Mr Phillip Grantham
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1. Submitted to the HCPC a CPD profile for 2014, in which you:
a. Plagiarised the CPD profile of Practitioner A which was submitted to the HCPC in 2012, in the following parts:
i. E Learning;
ii. Immediate Life Support;
iii. Fluid Management System (FMS);
iv. Flowtron Universal Training;
v. In conclusion;
vi. The CPD Profile number and;
vii. The Registration number,
viii. Medical Gases
2. The matters set out in paragraph 1 constitute misconduct.
3. By reason of your misconduct your fitness to practise is impaired.
1. The Panel noted that, in a letter dated 19 February 2016, the Registrant had advised that he would not be attending the hearing. He confirmed that he had admitted the allegation against him. The Panel was satisfied that notice of today’s hearing had been properly served on him at his address as it appears on the HCPC Register. The Panel next considered whether to proceed to hear the case in the Registrant’s absence. Given the stated intention of the Registrant not to attend the hearing, the Panel did not consider that any purpose would be served in adjourning these proceedings. The Panel was satisfied that there was no prospect of the Registrant attending on another occasion if these proceedings were to be adjourned. In reaching its decision, the Panel has taken account of the HCPC’s Practice Note on Proceeding in Absence and has borne in mind the advice which it has received that, if it determined to proceed in the Registrant’s absence, it should ensure that the hearing is conducted as fairly as possible and should take account of all those matters which are favourable to him and expose weaknesses in the case against him. After careful deliberation, the Panel determined to proceed in the Registrant’s absence in terms of rule 11 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003.
2. At the outset, the Panel invited Ms. Eales to consider whether there was an element of dishonesty in this case which had not been expressly charged. Ms. Eales invited the Panel to give the word ‘plagiarised’ its ordinary dictionary definition. She informed the Panel that “plagiarism” in the Oxford English Dictionary is defined as ‘the action or practice of taking someone else's work, idea, etc., and passing it off as one's own; literary theft’. As such, the definition of the word “plagiarised” incorporates the element of dishonesty. The Panel, having deliberated, considered and accepted that dishonesty is inherent in plagiarism.
3. The allegation against the Registrant arises from his registration as an Operating Department Practitioner (“ODP”). It is alleged that he submitted his profile for Continuing Professional Development (“CPD”) to the HCPC having plagiarised the CPD profile of another practitioner for an earlier year. The allegation is framed in terms of misconduct under articles 22(1)(a)(i) of the Health and Social Work Professions Order 2001. The Panel reminded itself that the burden of proof is on the HCPC to prove the facts set out in the allegation and that it is not for the Registrant to disprove any of them.
4. As noted, the Registrant was not present at the hearing. In a written submission date-stamped by the HCPC as having been received on 5 January 2015, he explained certain personal circumstances which had affected his life in the period prior to being required to submit his CPD profile. He explained that those circumstances had impacted on his life in a way which had caused him to be less organised and had led to the matters which are the subject of the allegations. He indicated that he had left the completion of his own CPD very late and had copied and pasted the CPD of a colleague to submit to the HCPC. Although he appeared to concede the matters alleged against him, he did not, in terms, admit the allegations against him.
5. The Panel had regard to the oral and written evidence of Witness 1, Registrations Quality Assurance Manager at the HCPC. He adopted his Witness Statement and explained to the Panel that the HCPC has five CPD Standards in terms of which a registrant must (1) maintain a record of CPD activities; (2) demonstrate that their CPD activities are a mixture of relevant learning for current and future practice; (3) ensure that the CPD undertaken has contributed to the quality of their practice; (4) ensure that the CPD benefits patients and service users; and (5) if requested by the HCPC, provide a written profile, which must be the registrant’s own work and for which evidence must be provided, showing that they have met the requirements and standards for CPD. He gave evidence about the requirements to complete the CPD annually and to confirm having done so. Each year 2.5% of registrants are randomly selected to submit their CPD profile for audit purposes. It was his evidence that the Registrant had been selected in 2012. He gave evidence of the communications which had been sent to the Registrant by the HCPC in this regard. He told the Panel that an application for deferral had been made by the Registrant and that he had been allowed until September 2014 (the next renewal period for his profession) to submit his CPD profile. It was eventually received on 25 November 2014. Witness 1 told the Panel that, on receipt by the HCPC, the CPD profile had been checked in the usual way. However, it was the Witness’s evidence that, although the Registrant’s CPD number was displayed on the front cover, the CPD number of a different registrant appeared in the accompanying documents.
6. In his oral and written evidence, Witness 1 confirmed that, as far as he was aware, the Registrant had not submitted a list of his actual CPD activities at the end of 2012. He told the Panel that, in their letter dated 27 December 2012, the Registrant’s employers had sent to the HCPC a record of his professional development activities since 2002. However, most of these had not been relevant to the HCPC’s audit of the activities undertaken by the Registrant within the previous two years, 2010 to 2012. Having received the Registrant’s plagiarised CPD profile in 2014, the matter was referred to the Fitness to Practise Department because of the concerns. He also told the Panel that registrants are required to make a declaration of compliance with CPD standards every time they applied for their registration to be renewed. Registrants are required to observe the guidance set out in the HCPC guidance documents entitled “Continuing Professional Development and your Registration” and “How to complete your continuing Professional Development Profile”. All registrants are required to undertake CPD but are not required to submit evidence of compliance unless specifically called upon to do so. As a consequence, registrants are taken on trust, and verification is only through the random audit process.
7. The Panel accepted the evidence of Witness 1 as objective and credible.
Decision on facts:
8. The Panel finds that the Registrant, as a registered Operating Department Practitioner, submitted to the HCPC a CPD profile for 2014 which was plagiarised. It was manifestly clear, because of the reference in that CPD profile to the CPD profile number of another registrant (“Practitioner A”) which had been submitted to the HCPC two years previously, in 2012, that the Registrant had copied and pasted that person’s CPD and presented it as his own. The Panel has had regard to the documents contained in the bundle and to the evidence of Witness A. The Panel has closely examined the documents in the bundle and is satisfied that the documents relating to (i) eLearning; (ii) Immediate Life Support; (iii) Fluid management System; (iv) Flowtron Universal Training; (v) “In conclusion”; (vi) The CPD profile number; (vii) The Registration Number; (viii) Medical Gases; were virtually identical in every respect to the CPD profile submitted by Practitioner A in 2012. The Panel has accepted the evidence of Witness 1 and finds that the Registrant had breached the HCPC’s CPD Standards. Accordingly the Panel finds the allegation proved.
Decision on grounds:
9. In considering the issue of misconduct, the Panel has accepted the submission which it has received from Ms. Eales as well as the Legal Assessor’s advice. The Panel has carefully considered the evidence and has concluded that the Registrant’s conduct in plagiarising another practitioner’s work and attempting to pass it off as his own fell seriously short of the standards expected of a registered Operating Department Practitioner.
10. The Panel finds that the evidence demonstrates that the Registrant’s conduct in submitting a CPD profile which he knew was not his own work fell short of the Standards of Conduct Performance and Ethics of the Health and Care Professions Council and in particular, standards 3 (you must keep high standards of personal conduct), 4 (you must provide (to us and to any other relevant regulators) any important information about your conduct and competence), 10 (you must keep accurate records) and 13 (you must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession) and also fell short of the Standards of Proficiency for Operating Department Practitioners for an Operating Department Practitioner (version applicable from May 2014), namely 3.1 (understand the need to maintain high standards of personal and professional conduct); 10.2 (recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines) and 12.1 (be able to engage in evidence based practice, evaluate practice systematically and participate in audit procedures). Accordingly, the Panel finds that the Registrant’s actions fell well short of the standard expected of him and amounted to misconduct.
Decision on impairment:
11. The Panel has considered whether the misconduct which it has found had crossed the threshold and amounted to impairment of the Registrant’s fitness to practise. It has had regard to the HCPC’s Practice Note on Finding Fitness to Practise is Impaired. As noted, the Panel considers that the Registrant’s actions demonstrated a serious departure from the Standards of Professional Conduct and the Standards of Proficiency expected of a registered Operating Department Practitioner.
12. The Panel has taken account of what was said by Mr. Justice Silber in the case of Cohen v General Medical Council  EWHC 581 (Admin) including the need to protect the individual patient, the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour. The Panel has also borne in mind Mr. Justice Silber’s guidance that it must be highly relevant in determining if a practitioner’s fitness to practice is impaired that first the conduct which led to the charge is easily remediable, second that it has been remedied and third that it is highly unlikely to be repeated. The Panel also considered what was said by Mrs. Justice Cox about the public interest elements in the case of CHRE v NMC and Grant  EWHC 927. The Panel has carefully reflected on the submissions which it has heard from Ms. Eales and also the advice of the Legal Assessor.
13. The Registrant has explained the personal circumstances which had affected him in the period from 2011 onwards. On one analysis, the Panel considers that the Registrant’s misconduct might be characterised as an isolated incident. However, the Registrant has provided no evidence of steps taken in remediation other than an assurance that his actions were out of character and that he has now retired and has no intention of returning to “any form of clinical practice”. The Panel has noted that he has recognised what it was about his conduct that was wrong.
14. The Panel considered whether he had demonstrated some insight into his behaviour and has expressed some remorse. The Panel considers that he largely understood that copying someone else’s work and presenting it as his own was wrong. However, the Panel was concerned that, in his statement received on 5 January 2015, he stated he was given the CPD profile of a colleague by a senior sister and had copied and pasted it into his own profile. He went on to say that “this was a foolish thing to do… …and I have asked the sister not to do this again as the temptation would be too great on anyone…”. Further, in that statement, the Registrant asserted that he had completed all the training sessions in question but the Panel noted that he has supplied some evidence to the HCPC but the Panel found this not to be cogent and attached little weight to it.
15. With regard to remorse, the Panel has noted the Registrant’s apologies for having plagiarised his CPD profile. However, it was of concern to the Panel that the Registrant stated in his letter of 19 February 2016 that “there is only so much apologising one can do”. This seemed to indicate that the Registrant’s remorse was also limited.
16. The Panel noted that the Registrant had been given further time, extending to more than two years, in which to prepare and submit his CPD profile and yet he had failed to take advantage of the additional time and had resorted to plagiarism. The Panel cannot be certain that Mr. Grantham might not return to practice in the future and that accordingly, that there would be no risk of repetition. Furthermore, he has provided no information of any steps taken to remediate his professional and attitudinal shortcomings. In particular, the Panel noted that the Registrant did not avail himself of the opportunity to submit his own CPD profile after he was caught out. In the Panel’s judgement, there is a risk of repetition of this conduct if the Registrant were to find himself in a similar situation in the future.
17. In regard to the public interest, the Panel has taken account of what was said in the case of CHRE v NMC and Grant that a panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances. The Panel considers that members of the public would be very concerned about the risk of harm posed by a registrant who plagiarised a CPD profile and in so doing denying the regulator an opportunity to validate the registrant’s compliance with his CPD, necessary to evaluate safe and ongoing clinical practice.
18. In all the circumstances, the Panel has concluded that the Registrant’s fitness to practise was impaired at the time of the events set out in the allegation and that it is currently impaired.
Decision on sanction:
19. The Panel has not had the advantage of hearing in person from the Registrant at this hearing although it has fully considered all of his written submissions. As previously noted, the Panel has accepted from his written response that he has some limited insight and has also expressed a degree of remorse and that he has indicated that he accepted that his actions were wrong.
20. The primary function of any sanction is to address public safety from the perspective of the risk which a health professional may pose to those who use or need his or her services. The Panel was conscious that in reaching its decision, appropriate weight must be given to wider public interest considerations, including the deterrent effect to other health professionals, the reputation of the profession of Operating Department Practitioners, as well as maintaining public confidence in the regulatory process.
21. The Registrant has not supplied any testimonial evidence but the Panel has carefully considered all the information which he has supplied. The Panel accepted his assertion that he has never done anything like this in his professional life and that he has had “40 years of unblemished service” in his career. The Panel has noted that the Registrant suffered a significant bereavement in 2011 and that he has had some health concerns. The Panel has also accepted from the evidence provided by the Registrant’s employers that he has engaged with their eLearning mandatory training package. However, although he has asserted that he completed his CPD for the relevant periods (2012-2014), he has not supplied any records.
22. The Panel has also considered matters in aggravation. The Panel has accepted that dishonesty is inherent in the act of plagiarism. The Panel considered that the Registrant’s behaviour in copying another practitioner’s CPD profile and presenting it as his own was wilful, reckless and dishonest. He was asked by the HCPC to supply a CPD profile for the period 2010 to 2012 and, when he was unable to do so, he asked for and was granted a two year deferral to supply this information for the period 2012 to 2014. Despite having this considerable extension, he failed to produce his own CPD profile and resorted to plagiarism. The Panel has considered his insight and, as noted at an earlier stage, the fact that he sought to transfer some of the blame for his actions onto a hospital sister (“I have asked the sister not to do this again…”) suggests that the Registrant does not accept full responsibility for his misconduct. In regard to remorse, the Registrant’s statement in his letter of 19 February 2016 that “there is only so much apologising one can do”, suggests to the Panel that, at least to a degree, his apology lacks sincerity.
23. The Panel has looked carefully at the question of remediation in the context of the issues which it has identified. The Panel recognises that misconduct involving dishonesty can be difficult to remediate. In Mr. Grantham’s case, there is no evidence before the Panel that he has recognised why his misconduct is so serious. Members of the public are entitled to expect high standards of registered health professionals and that includes demonstrating that professional knowledge and skills are maintained through CPD. Plagiarising another practitioner’s CPD and attempting to pass it off as his own, has the potential to damage public confidence in the regulatory process. It also has the potential to damage the reputation of the profession of Operating Department Practitioners as well as public confidence in that profession.
24. The Panel considered all the sanctions available to it under article 29 of the Health and Care Professions Order 2001 and took into account the guidance contained in the Health and Care Professions Council’s Indicative Sanctions Policy. Following the approach set out in Giele v. General Medical Council, the Panel considered the sanctions in ascending order. The sanctions included taking no action, mediation, a caution order, a conditions of practice order, a suspension order and given the Panel’s findings on misconduct in this case, striking off.
25. The Panel concluded that to take no action would not adequately protect the public because of the seriousness of the misconduct and the lack of insight demonstrated in this case. The Panel also considered that mediation would serve no purpose. The Panel then considered a caution order. The Indicative Sanctions Guidance states that a caution order may be appropriate for an isolated lapse of a minor nature or where there was a low risk of repetition and the Registrant had shown insight and had taken remedial action. The Panel finds that, while the Registrant has demonstrated some insight and remorse, and while this might be characterised as an isolated case, the misconduct is not of a minor nature and also that the Registrant has not provided any evidence of steps taken by way of remediating his misconduct. The Panel has therefore concluded that a caution order would not be sufficient in the circumstances of this case.
26. The Panel next considered conditions of practice. The Indicative Sanctions Guidance states that conditions of practice will be most appropriate where a failure or deficiency is capable of being remedied and where the Panel is satisfied that allowing the Registrant to remain in practice, albeit subject to conditions, poses no risk of harm or future harm. The Guidance goes on to state that before imposing conditions, a Panel should be satisfied that there is no general failure, that the matter is capable of correction and that appropriate, realistic and verifiable conditions can be formulated. Mr. Grantham has indicated in his letter of 15 February 2016 that he has retired from practice and that he has no intention of returning to work as an Operating Department Practitioner. However, the Panel could not be certain about the risk of repetition were he to return to work. The Panel also has reservations as to whether it would be possible to formulate appropriate realistic and verifiable conditions with which the Registrant could be expected to comply. The Panel has therefore concluded that a conditions of practice order would not be the appropriate order to make in this case.
27. The Panel then went on to give careful consideration to whether a suspension order should be imposed. The Indicative Sanctions Guidance states that a suspension order may be appropriate where lesser sanctions are insufficient or inappropriate to protect the public but where there is a realistic prospect that repetition will not occur. The Guidance emphasises that suspension is punitive in effect and that this must be borne in mind. It goes on to say that if the evidence suggests that a Registrant will be unable to resolve or remedy his failings, then striking off may be the more appropriate option unless there is a realistic prospect that the Registrant can resolve his difficulties whilst suspended. In this case, the Panel has concluded that the Registrant does not fully recognise the seriousness of, and the consequences of, his actions. He has stated that he is no longer working as an Operating Department Practitioner and that he has no intention of returning to practise. As noted, the Panel considered that he has limited insight and that his expressions of remorse do not encompass sincere apologies for the harm which he has caused. In addition, he has not taken any steps by way of remediation. A registered Operating Department Practitioner is expected to maintain high standards of personal and professional conduct and, as noted, the Panel has nothing before it to suggest that the Registrant has taken any steps towards recognising and remediating his behaviour. In all the circumstances, the Panel has serious reservations about the Registrant’s ability to resolve or remedy his failings during a period of suspension. For all these reasons, the Panel does not consider that a suspension order is appropriate in this case.
28. Finally, the Panel considered a striking off order. The Indicative Sanctions Guidance states that a striking off order is a sanction of last resort for serious, deliberate or reckless acts involving dishonesty. The Panel was satisfied that the nature of the Registrant’s misconduct as well as his subsequent correspondence with the HCPC demonstrated conduct which was serious, deliberate and reckless as to its potential consequences. It was also dishonest, a fact which the Panel has accepted is inherent in the act of plagiarism. Although the Registrant has accepted that his actions were wrong, the Panel considered that he has demonstrated limited insight and remorse, has demonstrated no remediation, and has failed to demonstrate any real understanding of the gravity of his behaviour in which he sought to undermine the regulatory process. The Panel considered that the dishonesty involved in plagiarising a CPD profile and presenting it to a regulatory body as his own, demonstrates behaviour which is fundamentally incompatible with continued registration. The Panel considers that a lesser sanction would lack deterrent effect and would undermine public confidence in the profession of Operation Department Practitioners and in the health and care professions generally. In all the circumstances, the Panel has decided that a striking off order is the only appropriate and proportionate order which can be made in this case.
That the Registrar be directed to strike the name of Philip Grantham from the Register on the date on which this order comes into effect.
The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.
History of Hearings for Mr Phillip Grantham
|Date||Panel||Hearing type||Outcomes / Status|
|21/03/2016||Conduct and Competence Committee||Final Hearing||Struck off|