David Littlefair

Preliminary Matters

Proceeding in private

1. Ms Welsh made an application to hold part of the hearing in private, given that private health issues may arise in the course of the hearing. The Applicant agreed and said that he wanted to raise such matters with the Panel. Having taken legal advice, the Panel decided that it was fair and appropriate to allow parts of the hearing to be heard in private in order to protect the Applicant’s private life.

Background

2. Mr Littlefair was present and represented himself. Ms Welsh, for the HCPC, set out the position. She referred to the relevant rules of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) and to Article 33 of the Health Professions Order 2001 regarding restoration. She referred the Panel to the HCPTS Practice Note on “Restoration to the Register” and summarised the background, including the decision of the panel at the substantive review hearing on 11 November 2011 to strike the Applicant from the Register. This followed a substantive hearing which took place on 16 November 2010, when a panel of the Conduct and Competence Committee found misconduct and imposed a 12-month Suspension Order.

3. Ms Welsh told the Panel that on 15 and 16 November 2010, a substantive hearing took place regarding a number of allegations. These included a refusal by the Applicant to conduct an x-ray, acting in an inappropriate and aggressive manner towards an A&E Consultant, refusing to discuss the incident, inappropriately instructing a patient to walk when they had an injury, making rude and inappropriate comments to a patient, causing unnecessary pain to a patient, removing his name badge to conceal his identity, and treating a patient inappropriately.

4. All the allegations were found proved at the substantive hearing, which the Applicant did not attend. The panel on that occasion found that several of the HCPC “Standards of Conduct, Performance and Ethics” had been breached and that the Applicant’s actions amounted to misconduct. A serious lack of insight was found, the Applicant not having engaged in the process, and a 12-month Suspension Order was imposed. At the review hearing on 11 November 2011, the Applicant did not attend and provided no information. That reviewing panel imposed a Striking Off Order.

The Applicant’s Evidence (10 October 2022)

5. At this hearing, the Applicant gave an Affirmation and gave evidence. He told the Panel that he qualified as a Radiographer in 1991. He worked from 1991-1997 as a Radiographer, then worked intermittently between 1997 and 2001, and then worked full-time again as a Radiographer from 2001. He was a Band 6 Senior Radiographer until he resigned in 2009. He did not attend his disciplinary hearing in respect of the allegations subsequently referred to the HCPC. He otherwise had a clean record, but told the Panel that from 1991 onwards, his employer had taken disciplinary proceedings against him about three or four times. These were in respect of similar unprofessional conduct related to his relationships with colleagues and patients, and shortcomings in his interpersonal relationships at work. None of these led to a dismissal or a referral to the HCPC.

6. The Applicant told the Panel that he went to New Zealand on 01 March 2010. He knew the HCPC substantive hearing was taking place and chose not to attend. Whilst in New Zealand, he had worked as a Radiographer in Wellington from 01 March 2010 until July 2011. He had stopped work as he thought that the HCPC or his previous employer had contacted his employer in New Zealand and they had removed his licence to practice. He said that he had gone to New Zealand not to escape proceedings in the UK but due to his wife wanting to work overseas. The Applicant said that he had not notified the authorities in New Zealand of the HCPC proceedings. When his licence to practice in New Zealand was removed, he did not challenge it and accepted that his fitness to practise was impaired and that it was not appropriate for him to work as a Radiographer. The Applicant said that in August 2020, he returned to the UK. He did not seek to practice as a Radiographer at that time, having understood that he had conducted himself in a very unprofessional way.

7. The Applicant said that his health condition undermined his professional performance.

8. The Applicant said that when he returned from New Zealand, he had stayed with his sister and her family, whom he had told about being struck off, and that she and her husband encouraged him to apply for restoration to the Register. He told the Panel that he had completed his Return to Practice procedure and, having contacted a local hospital, they had encouraged him to complete the course. He said that he had done a Return to Practice course in August to December 2021 and he had been very aware of his past misconduct. When he did that course, the Applicant said that it felt like he had never been away, and he had felt that he “polished” his efficiency and swiftly felt able to assist students and colleagues. He said he felt his return was a key to making up for his past shortcomings. He said he was very pleased to learn that his professional skills were still there and he had enjoyed the work, and had been very aware of seeking the highest professional standards. He wanted to impress patients and do a good job and build positive relationships.

9. The Applicant said that he had reflected, and it occurred to him that the problems he had faced in his life were due to him and his health condition. This made him realise that it was important to maintain good professional standards and this required acknowledgement of one’s own health. In 2022, the Applicant said that he had continued to read to try to keep his professional practice up-to-date, but realised that good technical skills and good relationship abilities were important for a Radiographer.

10. The Applicant said that he now saw things more clearly, that he wanted to identify and overcome his professional shortcomings, and that he had a deep desire to make amends. He felt that he still had 20 years to work. He said he wanted to be a better man, to be more humane in his practice, and to set a good example to others and make a contribution. He said that he had not, but could, get a reference from his supervisor for his Return to Practice course. He said he could also provide more details of formal Continuing Professional Development (CPD) or courses which the Applicant knew he would have to undertake.

11. In response to questions from Ms Welsh, the Applicant said that in 2009, at the time of the Allegation, he now thinks that he had just wanted to run away from the situation. He said that he now understands the importance of acceptance. He was now a more empathetic and compassionate person. He said his sister was a good support and he sees her very regularly, as she lives nearby. The Applicant told the Panel about the importance of trust in the profession.

Decision on adjournment on 10 October 2022

12. The Panel was mindful of the evidence it had heard from the Applicant and noted, in particular, how recently the Applicant had begun to engage with support. In his own evidence, the Applicant stated how early he is on his path to full engagement with support. The Panel was also mindful that it did not have before it any verification or independent evidence regarding the Applicant’s health.

13. The Panel accepted legal advice and decided that it was fair and appropriate to adjourn this hearing to be concluded on a future date. The HCPC remained neutral on the matter.

14. The Panel decided that it would likely assist the Panel for the Applicant to provide the following information no less than 7 days in advance of the resumed hearing:

• Details of any Continuing Professional Development (CPD) undertaken, including reflections on any informal CPD;

• A reference from VT, Supervising Radiographer at Kent and Canterbury Hospital, assessing his performance;

• Any further reflective pieces.

Resumed Hearing (07 December 2022)

15. The hearing resumed on 07 December 2022. The Applicant gave further evidence and told the Panel about his CPD, including reading the HCPC Standards and the relevant regulations known as IR(ME)R (2017), which are the ionising radiation (medical exposure) regulations. He told the Panel that he had also done more reading about his health condition, and that had helped him in his practice and had also helped him to better understand his own situation. He said he was seeking to better understand his health condition, which had adversely affected his personal and professional performance, which he regretted.

16. The Applicant said he did not want to ever repeat his misconduct and did not want to be “that person” who had been struck off in 2011. He wanted to give his patients good care. He said he now had compassion for himself and others. He had ambition and wanted to work as a Radiographer to make amends, to be trusted by colleagues and the public, and to make a contribution. He wanted to support and assist younger members of the profession.

17. The Applicant told the Panel that he was also undertaking an exercise regime which he said he felt had helped him. Although he did not do so often, he had also decided not to drink alcohol. He was open with his friends and family about his well-being and said that he felt well-supported.

18. The Applicant said that with regard to professional skills, he planned to refresh his knowledge of anatomy. He was also keen to develop his emotional intelligence, as he felt that would reduce the risk that he would repeat his misconduct. He said that he understood that the Return to Practice course was required before he can be restored to the Register.

Closing Submissions

19. Mr Bellis closed the HCPC case and reminded the Panel of the HCPTS Practice Note on “Restoration to the Register” and its role and powers when considering the restoration application, and its powers to impose conditions of practice. He said that steps have been taken to address the underlying issues and that the Applicant fully accepts his misconduct. He reminded the Panel that the initial decision was to suspend the Applicant and that Strike Off was imposed at a review of that order, the Applicant not having engaged to any extent at that stage. Mr Bellis adopted a neutral position on what decision the Panel ought to take.

20. The Applicant said that he had told the Panel about his position and stated that he wanted to apologise for his past misconduct. He said he ideally would want to meet and apologise to the patients who had suffered as a result of his actions. He wanted to make amends for his wrongdoing, and said he wanted to be a more professional Radiographer and a better person.

21. The Legal Assessor referred the Panel to the HCPTS Practice Note on “Restoration to the Register”. He reminded it about the factors to be carefully considered in light of all the evidence it has heard. It must be satisfied, on the balance of probabilities, that the application is made out, and he pointed out that the Panel may make a restoration subject to conditions and impose conditions of practice. The Panel requires to be satisfied that the Applicant meets the general requirements for registration, that he is capable of safe and effective practice, and is a fit and proper person to practice his profession having regard to all the circumstances, including those that led to the striking off.

Decision

22. The Panel carefully considered the HCPTS Practice Note and assessed all the evidence before it. The Panel found the Applicant was open, honest, credible, and reliable. It considered the documentary evidence received regarding the Applicant’s health condition, and the reference provided to the HCPC by VT, who supervised the Applicant’s Return to Practice course.

23. The Panel took account of the findings of the substantive hearing in 2010. The Applicant did not engage at that time, or later at the review of the Suspension Order, when it was replaced with a Strike Off Order.

24. The Panel heard extensive evidence from the Applicant about his health condition, his understanding of it, and his engagement with support. He explained that he has sought and continues to receive support. The Panel now has before it medical evidence confirming a number of health conditions and a detailed reflective statement from the Applicant. He continues to seek to learn about, understand, and deal with his health condition.

25. The Panel found that the Applicant was highly motivated and engaged in managing his health condition and his general well-being. He was open and the Panel found his evidence was cogent and comprehensive. The Panel accepted that he has made good progress. He has developed better relationships with friends and family. The Panel was satisfied that the Applicant appears to have good support networks in place, and that he is vigilant as to his well-being.

26. The Applicant has done 60 hours of a Return to Practice course. The Panel was also satisfied that the Applicant has the formal professional qualifications to be a Radiographer.

27. The Panel was satisfied that the Applicant has demonstrated good and sufficient insight into his past conduct. The Panel was satisfied that, on balance, the misconduct found in 2010 was rooted in the health condition which at the time the Applicant did not recognise, but which he has now clearly and credibly told the Panel he understands and manages well. The Panel was satisfied that the Applicant has demonstrated that he has a good understanding of, and continues to effectively manage, his health condition, and that he continues to actively engage in support.

28. In all the circumstances, having had regard to the particular circumstances that led to the striking off, the Panel found that the Applicant has taken steps to sufficiently remedy his deficiencies. The Panel concluded that the Applicant’s fitness to practice is not currently impaired, and that he is a fit and proper person to be restored to the Register.

29. The Panel was mindful that the Applicant has been out of practice since 2009. He has taken steps to maintain, so far as he can, his professional development, training, and education. The Panel noted that he has already completed a Return to Practice course. Whilst it is likely that on return to practice he will be given some level of supervision in the work place, the Panel considered that it was important for the safety of service users, in the Applicant’s own interests, and in the wider public interest in order to maintain confidence in the profession that such an arrangement should be formalised by the imposition of conditions of practice.

30. The Panel decided therefore to allow the Applicant to be restored to the Register subject to the following conditions of practice:

1. In the six months following the commencement of your employment as a Radiographer, you must place yourself and remain under the supervision of a workplace supervisor, registered with the HCPC or other appropriate statutory regulator, and supply details of your supervisor to the HCPC within 14 days of commencing such employment. You must attend upon that supervisor as required and follow their advice and recommendations.

2. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work;

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application).

The Registrar is directed to restore the name of Mr David A Littlefair to the Radiography part of the Register, but restoration is only to take effect once the Applicant has:

(a) provided the Registrar with any information and declarations required for admission to the Register;

(b) paid the prescribed restoration fee;

(c) satisfied the Registrar that, in relation to the Applicant, there is or will be in force appropriate cover under an indemnity arrangement; and

(d) provided evidence which satisfies the Registrar that the Applicant has successfully completed a 60-day period of professional updating in accordance with the HCPC Standards for Return to Practice.

And

The Registrar is further directed to annotate the Register to show that, for a period of 12 months from the date that this Order takes effect (the Operative Date), the Applicant must comply with the following conditions of practice:

1. In the six months following the commencement of your employment as a Radiographer, you must place yourself and remain under the supervision of a workplace supervisor, registered with the HCPC or other appropriate statutory regulator, and supply details of your supervisor to the HCPC within 14 days of commencing such employment. You must attend upon that supervisor as required and follow their advice and recommendations.

2. You must inform the following parties that your registration is subject to these conditions:

A. any organisation or person employing or contracting with you to undertake professional work;

B. any agency you are registered with or apply to be registered with (at the time of application); and

C. any prospective employer (at the time of your application).

No notes available

History of Hearings for David Littlefair