Mr Tahir Butt

Profession: Biomedical scientist

Registration Number: BS66226

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 15/02/2021 End: 17:00 22/02/2021

Location: Virtual via video conference

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

Allegation (As amended at the Final hearing)
“Whilst employed by North East Essex & Suffolk Pathology Services and registered with the HCPC as a Biomedical Scientist, between 26 September 2017 and 18 January 2018, you:
1. Arrived at work smelling of alcohol on the following dates;
 a) 16 November 2017
 b) 18 January 2018
2. On or around 14 January 2018 incorrectly barcoded and booked the blood transfusion sample for Service User 2.
3. Sent abusive text and/or voicemail messages to Colleague A on 13 January 2018, calling them;
 a) 'a prick'
 b) '******* nob';
 c) ‘you ******* gay boy’.
4. On 12 January 2018, you hit a window of a bar with your hand in anger, in front of colleagues and/or members of the public.
5. When dismissed from your employment on 18 January 2018, you;
 a) Were aggressive
 b) Threatened other employees
 c) Were abusive
 d) Had to be escorted from the premises

6. Your actions at paragraphs 1-5 constitute misconduct and/or lack of competence.
7. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.”

Finding

Preliminary Matters – Notice and Proceeding in Absence
1. The Panel was informed that the Notice of today’s hearing was sent to the Registrant on 3 November 2020 to the email address provided to the HCPC. The Panel was satisfied that the HCPC had taken all reasonable steps to serve notice of the hearing on the Registrant and that the Notice made clear that today’s hearing would take place remotely. The Panel, having taken legal advice, decided that notice of the hearing had been properly served in accordance with the relevant rules which in light of the current pandemic allow for service by way of email only to the address registered with the HCPC.
2. Mr Lloyd referred the Panel to the email from the Registrant received at 4.30am on the morning of 15 February 2021 (the day the hearing commenced), which advises that he will not be attending the hearing.  The Registrant does not ask for an adjournment.  Mr Lloyd referred to the public interest in proceeding and stated that two witnesses were warned for today. He submitted that the Registrant has had an opportunity to attend and to make submissions. He has not attended today and the Panel has had sight of the Registrant’s written submission that he provided to the Preliminary Hearing panel in July 2020. No further submissions have been made by the Registrant.  Mr Lloyd requested that the hearing proceeds in the Registrant’s absence.
3. The Panel is aware that its discretion to proceed in absence is one which should be exercised with care.  The Panel accepted the advice of the Legal Assessor who referred it to the HCPTS Practice Note on proceeding in absence and to the case of Adeogba v GMC [2016] EWCA Civ 162 which makes clear that the first question the Panel should ask is whether all reasonable efforts have been taken to serve the Registrant with notice. Thereafter, if the Panel is satisfied, the discretion whether to proceed must be exercised having regard to all the circumstances of which the Panel is aware, with fairness to the Registrant being a prime consideration, but with fairness to the HCPC and the interests of the public also considered.    
4. The Panel considered all the information before it and the email from the Registrant to the HCPC received today in which he states that he will not be attending the hearing. The Registrant is aware that the hearing is taking place and he has chosen not to attend.  He has not asked for an adjournment and the Panel has no reason to believe adjourning the hearing would secure his attendance.  The Panel are aware there are two witnesses warned for today and there is a public interest in proceedings.  The Panel decided that in all these circumstances it was fair and appropriate to proceed in the Registrant’s absence.
HCPC Application to Amend
5. Mr Lloyd sought to amend the allegation.  He explained that particular 2 required to be amended to better reflect the evidence from witness Mrs Harvey. He advised this involved the deletion of words in bold from particular 2 as follows:- 
“2. On or around 14 January 2018 incorrectly barcoded and booked at least 3 blood transfusion samples; the blood transfusion sample for Service User 2.”
6. Mr Lloyd advised that this amendment would avoid confusion and was sent to the Registrant in July 2020.  He has not raised any issue or objection to it.  Mr Lloyd submitted that the proposed amendment made the allegation more precise and specific and did not alter the mischief or the case to be presented.
7. The Legal Assessor advised the Panel to consider whether the proposed amendment altered the nature or gravity of the allegation and whether it gave rise to any prejudice to the Registrant.  The matter was one of fairness and in the interests of justice.
8. The Panel noted that the Registrant has had notice of the proposed amendment and he has not objected.  It concluded that the proposed amendment did not alter the overall nature or the gravity of the particular of the allegation, rather it served to clarify. The Panel decided that it was fair, and in the interests of justice to allow the proposed amendment.
9. Mr Lloyd referred to the email submission received from the Registrant on 7 July 2020.  He submitted that he did not seek to rely upon that email as an admission to any part of the allegation and he accepted that the burden of proof lay on the HCPC.
Background
10. Tahir Butt (the ‘Registrant’) was employed as a locum Band 6 Biomedical Scientist for North East Essex and Suffolk Pathology Services at Colchester Hospital between 26 September 2017 and 18 January 2018. On 16 November 2017, concerns came to light that the Registrant had attended work smelling of alcohol.
11. Luke Groves, Specialist Biomedical Scientist, reported to Carol Harvey, Transfusion Laboratory Manager, that the Registrant smelt of alcohol. Carol Harvey escalated it to Jackie Powell, Service Lead for Haemotology, and the Registrant was given a verbal warning.
12. On 12 January 2018, the Registrant attended a work social event with several colleagues. During this event, it is alleged that the Registrant behaved aggressively towards Colleague A, and deliberately hit the window of the bar in anger.
13. On 13 January 2018, following the altercation at the work social event, the Registrant is alleged to have sent abusive text messages and an abusive voice mail message to Colleague A who later confided in Luke Groves about the messages. Luke Groves escalated the concerns to Shelley Garrey, Business Development Manager. Shelley Garrey had a meeting with the Registrant to discuss the concerns that had been raised. On 18 January 2018, Shelley Garrey escalated the concerns to other senior members of management and the decision was made to terminate the Registrants contract.
14. On 18 January 2018, the Registrant was called to a meeting with Shelley Garrey, Andy Higby, Sarah Stalley and Tanya Muncey to terminate his employment. During the meeting, it is alleged that he became aggressive, threatened members of staff and security had to be called to escort him from the premises.
15. On 19 January 2018, the HCPC received a referral from North East Essex and Suffolk Pathology Services.
Witness 1 – Shelley Garrey  
16. Mrs Garrey is the Support Services Lead for Pathology at East Suffolk and North Essex NHS Foundation Trust (“the Trust”).  Mr Lloyd took the witness to her witness statement and she confirmed it was true to the best of her knowledge and belief.
17. Mrs Garrey told the Panel that her experience of the Registrant was that he often looked generally unwell and was often “disgruntled” and “jittery.” She said she noticed this throughout his time at the Trust. She told the Panel that she had also noticed at times a smell of alcohol from the Registrant, what she called a stale alcohol smell or “morning after” smell of alcohol.   She said his time keeping was very poor and she and other managers were aware of and monitored that issue. He was also known to “fly off the handle.”
18. Mrs Garrey told the Panel about the altercation between the Registrant and Colleague A on 12 January 2018 at a social function. Colleague A told her he had been most distressed by the events which were described as a “scuffle”.
19. Mrs Garrey told the Panel about the events at the Registrant’s dismissal hearing. She said that the Registrant swore and complained about being “always in f-ing trouble” and he had been very confrontational. She said she did not want to be in the room with him.  She said the Registrant’s demeanour was aggressive and he had refused to sit down. She said she was concerned the Registrant was going to assault her colleague Andy Higby. She described the Registrant as being “in his face.” 
20. Mrs Garrey said she was in a small office at the time and she said she felt very “uneasy”, not threatened physically but said that she had felt threatened by his behaviour.  She said she was concerned enough that she had wanted to call security but she could not get to the telephone.  She was concerned that colleagues may get hurt, although not deliberately as arms were “flailing”.  Mrs Garrey stated that the Registrant shouted at all those present at the meeting shouting “fucking idiots” and “this is bullshit” at the top of his voice.
Witness 2 – Carol Harvey
21. Mrs Harvey is a computer System Validation Lead in the Transformation Team - Cancer and Diagnostics at the Trust.  Mr Lloyd took the witness to her witness statement and she confirmed it was true to the best of her knowledge and belief.
22. Mrs Harvey told the Panel about the concerns regarding the Registrant smelling of alcohol on 16 November 2017 and she said that it was like beer, not alcohol hand cleanser.  A colleague, Luke Groves had raised his concerns with her about the Registrant whom he said was drunk and abusive. She had then taken it up with management that day and she and Jackie Powell had a meeting with the Registrant.  She said he smelled of alcohol but did not appear to be drunk and she said he was asked to go home, shower and change his clothes.
23. Mrs Harvey also told the Panel about the errors found in the bar coding of the blood samples in January 2018.  It was not a common error and she said it was a serious error and could be life threatening.  She said that she spoke to the Registrant about the error.  He said that he could not explain how he had made the error but he had apologised. She said that the Registrant had been with the Trust for some time and was experienced enough to be allowed to do lone working shifts.  She said that the laboratory did about 300 samples per day. She was not aware of any other errors the Registrant had made whilst at the Trust.
24. Mrs Harvey said she had heard the Registrant shouting in the meeting in January 2018 when he was dismissed. She was close by but was not at the meeting. She said she heard Mr Higby saying “get your hands off me”.  She said the Registrant was agitated, angry and swearing. She said she was worried for her colleagues and was concerned enough to call security. She told the Panel that she then asked a colleague to call the security guards to escort the Registrant from the premises. She saw that the Registrant was angry and that he did not appear to leave the premises willingly.  
Witness 3 – Colleague A
25. Colleague A is a Band 5 Biomedical Scientist at the Trust and has been in that role since January 2018. This role involves undertaking testing and processing of biomedical specimens, analysis and entering of results onto the computer. The witness confirmed his witness statement was true to the best of his knowledge and belief. He worked with the Registrant at the Trust from around late 2017 and occasionally socialised with him and other colleagues. 
26. Colleague A told the Panel that he gave the Registrant his telephone number as a means of being friendly to a new colleague and to help the Registrant get to know the area. He said he got on well at work with the Registrant and said there was some humorous banter at work, but nothing inappropriate.  He told the Panel that, before the 12 January 2018 incident, the Registrant had sometimes texted him and they had met socially previously.  Colleague A told the Panel that he got the impression the that Registrant was not entirely comfortable with his disclosure that he was gay.
27. Colleague A told the Panel about the incident on 12 January 2018 which was a leaving party for a colleague and about 10 of his colleagues attended. Colleague A said that the Registrant became aggressive towards him and raised his voice.  He seemed to be angry at him so he removed himself from the area. He said he did not understand why the Registrant was behaving this way and that things thereafter “spiralled.”  Colleague A said he and the Registrant had both consumed alcohol but he said he was not drunk, but was under the influence.
28. Colleague A said he went outside the pub and recalled that he may have made eye contact with the Registrant who was still inside. At that point the Registrant “charged” at the window and seemed to punch the glass, but did not break it.  Colleague A thought that the action was directed towards him and was spontaneous. He said that he did not recall that he had been dancing in front of the window.  He was upset and intimidated by the Registrant’s actions, but he said he did not understand why the Registrant was behaving this way. Colleague A said he had not taunted or been aware that he may have “wound up” the Registrant. 
29. Colleague A told the Panel about receiving the abusive text messages from the Registrant the next day, the 13 January 2018.  He said he did not recall doing anything to prompt that response and he was shocked and upset. He told the Panel that the screenshots in the exhibits were those from his mobile telephone received from the Registrant that night.  He said they had moved to another pub by this time and he had had no further engagement with the Registrant.
30. Colleague A said that he felt upset as they were “strong” messages, and said they were uncalled for, unnecessary and offensive. He said he did not understand how he had prompted that response from the Registrant.  He said that he had provided all the messages, which included screenshots, from his telephone.   
31. A transcript of the voice mail message was read aloud by Mr Lloyd and the voicemail message was played. Colleague A said that it was the Registrant’s voice in the message and that it had been received by him on his mobile telephone on the morning of 13 January 2018. He said he was surprised, shocked and very upset by the voice mail message received from the Registrant later that evening.  He said he had done nothing to prompt that response and had only tried to make the Registrant comfortable as a new colleague. He said that he just did not understand. 
32. Colleague A said he recalled receiving the text messages before he got the voicemail.  He said he was back home before he saw the messages and got the voicemail and then responded to the Registrant by text. He told the Panel that after the Registrant had been dismissed he received another text message from the Registrant saying “You horrible person, I hope you are happy”.  He said he did not understand the Registrant’s reaction and said he thought that the Registrant may have had some issues as he could be erratic and that other colleagues were aware of his behaviour.

 


Witness 4 – Luke Groves
33.  Mr Luke Groves is a Specialist Biomedical Scientist employed by the Trust for nine years. The witness confirmed his witness statement was true to the best of his knowledge and belief.
34. Mr Groves said that he found the Registrant to be competent and he seemed a smart person, and his work was fine but he did not always want to follow local procedures. Mr Groves told the Panel that he had experienced a difficult working relationship with the Registrant and had found training him difficult.  He said it was not unusual for locum staff to need some training as there were local policies that they needed to understand. 
35. Mr Groves said the Registrant was very unhappy with being asked to train and, during his training, the Registrant had become aggressive and raised his voice to him.  Mr Groves said that he did not want to train him and had stopped the training session.  He said the Registrant was rude and unprofessional to him and said that whilst he did not feel in danger, as he was physically bigger than the Registrant, when he continued to work with him, the Registrant was often very confrontational.
36. Mr Groves also told the Panel that he had experienced the Registrant smelling of alcohol. He was sure it was from the Registrant consuming alcohol rather than from any alcohol used in the lab as it had a very different smell. Mr Groves was so concerned that he escalated his concerns to his manager on a number of occasions. Frustrated at the apparent lack of action, he escalated his concerns to a higher level to Jackie Powell.  He had no knowledge of the Registrant’s personal circumstances. Mr Groves told the Panel that Colleague A had raised concerns with him about the Registrant’s behaviour towards him at the social event.  Mr Groves then escalated those concerns to Shelley Garrey. 
37. Mr Groves told the Panel that he saw the security guards escorting the Registrant from the lab the day he was dismissed.  Mr Groves said the Registrant was extremely upset and angry and was shouting a lot.  He was swearing and saying it was all “bullshit and lies” and he was also on his mobile telephone. 
38. Mr Groves said that he was worried for his family in case the Registrant knew where he lived. He said he was fearful of physical repercussions and he also felt concerned for his colleagues. Mr Groves said he now approached training with “extreme caution” and the experience with the Registrant was a constant reminder. Mr Groves said that the Registrant added all of the lab staff on social media and that was a real concern, so much so that he had initially been unwilling to give evidence. 
Witness 5 – Adam De Boarde
39. Mr De Boarde is a Biomedical Scientist at the Trust. The witness confirmed his witness statement was true to the best of his knowledge and belief.
40. Mr De Boarde told the Panel about working with the Registrant and referred to his witness statement. He found the Registrant could be argumentative but they had a good working relationship.  He said that Colleague A “occasionally comes out with sexual innuendo towards colleagues in a playful manner”.  He said that Colleague A and the Registrant often had what he called friendly banter, but he did not hear the content and thought nothing of it. He said their relationship was changeable and they seemed to like each other sometimes, and at other times not.
41. Mr De Boarde told the Panel about the incident in the pub. He said it seemed that night that the Registrant and Colleague A were not getting on and he felt caught in the middle.  He said that they seemed to have a chat but the Registrant was getting agitated about a sexual innuendo that Colleague A seemed to have made, but Mr De Boarde said he did not hear what Colleague A had said. He said he was sure it was not offensive or abusive as he had known Colleague A was friendly and flamboyant and often made funny remarks.
42. Mr De Boarde said he recalled Colleague A and the Registrant had consumed a few drinks but were not slurring their words. As regards the pub window issue, he recalled that the Registrant had used either open hands or a fist and he had hit the window “very hard”.  He recalled that Colleague A was dancing in a provocative way in front of the window and that the Registrant had come up to the window. Colleague A was right up against the window and seemed keen to provoke a reaction from the Registrant. The window was hit so hard that the security guards in the pub came over, but took no action.  He said a number of colleagues were also present and saw the incident. Mr De Boarde said he and others were shocked and he moved away.  He recalled that the Registrant said that Colleague A was annoying him and he had then left the pub.  
HCPC Closing Submissions
43. Mr Lloyd summarised the evidence in respect of each particular of the allegation and referred to his detailed written submissions.  He summarised the evidence and the relevant case law on the fact, grounds and on impairment of fitness to practise.
44. Mr Lloyd submitted that the evidence from the witnesses supported the allegation and should be found proved. He submitted that those facts, if found proved, amounted to misconduct. He further submitted that there was no evidence of remediation or insight by the Registrant and that his fitness to practise was currently impaired on both personal and public interest grounds.
Legal Advice
45. The Panel accepted the advice of the Legal Assessor. He advised the Panel on the approach to facts and to be mindful that the civil burden of proof, the balance of probabilities, rests on the HCPC. The Registrant need prove nothing. He advised the Panel to use the ordinary, natural meaning of the words “abusive” when assessing and weighing the evidence.
46. In relation to the ground of lack of competence the Legal Assessor reminded the Panel of the guidance in Holton v GMC [2006] EWHC 2960.  The standard to be applied was that applicable to the post to which the Registrant has been appointed and the work he was carrying out. He also referred to Calhaem v GMC [2007] EWHC 2606.  A lack of competence connotes a standard of professional performance which is unacceptably low and which (save in exceptional circumstances) has been demonstrated by reference to a fair sample of work.
47. On the ground of misconduct, the Legal Assessor referred the Panel to the guidance in Roylance v GMC (No 2) [2001] 1 AC 311 and reminded the Panel that misconduct was a matter for its own professional judgement.
48. On impairment of fitness to practise, the Legal Assessor referred the Panel to the HCPC Practice Note on Finding that Fitness to Practice is Impaired and to the guidance in CHRE v NMC & Grant [2011] EWHC 927(Admin). He reminded the Panel to consider the central issues of insight, remediation and the risk of repetition.  He advised the Panel that on impairment there was no burden of proof as this was a matter for its own professional judgement. The Legal Assessor stressed to the Panel the central importance of protecting the public and being mindful of the wider public interest.
49. In considering its decision on impairment, the Panel was mindful that the purpose of these proceedings is not to punish the Registrant but to protect the public. The Panel accepted the Legal Assessor’s advice and exercised its own professional judgement. It considered the guidance in the relevant HCPTS Practice Note and in the case of Grant, and was mindful of the central importance of protecting the public and the wider public interest, including public confidence in, and the reputation of, the profession and the Regulator.

Decision on Facts
The witnesses
50. The Panel carefully considered the live evidence, the documents before it and the submissions from Mr Lloyd. It accepted the advice of the Legal Assessor. The Panel considered and assessed the evidence of each of the five witnesses. It also considered the written submission from the Registrant dated 7 July 2020 which he sent to the HCPC for consideration by the panel at an earlier Preliminary hearing.
51. The Panel considered the evidence of Mrs Garrey.  It found she was open and sought to assist the Panel.  She was credible and reliable and did not speculate. 
52. The Panel considered the evidence of Mrs Harvey. She was open, consistent and her evidence was factually based.  She was credible and reliable.
53. The Panel found Colleague A sought to assist the Panel and was open. Whilst his recollection of the incident in the pub was, at times, somewhat vague, the Panel found his evidence was reliable and credible.  The Panel was mindful that Colleague A was the victim of the abusive behaviour alleged in the text and voicemail.
54. The Panel found Mr Groves was an open, clear and compelling witness.  He was balanced and fair and was credible and reliable.
55. Mr De Boarde sought to assist the Panel and was open.  He gave a clear recollection of the incident he had witnessed and he was a credible and reliable witness.
Particular 1 – Proved
  Whilst employed by North East Essex & Suffolk Pathology Services and registered with the HCPC as a Biomedical Scientist, between 26 September 2017 and 18 January 2018, you:
1. Arrived at work smelling of alcohol on the following dates;
a) 16 November 2017
b) 18 January 2018
54. The panel heard from Mrs Garrey and Mr Groves who clearly described their recollection about the smell of alcohol from the Registrant on 16 November 2017. The Panel accepted that evidence, which was not contradicted or undermined by any other evidence.
55. Mrs Garrey gave clear and detailed evidence about the 18 January 2018 and the Panel also considered the HR file notes she made at the time.  These are consistent with the events she described.  The Panel heard from Mrs Garrey about the size of the room she was in with the Registrant and her description of the smell of alcohol.  The Panel accepted this evidence and it found particulars a) and b) proved.
Particular 2 – Proved
2) On or around 14 January 2018 incorrectly barcoded and booked the blood transfusion sample for Service User 2.
56. The Panel heard the evidence from Mrs Harvey who explained the error made by the Registrant and the process that ought to have been followed. The Panel considered the supporting audit trail documentation and it also considered the evidence in the blood transfusion report from another member of staff.  This evidence describes the procedure and the error found and is consistent with the evidence from Mrs Harvey. The evidence supports the allegation that the sample was incorrectly bar coded and booked by the Registrant. The Panel found this proved.
Particular 3 – Proved
 3. Sent abusive text and/or voicemail messages to Colleague A on 13 January 2018, calling them;
a) 'a prick'
b) 'Fucking nob';
c) ‘you fucking gay boy’.
57. The Panel heard the voice mail and saw the text messages.  It accepted the evidence of Colleague A who confirmed that these were the texts he had received on his telephone and sent by the Registrant. Colleague A also confirmed that the recorded voicemail was spoken by the Registrant and had been sent to Colleague A’s mobile telephone. The words alleged at parts a) and b) appear in the text messages. Colleague A was shocked and upset by them.
58. The Panel concluded that the texts and the voicemail message were abusive, they were offensive, aggressive and insulting.  The voicemail message, containing the phrase alleged at c), is spoken by the Registrant in a hostile, threatening and very angry manner.  Colleague A was shocked and upset by it.  The Panel found all parts of his particular proved.
Particular 4 – Proved
 4. On 12 January 2018, you hit a window of a bar with your hand in anger, in front of colleagues and/or members of the public.
59. The Panel accepted the clear evidence from Mr De Boarde and from Colleague A.  Their accounts, whilst they varied in some details, were from differing perspectives and were very largely consistent. Colleague A recalled the Registrant hitting the window aggressively when Colleague A was outside. He thought it was directed at him.
60. Mr De Boarde recalled that the window was hit “very hard” by the Registrant who appeared angry with Colleague A.  The sound was such that the security guards from the pub attended. He also told the Panel that several members of the public and other staff members were present. The Panel found that the Registrant hit the window hard with his hand in anger in front of colleagues and the public and it found this particular proved.
Particular 5 – Proved
5. When dismissed from your employment on 18 January 2018, you;
a) Were aggressive
b) Threatened other employees
c) Were abusive
d) Had to be escorted from the premises
61. The Panel accepted the clear evidence from Mrs Garrey who was present in the room with the Registrant.  She described the Registrant’s behaviour which was aggressive, threatening and abusive.  Mrs Garrey described the Registrant as being angry and red faced and said “I was threatened by his behaviour”. She said that he had opened the door with such force that he left a dent in the wall.  She described his aggressive behaviour and how he went “toe to toe” with another colleague present, Mr Higby. She said the Registrant told the managers present “we were F’ing idiots”. The Panel accepted her evidence.

62. Mrs Harvey and Mr Groves also described the Registrant’s behaviour as he left, being escorted by security. They both described his loud shouting and swearing. Their evidence, although they were outside the meeting room, tended to support and was consistent with the events and behaviour described by Mrs Garrey. Mr Groves described his concerns and fear for his family and said he was concerned for their safety as a result of the Registrant’s threatening and aggressive behaviour.

63. The Panel found that the evidence of these three witnesses supports the allegation that the Registrant was abusive, aggressive and threatening when he was dismissed. They described how he was necessarily escorted out of the premises whilst shouting and swearing loudly.  The Panel found all parts of this particular proved.

Decision on Grounds
64. The panel first considered the ground of lack of competence.  It was mindful of the guidance in the Holton and Calhaem cases. It found that the issue of lack of competence only arose with respect to Particular 2, regarding the error barcoding and booking blood samples.
65. Particular 2 concerned the error in respect of the blood sample and the Panel found there was no evidence that this was a fair sample of his work. There was evidence that about 300 blood samples were processed per day in the lab. There was no evidence of any exceptional circumstances. The Panel concluded that there was insufficient evidence that particular 2 amounted to a lack of competence and it found that ground not proved.
66. The Panel next considered the statutory ground of misconduct. The Panel exercised its own professional judgement and accepted the Legal Assessor’s advice. It bore in mind the guidance in Roylance. 
67. The Panel found its findings in particulars 1, 3, 4 and 5 were all serious and, both individually and cumulatively, amount to misconduct. The Registrant repeatedly attended work smelling of alcohol.  The Registrant verbally abused and threatened colleagues in the work place and at a social event. He was hostile and abusive toward colleagues, and in particular he was abusive and threatening toward Colleague A on the basis of his sexual orientation.  Abusive, threatening, and aggressive behaviour to colleagues and the public is conduct which falls well below what would have been proper in the circumstances.
68. The Panel decided that the findings were also conduct that would be considered deplorable by fellow professionals.
69. The Panel found the Registrant breached the Trust’s Substance Misuse Policy and Procedure. This states as follows:
“4. CONSUMPTION OF ALCOHOL

4.1 Employee’s should be aware that the smell of alcohol on the breath can be unpleasant and of concern for service users and is contrary to professional
standards.

4.2 Employees should be aware that drinking off duty and in their own time can still have an effect on the service they provide when they return to work.”

70. The Panel found the Registrant breached the Trust’s Bullying and Harassment at Work Policy and Toolkit which states in section 4:-
“Harassment and bullying may be intentional or unintentional, the key issues are that it is unsolicited and unwelcome and fails to respect the rights of others. Whatever form it takes, it is unwarranted and unwelcome to the individual….”

That policy includes the following as an example of bullying and harassment:-

“Any conduct that denigrates, embarrasses or intimidates an individual whether directly or indirectly”

71. The Panel also found that the Registrant had breached the following HCPC Standards of conduct, performance and ethics (2016):-
Standard 1.5 – You must not discriminate against service users, carers or colleagues by allowing your personal views to affect your professional relationships or the care, treatment or other services that you provide.
Standard 2.7 – You must use all forms of communication appropriately and responsibly, including social media and networking websites.
Standard 6.1 – You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
Standard 6.2 – You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.
Standard 9.1 – You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
72. The Panel found that the findings, except particular 2, amount to misconduct.
73. The Panel did not consider that the finding in respect of the barcoding of the blood sample at particular 2 amounted to misconduct.  It was an error but there was no evidence that this was serious enough to be considered misconduct. The Registrant’s managers did not consider it serious enough to require any disciplinary action at that time, but the potential consequences with regards to his locum contract were pointed out to him.  The Panel concluded that this finding alone is not serious enough to amount to misconduct.

Decision on Impairment
74. The panel next considered impairment of fitness to practise. It accepted the advice of the Legal Assessor and was mindful of the guidance in Grant.  The Panel consider the misconduct found is remediable and it went on to consider insight and remediation.

75. The Panel considered the written submission made by the Registrant to the panel on 7 July 2020 when he stated that:

“After reviewing the evidence bundle provided I would like to take full responsibility for my actions, mistakes and behaviour at the time. I would like to apologise to all parties involved especially to [Colleague A] for saying those hurtful things due to inebriation.

I do believe at the time I was not in the right frame of mind due to loneliness and personal troubles after the holiday season. I admit I most likely was consuming too much alcohol at the time due to this.

I believe all my actions and mistakes made by myself were all made in a very short period, which does not show my true character.

I regret the mistakes I made and since have improved my personal character and have made improvements to my personal life ensuring these mistakes do not occur again.

I am proud of my career which I have worked very hard for but highly regret this short period of time where my actions do not show my overall professional character where my standards fell below par”

76. There has been very limited engagement in these proceedings by the Registrant and the Panel found that this submission in July 2020 was the only evidence from the Registrant that touches on the central issues of insight and remediation. The submission is somewhat limited and generic and does not address the allegations specifically. The Registrant has expressed some limited insight and remorse and he appears to accept some responsibility for his actions.  However, there is no evidence of any developed reflection and insight, or of any steps taken by the Registrant to remediate his practice.

77. The Panel noted that the Registrant has not apologised to his former colleagues, other than generically in this July 2020 submission. There was no evidence that he has apologised directly to Colleague A whom he verbally abused. There is no evidence of meaningful and developed reflection and insight.

78. In these circumstances the Panel concluded that the Registrant has not sufficiently demonstrated that he has insight into, or understands his misconduct. He has not developed sufficient insight into his conduct such that the Panel can be confident that it is not likely to be repeated. The Panel had no specific evidence of any steps taken by the Registrant to remediate his practice.

79. The panel considered the reference from the Blood Transfusion Department of Norfolk and Norwich University Hospital dated 19 August 2020.  It is addressed “To whom it may concern.”  Whilst, to an extent positive, this reference does not indicate any knowledge of the current allegations and does not address the Registrant’s behaviour and attitudes.  It addresses aspects of the Registrant’s technical competence and, as such, it is of very limited assistance in assessing whether the Registrant has reflected on and remediated his misconduct in this case.

80. The Panel had regard to the guidance in the Grant case and found that in all the circumstances, the Registrant has in the past brought, and is liable in the future to bring, the profession into disrepute. It also found that he has in the past breached and is liable in the future to breach fundamental tenets of the profession, namely the dignity of colleagues, respect for colleagues and cooperation with colleagues.

81. The Panel in these circumstances can have no confidence that the Registrant has sufficient insight into or addressed his misconduct. It concluded therefore, that the Registrant presents a high risk of repetition of his conduct in the future and that his fitness to practise is currently impaired on the personal aspect.
82. The Panel had regard to the important public interest considerations. Given the misconduct it has found, the Panel decided that it would undermine public trust and confidence in the profession, and in the regulatory process, if a finding of current impairment was not made in this case. Further, there is a need to declare and uphold proper standards of behaviour.
83. Accordingly, the Panel finds that the Registrant’s fitness to practise is currently impaired on both the personal and public components.

HCPC Submissions on Sanction 
84. Mr Lloyd reminded the Panel of the purpose of sanction and of the need to protect the public. He referred the Panel to the HCPC Sanctions Policy. He reminded the Panel of the need to act proportionately and balance that with the Registrant’s interests and that it should apply the least restrictive sanction.
85. In mitigation, Mr Lloyd submitted that the Registrant has no prior regulatory history and has not sought to deny the allegations. He has shown some, limited insight. 
86. Mr Lloyd submitted that the aggravating features were that there was a pattern of behaviour and a repetition of the conduct, both as regards smelling of alcohol and the aggressive, abusive and discriminatory behaviour. He submitted that this indicated a higher risk to the public and that a more severe sanction may be required as a result.
87. Mr Lloyd referred the Panel to paragraphs 62 - 66 of the Sanctions Guidance as regards lack of cooperation and discrimination. He also referred to the Sanctions Guidance on violence in paragraph 93 and the impact such a finding can have on public confidence in the profession. 
88. Mr Lloyd submitted that an appropriate sanction may be a Suspension Order and he referred the Panel to paragraph 121 of the Sanctions Guidance. He submitted that a Striking Off may also be appropriate and referred to paragraphs 130 and 131 of the Guidance.  He invited the Panel to impose the sanction that it considered appropriate and proportionate.

Decision on Sanction
89. The Panel accepted the advice of the Legal Assessor. He advised it to consider the HCPC Sanctions Policy and to consider sanction in ascending order of severity, applying the least restrictive sanction necessary to protect the public. The Panel must act proportionately and consider any aggravating and mitigating factors. It must be mindful of the public interest and that the primary purpose of sanction was protection of the public.
Mitigating and Aggravating Factors
90. In considering the appropriate sanction, the Panel had regard to its earlier findings of misconduct, and it accepted the Legal Assessor’s advice.
91. The Panel found the following mitigating factors:-
• No previous regulatory history;
• No denial of the allegations;
• Limited insight;
• Limited apology.
92. The aggravating features identified were as follows:-
• A pattern of unacceptable conduct;
• A pattern of aggressive and abusive behaviour to Colleague A;
• Discriminatory abuse regarding the sexual orientation of Colleague A;
• Abusive and threatening behaviour towards colleagues;
• A lack of evidence of remediation.
93. In view of the seriousness of the findings, to take no further action or to impose a Caution Order would not be appropriate. Neither would address the seriousness of the misconduct found proved. Neither would be sufficient to protect the public, to maintain confidence in the profession and the regulatory process, or to uphold and declare proper standards.
94. The Panel next considered a Conditions of Practice Order. The Panel has limited information from the Registrant’s written submissions about his current circumstances and there is no evidence that the Registrant is genuinely committed to resolving the concerns. 
95. The Panel was mindful of the nature and gravity of the misconduct found proved, which is essentially attitudinal and behavioural. A pattern of behaviour and a risk of repetition has also been identified.  In these circumstances, the Panel was not able to formulate realistic, appropriate and proportionate conditions of practice to sufficiently address the misconduct found and the risk of repetition. Conditions would also fail to sufficiently uphold public confidence in the profession or the Regulator, and would not serve as a deterrent.
96. The Panel next considered a Suspension Order. The Panel has found that the Registrant breached fundamental tenets of his profession. The Registrant has shown limited insight, as set out in his written submission in July 2020.  This also indicates some awareness of other issues that he states may have impacted on his conduct. There is, however, no further evidence of any remediation. The Panel noted that he has worked in his profession since the allegation and there is a reference, albeit limited, in that regard.
97. The Panel carefully considered Striking Off the Registrant. The Registrant’s conduct was serious and he abused his colleagues.  However, at this stage, the Panel concluded that a Striking Off Order would go further than was currently necessary to protect the public, would not be proportionate and would be unnecessarily punitive. 
98. In all the circumstances of this case, the Panel determined that a Suspension Order was the sufficient and proportionate sanction at this time. That sanction declares and upholds proper standards, sufficiently marks the misconduct as unacceptable and acts as a deterrent.  A Suspension Order will also serve to maintain trust and confidence in the profession and the Regulator, and will also serve to protect the public. 
99. The Panel decided, given the misconduct found, that it was appropriate and proportionate to impose the maximum period of suspension for 12 months.
100. The Panel considered that a Reviewing panel would likely be assisted by the following:-
• Full engagement and attendance by the Registrant;
• Evidence of apology to Colleague A and his other former colleagues;
• Evidence of developed insight into his misconduct and behaviour, such as a written reflective statement;
• Evidence of the steps taken to remediate his practice;
• Relevant references and testimonials including reference to the Registrant’s conduct and behaviour toward colleagues;
• Any relevant courses and training undertaken to enhance the Registrant’s understanding of his conduct, such as training on equality and diversity, anger management and relationships with colleagues.

Order

Order: The Registrar is directed to Suspend the name of Tahir Butt from the Register for a period of 12 months from the date this Order comes into effect.

Notes

The Order will be reviewed before its expiry.

Right of Appeal:
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Article 29(10) of the Health and Social Work Professions Order 2001, any appeal must be made within 28 days of 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.

Interim Order:
Decision on Interim Order
1. The Panel heard from Mr Lloyd and took account of all the information before it. He submitted that an interim order was necessary on public protection and public interest grounds given its decision to Suspend the Registrant.
2. The Panel accepted the advice of the Legal Assessor. He referred it to the HCPTS Practice Notes on Proceeding in Absence and on Interim Orders and he reminded the Panel that the primary purpose of an interim order was protection of the public and that it was necessary to balance the interests of the Registrant with the need to protect the public.
3. There has been no change in circumstances since the Panel decided to proceed in the absence of the Registrant. The Registrant has voluntarily absented himself and the Panel determined to proceed in respect of the interim order application. The Panel noted that the Registrant had received notice of the possibility of an interim order following a Final hearing in the HCPC notice of hearing.
4. The Panel decided that it would be wholly incompatible with its findings, and with the sanction imposed, to conclude that an Interim Order is not necessary for protection of the public and in the wider public interest. Given its findings the Panel determined that it is appropriate that a Suspension Order be imposed on an interim basis for a period of 18 months to cover any appeal period. When the appeal period expires this interim order will come to an end unless there has been an application to appeal. If there is no appeal the 12-month Suspension Order shall apply.

Hearing History

History of Hearings for Mr Tahir Butt

Date Panel Hearing type Outcomes / Status
15/02/2021 Conduct and Competence Committee Final Hearing Suspended