as a regulatory adviser providing legal and emotional Fitness to Practise guidance, as well as webinars and training for professional bodies.

In this conversation, Nicholas discusses his extensive experience with fitness to practise issues and the Health and Care Professions Council (HCPC). He shares insights into the emotional and professional impacts of fitness to practice complaints on health professionals, particularly psychologists. The discussion covers the purpose of the HCPC, the investigation process, potential sanctions, and practical advice for professionals facing complaints. Nicholas emphasises the importance of understanding the process, seeking support, and maintaining mental health during challenging times.

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To get in touch with Nicholas you can contact him via email or LinkedIn.

Listeners may find the following resources helpful:

ACP-UK Webinars (free to members):

• Demystifying the HCPC Part 1
• Demystifying the HCPC Part 2
• Navigating the Grey Zone: Everyday Boundary Dilemmas in Psychological Work (live on 16th October 2025)

Emotional Agility by Susan David – an accessible book offering practical strategies for navigating uncertainty and psychological pressure.

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I’d love to connect with you so do come and find me on LinkedIn or at my website and do check out the ACP-UK and everything it has to offer.

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Hi, I'm Dr Paula Redmond and you're listening to the When Work Hurts podcast, which is brought to you by the Association of Clinical Psychologists, the representative professional body for clinical psychologists in the UK. In this series, I'll be covering the difficult topic of surviving formal complaints, particularly for psychologists. I'll be bringing you conversations with brilliant guests, offering their expertise, experience and wisdom on this tough topic from a range of different perspectives.

If you receive a fitness to practise complaint, how should you respond? What should you do and not do? What can you expect from the process? How long does it take? What are the possible outcomes? Where can you go to get support? To answer these questions, I spoke with Nicholas Stockling, who works with psychologists and other health professionals as a regulatory advisor, providing legal fitness to practise guidance, as well as webinars and training for professional bodies.He began by telling me about his experience working in this field.

I have quite a long and detailed experience working within fitness to practise. So my background is actually in criminal defense law, but I worked in human rights as well. I worked in the UK, London, a little bit in Africa as well. And then I worked for the HCPC. So I spent quite a few years working as part of the fitness to practise team as in their serious case review team and also representing them in tribunals. So that was a prosecutorial role, which was contrary to everything I'd done previously. And to be honest with you, it was something I didn't feel particularly comfortable with. So my natural position in my legal mind was always looking to assist people as opposed to prosecute them. So when I was working with the HCPC and we had to prosecute social workers, psychologists, and people who I felt were primarily doing their best, I found that difficult. So I often tried to close cases, which didn't always go down too well with my supervisors. So yeah, after I decided that morally it wasn't really something I wanted to do, pursue people who work in health, then I created my own consultancy company where I now work representing people, psychologists, physiotherapists, anyone who's under the HCPC regime. I also assist bodies such as the ACP UK. So I'm involved with them as well, which I think is a really worthwhile and important organisation in terms of standing up for the rights of psychologists and actually one of the more powerful representative bodies when they are questioning some of the motives of the HCPC and holding them to task. So I really enjoy that work. So I work with clients who are involved in the HCPC process, fitness practise process. And I also am involved with representative bodies like the ACP UK and delivering webinars on really how to deal with the fitness to practise process and how to, yeah, how to manage it in a legal sense and also helping them understand the various emotional issues that can be involved, which I'm sure we'll get to as we progress. But yeah, I've had quite an interesting career that's led me to fitness to practise. I wouldn't have imagined that's where I was going end up, but I actually find it really, really interesting. I often say that outside of restricting someone's freedom in a criminal sense, the harshest sanction you can give to someone is to restrict them from practicing something they've dedicated their life to. So it's really important. It's really important. It's seen differently to criminal law and in terms of sanction. But for me, it's something I really enjoy dealing with people and helping them through the process.

Great. And I know you've done, as you've mentioned, some work with the ACP UK and there's a couple of webinars that you've done, which are great, which are available to members. So I'll put links to that in the show notes as well for people to check out. So given this work and your experience on sort of both sides of the story in terms of prosecuting and supporting registrants, I'm curious about your observations around the impact of fitness of practise complaints on health professionals. And I guess also curious about psychologists within that and whether that looks different or was experienced differently from other professional groups?

Yeah, I mean, it's an interesting question because, you know, having worked with various professionals, health care professionals, so physios, paramedics, sometimes nurses, which is in a different regime that are not under the auspices of the HCPC, psychologists are a really interesting one for me because the nature of the profession means that sometimes they… the actual personal impact can, I'd argue, be a little bit greater than other professions. And the reason why I've come to that conclusion is the fact that psychologists take their profession very, very seriously, as do a lot of other people, but the nature of the profession can often be such that it's almost like a calling for some people. And the question I often asked people that I'm involved with, clients, and also interesting, both my parents are psychologists, which is giving me sort of an understanding of, of the psychology, behind why people become psychologists. And I think there's a couple of different schools of thought, and obviously you guys are the professionals and it's your, it's your area of expertise, but why people become psychologists, maybe you've done podcasts on it? I would argue some people become psychologists to analyze themselves, other people become psychologists because they really want to help people. And it's really a profound sense to assist others in a, in the capacity they feel best capable to do so. So when you have an FTP complaint raised against you and your sense of worth is… and sense of self is so intrinsically linked to your profession, it can be really rupturing. So I have seen professionals across all the HCPC professions really suffer as a result of FTP investigations. I've seen divorces, I've seen people change professions, long service leave, retirement, you know, serious anger towards those who have raised the complaint, serious anger towards their place of work, because they feel like they haven't been properly helped. So the fact that psychologists you know, feel that like everyone else feels it, but I'd argue they feel it even more deeply, at least in my experience. But fundamentally across the board, it is a highly rupturing experience. It is a really destabilising experience. It's something that a lot of people are unaware of in the sense that they know there's a chance that a complaint is going to be raised against them, it's the nature of the profession. But the fact that it's out of their control once the concerns been raised and the time limit is often unknown, which I'm sure we'll get to later. That can be really, yeah, undermining and really, you can lose your sense of self and I've seen it. So yeah, how does it impact psychologists compared to other professionals? I'd say a little bit more deeply, but across the board, it's a really unsettling experience.

And you use that word rupture, but it's a really kind of significant rupture. And that's really striking, I guess, on lots of levels that a rupture with your relationship to your profession and I guess, relationship to the HCPC, whereas it might be something that you've seen as a body that, you you're proud to be registered with, or, you know, it kind of shows off your credentials and, you know, you can establish yourself as a legitimate practitioner and, you know, in psychology, we get, you know, really cross with people who are saying they are psychologists and not registered with the HCPC. And you know, with some, you know, have a kind of attachment to that as a positive thing and then to be on the receiving end of what can feel like an attack from that organisation. Big rupture. And as you mentioned, that sense of a rupture between, you know, relationship to your clients or whoever has made the complaint, whether that's a colleague or a client, that you know shock of of you know when you are wanting to help and be of service and that's coming back at you in that way… yeah.

Absolutely. I mean, it's a really conflicted relationship people have with the HCPC. As you said, I mean, the protection of title is something people work very hard to, they study their life for. They study for many years of their life. I mean, psychologists, clinical psychologists, and I'm sure there are different types of psychologists on the different domain names listening to this podcast, but people study a long time to get to, to receive their accreditation to, you know, all the various time that they have to give to this profession. So to then have the HCPC accord you the right to be labeled a clinical psychologist, educational psychologist, whatever it may be, is a proud moment. And then it can at the same time comes the recognition that well, now all my actions are under scrutiny, which I think people understand, but at the same time, that can be really difficult to go, wait a second, I've been waiting for the support of this organisation. And now they're after me. Now, what I try and do with clients and when I'm running webinars or seminars, is I think what's really important is for people to understand what the purpose of the fitness to practise regime is. What's the purpose of fitness to practise? What's the purpose of the HCPC and other regulators? And in my experience, those who accept that and understand what the purpose is and thereby want to interact with it, they have a much better time dealing with a fitness to practise regime. So what is the purpose of it? The purpose is to protect the public. Fundamentally, the purpose of the HCPC and any regulatory body is to protect the public. So I think as professionals, we don't want people who are unfit to practise demeaning their profession. It's about upholding the integrity of profession. And, you know, when I was working at the HCPC, there were many examples of people who did not deserve to be registered. So it does happen. There are people who are bringing the profession into disrepute, whether through poorly backed scientific therapy, through inappropriate practises, and I think as a profession, we don't want those people working with us, amongst us. So the ACP UK actively pursues, will be involved in making sure that the integrity of the profession is upheld. And if there are some, for want of a better expression, cowboys out there who are dangerous to the public, it's understandable that FTP cases are raised. So once we understand that the purpose of the system is there to protect you and also protect the public, it means that all the failings that are inherent within the regime, within the HCPC regime, and all the timeline issues and the various case manager changes and all the imperfections that exist, they can be dealt with a bit easier once we go, well, end of the day, this is what it's there for, and fundamentally, I agree with the idea of public protection. And that's, I sound like I've got my HPPC hat on, and trust me, later on, I'll take it off because there are major issues with the organisation, but fundamentally, it is a body that is there to do good as all regulatory bodies are. And if we look at some of the issues that arise with psychotherapists and counselors and their desire to, you know, in many circumstances to have a regulatory body, and the movement through government petitions and through various avenues to seek recognition and have a governing body shows just how important these bodies are because the fact that there is no, there is limitable, there are regulatory bodies, but there's no recognised statutory body that regulates these two psychotherapists and counsellors has led to some major issues and significant problems in the family court. There's, you know, it really is, it's an, it's not a good situation. And I think the ACP UK is involved in that as well. I mean, it's something that needs to be addressed. So we can see where there isn’t a regulatory body, the inherent dangers that exist. So yeah, it's important to understand what the purpose of the HCPC is, and thereby that can assist you in how you deal with what's coming when you have an FTP investigation.

So what is the process? Because, you know, I have been qualified for over 15 years and until I started this podcast, I had no idea. So what information do you think would be really helpful for psychologists or other health professionals listening to know about what happens when a complaint is made?

Yeah, I mean, I think now that we've sort of established what the purpose of the HCPC is as a basis, I think it's really important to understand the likelihood of you having a case raised against you, understand the various stages that may arise, and to understand the possible sanctions, because these are issues that I'm often asked. A case is raised against me am I going to get struck off? So I often get, I have phone calls from very, very distressed people about a complaint, which once I've read the facts of the case, they're not going to get struck off. And sort of alleviating those fears is only possible through an understanding of the likelihood, statistical likelihood, an understanding of the process, understanding of the steps. So as I mentioned before, there's approximately 27-28,000 practitioners, psychologists in any year. And about 280 complaints are raised a year against these psychologists. Now that's not an insignificant number, but it's not a large amount either. So if we think about it as a profession, it's the second most complained against profession. So paramedics have more complaints raised against them than anyone else, psychologists are second. We know that about 0.7% of psychologists in any given year will have a complaint raised against them, which is higher than the actual average, which is about 0.5. So what I often ask various bodies that I've worked with is why do we think that is? I mean, I'm curious to know your opinion. Why do we think that psychologists have so many complaints raised against them? I have my personal opinions, but I'm curious to know as a psychologist what you think?

Well, I guess the complexity of work, maybe the often quite, I suppose, intimate nature of the work in an emotional sense, and you would be working, I guess, much more privately with people than maybe other health professionals who are working in teams and, you know, contexts. And… yeah, the kind of boundary challenges that can show up in the nature of therapeutic work that can be tricky.

Yeah, I mean, they're exactly some of the reasons that I've thought personally and a similar, it's a common list of reasons why. From a legal perspective, I'd add to that the vulnerability of patients. So by definition, people come to psychologists due to whatever the issue may be, and this can be, as you know, relationship breakdown, monetary issues, all the way to serious psychiatric disorders. And what happens in those circumstances is that, and I've seen this working with the HCPC, highly vulnerable patients of psychologists can be very active. So if, for example, and I think of a case that I've worked on quite extensively, there has been a case where the psychologist has signposted their termination of the professional relationship very, very well. They've had a 10 year relationship with a client who has a mental illness. And as it draws to an end, the client becomes somewhat upset about that. It's purely a personal reason that the fact that psychologist is moving overseas, so it was quite clear that there was no way the relationship could continue. The relationship, professional relationship ends and then the patient starts raising complaints. Now, in these circumstances, this had to do with onset of health issues, the reoccurrence of mental health issues due to the breakdown of the relationship. And some of the allegations raised were incredibly serious. So if we look at the HCPC having to deal with that and having been in that position, you'll receive a bunch of emails from a person who may be in a state of semi-psychosis, but does not in any way, shape or form mean they cannot write a very coherent email. In fact, that may even assist their ability to write their email, if we understand the nature of certain mental illnesses. And they've written 18 pages of very clear issues about what this person did wrong. It's structured, it's not completely off the air. And they've raised allegations of inappropriate touching, they've raised allegations of privacy issues. Now this is an extreme case, but it gives an example of what can happen. Now the HCPC has to deal with that case. And I, having worked in that situation, I'm reading this and I'm going, okay, well, this is going to go to final hearing probably. As the case progresses, and this is a sort of symptomatic of the nature of the HCPC cases and the FTP process, as the case progresses, it becomes clear to the case manager that this person is unwell because repeatedly you're getting 20 emails, 30 emails, and it becomes quite clear, okay, there probably isn't that much to this. But just because someone is having a mental health issue or crisis, doesn't mean they don't deserve to be heard. So I think as psychologists, you understand that better than anyone else. So the HCPC in there doing their job properly, when it is done properly, and I would argue when I was in that position, I did it properly. I'd investigate that and I try and get to the basis of it. And it becomes quite clear, quite quickly, actually, this person is not particularly well and let's try and get some information elsewhere to determine that, some medical records, yeah, and inherently delve into the issue. And in this case, it was closed. It didn't even reach ICP. So it became quite clear quite quickly that that case was closed. But it doesn't mean that the psychologist who had the case raised against her was not deeply affected by this, deeply affected. An eminent psychologist with unbelievable experience across numerous countries, lectured across the world. Now, a very, very impressive person. And she actually dealt with it very well. She was one of these cases, which I talked about previously, where she understood very quickly the purpose of the process. And she coped with it very, very well, but it was an absolute shock to her. But once she understood who raised the complaint, the nature of the professional relationship, she had a position of empathy, which I think can be really useful. And I have a lot of clients, and I'd argue psychologists do that better than anyone else in my personal anecdotal experience, if you have empathy to the person, particularly if it's a former patient, that can really help. You can have anger towards the HCPC, but that's not going to help either. So understanding the process and why these concerns are raised. So in terms of why so many psychologists have complaints raised against them, there's a good example, because this person raised a complaint against that psychologist, actually raised a complaint against everyone else in her team, her healthcare team. So there's about six complaints that were fired out across one NHS trust. And that just raised the numbers.

Because it's interesting when you think about HCPC, which you're not necessarily aware of, regulates a huge range of professions. So you've got podiatrists and kind of, you know, I think like hearing aid technicians and, you know, a whole range who will have a very different kind of patient profile and also the nature of the work is very different. So I can see those parallels with paramedics being, you know, working with people in very high emotive contexts, that there's similarities there, which is very different from a hearing aid technician. It will be seeing different people in different contexts.

And it also means that in terms of defending a psychologist, it can be more difficult due to the nature of the profession itself, because it can often be an argument of ideas. There can be different theoretical reasons of why we undertake a particular form of therapeutic intervention. While if you're a hearing aid professional, if you're working in podiatry, you often have a set amount of tasks that need to be done. If you don't do them properly, it's quite clear what you did wrong or right. And that's why defending psychologists, I'd argue are the most interesting cases and also the most complicated. Because if you're a paramedic and you arrive at a scene, you have to perform six different actions if it's a cardiac arrest. If you don't do those six different actions, then you're in breach of your standards. So it's quite clear your clinical knowledge is not up to scratch, but a psychologist having a personal relationship and deciding, you know, making a risk assessment at a certain point, but not at the point that the complainant alleges should have been done is a question of professional opinion. And also what type of intervention you use, what type of treatment you use. There is a broad range and obviously you understand that far better than I do, but helping someone defend that case can be far more complicated, particularly from the HCPC's perspective, because a case manager may not necessarily understand the intricacies of psychological theory, but they can see this is the complaint and if it's been properly drafted by the complainant, by someone who alleges that something wrong is done, it's quite clear to go, well, that looks wrong to me, but if you don't have much expertise in that. So therefore defending that and understanding as a registrant that, okay, the first stage of the process is triage. So a complaint is raised and that should in theory go to an investigating committee panel within six months. So the first stage should take six months. That's what the HCPC objectives state. That's what the literature says, that's their standards that they want to adhere to. Now that is not the case. That is absolutely not the case. And I think it's worthwhile here referring to the PSA, so the Professional Standards Authority have many times raised serious concerns with the HCPC. Now the PSA is the regulator of regulators. It's a really important body. Regulates all different professions. So it regulates those who regulate. So it will determine whether you're doing a good job. Now, when I worked with the HCPC, when the PSA reports came out, these were really tumultuous times for the whole organisation, because the HCPC was in breach of many standards of good regulation while I was there. Now, in fairness to them, it's improved. The last report said they'd reached 16 of 18 standards of good regulation. But the two they didn't reach relate to timelines. So again and again, the HCPC is in breach of their objectives in terms of how quickly they process cases. Now, those who have dealt with the FTP process, and those within the ACP UK are well aware of these timeline issues. So essentially what the HCPC wants is to have all cases resolved within a year. That's their objectives. Now, in my experience, it's closer to 30 months, even longer. So I have a case that I'm working on now, which is a case that was raised in 2021. And we are not even at investigating committee panel stage. And now this is really complicated and really difficult to understand as a practitioner. So that's been that many years now and we still haven't reached the first stage. So the reality is that it doesn't take six months. It doesn't take one year to get to a final hearing. If you go to an ICP, so that's the first stage, if they decide that the allegations, the concerns raised are worthy of allegations. So the HCPC will receive the complaint. They'll say, this is the broad area of concerns that we have. And then they'll investigate more, and if they decide the threshold has been met, they will send a list of allegations with particulars. So allegation one A, B, C, D, you did not do this on this date. You inappropriately did this. Now, from that point onwards, you have a time, you have usually a month to respond so you can prepare your response to allegations. That's where I get involved a lot before it goes anywhere near a final hearing. And during that period, that's when you present your side of the case. But then it gets sent to an investigating committee panel, which is three people who listen to it, who read the case just on the papers. So there's no one representing them. So that will be a panel chair. That'll be a lay person and that'll be a member of the profession. So you'll have a member of the psychologist’s profession sitting on that panel. So that's an HCPC registered psychologist. And that will decide whether there's a possibility that these cases, these allegations can be proven at a final hearing. So that's… the great majority of, I think it's about 45% of cases are dismissed at ICP. So investigate on the committee panel. So if it goes to an ICP, it doesn't in any way, shape or form mean that it's going to go to a final hearing. And it's worth noting that. So I think having an understanding of what types of cases go forward, obviously misconduct cases, behavioural attitude cases, communication issues. So these are the types of cases that the HCP looks obviously quite seriously into. If you have committed a crime outside of your profession, a drink driving crime, a violent offense, the HCPC, first of all, you must inform the HCPC of that and not doing that is problematic. But I think understanding that self-reporting is a really important step in the process as well. So if you have been caught drink driving, if you have had a criminal charge against you, alert the HCPC, in the long run, it's gonna be good for you. I think that's worth noting.

Nicholas, I just wanted to check what, when do you find out about, that a complaint has been made against you? Is it like day one, the same day that HCPC hears about it?

Not at all. So as a registrant, you'll have a phone call, phone call or an email, which then gets sent to a triage team in the HCPC. And I've worked in part of that process, not in triage itself. And they'll determine whether it's worthy of investigation, whether the threshold has been met. And at that point, you will then be alerted. Due to the backlog of cases, that can take a while. I couldn't give you a number because I don't know if there's statistics out of reporting from triage to being alerted. But you'd hope, depending on the severity of the case, determination should be made as the threshold quite quickly. So you should learn within a couple of weeks, I imagine.

And do you hear what that, the complaint is? Because I have heard from people who have been informed that a complaint has been made about them, but no detail as to what that is for months and months, years, and they don't know what it is that they're facing. Is that common?

I mean, yes, that's probably one of the greatest gripes, both I have in a professional sense in my work and that clients and registrants have is the fact that you can have a complaint raised against you, and we will say something along the lines of we think the concern has been raised in regards to your actions, which suggests that you are in, that you're not upholding standards one, two, three, five and six, which can be really broad. It can be communication, it can be the clinical issues. It can be really broad. And at this stage, they will say often, it's in relation to your work with this person. So the person will be identified. And that's the nature of, I think that's something that people can find quite difficult. And I think that's why a lot of people, from the other side, people raising complaints can often be a little bit wary of raising complaints because they will be identified. And I think if you're a psychologist and you're working with someone or a health care professional in any form, and you're working with someone who's clearly working, acting inappropriately or doing something in a clinical sense or I don't know, I think of inappropriate behavior with colleagues or racism or sexism or one of these sort of things, and you want to alert the HCPC to that, which is I think the right thing to do in certain circumstances, that your name will be on the, or understanding that I think is… can lead to people not wanting to raise complaints. But at the same time, we can also lead to some workplace issues because I think members of the public, I think raise about two thirds of all complaints, it's colleagues and your employment that raise about, I think 20%. You have members of the public and you also have self complaints. So you're essentially raising issues about yourself. And these often relate to health issues. So if you have to cease working for whatever reason it is, and you're essentially asking, you're alerting the HCPC to the fact that you have a medical condition. Now, one of those can be an addiction issue. One of those that can be a cancer diagnosis. So they're essentially the different types of people that raise complaints. Yeah.

Okay, great. So it's triaged, you're informed, and then the next stage is a more detailed kind of breakdown of what the allegations are. And at that point, you would put your sort of response, a written response together that then goes to this, investigatory… what's the C stand for?

Committee panel.

Investigating Committee Panel.

Exactly right. So the way it works is that you'll receive this sort of general complaint and then you'll often wait a year, in my experience, and particularly in certain circumstances, three years. Like the case I'm working on, very serious cases. I mean, I don't want to scare people, that's quite an exceptional case, but you know, waiting a year, 18 months is not uncommon. And then you will receive the allegations and contained within the allegations will be a bundle of all the investigations made. So there will be all the reports, all those testimony. Now I think understanding why these issues and why these investigations take so long is really useful for registrants. So why does it take a year and half or two years for the HCPC to form its allegations? Now there are various reasons for that. One of the reasons is a lack of funding to the HCPC. Case managers turn over all the time. There's too many cases, people are overworked. I think that's one reason. So that's just poorly run organisation in some circumstances. And the HCPC will, I would argue readily, admit that there are things they can do better. But in certain circumstances, and I'll give the example of cases involving, say for example, the death of someone, the death of a young person, a suicide, a vulnerable person dying in tragic circumstances, what will happen there, there'll often be an external investigation. So these serious case reviews in certain circumstances. So when I was at the HCPC, I worked with the serious case reviews. So what would happen if, for example, there's a death of a toddler, which will get a lot of media attention, a serious case review will be undertaken. And in that review, it'll identify certain people that are involved in the care of a particular person, social workers, psychologists, doctors, et cetera. Now, what the HCPC will do if they're aware that a serious case review is being undertaken or even an investigation done within the place of employment, so an NHS internal review, they will wait for the completion of that before they draft the allegations. Now, understanding that, you know, and everyone’s worked in various organisations where it takes a while to get stuff done. So NHS Trust are doing an investigation into the attempted suicide of a patient who's under their care. Getting all the documents in place to write that review can take a year. It just really can. The HCPC will defer judgment until that report's been done. We think with criminal investigation, they'll defer judgment until the police investigation complete. Now, we know how long a police investigation can take. So understanding that why am I waiting three years when the case of… a case I'm working on now, there was an internal review being undertaken by the trust she worked for. There was a serious case review being undertaken by an external organisation designated by the trust. And until that was done, the HCPC weren’t drafting allegations. So that's one reason why it took so long. I think that's worth understanding.

So you get the allegations and as you said, all the bundle of all the reports, everything that they've gathered, and then you get to respond. And I guess that's the point or, you know, that someone like you would be really useful to help. Is that part of your role, helping people respond to the allegations? Yeah.

Yeah, absolutely. I mean, I guess the first step that I'd suggest to people is to contact your professional body. Clinical psychologists, if you're in that circumstance and you're unsure what to do, have a chat to the ACP or the similar organisation for whatever domain you work under. And then seek assistance. So what I do in that circumstance is I will help a registrant prepare their defense, essentially. So you have six weeks, four weeks, you can usually get that double to eight weeks. And we'll try and present their side of the story. So you respond to each individual allegation. On this date, you did not undertake a risk assessment. Yes, I did, and these are my clinical notes to prove it. Here are some witness statements from those who I worked with to prove that I did do it. And you can build a very comprehensive response that way. Witness statements are often highly valuable sources of evidence, as well as your view of events and having, you know, this is your chance to really explain that you disagree wholeheartedly with the allegations. So then that gets put into a response to the allegation bundle. And then that gets sent to the ICP, the investigation committee panel, who then will meet, the three of them together, and they will look at the allegations and they'll look at the response panel and they'll make an assessment based on that. So at that stage is, depending on the severity of the case, is where I strongly suggest people seek help, whether it's legal, whether through consultants like myself or through your representative bodies. It's very useful, and in an ideal world, you'll have everything stopped at ICP because going to a final hearing is a far more expensive undertaking. It's a similar, these can be week long, two week long. It's less formal than a court, but you'll often have barristers and, the HCPC, they use Kingsley Napoli. So they'll have some really good lawyers prosecuting their case. And at that point, you really want to, yeah, if you can stop it at the ICP, it's suggested. If you think the evidence is such that you present a strong, solid rebuttal of all the allegations, do it before ICP. Don't let it get to a final hearing, because then it becomes far more serious and far more expensive as well. Then you have to, it's suggested you get a barrister.

Okay. So, and you said about 45% of cases might get, might stop at that ICP stage?

Yeah, I mean, it depends, but yeah, more than half, I think it depends on which report you're actually reading. So if at a general assessment, 40% thereabouts. So you can, it's quite likely it'll be stopped at ICP.

Yeah. And stop… does that mean they've decided there's no case to answer?

Absolutely. That's literally the words. No case to answer. That's the end of the matter. Now there's a five year rule, which means that the HCPC will hold onto the fact and will keep on their records that there was a case raised and for five years that'll be on their system essentially, but there will be no public record of that. No, you do not have to inform anyone. On the register, there'll be no mention of it. It is essentially, it's finished. So I think, as I said, in an ideal world, you'll have it stopped at ICP so it doesn't progress any further.

Okay. And if ICP decides it needs to progress, then that's to final hearing. That's the next stage?

That's the next stage. And that's when witnesses will be cross-examined. That's when, yeah, as I said, it's less formal than a criminal proceedings or a family court, but it's still, you know, it's a serious matter now.

And how long does that take from ICP to final hearing?

I think again, the HCPC, their aims do not meet the reality. So that can be very often another six months, another year. So as I said, from the first time a complaint is raised to a final hearing, in my experience and according to the PSA, 30 months is not uncommon. So that's what you're sort of, essentially three years from beginning to end. If it goes to that end, that case. And as I said, there are certain cases where absolutely they need to be investigated. Amongst 30,000 members, 28,000 psychologists, there are going to be a few bad eggs. That's just the law of averages. So these cases need to be prosecuted to the end. So what we don't want is the less serious cases passing through ICP. That's really a waste of everyone's time. It's a waste of the HCPC’s funding. If they're hiring lawyers, registrants are hiring, sometimes QCs to defend themselves. If we can cut it off earlier, it's really ideal, but some cases absolutely need to be thoroughly examined. And what I'd say to registrants is if you honestly believe that you have acted appropriately, if it's a clinical issue or you're a risk assessment issue or note taking or something of the like, and you're absolutely adamant and you, and you know that you've done the right thing, the truth will come out. And it really will. In my experience I've never, very rarely seen, in fact, I can think of one or two cases where I disagreed with the final hearing outcome. So essentially, if it goes to final hearing and they’ve decided that the sanction is to be struck off or they decide that the sanction is to be a warning or the conditions of practise, usually it's correct because they've had a full week, sometimes two weeks to thoroughly investigate the evidence. They cross-examine people. So the truth comes out. So rest assured, if you think that what your actions were appropriate, eventually that's going to come out. You might think, how on earth is it past this step? It's gone through triage. How's it passed that? How's it gone through ICP? Well, the truth comes out, that’s been my experience. And I think that's something to hold onto if you're confident in the way you behave. So in terms of actually being struck off, you have to really have done something fundamentally inappropriate for that to happen. So bear that in mind. When you have a concern raised against you to do with some of your actions, even if it's involving a tragedy, even if it had a tragic outcome, you are merely a cog in a greater system. And the HCPC need to prove that you are unfit to practise. And that's quite a high bar, I would argue. You are currently unfit to practise based on something that you did a couple of years ago. So rest assured, if you've done the right thing, you should be okay.

And so what are the possible sanctions?

If you get to a final hearing, the panel or the tribunal decides that the allegations are founded, are based in reality. You can have a strike off order, which essentially permanently removes you from the register. And that's approximately 25 to 30% of cases that reach final hearing. So we're talking about the extreme end of it, the far end of the process. So 25 to 30% of cases that go to final hearing will end up with a strike off. And if we think of the nature of cases that go to final hearing, inappropriate relationships or some serious matters, some criminal matters, some issues to do with health, so that's 30%. You can have a suspension order, which will temporarily remove you from the register, usually for six to 12 months. And about 20 to 25% of all cases, that's the outcome. A conditions of practise order, which for psychologists is a very difficult judgment because essentially it means that often what the conditions of practise will be that you cannot have sessions without someone else in attendance. So you will have someone, a chaperone for want a bit of expression. So obviously in those sort of circumstances, it's unlikely you're going to be able to continue your job. So that's about 10 to 15%. And then also a caution order. So that allows you to continue to practise and the caution order is usually one to five years. And you continue to practise, but you're under caution. And that's approximately 15 to 20% of all cases end up with those. So there's quite a broad spectrum, but as you can see, if you get to final hearing, the panel decides based on the evidence that they've investigated and based on the cross-examination of witnesses and the evidence before them, that you've acted inappropriately or you're not upholding the standards, then the outcomes are pretty serious. But again, it's worth remembering, these are a small percentage of cases amongst a small percentage of people who have cases investigated amongst a rather large profession. Some 28 to 30,000 psychologists. Those who get struck off are very, small percentage. And it's worth remembering that. So not to panic.

I also just wanted to ask you, because you can, you know, anyone can go on the HCPC website and look up these cases. And well, what I'm not clear about, I don't know if you know the answer, is at what point is it made public? At what point is your, you know, you can go on the HCPC website, you can find your name. It seems very inconsistent about how much information is available about… sometimes it's just a name. Sometimes there's huge detail, you know, text messages sent between people. And it doesn't seem, you know, I've seen cases on there where someone, you know, couldn't attend the trial because they were in prison for torturing someone, you know. And then you've got other people who, you know, they messed up the renewal of the HCPC registration, you know, let it lapse and for a period of weeks were using the title without actually being registered. I guess it's sort of snowballed from there probably, but those are two cases where like all the details are public or there's a lot of detail, you don't know what's not public, but there's a lot of detail that's public and that they're opposite ends of sort of severity, I would think.

Yeah, I mean, essentially what is published depends on the actual nature of the proceedings, but at final hearing, obviously then the case will be uploaded. So that will be published on the HCPC website. Now what's included in that publication depends on the nature of the case. So some cases will be more, they'll anonymise more than others. I've got a case at the moment, which pertains exactly to what you're talking about, whereby people were reluctant to give witness statements to support one of their colleagues because they're worried about their statements being included in the public domain. So generally, I mean, would all reports and all text messages be included in a judgment which is presented on the HCPC website? No, not necessarily, but a great deal of information will be. Obviously, we understand the rationale behind that because it's a fair process and people have a right to know what happened in terms of protecting the identification of people involved, particularly in psychology. Obviously there'll be a lot of protection for those who deserve protection, children and the like. But in terms of what's actually published, well, at final hearing, the decision will be made by the panel chair to include certain elements in the publication. So I'd argue that the great majority of the information will be made public if it goes to final hearing. These are essentially public proceedings. So you have a right and journalists have a right, and I've been in cases where there are journalists, to sit in on hearings unless the panel decides that this needs to be heard in private. And the HCPC can make an application to have a matter heard in private if it's for protection of people's personal matters in certain circumstances. But essentially they're public matters.

But that's only at the point of it going to the final hearing. It's not published before then?

Absolutely. Before final hearing, it's not at all. And I think that's a real fear is that, you know, what information can I share? People getting… garnering witness statements can be really difficult. People really worried about, I mean, I think of a case that I worked on not that long ago where this involved the death of a young person. And people were very nervous about providing supportive statements to my client based on the fact that the HCPC would read those statements and go, wait a second, maybe there's something there we can raise against you. So there's a fear that if I engage in the process at all, maybe they're going to see fault in my behavior. And that's, in my experience, the HCPC doesn't really work like that, but it's not impossible for that to happen. So if you're reading complaints, there's a concern raised against say a physiotherapist, and within that, you're reading a report, which was commissioned by the trust. And within that report, they've raised concerns against the person who has the concerns raised against them, the physio. But there's also some suggestions that some other people have not done the appropriate things from the internal report. The HCPC, in theory, can open investigations into them. So people don't want to engage. And that's one of the problems with the HCPC, which I think we'll talk about a bit later, is something that they can improve because there is a real fear of, well, what's going to happen to my testimony? What's… should I even respond to this email? And the reality is, in the interest of procedural fairness, you should respond. You should be able to present your version of events or your supportive state without any of you being investigated yourself. So it's something they need to work on.

Yeah. So it sounds like, you know, in terms of the impact on people, there's, you know, the sort of horror of receiving a complaint and the idea that, you know, things might be risky for you or that you might have done something to harm someone or that someone thinks you've done something to harm one, the sort of professional risk and horror of that. But the actual process of the investigation in itself sounds awful and sort of traumatic kind of adding insult to injury. That's really hard.

It's never easy. I think that's essentially, there's no way to sugarcoat it. It's not easy to have your integrity questioned. Again, I refer back to my original sort of premise that if we understand why it's there, we can sort of accept a little bit more readily that essentially the purpose of the regime is there for the public good, but the impact on the individual is intense.

The only way, I think that we, one can deal with it appropriately is to, to use some particular psychologists, is to use some of the techniques that, that you guys, help other people with in terms of, you know, meditation or whatever it is in terms of managing your own expectations, try not to catastrophise these sorts of issues that you talk with clients about. So for psychologists, I often say to some of my clients, I can hear you sound very anxious, I can hear you sound very angry. That's a common experience I have. And what I'll say is, well, that anger is really only affecting you, and your anger towards the HCPC and the case manager. And what will happen often with the HCPC, if you have a three year case, a case that you have in the system for two, three years, you will maybe have six different case managers. So the person that you're dealing with, and that sounds extreme, but it's actually not. In fact, if you have a one year case, you're lucky to have three different case managers. Because the lifespan of an HCPC case manager is very short. You can get very, very good, you can get some great aspiring lawyers that end up moving on to being top… there's not a reflection on the nature, the quality of the people that take that job, but it's often a stepping stone to other things and it's not very well paid. So if we understand that wait a sec, that person I've been dealing with for three months is now gone. And I've got another one who doesn't even know who I am. And then I've got another one who's sending me very blunt emails. Getting angry is the natural response, but it's not going to help you. It's actually, particularly as a psychologist, it's something, you know, some of the systems that you have in place to assist your clients, to incorporate those into your daily life. Yeah, it's not easy. There's no other way to say it. Some of those clients that I've had that have dealt with a few complaints. And I've seen sort of heads of trusts, so very experienced, high up, in this case, psychologists who've been in the profession for 30 years and as the head of trust have had complaints raised all the way up the system. So they've had a few complaints. So as I said about previously, you may have a person in the example of the death of a young person. You may have the parents raise complaints against the treating psychologist, anyone involved in the DMTs, anyone involved in the treatment externally, head of hospital, the head of, so that's eight complaints. The person at the very top will be like, well, this has happened before. I trust the process. I've been okay so far. So I look to those as ways, as examples of how to best cope with the ride, because it's a ride.

So if we think about, I mean, you've mentioned quite a few things, but what changes you would like to see in the process? What improvements would you like to see happen?

Yeah, I mean, it's a question I get asked quite regularly. Having worked there and seen the issues that exist, I mean, fundamentally, I would argue that the main problem is a funding issue. There's not enough case managers. So in terms of expediting cases, they just need to have more case managers. So that's the first basic, simple change that could happen. It's just double your team. Have people working more closely on cases and having less cases. So for example, instead of having 20 cases that you need to investigate as a case manager, have five and then you'll get better. But I think that's not going to happen. That's unlikely. So I think a more realistic issue that could be improved is transparency with communications. So I think a lot of people are really upset and I know the ACP dealt with that, is the, there's limited updates from the HCPC, there's unclear explanations about the process, timelines are unclear. And I think even just explaining, for example, what I just did, that we are waiting for the report and that is going to take a year and a half. And until then we're reserving judgment. That is very, very rarely passed on to registrants. So knowing what I'm waiting for is a pretty basic step, and I think a decent step. What am I waiting for? I'm waiting for the conclusion of the police investigation, which has nothing to do with you personally, but you're involved in that. And we're to take some reading of that. So that's one way it could be improved. And I think that's probably the most common complaint. Like I've not been updated for nine months, for a year, and then suddenly a completely different complaint raised against me. So it was a very broad complaint and now it's not even related to the original letter I received. That's a very common one. Secondly, I think more emotional and psychological support for registrants. I don't know how well the HCPC recognises the emotional toll that the FTP investigations have. They paid lip service to that. So there is an understanding at least publicly that this is a difficult process and they have some form of support systems within the HCPC, but in my opinion, they're not really fit for service. So embedding or partnering with counseling support services might be a better way of doing it and really being kinder to registrants. So when I was there, I tried to do that and it was one of the reasons, you know, if you're making 10, 15 phone calls, updating people, you know, understand that this is really important to those individuals and that's to do with training. So better training into the psychological impact. That's something HCPC could definitely work on. And maybe also a better understanding of proportionality. So early resolution for cases that are clearly going nowhere. So people are waiting in limbo for years for something that is pretty clear. When I, as a defendant, or representing someone as a defendant, talk to an HCPC case manager privately, I will say, OK, so what's your view on this? And quite often, their view will be, well, we don't think it's really going anywhere. So in that case, you know, well, let's resolve it. So there are, you know, managing that with giving everyone the opportunity to be heard is a fine balancing act. This is not simple stuff. There's no fixed solution. It's complex. If you talk to anyone involved with any regulatory body, it's a similar problem across all bodies. So there's not really any quick fix solution, but they could definitely improve, yeah, early resolution for cases that are going on nowhere, better training, more emotional support and greater funding. That would be the sort of my top suggestions.

Yeah, great. So maybe just to end off with Nicholas, to think about what the do's and don'ts might be, your advice for anyone who has the dreaded phone call or the email. What would you suggest?

First off, don't panic. Straight away, the first instinct is to go into sort of crisis mode. And that's, first of all, in a procedural sense is not the best approach to take and also in a mental health sense is not the best approach to take. So take the complaint seriously, but don't panic about it. It doesn't in any way, there's no absolute certainty that anything's going to be proven. It may not proceed beyond the initial stage. This is just the first step and it may be the final step. Secondly, look after your mental health. I mean that, it sounds simple, but in terms of how well, how best you prepare your defense, in terms of how best you continue to live with your life in your family life, in your professional life will be determined by how well you're looking after yourself. So if you are in full panic mode from the outset, and this is going to go for three years, well, your life is going to crumble. If you accept that it's, well, there's a system in place, the truth is going to come out. I'm okay. I've done everything correctly. If I want to use statistics, it's unlikely in a statistical sense that I'm going to be struck off. And I need to just look after my family. I need to keep connected with my colleagues. I need to look after my mental health. So the second advice would definitely be, you know, it's common for people to feel shame, isolation, fear of professional ruin. That sense of shame is very common and it's a wasted expenditure of energy because there's no shame in having these issues raised against you. In fact, I would argue in some circumstances, the fact that you're dealing with some very vulnerable people in highly complicated cases, it's only natural that eventually in 20 years experience, someone's going to raise a complaint against you. It doesn't anyway reflect upon the fact that you've done anything wrong. Maybe you're on the coal face, you're dealing with those issues head on. So kudos to you. So that's one other way of looking at it. I would definitely say engage. Now this is something that people do not do. Of course, psychologists in my experience are better than other professions, but some people are so angry, are so hurt that they just go, I'm not even talking to the HCPC. Now that does not work, it reflects poorly on you. You're showing a lack of respect to the institution, whether you dislike it, whether you hate it, whether you think that the whole thing is a scam, whether you think it's corrupt. I've heard that allegation as well. Accept the fact that the regime is there in place for a good reason. So therefore engage with it. Say you disagree wholeheartedly, put your voice forward. Absolutely put your case forward, but do not ignore letters. Do not ignore that phone call. Do not, not take it seriously because not taking it seriously and not engaging is really the worst legal step you could take because our panel will go, well what are they hiding? Just put your case forward, get some connections. I'd say get professional support very early, whether that's with your regulatory, with your professional body like the ACP, whether it's with people like myself, whether it's with colleagues. Yeah, the way I essentially structure my work is to yeah, to be involved in the emotional support at the beginning, be involved in the preparation of bundles. We really have a proactive response because I think the biggest issue people have is they feel like I don't have control of the situation. So after this many years experience, the first thing I say is, okay, let's take control. We can't wait for these emails. We can send chaser emails to the HCPC saying, when are you updating? What are you doing? But you might be throwing them into the ether. We can keep on trying to get them to respond, but what we can do is proactively move forward. So that means thinking about the types of evidence we need to start to collect, thinking the types of witness statements we can find. So talking with colleagues, okay, so this is the timeline, these are the dates, who am gonna talk to, to be ready? Get a list, a plan of action, things every week. And that once you've regained control of the situation, that I feel like makes people feel, yeah, more comfortable, less stressed. It's not an elixir, you're still gonna have that sense of anxiety, but it definitely helps. If you just throw your hands up in the air and go, ‘I'm not talking to anyone about it. I'm not talking to my colleagues. I'm not talking to my line manager.’ And people do this. ‘I'm so ashamed. I'm going to take a couple of weeks off work. I'm going to sit in my room.’ And I've seen that. And I've literally been the first point of contact for some registrants who haven't left the house. And it sounds extreme, but this is some of the responses people have. Like, what do I do? I'm going to lose my mortgage. I'm going to lose my house, my husband, my wife's gonna leave me, whatever it is, these are natural responses. It's sort of a crisis mode that can happen. Try and be very careful not to slip into that crisis mode, because this is gonna go for a long time. According to statistically, even if you go to ICP, you're likely to wait a year. So there's a fair chance you're gonna wait for a year. And to be on high revs in crisis mode, we know as psychologists, as you guys are, is not a healthy way to exist. You need to stay calm, seek support. Again, I refer to the ACP as one of the best representative bodies that I work with. I work with a few others in different professions. They work actively to support their members. I've got no reason to say that, they really are a great body. So if you have a question that you need to know, or you're unsure about what are the support systems, contact them, contact legal consultants like myself as well.

And would you, I guess you'd be contacting your indemnity insurance, your professional indemnity?

Yes, absolutely. I mean, that's a slightly different discussion. I mean, who your insurer is, I mean, you'll have a discussion with your insurer who's going to actually run the case, because often your insurer will have a designated law firm they work with. It's your decision whether you want to go with that law firm. In my experience, some people are not very happy with the care that they get. So that's something for you to decide. But yeah, you definitely need to contact your insurer and determine which way you want to go. Whether you actually follow their suggested path, that's something entirely for you and you don't have to. It's worth noting that.

Yeah, okay, okay, great. Anything else, Nicholas, that you want to add or any final kind of take-home messages for the listeners?

Yeah, I mean, it's a difficult and fraught process, the FTP process. So to understand the purpose of why it's there, to realise that you are not alone in this and it is a possibility, a statistical possibility that if you have a career of 30 years, you are going to encounter the FTP regime. That may be that you're raising a concern against someone else and that's okay. You're allowed to do that if you think someone's acting inappropriately. You may be asked to provide a witness statement. You may be a professional appearing in a tribunal. To understand the process is very worthwhile and to really accept the fact that it's there for the right reasons, to not panic, as I said earlier, and to understand that looking after your mental health as you approach what is very likely to be quite a drawn out process is really something you need to do. And finally, I'd say trust the fact that in the end, if you have acted appropriately, it will come out in the wash. The steps are there in place. Even if it has to go all the way up to ICP and final hearing, if there's a rigorous investigation of the evidence and you are confident that what you did is right, it'll come out. It will definitely come out. So be confident in your actions and look after yourself. That'd be my final word.

Brilliant. And it's so great to know that you are out there, that there's people like you who can provide that support. That also wasn't something I was aware of. And as you say, the ACP UK does have a great support scheme for its members to support them emotionally and practically through this process. So we're going to include all the links so people can find you and find the support in the ACP as well, if they need it. But brilliant. Thanks so much, Nicolas.

Thanks so much Paula.

Thank you for listening. If you've enjoyed this episode, please support the podcast by sharing it with others, posting about it on social media, or leaving a rating or review. I'd love to connect with you, so do come find me on LinkedIn or at my website, and do check out ACP UK and everything it has to offer. All the links are in the show notes. Thanks again, and until next time, take good care.