Mr Purnoor S Bawa

Profession: Physiotherapist

Registration Number: PH71238

Interim Order: Imposed on 13 Sep 2017

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 14/01/2019 End: 17:00 16/01/2019

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

During the course of your employment with Kent Community Health NHS Foundation Trust as a Band 8a Physiotherapist, you:

 

  1. Between January 2014 and December 2015, did not work your contracted hours, in that you consistently arrived late for work and/or left early.
  2. Agreed to work approximately 53.5 extra hours in lieu of paid annual leave between September 2014 and January 2015 and then did not work all of the agreed extra hours.
  3. On one or more occasions between July 2014 to September 2015:
  1. changed patient appointments without informing administrative staff and/or updating your electronic calendar, including:

i) Patient A on 4 July 2014

ii) Patient B on 15 September 2015;

b. changed patient appointments as referred to in Paragraph 3(a) to suit your own personal circumstances.

  1. The actions described in paragraphs 1-3 are dishonest.
  2. The matters described in paragraph 1-4 constitute misconduct.
  3. By reason of your misconduct, your fitness to practise is impaired.

Finding

Preliminary Matters

Application to be heard in private
1. Ms Hart applied under Rule 10 for those parts of the hearing which involved reference to the health of the Registrant, and members of his family to be heard in private. Ms Hastie did not oppose this application.

2. The Panel determined that those parts of the hearing involving such matters should be heard in private.

Background
3. The Registrant qualified as a Physiotherapist in 2003. From August 2005 he worked as a Physiotherapist at a number of hospital trusts in the UK.

4. In August 2011 he was employed as a Physiotherapist, Extended Scope Practitioner Band 8a, by Kent Community Health NHS Foundation Trust (“the Trust”). He remained in that employment until May 2016.

5. The Registrant held clinics in a number of different centres. He was contracted to work four days weekly for a total of 37.5 hours. On three days his hours were 8:00am to 6:00pm, on the fourth day 8:00am to 5:30pm.

6. On various occasions the Registrant found it difficult to arrive at his clinics at the appointed time. Furthermore, on occasions he was leaving earlier than the contractual time. He said that this was due to his childcare arrangements.

7. Eventually, in September 2015, when it became apparent that these were more than isolated instances, a review of the Registrant’s working times was instituted. This revealed that he was consistently arriving more than half an hour later than his start time, and was leaving, on occasions, as long as two hours before his contractual finishing time. Furthermore, that he was moving patient appointments to an earlier time with a consequent loss of potential clinic time. This lost time could have been used to accommodate other patients, or to enable him to undertake triaging of patients who had been referred to the service.

8. In September 2014, the Registrant was granted leave to travel to India, to visit his unwell father. He explained to the Trust that he could not afford this leave to be unpaid. It was therefore agreed, before he left, that on his return he would work 53.5 extra hours to make up the time lost. These additional hours were added to his clinic calendar.  However, the review indicated that the agreed 53.5 hours were not completed. 


Admissions
9.  At the outset of the hearing, admissions were made to Particulars 1, 2 and 3, and to Particular 5 where this related to Particulars 1 to 3, and to Particular 4 if proved.

10.  There was before the Panel a bundle of documents prepared by the HCPC containing witness statements and exhibits. There was also a bundle from the Registrant, which comprised his witness statement together with his supporting documents.

11. The following witnesses were called on behalf of the HCPC:

VP was employed by the Trust as Deputy Acute Dietetic Manager. She was appointed to be Investigation Manager in relation to the matters now alleged against the Registrant. Her report, dated 30 March 2016, together with appendices, was before the Panel. In her evidence she spoke to her report. The Panel found her to be a credible witness. Her evidence, although limited in scope, was consistent with her report. 

CJ was employed by the Trust as Deputy Head Musculoskeletal Services. She was responsible for non-clinical management of some 100 staff, including the Registrant. She raised concerns about, and conducted an informal investigation into, the matters now alleged against the Registrant. This led to the Trust’s investigation, undertaken by VP, and then to a counter-fraud investigation conducted by TIAA Limited, an external organisation. In her evidence she spoke to her report. The Panel found her to be a fair and credible witness.

12. The Registrant gave evidence. He admitted the facts as set out in Particulars 1 to 3 in their entirety. His evidence was that, albeit on reflection, he recognised that what he did was dishonest, he did not, at the time, realise that he was in fact acting dishonestly. He said that, although on occasions he arrived late and left early, he did see the required number of patients and the standard of care given was not affected.

13. Furthermore, he said that he was not motivated by financial gain, but acted only because of his childcare and other family responsibilities. He did not undertake additional work elsewhere during the time when he was contracted to be working at the Trust. He pointed to the email exchanges with management where he raised his difficulties over his working hours. 

14. In regard to the agreement to work extra hours following his trip to India, he said that he endeavoured to fulfil this obligation, but accepted that he had not done the additional administrative work which he had agreed to complete. This allocated time for administrative work at home was clearly set out in his calendar. 

15. He said that at no stage was he given any warning in regard to his working hours.

Decision on Facts
16. In reaching its decision on the facts, the Panel considered all the evidence before it, both oral and documentary, together with the submissions made by Ms Hastie and Ms Hart. The Panel accepted the advice of the Legal Assessor. It had well in mind that although the Registrant has admitted a number of the facts, the burden of proof is on the HCPC. Further that the facts must be proved on the balance of probabilities.

17. Particular 1 is found proved on the basis of the Registrant’s admissions and the evidence of VP and CJ, together with documents in the exhibit bundle. These include the Registrants employment contract, his logging on and off details, which recorded the actual hours worked, and also his calendar sheets.

18. Particular 2 is found proved on the basis of the Registrant’s admissions and the evidence of VP and CJ, together with documents in the exhibit bundle. These include email correspondence between the Registrant and the Trust, and his calendar sheets.

19. Particular 3 is found proved on the basis of the Registrant’s admissions and the evidence of VP and CJ, together with documents in the exhibit bundle.

20. Particular 4 is found proved. As an autonomous professional, working at different locations, the Registrant was trusted to fulfil his contractual obligations. He would be well aware of this. There was no agreement with management that he could curtail his working hours to facilitate his travel arrangements and childcare responsibilities. Indeed, the Registrant had rejected, on financial grounds, management’s offer earlier in his employment to reduce his working hours. Further, these were not isolated incidents, but amounted to a pattern of behaviour over a significant period. As an autonomous professional, warnings about such conduct would not have been necessary. It must have been apparent to the Registrant that he was in breach of his contractual obligations. The Panel therefore concluded that the Registrant’s actions found proved under Particulars 1 to 3 were dishonest.

Decision on Grounds
21. In reaching its decision, the Panel considered all the evidence and information before it, together with the submissions of Ms Hastie and Ms Hart. It has had well in mind the HCPC Practice Notes. It has accepted the advice of the Legal Assessor.

22. The Registrant is an experienced professional, having been a qualified Physiotherapist since 2003, who has worked at a number of NHS Trusts. At the relevant time he was employed as an Extended Scope Practitioner Band 8a, working autonomously at a number of locations.

23. The Registrant’s dishonest conduct occurred over a lengthy period and was revealed only in the course of an internal investigation at the Trust. He had not disclosed to management, that in breach of his contractual obligations, he was curtailing his attendance or amending appointment times to suit his personal circumstances.

24. Although he referred to what he described as his challenging personal circumstances as being the cause of his actions, these circumstances were not uncommon nor impossible to address. By his actions, the Registrant was in breach of the HCPC’s Standards of Conduct, Performance and Ethics:

• Standard 3 – “You must keep high standards of personal conduct”
• Standard 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.”

25. These acts of dishonesty fall seriously short of the standards expected of a Physiotherapist and the Panel has concluded that they amount to misconduct.


Decision on Impairment 
26. The Registrant has made admissions in regard to his actions and accepted, albeit with hindsight, that they would be regarded as dishonest. He has demonstrated that he has reflected upon his actions and has undertaken counselling in this regard. He has developed a degree of insight into his wrongdoing and begun to recognise the effect that this could have upon the Trust. Among other matters, he could have undertaken triage of patients in the time he absented himself from work. He is also now aware of the impact of his actions on the reputation of the profession. His personal, family, and work circumstances have changed significantly.

27. As a consequence, it appears to the Panel that there is little likelihood of repetition. The Panel has therefore concluded that in regard to the personal element alone, his fitness to practise is not currently impaired.

28. Despite there being no allegation in relation to any risk to service users, with regard to the public element, the Panel has determined that fitness to practise is currently impaired. The dishonesty found proved was a serious abuse of the Registrant’s position of trust as a senior and experienced practitioner. Furthermore, by his absence, there was a loss to the public of money and resources which should have been devoted to patient care. Despite testimonials referring to his actions as being out of character, right thinking members of the public would be concerned if a finding of impairment were not made.

29. A finding of impairment is therefore necessary in the public interest, in order to declare and to uphold proper standards, and to maintain confidence in the profession and the regulatory process.

Decision on Sanction
30. In reaching its decision on sanction, the Panel considered all the evidence and information before it, together with the submissions made by Ms Hastie and those made by Ms Hart. It had well in mind the HCPC Indicative Sanctions Policy. It accepted the advice of the Legal Assessor. It has exercised the principle of proportionality at all times.

31. The Panel found these to be aggravating factors:
• The dishonest actions were in the course of the Registrant’s employment.
• The Registrant, as an autonomous practitioner, was in a position of trust.
• The dishonest actions occurred over a lengthy period.
• The dishonesty resulted in a loss to the Trust of money and resources, including the opportunity for additional patients to be treated or triaged.

32. The Panel found the mitigating factors to be:
• There were no public safety concerns.
• The Registrant’s challenging personal circumstances.
• The Registrant made early admissions, and demonstrated a degree of insight.
• The Registrant has expressed remorse.
• There has been no repetition of the dishonest misconduct since 2015.

33. The Panel first considered whether to take no action, but the nature of the misconduct, which involved dishonesty, was such that this would be wholly inappropriate. Misconduct of this nature requires a sanction.

34. The Panel considered a caution order, but determined that the Registrant’s failings were not isolated, limited or relatively minor in nature. This too would be inadequate; such a sanction would not demonstrate to the public the serious nature of the misconduct found proved.

35. The Panel next considered a conditions of practice order, but conditions appropriate to address the public interest could not be formulated, and would be insufficient as a sanction.

36. The Panel therefore considered a suspension order. It concluded that suspension for a relatively short period would be sufficient, appropriate and proportionate as a sanction. It would address public interest concerns, and would send a message to the profession that dishonest conduct is unacceptable. Furthermore, such an order would be an opportunity for the Registrant to reflect upon his misconduct, its effect upon the Trust and his consequent reduced availability to patients.

37. The Panel did consider a striking off order, but concluded that in the light of the fact that there are no public safety concerns and that testimonials indicate that the Registrant is a competent and respected practitioner, this would be disproportionate.

38. The Panel therefore determined to impose a Suspension Order for a period of three months. Whilst this is a relatively short period of suspension, the Panel determined, in the circumstances, that a longer period would be disproportionate. The Panel has already determined that the Registrant’s fitness to practise is impaired solely in relation to the public component and there are no public safety issues. The Panel has also borne in mind the Registrant’s personal circumstances and the impact of a suspension on his family.

39. Any reviewing panel would doubtless be assisted by a written reflection by the Registrant about the likely effect that his misconduct had upon the Trust, his availability to patients, and the reputation of the profession and public perception about his conduct.

Order

The Registrar is directed to suspend the registration of Mr Purnoor S Bawa for a period of three months from the date this order comes into effect.

Notes

The order imposed today will apply from 13 February 2019 (the operative date).

Hearing History

History of Hearings for Mr Purnoor S Bawa

Date Panel Hearing type Outcomes / Status
12/04/2019 Conduct and Competence Committee Review Hearing Hearing has not yet been held
30/01/2019 Investigating Committee Interim Order Review Interim Suspension
14/01/2019 Conduct and Competence Committee Final Hearing Suspended
06/12/2018 Investigating committee Interim Order Review Interim Conditions of Practice
25/05/2018 Investigating committee Interim Order Review Interim Conditions of Practice
27/02/2018 Investigating committee Interim Order Review Interim Conditions of Practice
13/09/2017 Investigating committee Interim Order Application Interim Conditions of Practice