
Mr Salman Rafi
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Allegation
As a registered Operating Department Practitioner (ODP38814):
1. On 26 January 2024 you were convicted at Leeds Crown Court of:
a) Adult attempt to engage in sexual communication with a child,
b) Adult attempt to meet a girl under 16 years of age following grooming.
2. By reason of your conviction your fitness to practise is impaired.
Finding
Preliminary Matters:
1. The Panel convened to consider an Allegation against Mr Salman Rafi. Miss Mosley appeared on behalf of the HCPC. Mr Rafi attended and represented himself.
Background:
2. The Registrant had been employed as an Operating Department Practitioner (‘ODP’) in adult surgical wards within NHS trusts, working within a surgical unit with a private agency called 18 Week Support (‘the Agency’).
3. In June 2023, the Registrant began engaging online with a person whom he believed to be a 12-year-old girl. During the communications, the age of the girl was made clear to the Registrant. The communications were of a sexual nature.
4. Between 31 July 2023 and 2 August 2023, the Registrant was working in Shrewsbury. On 1 August 2023, the Registrant travelled by car from Shrewsbury to meet the supposed child in Wakefield. The Registrant was arrested when he arrived at the train station to meet the girl.
5. The Registrant admitted to the police that he travelled to meet the child but denied that this was sexually motivated. The Registrant stated that he had planned to take her to KFC (Kentucky Fried Chicken). The Registrant was charged with two offences under Section 15 of the Sexual Offences Act 2003.
6. On 7 August 2023, the Agency was notified by the City of London Local Authority Designated Officer that the Registrant had been arrested. The Agency notified the HCPC of the Registrant’s arrest and submitted a referral form.
7. On 15 August 2023, the Agency wrote to the Registrant informing him that he was placed on short term inactive status and that his shifts would be paused.
8. On 31 August 2023, the Registrant appeared in Court for his first hearing.
9. On 26 January 2024, the Registrant pleaded guilty to, and was convicted of, the following offences at Leeds Crown Court:
a. Adult attempt to engage in sexual communication with a child.
b. Adult attempt to meet a girl under 16 years of age following grooming.
10. These offences relate to Section 15 (Meeting a child following sexual grooming etc) and Section 15A (Sexual communication with a child) of the Sexual Offences Act 2003.
11. The Registrant was sentenced on 28 February 2024. The Judge’s sentencing remarks provide further detail and outline the seriousness of the Registrant’s offences. The sentencing remarks state that:
• The offending dates back to 2 June 2023.
• The Registrant was communicating with an individual he initially believed was 13 but later believed to be 12 years old.
• The Registrant asked for images of the young person and asked whether she had tried anything sexual in the past, whether she had a boyfriend and whether she was a virgin.
• The Registrant sent pictures of himself semi-naked from the top in a hotel room and in a pool.
• The Registrant repeatedly asked to meet up, offering the young person money, financial inducements, that he would take her out for food or to the cinema, all elements of grooming.
• The Registrant asked the young person to delete their conversations in order to protect and hide what he was doing.
• The Registrant drove from Shrewsbury to Wakefield in order to pick up the young person and to commit a serious sexual offence.
• The young person was a decoy deployed by police. However, the Registrant genuinely thought he was going to meet a real child to commit serious sexual offences.
• The Registrant lied to the police, saying he had travelled from Shrewsbury to Dewsbury to meet a friend called Rabia. He was only then going to meet the young person for an hour or so and have a KFC and there was no other reason to meet her.
12. The Registrant was sentenced to 15 months’ imprisonment, suspended for two years. The Registrant is also required to attend a sex offenders programme and is subject to a Sexual Harm Prevention Order and notification requirements for a period of 10 years.
13. In an email to Blake Morgan Solicitors, dated 31 October 2024, the Registrant’s Probation Officer referred to the requirements of the two-year suspended sentence order as (1) Accredited Programme - Horizon, and (2) 55 days Rehabilitation Activity Requirement. The Probation Officer said that the Registrant, “… has been progressing very well with the order. He is engaging well and addressing his issues. He is yet to commence the accredited programme but the delay in commencing the same is due to internal Probation issues.”
Decision on Facts:
14. In reaching its decisions on the facts the Panel took into account the memorandum of conviction which, the Legal Assessor advised, is conclusive proof of the conviction. Accordingly, the Panel found the facts as set out in Allegation 1(a) and (b) proved. The Panel also took into account the Registrant’s admissions to these facts at the hearing.
Decision on Grounds:
15. The Panel next considered the statutory ground. Because this is a conviction case, and the Panel had been provided with the memorandum of conviction, the Panel found the statutory ground to be made out.
Decision on Impairment:
16. Having found the statutory ground of conviction to be well founded, the Panel went on to consider whether the Registrant’s current fitness to practise was impaired as a result of that conviction. In doing so it took into account the submissions made by Ms Mosley, the oral evidence provided by the Registrant and all the documents provided. The Panel accepted the advice of the Legal Assessor.
17. The Registrant gave oral evidence to the Panel. He disputed that his fitness to practise was currently impaired. He said he loved his job and had worked and studied very hard to get where he is today. He provided some background to his career, starting from when he qualified in 2018 and his first job as an ODP at Ashford and St Peter’s Hospital. He said he was there for four years and “achieved things that nobody else had in that job.” He said he was promoted to Team Leader after just two years because his employer saw the “drive in him to do things to the best of my ability and to go above and beyond in carrying out my work.”
18. The Registrant said the Hospital wanted him to become a Band 7 ODP, however he wished to remain working part-time and doing locum work. He particularly liked doing locum work as it took him all over the country seeing the way that different hospitals operated. He said he had always received positive feedback about his work. He added that he had never allowed his fitness to practise to be affected by anything going on in his personal life.
19. The Registrant said he had a letter from his Manager at the Ashford and St Peter’s hospital confirming that he has been an excellent colleague to work with. He added that he had taught a number of students as well and he always left a positive impression on people in his work. He said he had not worked as an ODP since his Interim Suspension Order was put in place last year. When asked about any Continuing Professional Development he had been doing, he said he had been watching ‘You Tube' and keeping abreast of new drugs being used in other countries. The Registrant said he wanted to be allowed to go back to the job that he loved and to “give a lot more back to the community.”
20. With reference to his conviction, the Registrant said that he had been going through a phase. He was asked by Ms Mosley about some of the observations made by the sentencing Judge in the Crown Court. The Registrant said that for the first part of the communications with the ‘decoy child’ he was added into an online group by someone, he did not know who. He said he never believed the person he was corresponding with was 12 or 13, because the ‘app’ was “full of spam and fake people.” He said he thought the person would just ask for money and that would be that, but “this person carried on talking.” He said he never sent her any sexual images of himself, and he never asked her to send him sexual images of herself. He said he did not believe it was a girl talking to him because “why would a child talk to me?”
21. The Registrant said he accepted that he had sent a text asking the person if she was a virgin, but said this was because he was going through a phase at the time with his marriage and being away from home and added “I was just looking for someone to talk to, to be honest.” He reiterated that he never believed the person he was corresponding with was 12 or 13 and in fact did not believe they were a real person at all.
22. The Registrant was asked about the accredited programme as part of his Crown Court sentence that specifically addresses sexual offending and he said that due to staff cuts he was still waiting for that to start. He added, however, that he has been completing his rehabilitation activity requirement, which includes work to address sexual offending. He said he was never going back to “that stage” and that his wife and family were very supportive of him. He was also asked about public perception and the Registrant said that people make mistakes and he believes they should be given a second chance. He said the Judge gave him a second chance and he thought this Panel should do so as well. He said, “I understand the grave mistake I made.” He said that the public may not be happy to be treated by him, but that “once they see the care I provided to them they would probably want me.”
23. With reference to his being on the Sex Offender’s Register for a period of ten years, the Registrant said he was working with a charity to try and reduce the period for which he is on the Register. However, he accepted that a member of the public might have some concerns about being treated by someone on the Register.
24. The Panel was subsequently provided with the reference from the Matron at Ashford and St Peter’s Hospital, dated 11 July 2023. The Matron says that the Registrant has “demonstrated a high level of dedication, expert skills, knowledge and enthusiasm during his employment within the Operating Theatres as a Senior Anaesthetic ODP. He is able to remain calm in times of difficulties. He responds to emergency situations promptly while maintaining his effectiveness in delivering quality care.” She goes on to describe him as “polite, honest, flexible, passionate and works well within a multidisciplinary team.”
25. Ms Mosley submitted that the Registrant’s current fitness to practise is impaired. She reminded the Panel of the Judge’s sentencing remarks, which highlight that it was the Registrant that initiated communication with the decoy child named ‘Layla’. He initially believed ‘Layla’ to be 13 but was quickly told that she was in fact 12 years old. The Registrant repeatedly asked for images of ‘Layla’ and queried whether she had tried anything sexual in the past, whether she had a boyfriend and whether she was a virgin. When he was sent images of ‘Layla’ purporting to be in her school uniform he told her that she looked good, and responded with images of himself.
26. Ms Mosley submitted that the Judge’s remarks also showed that the Registrant repeatedly requested to meet up and offered ‘Layla’ gifts and financial inducements. He asked ‘Layla’ to keep the conversations between them secret or delete them. The Registrant drove from Shrewsbury to Wakefield in order to collect ‘Layla’ with the intention to commit a serious sexual offence. ‘Layla’ was a decoy deployed by the police and so thankfully no harm occurred, however, the Registrant genuinely thought he was going to meet a real 12 year old child. The judge described the Registrant’s actions as “serious deviant behaviour”.
27. Ms Mosley said that the Registrant does not appear to fully accept the facts of the conviction. He told the Panel that he never believed that ‘Layla’ was a real person or that she was aged 12. He stated that he was going through some issues with his marriage and was merely looking for someone to talk to. She submitted that the Registrant downplayed his actions, telling the Panel that he never asked ‘Layla’ for any sexual images or sent any sexual images of himself to her. He did however accept asking ‘Layla’ about her sexual history. Ms Mosley said the Registrant had demonstrated a limited level of insight into his behaviour and there was, therefore, a risk of repetition. She added that the Registrant’s behaviour is attitudinal, rather than clinical, and is therefore difficult to remediate.
28. Ms Mosley reminded the Panel that the Registrant has yet to commence the accredited program designed to address his sexual offending and had therefore not taken sufficient remedial action to demonstrate that his actions were unlikely to be repeated. She made reference to the case of Fleischmann (CRHCP v GDC and Fleischmann [2005] EWHC 87 (Admin)), where the Judge held that “where a practitioner has been convicted of a serious criminal offence or offences, he should not be permitted to resume his practice unrestricted”. The Judge went on to explain that “the rationale for the principle is that good standing in a profession must be earned if the reputation of the profession is to be maintained.”
29. Ms Mosley submitted that the Registrant’s fitness to practise is therefore currently impaired on both the public and personal components, referred to in the HCPTS Practice Note on ‘Fitness to Practise Impairment’.
30. The Panel noted that the reference from the Matron (referred to above), whilst very positive in terms of his abilities in a clinical setting, made no reference to the criminal conviction and, accordingly, the Panel found it to be of limited assistance. The Panel acknowledged that the conviction in this case is not directly related to his practice as an ODP. However, the conviction is very serious and has an underlying indirect effect on patients he could be involved with. Although the Registrant has said he works with adults, ODPs can work with any patient group so there is an underlying risk of harm because of access to child patients and patient information.
31. The Panel was of the view that the Registrant had breached the following standard of the 2012 Standards of Conduct, Performance and Ethics:
13. You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession.
32. The Panel was in no doubt that the Registrant’s behaviour has damaged public confidence in both him and the profession. The public need to have confidence in the registrants who treat them. The public is entitled to expect registrants to be professionally competent and to act with decency, honesty and integrity. Arranging to meet a 12-year-old child with the intention to commit a serious sexual offence cannot be said to be acting with decency or integrity.
33. The Panel had been advised by the Legal Assessor that an important factor when considering current impairment is whether the conduct which led to the allegation is remediable, that it has been remedied and that it is highly unlikely to be repeated. Central to the issue of remediation is the Registrant’s insight. At the Crown Court he showed none. He maintained he had no sexual attraction towards children. The Judge dismissed this saying, “Of course you are sexually attracted, I am afraid, to children and this is serious deviant behaviour.” It follows that there is a significant risk that the Registrant will repeat such deviant behaviour. The Panel acknowledged that the Judge had suspended the prison sentence because the Probation Service had come to the view that there is work that they can do to rehabilitate the Registrant. That work has begun, but clearly has a long way to go.
34. The Registrant attended and gave oral evidence as detailed above. However, he is clearly in denial and not addressing his offending behaviour. He is claiming he was going through a phase and just wanted someone to talk to. He said he never believed the person he was contacting was real and he never believed they were 12 or 13 years old. He tried to minimise his involvement by claiming his first communication was nothing to do with him. He displayed very limited understanding of what he had done and how the public would view such behaviour. What he was telling this Panel made no sense and was contradictory. If he did not think he was corresponding with a real person then what was he doing asking for photos, why did he advise the person to delete the messages and why did he travel such a distance to meet what he now says he thought was not a real person.
35. The Panel concluded that the Registrant had virtually no insight and little understanding of the seriousness and consequences of his conviction. Furthermore, he had shown no understanding of what had motivated him to attempt to groom, and then try to meet, what he clearly thought was a 12 year old girl with a view, as the Judge put it, to committing serious sexual offences. Nor did he provide the Panel with any reassurance about how he might prevent such behaviour being repeated.
36. The Panel therefore concluded that the Registrant’s fitness to practise as an ODP was at the time, and remained, impaired on public protection grounds, not least because in his work he would be expected to interact with the public, which could include children, but also because of the impact on patients of learning that an ODP had behaved in this way.
37. The Panel went on to consider whether this was the type of case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and the Regulator and to uphold professional standards. In his submissions to the Panel, the Registrant did not address the impact of his conviction on his profession or on the public confidence in that profession. He instead focused his submissions on the impact of the convictions on himself personally. The Registrant failed to acknowledge the serious consequences his actions could have had if ‘Layla’ had been a real person, despite him having a daughter of his own.
38. The Panel was satisfied that a fully informed member of the public, who was aware of all the background to this case, would have their confidence in the profession and the Regulator significantly undermined if a finding of impairment were not made. The Panel considered that a member of the public would be shocked if the Regulator took no action in a case where an ODP had been convicted of serious offences relating to the grooming and attempting to meet up with a 12-year-old girl to, as the Judge put it, commit serious sexual offences. The Judge also said that had this child been a real person the Registrant would have faced a sentence of 28 months imprisonment. There was clearly a need to send out the message to the profession that this sort of behaviour is wholly unacceptable and not to be tolerated.
39. The Panel also noted that the Registrant had yet to complete his sentence from the Crown Court and that, in accordance with the case of Fleischmann (ibid), he should not be permitted to resume his practice until he had satisfactorily completed his sentence in February 2026.
40. The Panel therefore determined that the Registrant’s fitness to practise is currently impaired on public protection and public interest grounds and that the allegation of impairment is well founded.
Decision on Sanction:
41. In reaching its decision on sanction, the Panel took into account the submissions made by both parties, together with all the written evidence and all matters of personal mitigation. The Panel also referred to the guidance issued by the Council in its Sanctions Policy. The Panel had in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of conduct and performance. The Panel was also cognisant of the need to ensure that any sanction is proportionate. The Panel accepted the advice of the Legal Assessor.
42. The Registrant addressed the Panel on the question of sanction. He said he had read the Panel’s decision on impairment and the reference to his not having insight and the concern about him repeating such behaviour. The Registrant said that he wanted to clarify that he is very sorry and apologetic about what he had done. He added, “I realised the mistake I made and the consequences I have been suffering for the past year and a bit. I can assure you this was first and last time it would ever happen. It has never been an issue before in my life, I have no previous record and nothing else was found on my phone. I will definitely never make such a mistake again.”
43. The Registrant said some hospitals only take in adult patients so if his practice was to be restricted it could be done in such a way as would allow him to work with adults in hospital settings.
44. The Registrant had provided little by way of mitigation to this Panel and had demonstrated minimal insight. Even at this late stage he was still referring to the consequences his behaviour had had upon himself, with no reference being made to the consequences for children, the public and the profession. He had made admissions at Court but, as stated above, the Panel considered these were diminished by his claim to the Probation Service that he was not sexually attracted to children. He admitted the fact of his conviction to this Panel, but in his oral evidence to the Panel he minimised his conduct. He provided some evidence of remediation and a positive progress report from his Probation Officer, but he would appear to be at an early stage of his rehabilitation. The Panel took into account the Registrant’s previous good character, the reference provided attesting to his clinical skills and his desire to return to the work that he loves and trained hard for.
45. The Panel considered the aggravating factors in this case to be:
• predatory behaviour, targeting a 12-year-old child;
• the Registrant is subject to a live sentence;
• the Registrant is on the Sex Offender’s Register for many years;
• a complete lack of any meaningful insight or remediation;
• behaviour that actively undermined the profession.
46. In light of the serious nature of the conviction, the Panel did not consider this was an appropriate case in which to take no further action.
47. The Panel next considered whether a Caution Order would adequately reflect the seriousness of the conviction. The Panel’s role, as indicated by the Sanctions Policy, was not to punish the Registrant twice for the same offence, but to protect the public and maintain high standards among registrants and to maintain public confidence in the profession. The Panel did not consider that such an Order would adequately mark the seriousness of the behaviour or protect the public.
48. This was not a case where conditions of practice would be appropriate because of the serious nature of the Registrant’s conduct and his lack of insight. Conditions are essentially aimed at clinical concerns and there are none of those in this case. The concerns are not clinical, they are attitudinal and the Panel is not confident that the Registrant is addressing those concerns at this time. The Panel considered that conditions would not protect the public or the public interest and in any event the Panel considered a Conditions of Practice Order would not adequately reflect the seriousness of the Registrant’s offending behaviour.
49. The Panel next considered whether to make a Suspension Order. The Sanctions Policy states that, “A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register.” The Sanctions Policy further states that 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.
50. The Panel has already concluded that the Registrant has virtually no insight and thus the issues are likely to be repeated. Until he develops his insight he is unlikely to be able to remedy his failings. The Panel reminded itself of the nature of the conviction, namely attempting to engage in sexual communication with a child and attempting to meet a 12 year old girl following grooming. The Panel considered it appalling for anyone, let alone a registered health care professional, to behave in this harmful way and the Panel was concerned about the real risk of repetition, given the minimal insight and remediation.
51. Although a Suspension Order would provide protection to the public for its duration, having identified a risk of repetition of this behaviour and, in the absence of any meaningful evidence from the Registrant about remediation, the Panel decided that suspension was not appropriate. In addition, the Panel was not satisfied that it would be sufficient to maintain public confidence in the profession or the regulatory process, or to send a clear message to the profession at large that such behaviour would not be tolerated. The Panel determined that a Suspension Order would not be a sufficient sanction in the circumstances of this case.
52. In reaching this decision the Panel took into account the case of Fleischmann referred to above, where the High Court stated that as a matter of general principle, where a registrant had been convicted of a serious criminal offence, he should not be permitted to resume his practice until he had satisfactorily completed his sentence. This had direct relevance to this case because the Registrant had been convicted of a serious criminal offence and his sentence would not be completed until 27 February 2026.
53. The Panel therefore looked at the guidance in the Sanctions Policy on making a Striking-Off Order, so as to be able to decide whether such an Order would be appropriate. The guidance states that, “Striking off is a sanction of last resort for serious, persistent, deliberate or reckless acts involving: sexual abuse of children.”
54. The guidance also states that,
“Sexual abuse of children involves forcing or persuading them to take part in sexual activities and includes both physical contact and online activity …”
“Sexual abuse of children, whether physical or online, is intolerable, seriously damages public safety and undermines public confidence in the profession. Any professional found to have participated in sexual abuse of children in any capacity should not be allowed to remain in unrestricted practice.”
55. Paragraph 85 of the Sanctions Policy refers to registrants on the Sex Offender’s Register, stating “a panel should normally regard it as incompatible with the HCPC’s obligation to protect the public to allow a registrant to remain in or return to unrestricted practice while they are on the sex offenders’ database.”
56. The Panel finds that this case is characterised by seriously deviant behaviour, involving an attempt at grooming what the Registrant believed to be a 12-year-old girl. As the Judge said, the Registrant went further than just attempting to communicate with a child unlawfully and illegally and had arranged to meet the child. He then, said the Judge, “travelled a considerable distance in order, in your mind, to meet a 12-year-old, in your mind to go to a hotel, in your mind to commit a serious sexual offence.” The Panel dismissed the Registrant’s claim that he did not think the person he was corresponding with was real or that they were a 12-year-old girl.
57. The Sanctions Policy goes on to observe 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’. The Panel’s earlier finding in relation to the consideration of a Suspension Order identified that a lesser sanction would indeed be insufficient to represent these wider public interest issues in the specific circumstances of this case.
58. The Panel concluded that, in light of the seriousness of the behaviour and the limited insight and remediation, there is a real risk that the behaviour would be repeated. It appeared to the Panel that the Registrant had not really begun to address the underlying causes of his offending behaviour and was, as it has already stated, still in denial. He is also subject to a live prison sentence, suspended until 27 February 2026.
59. In all the circumstances, the only appropriate sanction in this case was to make a Striking-Off Order. The Panel considered that attempts to engage in sexual communication with a child and an attempt to meet a girl under 16 years of age following grooming, were acts that are fundamentally incompatible with being a registered healthcare practitioner. The same was true of someone on the Sex Offender’s Register and also subject to a live sentence. The Panel took into account the impact this was likely to have upon the Registrant, but concluded that the need to protect the public outweighed his interests and that no other sanction would adequately protect the public and the public interest.
60. Accordingly, the Panel makes a Striking-Off Order and directs the Registrar to erase Salman Rafi’s name from the Register.
Order
The Registrar is directed to strike the name of Mr Salman Rafi from the Register on the day this Order comes into effect.
Notes
Interim Order:
Application
1. Ms Mosley made an application for an Interim Suspension Order for a period for 18 months to cover the appeal period and any appeal, in the event that one were to be made. The application was made on both public protection and public interest grounds.
2. The Registrant did not make any representations, but just wanted, and was provided with, clarity of the position with regards to any appeal.
Panel Decision:
3. The Panel has found that the Registrant attempted to engage in sexual communication with a child and attempted to meet a girl under 16 years of age following grooming. The Panel has already concluded that the Registrant represents a continuing risk to the public because there remains a concern that he would repeat the behaviour in the absence of any evidence to the contrary, particularly given his limited insight and lack of any meaningful remediation. The Panel therefore concluded that an Interim Order was necessary to protect the public from the risks it had identified, during the 28 day appeal period, or the time taken to conduct any appeal, in the event that one is made.
4. The Panel is also of the view that, given the nature and seriousness of the conduct in this case, public confidence in the regulatory process would be undermined if the Registrant were allowed to remain in practice on an unrestricted basis during any appeal period. The Panel therefore determined that an Interim Order is otherwise in the public interest.
5. The Panel first considered whether a Conditions of Practice Order would be sufficient. However, for the same reasons as dealt with at the sanction stage, the Panel concluded that conditions would not be appropriate or proportionate in this case.
6. The Panel therefore decided to make an Interim Suspension Order for a period of 18 months.
Interim Suspension Order:
The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.
This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.
Hearing History
History of Hearings for Mr Salman Rafi
Date | Panel | Hearing type | Outcomes / Status |
---|---|---|---|
01/11/2024 | Conduct and Competence Committee | Final Hearing | Struck off |