Imran Khan

Profession: Chiropodist / podiatrist

Registration Number: CH34297

Interim Order: Imposed on 09 Jun 2021

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 17/12/2024 End: 17:00 17/12/2024

Location: Virtually via video conference

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

No information currently available

Finding

Preliminary Matters

Service

1. The Panel was satisfied that the email sent to the Registrant’s registered email address on 19 November 2024 informing him of the date and time of this hearing, as well as the fact that it was proposed that the hearing would be conducted remotely by the use of Microsoft Teams, constituted good service of the notice of hearing.

Proceeding in the absence of the Registrant

2. Mr Fitzgerald submitted that the hearing should proceed in the Registrant’s absence. He referred the Panel to an e-mail from the Registrant dated 3 December 2024 in which he stated “I am not in the uk at this time and will not be able to attend the hearing”.

3. A Paralegal from the Case Preparation and Review team acknowledged the Registrant’s email and asked him to confirm whether he would be providing documentation for the review hearing. The Registrant did not reply to this e-mail and a follow up e-mail was sent on 13 December 2024. To date there has been no response from the Registrant.

4. The Panel accepted the advice of the Legal Assessor and had regard to the guidance in the HCPC Practice note entitled, “Proceeding in the Absence of the Registrant”.

5. The Panel noted that the Registrant is aware of today’s hearing and that he has voluntarily absented himself. There is an obligation on the regulator to undertake a review of the suspension order before it expires, and the Panel considered that the public interest in expedition outweighed the Registrant’s interests. In the circumstances the Panel decided that it was fair and appropriate to proceed with the hearing in the Registrant’s absence.

Background

6. The Registrant was employed as a Podiatrist by Walsall Health Care NHS Trust (the Trust) between 12 August 2019 and October 2020.

7. Concerns regarding the Registrant’s conduct arose after he suffered an epileptic seizure in September 2019 following which he was prohibited from driving for six months. In contravention of this he was seen on multiple occasions by his colleagues driving to and from work. He was spoken to about this on multiple occasions by his Team Leader, CH, and his manager, MK, the Clinical Lead Podiatrist.

8. Concerns were also identified relating to the Registrant’s inadequate record-keeping in respect of fourteen patients.

9. Following a period of sick leave in March 2020, the Registrant was taken off clinical duties due to the concerns raised regarding his patient care and he was to work as a Clinical Support Worker (CSW) to assist with the COVID-19 pandemic. In the course of a two-day health and safety training day at the hospital, designed to prepare him for this role, the Registrant was witnessed introducing himself as a doctor. Thereafter he was redeployed to administrative duties.


Substantive panel decision on impairment and sanction

10. In its determination in relation to current impairment, the substantive panel stated:

“In relation to the Registrant’s record-keeping, in assessing future risk the Panel noted that whilst the Registrant had reflected on the importance of accurate record-keeping and had attended a relevant course in February 2022, he had not meaningfully demonstrated what he had learned from that course. In addition, because the Registrant has not been working in a clinical post in the interim since he left the Trust, the Panel was not satisfied that the Registrant had demonstrated there were no longer any ongoing concerns and that he now fully complied with his professional obligations within a clinical setting. As such, the Panel concluded that it was not satisfied that the Registrant had, in practice, remediated his failing in this regard. In the circumstances, it concluded that there remained an ongoing risk of repetition of his lack of competence.


As such, in relation to the Registrant’s lack of competence, the Panel determined that the Registrant’s fitness to practise is impaired on the personal component.

In relation to dishonesty, the Panel recognised that dishonesty is difficult to remediate. The Panel carefully considered the Registrant’s reflective statement and was satisfied that the Registrant had demonstrated some insight into his dishonesty. Whilst recognising that he would not now lie about driving or state that he was a doctor, the Panel concluded that his insight was limited because it was not satisfied that he had meaningfully reflected and demonstrated insight into the impact of dishonesty on the reputation of the profession generally. The Panel also took into account that the matters found proved reflected repeated acts of dishonesty over a six-month period in relation to separate and distinct events. Given the Panel’s finding that the Registrant’s insight was limited, it concluded that there remained an ongoing risk of dishonest behaviour, albeit that it may not be in relation to the exact same circumstances as arose in this case.


As such, in relation to the Registrant’s misconduct, the Panel determined that the Registrant’s fitness to practise is also impaired on the personal component.

The Panel also took into account the overarching objectives of the HCPC to protect, promote, and maintain the health, safety, and wellbeing of the public and patients, and to uphold and protect the wider public interest, which includes promoting and maintaining public confidence in the Chiropodist / Podiatrist profession and upholding proper professional standards for members of the profession. The Panel therefore considered that, given the serious nature of the dishonesty found proved and the Registrant’s lack of competence that had yet to be fully remediated, public confidence in the profession would be undermined if a finding of impairment were not made in all the circumstances.

Having regard to all of the above the Panel found that, by reason of his misconduct and lack of competence, the Registrant’s fitness to practise is also currently impaired on the public component of impairment.”

11. In considering sanction, the substantive panel stated that it had identified the following aggravating factors:

o “That the Registrant behaved dishonestly in relation to two separate issues over a six-month period;

o That the Registrant drove on at least three or four occasions when he should not have done so, thereby repeatedly putting himself and others at risk.”

12. The substantive panel identified the following mitigating factors:

o “The Registrant engaged in the regulatory process and made early admissions to a number of particulars, including one allegation of dishonesty, at the outset of the hearing;

o The Registrant had difficult health and personal circumstances at the time which impacted on his performance.

o The Registrant provided a positive testimonial attesting to his character and professionalism. However, the Panel attached less weight to that reference than might otherwise have been the case, given that the author had not worked with the Registrant since 2017 and had only done so for approximately five months. The Panel also noted that the referee made no comment on the current allegations or that he was aware of them.”

13. The substantive panel stated:

“In identifying mitigating factors, the Panel considered that it was incumbent on the Registrant to familiarise himself with the Trust’s procedures, particularly handwriting patient notes, and therefore attached little weight to Mr James’ submission in this regard.

Similarly, whilst the Panel noted that the Registrant has undertaken a record-keeping course, the Panel considered that the Registrant has not meaningfully demonstrated what he took from the course nor demonstrated how he has effectively put his learning into practice.

Considering all of the circumstances in the round, the Panel considered the Registrant’s dishonesty to be towards the centre of the spectrum of dishonesty.”

14. The substantive panel considered the available sanctions taking account of proportionality and decided that the appropriate sanction was a period of 4 months’ suspension.

15. In its written determination the substantive panel explained that it considered that this was the appropriate sanction to impose because:

o “The matters found proved, as set out in the determination on misconduct, represented serious breaches of the HCPC “Standards of Conduct Performance and Ethics”;

o The Registrant demonstrated some insight into his failings, particularly in relation to Particular 1;

o The Registrant had developed some insight into his dishonest behaviour even though that process was not as yet complete.”

16. The substantive panel stated that a future reviewing panel would be assisted by:

a. Further evidence of remediation in relation to record-keeping;

b. Evidence of reflection by the Registrant on his conduct, demonstrating meaningful insight into the impact of his dishonest behaviour on the wider profession and the public;

c. Up-to-date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

d. Evidence that the Registrant has kept his skills and knowledge up to date;

e. Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.

Review hearing 22 August 2023

17. The Registrant did not attend the first substantive review hearing, held on 22 August 2023. The first substantive review panel concluded that it had no new or up to date information from the Registrant, for example about his current circumstances or any action he may have taken towards remedying his misconduct and lack of competence, or further developing his insight. The first review panel agreed with the findings of the substantive panel and concluded that there remained a risk to service users and that the Registrant’s fitness to practise was impaired on both the personal and public component of impairment.

18. In relation to sanction the first review panel decided that the appropriate and proportionate order was to extend the suspension order for a further period of 12 months. That panel considered the information which is likely to assist a future review panel remained the same as recommended by the original panel, but emphasised to the Registrant that the information or evidence that he provides may relate to paid, unpaid or voluntary work.

Second review hearing of 13 September 2024

19. The Registrant attended the second review hearing and provided the following evidence:

I. Letter from the GP to the HCPC (dated 13 January 2021);

II. Letter from Dr Zan Abbas (dated 12 June 2024);

III. Certificate of CPD (dated 29 August 2024);

IV. Record Keeping and Consent CPD (dated 29 October 2021);

V. Registrant’s Reflection Statement (undated).

20. In response to panel questions the Registrant said that he had used social media videos and YouTube videos to further his professional development, and that he had recorded his reflections in the form of video diaries, although he accepted that he had not provided these to his regulator. The Registrant also stated that he had discussions with fellow graduates but had no details of those discussions to provide to the panel. He said that he accepted the findings of the substantive panel.

21. In considering current impairment, the panel second review panel concluded that the Registrant had shown some remorse and remediation. He had stated that he accepted the findings of the substantive panel. He had provided a reflective statement and had evidenced one area of CPD completed by him.

22. The second review panel concluded that the Registrant’s reflective statement provided sufficient remediation for Particulars 1, 5 and 6. The panel concluded that the Registrant had reflected sufficiently on the impact of his actions relating to dishonesty and was satisfied that the risk of repetition of this behaviour was now low.

23. However, the second panel was not satisfied that the Registrant had provided sufficient evidence of remediation for Particular 2. The Registrant informed that panel orally that he had conducted further remediation and reflection in the form of online research and video recordings, but he had not evidenced this for his regulator or the panel.

24. In those circumstances the second review panel concluded that there remains a likelihood of repetition of the Registrant’s past behaviour in Particular 2 if he were to be allowed to practise unrestricted, and that the risk of harm to the public if permitted to practice unrestricted remains.

25. The second review panel concluded that the Registrant remains impaired on the personal component by reason of his lack of competence in Particular 2.

26. The second review panel also concluded that public confidence in the profession and the declaring of proper standards of conduct and performance demanded a finding of impairment in relation to Particular 2 given the seriousness of the matters found proved.

27. The second review panel decided to further extend the suspension order for a period of 4 months. It considered that this would enable the Registrant to evidence his remediation and further develop his insight.

28. The second review panel considered that the following information is likely to assist a future review panel. The information or evidence that he provides may relate to paid, unpaid or voluntary work.

- Further evidence of remediation in relation to record-keeping in the form of a portfolio demonstrating reflection and learning

- Up-to-date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

- Evidence that the Registrant has kept his skills and knowledge up to date;

- Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.

Submissions for this review

29. Mr Fitzgerald outlined the background and submitted that the Registrant has not demonstrated adequate reflection on his failure to keep records or provided any further evidence for this review, despite the recommendations made by previous panels. Mr Fitzgerald therefore submitted that there is nothing for this Panel to consider. On behalf of the HCPC Mr Fitzgerald invited the Panel to impose a further suspension order for a period of six months. This would enable the Registrant to provide sufficient and adequate evidence as recommended as previously requested.

Decision

30. The Panel accepted the advice of the Legal Assessor which addressed the issues of impairment and sanction. The Panel bore in mind that in accordance with the guidance in the case of Abrahaem v GMC [2008] EWHC 183 (Admin), there is a persuasive burden on the Registrant at the review to demonstrate that he has sufficiently addressed the past impairment.

31. The Panel noted that, following the review hearing on 13 September 2024, the issue is whether the Registrant’s fitness to practise is currently impaired by reason of lack of competence. As confirmed by the Legal Assessor the maximum sanction that can therefore be imposed under Article 29 of the Health Care Professions Order is a Suspension Order, as the Registrant has not been continuously suspended for a period of two years at the date of this hearing.

32. The Panel considered all the documents presented and the submissions on behalf of the HCPC. No submissions or evidence had been provided on behalf of the Registrant.

33. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Registrant has not attended today or provided any up-to-date information to this Panel. This Panel has no new information about any action he may have taken towards remedying his lack of competence or further developing his insight.

34. The Panel considered that the Registrant was given clear guidance by the review Panel on the information which he should provide to assist this panel, but he has not engaged with the recommendations or provided any information for this panel to review.

35. The Panel concluded that the Registrant has not discharged the persuasive burden upon him to satisfy it that he is fit to practise and the concerns of the substantive hearing and the review hearing relating to his competence remain unaddressed. In the absence of information, the Panel concluded that there remains a risk to service users, and that the Registrant’s fitness to practise remains impaired.

36. Having decided that the Registrant’s fitness to practise remains impaired, the Panel next considered the available sanctions in ascending order of seriousness.

37. The Panel was satisfied that, given the importance of record keeping, that to take no action, or to issue a caution to the Registrant would not provide the necessary public protection or address the public interest. The Panel considered a conditions of practice order, but decided that it would be insufficient in circumstances where the Registrant has not engaged with any of the recommendations made by the previous review panel or attended this hearing. The Panel had insufficient confidence that the Registrant would engage or comply with conditions of practice.

38. The Panel next considered whether a further period of suspension would be appropriate. A suspension order protects the public and it is currently the most serious sanction available to Panel. A suspension order would give the Registrant a further opportunity to address the issues identified by the review panel on 13 September 2024 and to re-engage with the HCPC process.

39. The Panel decided that a Suspension Order is the appropriate and proportionate sanction. The Panel considered that a period of six months was proportionate and would allow the Registrant ample opportunity to provide evidence for the next review panel to review if he wishes to do so.

40. The Panel takes this opportunity to remind the Registrant that at the next review the review panel will have the option of a Striking Off Order and that the panel, at that time, will consider whether there is evidence available to them to suggest that the Registrant is able to resolve or remedy his failings.

41. The option of a Striking Off order was not considered by the Panel today because it is does not have the power to impose this sanction.

42. The Panel considered the information which is likely to assist a future review panel remains the same as recommended by the review panel on 13 September 2024 as follows:

• Further evidence of remediation in relation to record-keeping in the form of a portfolio demonstrating reflection and learning;

• Up-to-date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

• Evidence that the Registrant has kept his skills and knowledge up to date;

• Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.

Order

ORDER: The Registrar is directed to suspend the registration of Imran Khan for a further period of six months upon the expiry of the existing order.

Notes

The Order imposed today will apply from 22 January 2025.

This Order will be reviewed again before its expiry on 22 July 2025.

Hearing History

History of Hearings for Imran Khan

Date Panel Hearing type Outcomes / Status
17/12/2024 Conduct and Competence Committee Review Hearing Suspended
13/09/2024 Conduct and Competence Committee Review Hearing Suspended
23/08/2024 Conduct and Competence Committee Review Hearing Adjourned
22/08/2023 Conduct and Competence Committee Review Hearing Suspended
17/04/2023 Conduct and Competence Committee Final Hearing Suspended
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