Mr Christian Taylor

Profession: Operating department practitioner

Registration Number: ODP12685

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 24/11/2020 End: 17:00 30/11/2020

Location: Virtual Hearing

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

As a registered Operating Department Practitioner (ODP12685) your fitness to practise is
impaired by reason of misconduct. In that:

1. On 28 January 2019 you:

a) Took controlled drugs without authorisation; and

b) Intended to use the drug for personal use.

2. Your conduct in relation to allegations 1a above was dishonest.

3. Your actions described at 1-2 above constitute misconduct.

4. By reason of your misconduct your fitness to practise is impaired

Finding

Preliminary matters:

Proof of Service

1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent, by email (owing to the Covid-19 Pandemic) to the Registrant, on 27 August 2020. The certificate confirmed that the Notice had been sent to the email address held for the Registrant on the HCPC register.

2. The Panel accepted the advice of the Legal Assessor and was satisfied that notice had been properly served.

Proceeding in absence of the Registrant

3. Ms Lykourgou, on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence as permitted by Rule 11 of the HCPC (Conduct & Competence) (Procedure) Rules 2003.

4. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPTS Practice Note “Proceeding in Absence”.

5. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:

i. The Panel noted that the Registrant sent an email to HCPC, dated 24 November 2020 timed at 10.33am, which stated: ‘There are a number of reasons as to why I don’t feel able to join the hearing. First and foremost, my landlady and close friend has just suffered a loss and I feel it is more important for me to be available as support to her. Secondly, I don’t feel that I could say anything to the panel to defend my actions. It is a period of shame and embarrassment and I don’t feel able to relive it. I hope the panel understands.  I may be able to answer any pressing questions via email as a form of compromise. Christian’. The Panel was satisfied that it was reasonable to conclude that the Registrant’s non-attendance was voluntary and therefore a deliberate waiver of his right to attend and participate in person;

ii. There has been no application to adjourn and no indication from the Registrant that he would be willing or able to attend on an alternative date and therefore re-listing this hearing would serve no useful purpose;

iii. The HCPC has made arrangements for three witnesses to give evidence during the hearing. In the absence of any reason to re-schedule the hearing, the Panel was satisfied that the witnesses should not be inconvenienced by an unnecessary delay and should give evidence whilst the events are reasonably fresh in their minds;

iv. The Panel recognised that there may be some disadvantage to the Registrant in not being able to give evidence or make oral submissions. However, the Panel noted that he had previously provided written submissions, in a Disciplinary Investigation which are included within the HCPC bundle of documents and which went some way to mitigate any potential disadvantage to the Registrant; and

v. As this is a substantive hearing there is a strong public interest in ensuring that it is considered expeditiously. It is also in the Registrant’s own interest that the allegation is heard as soon as possible.

Application to amend the particulars

6. Ms Lykourgou made an application to amend the Allegation. She informed the Panel that the Registrant had been put on notice of the proposed amendments in a letter dated 15 June 2020.

7. The proposed amendments were as follows:

i. Particular 2 – insertion of the words ‘Particular 1a’ and deletion of the word ‘allegations’;
ii. Particular 2 amended to be numbered Particular 3 with the insertion of the number ‘2’ in the body of the particular; and
iii. Particular 3 amended to become Particular 4.

8. The Panel accepted the advice of the Legal Assessor and carefully considered the HCPC application to amend the Allegation. The Panel concluded, after reviewing each of the proposed amendments, that they would agree to the Particulars being amended for the following reasons:

i. the Registrant had been provided with significant notice of the HCPC’s intention to amend the Allegation, having been put on notice in June 2020, five months before the commencement of the substantive hearing;
ii. the Registrant had not provided any objection to the proposed amendments;
iii. on the whole, the proposed amendments were to correct typographical errors and to provide further clarification of the Allegation; and
iv. the proposed amendments did not seek to widen the scope of the Allegation.

9. The Panel therefore concluded that the proposed amendments to the Allegation did not heighten the seriousness of the Allegation and therefore there was no likelihood of injustice to the Registrant.

Application for parts of the hearing to be held in private.

10. Ms Lykourgou, invited the Panel to conduct parts of the hearing in private, submitting that conducting the hearing in private would protect the Registrant’s right to a private life.

11. The Panel accepted the Legal Assessor’s advice and had regard to the HCPTS Practice Note on ‘Conducting Hearings in Private’, the documents provided to it and Ms Lykourgou’s submissions.

12. The Panel carefully considered the public interest grounds in the case being heard in public. However, the Panel was satisfied, that the Registrant’s mental health and wellbeing would be at risk of being compromised if the hearing was to proceed wholly in public.
13. The Panel was therefore satisfied that there was a need to protect the Registrant’s right to a private life and ordered that parts of the hearing pertaining to the Registrant’s health should be conducted in private.

Application to adduce hearsay evidence

14. Ms Lykourgou made an application to adduce hearsay evidence in respect of the witness statement of Lina Zarghani, dated 17 April 2020, along with the accompanying exhibits which included the following:

a) Disciplinary Investigation Report dated 22 March 2019 (Exhibit 1);
b) Letter to Christian Taylor regarding Notice of Investigation dated 8 February 2019 (Exhibit 1, Appendix 1);
c) Witness Statement of XO dated 28 January 2019 (Exhibit 1, Appendix 2);
d) Witness Statement of LS dated 28 January 2019  (Exhibit 1, Appendix 3);
e) Witness Statement of LW dated 29 January 2019 (Exhibit 1, Appendix 4);
f) Witness Statement of IE dated 29 January 2019 (Exhibit   1, Appendix 5);
g) Witness Statement of LS dated 28 January 2019 (Exhibit 1, Appendix 6);
h) Witness Statement of LP dated 28 January 2019 (Exhibit 1, Appendix 7);
i) Letter to Christian Taylor regarding Notice of Exclusion dated 28 January 2019 (Exhibit 1, Appendix 8);
j) Letter to Christian Taylor regarding Review of Exclusion dated 12 February 2019 (Exhibit 1, Appendix 9);
k) Notes of Meeting dated 20 February 2019 (Exhibit 1, Appendix 10);
l) Notes of Meeting dated 19 February 2019 (Exhibit 1, Appendix 11);
m) Minutes of Meeting dated 14 February 2019 (Exhibit 1, Appendix 12); and
n) Minutes of Meeting dated 22 March 2019 (Exhibit 2).

Panel’s approach

15.  The Panel accepted the advice of the Legal Assessor and noted that the Legal Assessor drew the Panel’s attention to the distinction between the admissibility of hearsay evidence and the weight that might be attached to it.

Panel decision in respect of application to admit hearsay evidence

16. The Panel noted the contents of witness statement and the exhibited documents attached to it. In particular it noted that the exhibits contained statements and letters pertaining, on the whole, to the Trust’s internal investigation into the concerns raised and that the material facts contained within the documents were not disputed or objected to by the Registrant.

17. Having carefully considered the application, the Panel decided to admit the hearsay evidence. The Panel was of the view that it would not be unfair to the Registrant for the evidence to be admitted because the statements had been made contemporaneously, as part of the Trust’s internal disciplinary proceedings. Further, the Panel was of the view that the Registrant had been put on notice that the hearsay evidence was intended to be relied upon by the HCPC and noted that he had not objected to them being placed before the Panel. Consequently, the Panel determined that it would not be unfair to admit the evidence into the proceedings and it would determine what weight, if any, to place on the statement and exhibits when deciding on facts.

Background

18.  The Registrant was employed by the Royal Surrey County Hospital, NHS Foundation Trust (‘the Trust’) as a Senior Operating Department Practitioner (‘ODP’). The Registrant commenced his employment at the Trust on 01 May 2008.

19. On 28 January 2019, it was reported that the Registrant was seen entering a Theatre room and it is alleged that he was acting suspiciously. His colleagues reported that they had witnessed him taking used vials of a controlled substance from Theatre without authorisation. Subsequently, their concerns were raised to the Theatre Operations Manager at the Trust who confronted the Registrant on the same day. It is said that, on request, the Registrant removed used vials of a controlled substance as well as other equipment, which he had taken from Theatre, from his pockets. It is also said that the Registrant confirmed that the items he had taken were intended for his personal use. The Trust subsequently conducted an investigation and obtained statements from a number of witnesses who confirmed the reported details of the incident.

Evidence called on behalf of HCPC

20.  The Panel heard oral evidence from the following witnesses on behalf of the HCPC:

i. XO;
ii. LS; and
iii. IE.

21. The Panel read the hearing bundle submitted by the HCPC. Before the commencement of the HCPC case, the Panel also read the Registrant’s bundle which included the following:

i. A letter from the Registrant dated 1 January 20120, making admissions to the Allegation;
ii. An undated reflective account, prepared for the Registrant’s employment disciplinary hearing;
iii. Testimonial letters from:

a) Dr. Hamish Griffiths, dated 20 March 2019;
b) Geeta Aggarwal, dated 18 March 2019;
c) WJ Fawcett, dated 18 March 2019;
d) Dr. Sam Huddart, dated 18 March 2019;
e) Dr. Leigh J S Kelliher, (undated); and
f) Sarah McHugh, (undated);
iv. Certificate of Level 3 Diploma in Professional Cookery; and
v. Response pro-forma and pre hearing information form;

Witness XO

22. Witness XO is a registered, Senior ODP at the Trust and has been in that role since 18 April 2017. XO told the Panel that she holds a Higher Education Diploma in Operating Department Practice from the University of Portsmouth, awarded in 2013. She also told the Panel that she holds a BSc (Hons) in Delivering Quality Healthcare from the University of Surrey, awarded in 2017 and has been registered with the HCPC since 2013.

23. XO told the Panel that her responsibilities at the Trust include both clinical and non-clinical duties; but that the majority of her duties are clinical. XO informed the Panel that she assists the anaesthetists in the provision of anaesthetic care to patients in the anaesthetic phase of surgery. This includes checking patients during surgery, the intubation of patients as well as preparing the relevant drugs required. XO informed the Panel that she is also responsible for holding the controlled drugs keys and ensuring the safekeeping of the controlled drugs.

24. With reference to non-clinical duties XO informed the Panel that she was responsible for record keeping and reviewing and investigating discrepancies identified in the audit forms produced by the pharmacists in respect of controlled drugs.

25. XO told the Panel that the Registrant was employed as a Band 6 senior ODP at the Trust.

26. XO informed the Panel that on 28 January 2019, she was assigned to a morning list in Theatre 4 where she was assisting an anaesthetist with a patient who was undergoing a liver resection. During this operation XO informed the Panel that two controlled drugs were used. Namely, 100mcg of Fentanyl and 2mg of Remifentanil in total. She told the Panel that each ampoule of Remifentanil holds 1mg of the controlled substance. As such two 1mg ampoules were used during the procedure. XO also told the Panel that Remifentanil is an opioid that is used as pain management prior to surgery and that in order to administer the drugs used, they were diluted with 0.9% Sodium Chloride, more commonly known as saline solution and then the fluid was ‘drawn down’ from the ampoule and further diluted prior to being placed in a syringe driver and administered to the patient.

27. XO gave evidence to the Panel that after the two ampoules of Remifentanil were administered to the patient she placed them in the drug tray. XO told the Panel that it is standard practice to keep all of the used ampoules and drug bottles that have been administered to a patient during surgery in the drug tray. This is to ensure that, in the event that a patient has a bad reaction the practitioner can quickly identify what drugs and exactly how much of each drug was administered to the patient. The used ampoules are only discarded after the patient leaves the operating theatre and are usually disposed of into a sharps bin.

28. XO also told the Panel that when she referred to empty or used ampoules, they are “never completely empty” because it is difficult to fully withdraw all of the Remifentanil from an ampoule and that often there is some residue in an ampoule after withdrawal from it. She told the Panel that Remifentanil is provided in a powder form. Saline solution is added to the ampoule to enable the powder to be extracted from the ampoule and then once drawn out of the ampoule, using a needle the liquid is then further diluted before it is administered to the patient.

29. XO informed the Panel that once the surgery on the patient had commenced, she and LS, a newly qualified supernumary ODP, remained in the anaesthetic room, within Theatre 4, to clear up and prepare for the next patient. She told the Panel that she had begun performing the record keeping process, which she is required to complete in respect of the controlled drugs used during the procedure. XO told the Panel that it was at this point that the Registrant entered Theatre 4, via the anaesthetic room, and began engaging in “small talk”.

30. XO gave evidence to the Panel that at first she did not find his demeanour to be particularly unusual until he halted by the drug tray and began inspecting its contents. XO told the Panel that the Registrant reached into the drugs tray and picked up an empty bottle of Metronidazole with one hand; XO stated that this is not a controlled drug. XO told the Panel that the Registrant then began to examine the contents closely and that she found this to be unusual because the drug is a commonly used antibiotic and that, had the Registrant been looking for dates on the bottle itself, the dates are clearly visible. However, he was taking longer than necessary to do so.
31. XO explained to the Panel that based on the Registrant’s mannerisms she formed the view that the Registrant was “putting on an act” and the Registrant’s actions immediately raised concerns for her.

32. XO told the Panel that the Registrant then put the bottle of Metronidazole back into the drugs tray and at the same time that he did so, she saw him swiftly pick up something which imitated the size of the ampoules with the same hand. XO told the Panel that at this stage she was not aware that they were the Remifentanil ampoules. XO informed the Panel that she recalled the Registrant’s hand was clenched as if he was holding something small inside of his palm and he immediately placed that hand into his pocket.

33. XO gave evidence to the Panel that throughout the incident the Registrant had made light-hearted small talk and continued to do so for a couple of minutes after taking the ampoule, as though nothing had happened. The Registrant then left Theatre 4. XO told the Panel that she immediately went over to the drugs tray and noted that at least one Remifentanil ampoule, which had been previously there, was no longer there.

34. After a couple of minutes the Registrant returned to Theatre 4 at which point XO mouthed to her colleague, LS, to get the Theatre Manager, IE. XO told the Panel that LS left the Theatre room immediately and she was left alone with the Registrant. After a few minutes of conversation, used as a means of distraction, the Registrant went to leave Theatre 4 again and IE approached the Registrant and asked if he could speak to the Registrant alone.

35. XO provided further evidence to the Panel that as a Senior ODP she has to abide by the Trust’s Controlled Drugs Policy (‘the Policy’). XO provided a copy of this policy for the Panel to consider.

36. The Panel found XO to be a knowledgeable, credible and reliable witness. The Panel had no reason to doubt her recollection of events. Her oral evidence was balanced and was, on the whole, largely consistent with her witness statement. If she was unable to recollect a particular event she said so and she provided reasons for any views or inconsistencies expressed. The Panel felt that XO provided an objective view of the Registrant and what she had witnessed.

Witness LS

37.  LS is registered as an ODP with the HCPC and has been employed by the Trust since January 2019. LS told the Panel that she holds a Diploma in Higher Education in Operating Department Practice from the University of Surrey, which she was awarded in 2019.

38. LS informed the Panel that she first met the Registrant when she commenced her training at the Trust in December 2017. LS told the Panel that at this time she was a student and was required to shadow a qualified ODP as part of her training and the Registrant had been appointed as one of her mentors.

39. LS gave evidence to the Panel that prior to the incident on the 28 January 2019 she had cause to report two other incidents of unusual behaviour, on the Registrant’s part, to IE.

40. LS told the Panel that on 28 January 2019 she was in the anaesthetic room for Theatre 4, alongside her colleague XO, and she witnessed the Registrant come into the room pick up a bottle of Metronidazole, an anti-microbial drug, and then return it to the drugs tray. LS told the Panel that she witnessed the Registrant then pick up a 1mg ampoule of Remifentanil and put it in his pocket. LS told the Panel that upon witnessing this, she decided to go and find IE and report the matter.

41. LS told the Panel that the as an ODP she adheres to the Trust’s Policy on controlled drugs.

42. The Panel found LS to be clear, credible and unwavering in her evidence. She accepted when she did not know things and was very clear with the evidence provided when she did know what was asked of her. The Panel noted that LS’s evidence was consistent with her previous statements and that she gave the impression of wanting to assist the Panel without making any assumptions or casting aspersions.
 
Witness IE:

43. IE informed the Panel that on 28 January 2019, he was employed by the Trust as a Theatre Operations Manager and he had been in that role since May 2018. He also told the Panel that since that time, he had been promoted to be the General Manager of Theatres within the Trust.

44. IE gave evidence to the Panel that his role required him to manage the operational running of 15 theatres; managing staff within the department including Band 7 team leads and support staff. He also told the Panel that he was responsible for the management of equipment and theatre scheduling.

45. IE told the Panel that he first met the Registrant when he started his training as an ODP at the Trust around the end of 2009. He explained that the Registrant had initially been one of his mentors, within the Trust, during his training and that he continued to work alongside the Registrant as his career progressed. He informed the Panel that they were work colleagues and did not socialise outside of work. IE told the Panel that his routine contact with the Registrant, in his role as Theatre Operations Manager would be limited to a weekly conversation, during which they would discuss work related matters.

46. IE gave evidence to the Panel that ODP’s are required to assist anaesthetists by preparing drugs, including controlled drugs, which are then administered to the patient by the anaesthetist during the surgical procedure. He told the Panel that not all drugs used are controlled drugs, but controlled drugs were kept locked away in a secure drugs cupboard in the anaesthetic room, attached to each Theatre. He further explained that each controlled drugs cupboard had a drugs register which is used to document who has signed out each controlled drug, for which patient and the amount that was dispensed, utilised and then disposed of, if there was any surplus after the operation had concluded.

47. IE told the Panel that Remifentanil is a controlled drug and is a synthetic opioid, used in the management of pain during an operation. He explained that it is a powdered substance that is stored in 1mg vials, which are each secured by a rubber seal under a metal rim. IE explained that before a vial of Remifentanil is administered to a patient, it is mixed with 2ml to 3mls of sterile saline solution. Once mixed together, the member of staff preparing the Remifentanil uses a syringe to draw out the substance from the vial. The concentration of the Remifentanil is then diluted further with saline solution to make up a diluted solution to a volume of 40mls or 50mls. IE told the Panel that due to the shape of the needle that is used to draw up the diluted solution, from the vial, and the method by which this is done there are often small remnants of Remifentanil left inside the vial. Therefore, he explained, used vials are not completely empty.

48. IE explained to the Panel that once the controlled drugs are administered to the patient, by the anaesthetist, the ODP usually places any empty drug bottles/vials/ampoules that are used before or during the surgical procedure, in a drugs tray. The drug tray is then usually placed on the work surface of the anaesthetic room. He told the Panel that whilst every ODP might do things differently, this process is the most usually adopted as it allows practitioners to cross reference and carry out a visual check to ensure that all the controlled drugs administered during the procedure have been accounted for; particularly when they complete the recording of the controlled drugs used during a procedure, within the controlled drugs register.

49. IE told the Panel that anything collected in the used drugs tray, including wasted/surplus drugs, not required during the procedure, should be disposed of at the end of the surgical procedure in the sharps bin available in each room.

50. IE also explained that there are instances where not all drugs are administered to the patient and that as such the remaining drugs will be considered as wastage and that any wastage of controlled drugs that are disposed of must be witnessed by two registered members of staff; this usually being the anaesthetist together with the ODP and that both witnesses sign the controlled drugs register.

51. IE told the Panel that on 28 January 2019 he was standing in the corridor, outside his office, talking with two colleagues responsible for the procurement of hospital equipment and that during his conversation with his two colleagues, he was approached by LS. IE told the Panel that LS had informed him of her concerns regarding the Registrant’s actions in removing the Remifentanil from Theatre room 4. IE told the Panel that he instructed LS to go and get the Registrant’s manager and at this stage he recalled seeing the Registrant walking down the corridor towards him. IE told the Panel that he was reluctant to engage in a discussion about his concerns in front of his procurement, and before the Registrant’s manager had confirmed the situation, so asked him to join in the discussions regarding the equipment as a means of keeping the Registrant with him whilst the Registrant’s manager was sought.

52. IE told the Panel that once the Registrant’s manager was present, he, and his manager (LS) asked the Registrant to join them in IE’s office so that they could confront the Registrant about the concerns raised. IE informed the Panel that he asked the Registrant “if there was anything that he would like to tell him?” to which the Registrant replied “no”. He then asked the Registrant if “he had anything on his person that he shouldn’t have?”. IE explained to the Panel that it was at this stage that the Registrant handed over two vials of used Remifentanil. IE told the Panel that he immediately recognised the vials as Remifentanil as he could read the name on the vials. IE also told the Panel that the Registrant’s demeanour at this stage was “head-down, quiet and very solemn”.

53. IE indicated to the Panel that at this stage he informed the Registrant that he would have to escalate matters to his own superiors. He explained that the decision was taken by the Trust’s lead pharmacist to call the Police and upon their arrival the Registrant admitted, to the Police officers in his presence, that he had taken the vials and that he had intended to use the controlled drugs for his own personal use.

54. IE told the Panel that following the Police arrival and initial discussion, he waited in the corridor until the Police had concluded taking a statement from the Registrant. He then, along with the Registrant’s manager escorted the Registrant from the premises of the Trust.

55. IE confirmed that some time later he had referred the Registrant to Occupational Health, located within the Trust’s building. He could not recall when he had done this exactly.
 
56.  Further, IE told the Panel that as an ODP employed by the Trust, both he and the Registrant, along with all members of staff who handled controlled drugs were subject to the Trust’s Policy and further, that there would have been no legitimate reason or justification for the Registrant to remove the used vials of Remifentanil from the Theatre or anaesthetic rooms.

57.  The Panel formed the view that IE was a fair, balanced and matter of fact witness. He had a good knowledge of the ODP role and responsibilities and was clearly a senior member of the team and was very experienced. The Panel noted that IE did not seek to apportion blame on the Registrant. He stated the facts as he saw them and was helpful and clear with what he did and did not know. The Panel was also of the view that when discrepancies were raised between IE’s evidence and that of the other witnesses, he was not defensive and accepted that, owing to the passage of time, his recollections may have been incorrect. The Panel therefore considered IE to be a credible and reliable witness.

Decision on Facts

Panel’s Approach

58. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the Allegation could only be found proved if the Panel was satisfied on the balance of probabilities.
59. In reaching its decision the Panel took into account the oral evidence of the HCPC witnesses, the documentary evidence contained within the hearing bundles, as well as the submissions made by Ms Lykourgou.

60. The Panel also had regard to the fact that the Registrant admitted all of the Particulars contained within the Allegation.

61. The Panel accepted the advice of the Legal Assessor.

62. In respect of the hearsay evidence contained within the HCPC bundle, which the Panel had agreed could be admitted during the course of these proceedings, the Panel considered whether it should place any weight on each of the statements or exhibits.

63.  In deciding to place little to no weight on each of the statements and documents produced by LZ, the Panel noted that it would have been reasonable and practicable for the HCPC to have obtained a witness statement from the maker of each of the exhibited witness statements for the purpose of these proceedings and for the HCPC to have called them to give evidence. The Panel noted in particular, that the exhibited witness evidence could not be tested or challenged. The Panel also noted that whilst the Registrant had not contested the admission of the hearsay evidence and the Panel had determined that it would not be prejudicial to him for it to be admitted into evidence, given the notice that he had been given prior to the hearing. The Panel was of the view that because the evidence was unable to be tested, it would be unfair to place any significant weight on the statements or exhibits. Consequently, the Panel considered the oral evidence of the witnesses and their exhibits, along with the Registrant’s admissions when making determining the facts in the case.
 
Particular 1a)
 As a registered Operating Department Practitioner (ODP12685) your  fitness to practise is impaired by reason of misconduct. In that:

  1. On 28 January 2019 you:
   a. Took controlled drugs without authorisation; and

64. The Panel noted that there was no dispute that the Registrant was a registered ODP practitioner with the registration number ODP12685.

65. The Panel also noted that the Registrant accepted, in his written admissions to the HCPC, that he took controlled drugs without authorisation on 28 January 2019.

66. The Panel had regard to the oral evidence of the three witnesses. In particular witnesses XO and LS who told the Panel that they saw the Registrant take a vial of Remifentanil, a controlled drug, without authorisation to do so, from the anaesthetic room of Theatre 4.
 
67. The Panel also noted IE’s evidence whereby he told them that when he confronted the Registrant about having anything on his person that he ought not to, that the Registrant then handed over two used vials of Remifentanil. The Panel also noted that IE had given evidence to it that the Registrant would have been aware of the Trust’s policy concerning controlled drugs and that there was no justifiable reason for him having the controlled drugs on his person outside of the Theatre / Anaesthetics rooms.

68.  The Panel found as a matter of fact therefore that the Registrant did take two used vials of Remifentanil, a controlled drug, without authorisation to do so.

69. Accordingly, the Panel found Particulars 1a) proved.
 Particular 1b)
  b. Intended to use the drug for personal use.

70. The Panel had regard to the Registrant’s written admission that he had taken the controlled drug with the intention of personal use.

71. The Panel accepted IE’s evidence that when the Registrant was being questioned by the Police, in his presence, that he admitted to taking the vials, containing a controlled drug, for personal use.

72.  Taking all of the evidence together, the Panel was satisfied and found as a matter of fact, that the Registrant took the controlled drug and that he intended to use the controlled drug for personal use.
 
73. Accordingly, the Panel found Particular 1b) proved.

 Particular 2

 2. Your conduct in relation to particular 1a above was dishonest

74. The Panel, having found particulars 1a) and 1b), proved went on to consider the issue of dishonesty.  The Panel had regard to the case of Ivey v Genting Casinos [2017] UKSC 67.

75. The Panel noted that the Registrant had made admissions to the HCPC where he stated ‘I admit the allegations in their entirety in that I stole two empty vials of Remifentanil for the purpose of using any remaining contents.’

76. Further, IE described the Registrant’s demeanor, during his time with the Registrant in his office when he first confronted the Registrant and before the Police arrived, as someone who was “solemn and quiet”.

77. The Panel was satisfied on the evidence and admissions before it that the Registrant knew that he should not have taken the two used Remifentanil vials without authorisation.

78. The Panel was therefore satisfied that the Registrant’s actions were not an error of judgement, but that his actions were deliberate and dishonest. In the Panel’s view he intentionally took the used Remifentanil vials from the Trust, with a view to using any remaining contents from the used vials, for his own personal use. The Panel was also satisfied that having regard to all of the circumstances presented to it that an ordinary member of the public would also consider the Registrant’s actions to be dishonest.

79. Consequently, the Panel found Particular 2 proved.

Decision on grounds

80. Having found Particulars 1a), 1b) and 2 proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct.

Panel’s Approach

81. The Panel took into account the oral submissions made by Ms Lykourgou on behalf of the HCPC. The Panel accepted the advice of the Legal Assessor.

82. In considering the issue of misconduct, the Panel bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:

 “Misconduct is a word of general effect, involving some act or  omission which falls short of what would be proper in the  circumstances. The standard of propriety may often be found  by reference to the rules and standards ordinarily required to  be followed by a … practitioner in the particular  circumstances. The misconduct is qualified in two respects.  First, it  is qualified by the word ‘professional’ which links the  misconduct  to the profession ... Secondly, the misconduct is qualified by  the  word ‘serious’. It is not any professional misconduct which will  qualify. The professional misconduct must be serious.”

83. The Registrant, as a qualified ODP, had a professional obligation to comply with the Medicines Act 1968 and the Trust’s policy in respect of the management and safeguarding of controlled drugs. The Panel was of the view that the Registrant’s colleagues and members of the public would expect the Registrant to follow the procedures set out in the Trust’s policy in respect of the handling, storage and disposal of controlled drugs and that by taking the two used vials of Remifentanil for his own personal use, he has fallen far below the standards expected of a registered ODP.

84. The Panel was of the view that the Registrant’s colleagues and members of the public would expect him to perform his role professionally and to act with honesty and integrity at all times. Instead, the Registrant chose to steal two used vials of a controlled drug, Remifentanil, with a view to extracting the remaining Remifentanil from the used vials, for personal use. In the Panel’s view his dishonest actions represented a fundamental breach of trust and confidence.

85. The Panel considered the HCPC Standards of Conduct, Performance and Ethics and was satisfied that the Registrant’s conduct breached the following standards:

• 9 – Be honest and trustworthy;
• 9.1- You must make sure that your conduct justifies the public’s trust and confidence in you and your profession; and
• 6.3 – You must make changes to how you practise, or stop practising, if your physical or mental health may affect your performance or judgment, or put others at risk for any other reason.

86. The Panel also considered the HCPC Standards of Proficiency for Operating Department Practitioners and was satisfied that the Registrant’s conduct breached standards:

• 2 - be able to practise within the legal and ethical boundaries of their profession – specifically;
• 2.6 - be able to practise in accordance with relevant medicines legislation;
• 3 - be able to maintain fitness to practise;
• 3.1 - understand the need to maintain high standards of personal and professional conduct; and
• 15 - understand the need to establish and maintain a safe practice environment.

87. The Panel was aware that a breach of the standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that the Registrant’s conduct and dishonest behaviour fell far below the standards expected of a registered ODP.

88. The Registrant knew that what he was doing was wrong, but he chose to do it anyway. The Registrant’s conduct had an adverse affect on his colleagues, the Trust and the wider profession.

89. The Panel was satisfied that the Registrant’s conscious and deliberate dishonesty amounts to serious misconduct.

Decision on Impairment

Panel’s Approach

90. Having found that the Registrant’s actions and dishonest conduct amount to misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the HCPTS Practice Note: “Finding that Fitness to Practise is Impaired”.

91. The Panel also took into account the oral submissions of Ms Lykourgou, on behalf of the HCPC, and accepted the advice of the Legal Assessor.

92. The Legal Assessor advised that in determining current impairment the Panel should have regard to the following aspects of the public interest:

i) The ‘personal’ component: the current behaviour of the individual Registrant; and

ii) The ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

Panel’s Decision

93. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

94. The Panel took the view that the factual findings in this case raise significant concerns regarding the Registrant’s integrity and also his ongoing health issues.

95. The Panel appreciated that demonstrating remediation following a finding of dishonesty is inherently difficult. In considering whether the Registrant has remediated his conduct the Panel considered the information before it. The Panel noted that whilst the Registrant had expressed some remorse for his conduct and behaviour, his submissions were largely centred on the impact of his actions on himself rather than his colleagues, employer, the public and the wider profession. The Panel was of the view that the Registrant’s acknowledgement of fault lacked depth and any qualitative analysis of why he had acted as he did, what he had learned from the experience and what steps he had taken to ensure that it did not happen again in the future. The Registrant made decisions, which necessarily involved a degree of premeditation and instead of focussing on his own actions, the Registrant, in his written submissions, emphasised the impact the proceedings had had on him and his life. As a consequence, the Panel concluded that the Registrant had demonstrated minimal insight.

96. In the absence of sufficient insight and meaningful reflection the Panel concluded that there was a risk of repetition. In particular, the Panel concluded that the Registrant’s actions brought the profession into disrepute, breached a fundamental tenet of the profession and demonstrated that his integrity could not be relied upon. There was limited evidence before the Panel that the Registrant had fully and appropriately reflected on these issues, all of which are fundamental to the role of an autonomous ODP and therefore the Panel was led to the inevitable conclusion that there is an on-going risk of repetition.

97. The Panel concluded that for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.

98. In considering the public component the Panel had regard to the public interest, which included the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.

99. In the Panel’s view, the dishonest conduct demonstrated a blatant disregard of his professional obligations. Members of the public would be extremely concerned to learn that a registered ODP had taken two used vials of Remifentanil, a controlled drug subject to strict controls, without permission and for his own personal use. While the Panel acknowledged that the vials in question had been used and only a remnant was contained within the vial, the contents and the vial still remained within the parameters of the Trust’s controlled drug policy.  It is critically important for the profession to have integrity and for the public to be able to trust the words and actions of an ODP.

100. A significant aspect of the public component is upholding proper standards of behaviour. The Registrant’s conduct fell far below the standard expected of an ODP. The Panel concluded that public confidence in the profession would be undermined if a finding of fitness to practise was not made, given the seriousness of the Registrant’s dishonest conduct and behaviour.
101. The Panel therefore concluded that the Registrant’s current fitness to practise is impaired on the basis of both the personal component and the wider public interest.

Decision on Sanction

102. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Lykourgou and had regard to the Registrant’s written submissions. The Panel also referred to the ‘Sanctions Policy’ issued by the HCPC.

103. The Panel accepted the advice of the Legal Assessor.

104. The Panel had in mind that the purpose of sanction was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of performance, conduct and ethics. The Panel was also cognisant of the need to ensure that any sanction is proportionate.

105. The Panel considered the following mitigating factors and found that the Registrant had:

i. an extensive unblemished ODP career, with no previous HCPC disciplinary record;
 
ii. made early admissions regarding his conduct;


iii. endured a challenging time in his personal life; and

iv. provided a number of character references, all of whom spoke highly of the Registrant’s clinical ability. However, the references indicated that the referee’s had not been informed by the Registrant of the nature of the allegations.

106.  The Panel considered the aggravating factors in this case to be:

i. the Registrant is an experienced and senior ODP, who had responsibility for mentoring more junior members of staff;
ii. his conduct amounted to a significant breach of professional trust; and
iii. his conduct was premeditated.

107. In light of the seriousness of the Registrant’s misconduct, the Panel did not consider that this was an appropriate case to offer mediation or take no further action on, since this would not protect the public from the risks identified by the Panel.

108. The Panel then considered whether to caution the Registrant. However, the Panel was firmly of the view that such a sanction would not reflect the seriousness of the misconduct in this case. The Panel was also of the view that public confidence in the profession, and the HCPC as its Regulator, would be undermined if such behaviour were dealt with by way of a caution.

109. The Panel next considered whether to place conditions on the Registrant’s registration. As identified at the impairment stage, dishonesty is difficult to remedy. Further, for a Conditions of Practice Order to be effective the Panel has to be satisfied that the Registrant will co-operate with any conditions imposed and that he would be genuinely committed to resolving the issues highlighted. In light of the Registrant’s limited insight and engagement with the regulatory process, it was not possible for the Panel to formulate conditions that would be suitable, workable or appropriate.

110. The Panel next considered whether to make a Suspension Order. The Panel had regard to the sanctions policy and in particular noted that it stated, at paragraph 121, that a suspension order would be appropriate where ‘there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but that these do not require the Registrant to be struck off from the Register. These types of cases will typically exhibit the following factors: the concerns represent a serious breach of the Standards of conduct, performance and ethics; the Registrant has insight; the issues are unlikely to be repeated; and there is evidence to suggest the Registrant is likely to be able to resolve or remedy their failings’. 

111. The Panel carefully evaluated the mitigating circumstances in this case, but considered that they had limited weight. The Panel was of the view that whilst the Registrant has shown some limited insight and remorse, it noted that he had failed to engage in the regulatory proceedings in any meaningful way. These facts did not reassure the Panel in relation to the fundamental matter of the Registrant’s integrity or future conduct. The Panel was of the view that the misconduct in this case is serious. Stealing any amount, however small, of a controlled drug from his employer was unacceptable and members of the public would expect the regulator to regard such conduct as incompatible with continued registration, especially when there is no evidence of a commitment from the Registrant to acknowledge and address the Panel’s concerns.

112. The Registrant had not provided sufficient evidence to the Panel to show his true understanding of the seriousness of the case and had provided little evidence to demonstrate his commitment to ‘resolve or remedy his failings’ by dealing with his health issues, specifically those relating to his use of drugs. The fact that he had failed to inform his referees of the nature of the charges against him, again illustrated a degree of opaqueness that made the Panel further doubt his integrity, his insight and his readiness to actively address his health issues.

113. The Panel formed the view that whilst a suspension order would provide the necessary degree of protection for the public, whilst also leaving open the possibility of remediation and improved insight, it was not satisfied that a suspension order was appropriate. This case concerned very serious misconduct and the Panel has insufficient confidence that the Registrant would be able to return to safe practice in the future because of the minimal information from him about his attempts to remediate his misconduct and his limited understanding of the seriousness and repercussions of his actions.

114. The Panel therefore went on to consider the option of a striking off order. The Panel again had regard to the sanctions policy and noted that it stated, at paragraph 131, that a striking off order is likely to be appropriate where ‘the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the Registrant lacks insight…and is unwilling to resolve matters.’

115. The Panel noted that many of the factors highlighted in the case law, which indicated that a striking off order may be appropriate, were present in this case. Including proven dishonesty in the course of professional duties, a breach of trust and a lack of insight.

116. In making its decision the Panel considered the Registrant’s interests, but decided that they were outweighed by the need to protect the public and the wider public interest.

117. The Panel determined, having regard to all of the information before it, that the appropriate and proportionate order, in this case, is a striking off order.

Order

The Registrar is directed to strike the name of Mr Christian Taylor from the Register on the day this Order comes into effect.

Notes

Interim Order:

1. The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001. The Panel formed the view that it was necessary to impose an interim suspension order because not to do so would be inconsistent for the Panel’s earlier decision.

2. The Panel was satisfied that the Notice of Hearing dated 27 August 2020 set out the Panel’s powers and that under these circumstances it was appropriate to proceed in the absence of the Registrant.

3. The Panel was also satisfied that a member of the public would be dismayed to learn that the Registrant was permitted to continue in practice pending the outcome of appeal period, if an order was not made.

4. Therefore, the Panel was of the view that an interim suspension order is necessary to protect members of the public to maintain confidence in the profession and regulatory process and is otherwise in the public interest. 

5. 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.

Hearing History

History of Hearings for Mr Christian Taylor

Date Panel Hearing type Outcomes / Status
24/11/2020 Conduct and Competence Committee Final Hearing Struck off
28/08/2020 Conduct and Competence Committee Interim Order Review Interim Suspension