Mr Stuart Grave
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During the course of your employment as an Operating Department Practitioner for The Royal Liverpool and Broadgreen University Hospitals NHS Trust:
1. On 14 November 2011 whilst on duty you self-administered oxygen from an anaesthetic machine.
2. On 2 August 2013, whilst on duty you:
a) Misappropriated 2 ampoules of tramadol from your workplace;
b) Self-administered the tramadol described in paragraph 2a).
3. Your action as described in paragraph 2a) was dishonest.
4. Your actions as described in paragraphs 1 – 3 constitute misconduct.
5. By reason of that misconduct your fitness to practise is impaired.
1. The Panel has been convened to undertake a review of a substantive suspension order imposed on Mr Grave. Mr Grave has neither attended the hearing nor been represented at it.
2. The Panel first considered whether a valid notice of hearing had been sent to Mr Grave. It concluded that the letter dated 7 June 2016 addressed to Mr Grave at his address as it appeared on the HCPC Register at that date, informed him of the day, time and location of the hearing, and constituted good service.
3. The Panel next considered the HCPC’s application to proceed with the hearing in the absence of Mr Grave. The Panel accepted the advice of the Legal Assessor that a decision to proceed in the absence of a registrant is one that should be taken with great care and caution. The Panel also considered the factors identified in the HCPC’s Practice Note entitled “Proceeding in the Absence of the Registrant”. Having carefully considered the matter, the Panel concluded that the hearing should proceed in the absence of Mr Grave. The reasons for this decision were:
• It was clear that Mr Grave had knowledge that the hearing was due to take place today as he replied to the emailed notice of hearing. In that reply he clearly stated that he would not be attending the hearing. The Panel has therefore concluded that he has voluntarily absented himself from it.
• Significantly in view of the fact that previous Panels have made suggestions as to information Mr Grave might wish to supply to a reviewing Panel, he has had an opportunity to make written submissions for the purposes of today's hearing.
• The review of the current period of suspension must take place before 6 August 2016 as from that date jurisdiction to make an order will be lost.
• Not only are there no grounds for believing that Mr Grave would be likely to attend a hearing before jurisdiction is lost by the expiry of the current period of suspension, but it is doubtful whether there is time for the HCPC to provide valid notice for such a hearing.
• All these factors result in the clear public interest in the review being undertaken expeditiously outweighing the absence of Mr Grave.
4. The order being reviewed today is a suspension order imposed for a period of six months to run from 6 February 2016. The history of the matter is as follows:
• Mr Grave was employed as an Operating Department Practitioner in the Theatres and Anaesthetics Directorate at the Broadgreen University Hospital from 1 July 2002 until his employment was terminated in connection with the events underpinning the HCPC case. On 14 November 2011 he was seen with the patient end mouthpiece of an oxygen anaesthetic machine in his mouth. At a disciplinary hearing held in July 2012 he admitted self-administering oxygen. During a working shift on 2 August 2013 he self-administered Tramadol that he had taken from the medications cupboard. He was found by colleagues in a collapsed state in the corridor outside surgical theatres. Empty ampoules of Tramadol were found around his body and he admitted the unauthorised taking and use of that drug.
• On 9 July 2014 a Panel of the Investigating Committee found that there was a case to answer in relation to the allegations that are set out at the head of this written determination.
• The final hearing of the allegations took place on 9 January 2015. Mr Grave did not attend it. The Panel conducting that hearing found that Mr Grave’s fitness to practise was impaired by his misconduct, the facts constituting the misconduct being those matters set out in paragraphs 1, 2 and 3. In deciding that the appropriate sanction was a Suspension Order for a period of 12 months, the final hearing Panel decided that such an outcome was proportionate notwithstanding the seriousness of the findings in view of the fact that Mr Grave had practised without concern about his abilities for many years and that it would be possible to contemplate his return to practice. The Panel made a number of suggestions of information Mr Grave might wish to consider providing to a reviewing Panel. They suggested independent evidence that health issues had been satisfactorily addressed, information that he had kept his skills and professional knowledge up-to-date as well as personal testimonials.
• A review of the suspension order imposed at the final hearing took place on 21 December 2015. Again, Mr Grave did not attend the hearing. Mr Grave sent an email indicating he had been drug free for two years. However, he provided no further substantial or corroborative evidence, whether in accordance with the suggestions of the final hearing Panel or otherwise. The reviewing Panel decided, that in view of the background health issue, it would not be appropriate to deny him the opportunity to demonstrate that he is, or might be, fit to practise. Accordingly, in order to give Mr Grave an opportunity to engage in the process, they imposed the further period of suspension currently being reviewed and associated themselves with the suggestions as to the information he would be well advised to consider supplying.
5. The submission made on behalf of the HCPC today is that if the Panel concluded that Mr Grave should be given a further time to remediate the findings made against him, then a yet further period of suspension should be ordered. If the Panel concluded that there was no point in such an opportunity being given, then a striking-off order should be considered.
6. Mr Grave’s submissions have been limited to stating changes to his health and that he wishes to be removed from the HCPC Register.
7. The Panel has approached this case on the basis that it has first to consider whether Mr Grave’s fitness to practise is still impaired. The Panel’s considerations are as follows:
• The present Panel agrees with the view of both the final hearing Panel and the reviewing Panel that the findings against Mr Grave were potentially remediable. The present Panel finds, however, that given the seriousness of the findings, substantial and independent evidence that underlying problems had been addressed would be required. Given the nature of the issues involved, that evidence could only come from Mr Grave, and quite simply he has not provided it. It follows that it is not possible for the present Panel to find that his fitness to practise is any less impaired than it was at the time of the final hearing in January 2015.
• Mr Grave has provided no evidence of insight into his shortcomings.
• The public would be concerned at the prospect of an Operating Department Practitioner against whom these very serious findings have been made being permitted to return to unrestricted practice in circumstances where there has been no insight and a lack of remediation.
In the Panel’s view, the Registrant’s fitness to practise remains impaired.
8. The Panel next considered whether the finding that Mr Grave’s fitness to practise is still impaired necessitated a further sanction when the current period of suspension ends. The Panel approached this issue on the basis that a further sanction should not be imposed to punish Mr Grave, but should be the least restrictive consistent with what is required to protect the public and to maintain a proper degree of public confidence.
9. The conclusion of the Panel is that a further sanction is required to protect the public and to maintain a proper degree of public confidence as well as declaring proper standards of behaviour. The Panel considered the available sanctions in an ascending order of gravity and concluded that no sanction that would enable Mr Grave to return to practice, even subject to conditions, would afford a proper degree of protection and public confidence. It followed that the realistic choice was between a yet further period of suspension and striking-off. The Panel concluded that no purpose would be served in ordering a further period of suspension. Mr Grave has repeatedly stated that he wishes his name to be removed from the HCPC Register. That view is consistent with his decision not to embrace the suggestions made by the two Panels that imposed suspension orders to enable him to reconsider whether he wished to return to practice. The logical conclusion of these findings is that a striking-off order is required.
With effect from the expiry of the current period of suspension, namely from 6 August 2016, the Registrar is directed to strike the name of Mr Stuart Grave from the Register.
Right of Appeal:
You may appeal to the appropriate court against the decision of the Panel and the order it has made against you. The appropriate court is the High Court in England and Wales.
Under Articles 30(10) and 38 of the Health and Social Work Professions Order 2001, an appeal must be made to the court not more than 28 days after the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.
European alert mechanism
In accordance with Regulation 67 of the European Union (Recognition of Professional Qualifications) Regulations 2015, the HCPC will inform the competent authorities in all other EEA States the your right to practise has been prohibited.
You may appeal to the County Court against the HCPC’s decision to do so. Any appeal must be made within 28 days of the date when this notice is served on you. This right of appeal is separate from your right to appeal against the decision and order of the Panel.
History of Hearings for Mr Stuart Grave
|Date||Panel||Hearing type||Outcomes / Status|
|08/07/2016||Conduct and Competence Committee||Review Hearing||Struck off|
|21/12/2015||Conduct and Competence Committee||Final Hearing||Suspended|