Houman Motamedi

Preliminary Matters
Service
1. The Panel was provided with a Service Bundle from which it noted that the Registrant had been sent a Notice of Hearing dated 18 June 2024 (“the Notice”), informing him of the date, time and venue (remote) for the hearing. It was submitted that proper notice of the hearing had been served.
2. The Legal Assessor advised the Panel that Rule 6(1) of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (as amended) (“the Rules”) required that at least 28 days’ notice of the hearing had to be served on the Registrant. He referred the Panel to the HCPTS’ Practice Note, “Service of Documents”. He advised that the Practice Note indicates that an email header should be taken as evidence of sending the document.
3. The Panel accepted the legal advice and was satisfied that notice of the hearing had been served on the Registrant in accordance with the Rules. In addition, it was clear that the Registrant was aware of the proceedings, having been in contact with the HCPC’s representatives this morning.

Proceeding in the Absence of the Registrant
4. The Registrant had not attended the hearing and was not represented. Mr Anderson applied to the Panel for it to proceed notwithstanding the absence of the Registrant, in accordance with Rule 11. He referred the Panel to the cases of Jones and Adeogba (see below). Mr Anderson submitted that witnesses had been arranged to attend the hearing. The Allegation was of some age and expedition in proceeding was a factor.
5. Mr Anderson submitted that the Registrant had until recently been represented by a firm of solicitors, and since then it was understood that the Registrant was representing himself. Before the hearing, the Registrant had telephoned the HCPC’s representatives. It was recorded that the Registrant had stated that he did not want to participate in the hearing and will not be attending. It was further stated that the Registrant had found the whole process very stressful and he did not want to attend the hearing as it would just affect him negatively and cause more stress.
6. Mr Anderson said that there was no information from the Registrant as to whether he would be likely to attend on a further date. Mr Anderson submitted that there would be some disadvantage to the Registrant in proceeding in his absence, in particular there were disputes over the Registrant’s interactions with the Complainant. Nevertheless, he submitted, any disadvantage was outweighed by the public interest in dealing expeditiously with proceedings. It was submitted that the Registrant had voluntarily waived his rights by a last minute decision to not attend the hearing.
7. The Legal Assessor advised the Panel that Rule 11 allowed the Panel a discretion to proceed in the Registrant’s absence, if it was satisfied all reasonable steps had been taken to give notice of the hearing to the Registrant. He referred the Panel to the HCPTS’ Practice Note, ‘Proceeding in the Absence of the Registrant’.
8. The Legal Assessor advised the Panel of the cases of R v Jones [2002] UKHL 5 and GMC v Adeogba [2016] EWCA Civ 162, and the factors that those cases set out. He advised the Panel that it had a discretion to proceed, which had to be exercised with ‘utmost care and caution’. He advised that in Adeogba, the Court of Appeal had stated that the interests of the Registrant must be balanced as a prime consideration with the public interest. Where the balance of fairness lay would vary with the facts of each case. He advised the Panel that where ‘health’ reasons are advanced for a case not going ahead, the Panel is required to give proper scrutiny to evidence of ill-health said to be preventing attendance: GMC v Hayat [2018] EWCA 2796.
9. The Panel was satisfied that all reasonable steps had been taken to give notice to the Registrant. Notice had been properly served in accordance with the Rules. It was apparent from the recent email that the Registrant was aware of the hearing today. Notice of the hearing had been served some time ago and there had been no request for an adjournment. There was no indication from the Registrant that he would attend a future hearing, if this hearing is adjourned. The Notice warned the Registrant that the hearing may proceed in his absence if he did not attend. The Registrant had referred to stress arising from the proceedings as being his reason for non-attendance and the Panel considered that this would not be different for any adjourned hearing. There was no formal evidence provided supporting the Registrant’s inability to attend due to stress.
10. The Panel acknowledged that the Registrant would be disadvantaged by not attending to give an account on the disputed issues around the allegations concerning the appointment with the Complainant. Further, the Panel would not hear from the Registrant about his practice in recent times. However, the Panel balanced this with the fact that the Allegation is now of some age. Witnesses were due to attend to give evidence about the consultation on 26 February 2018 and it was undesirable to further delay matters because of the effect on their recollections. The Panel took into account also that the Allegation involved matters which concerned potential risks to public safety, due to alleged failures to carry out proper audiology procedures and also the public interest in dealing with matters expeditiously.
11. The Panel concluded that the Registrant had chosen not to take part in the hearing, in the knowledge that the hearing is due to take place. It had no reason to believe that an adjournment would secure the Registrant’s attendance. In all the circumstances the Panel concluded that it should proceed with the hearing in the public interest.
12. The Panel granted Mr Anderson’s application to proceed in the absence of the Registrant.

Background
13. The Registrant is a Hearing Aid Dispenser registered with the HCPC. At the time of the events giving rise to the Allegation he was employed as a Director and Hearcare Joint Venture Partner of Specsavers Woking.
14. The HCPC received a referral dated 31 March 2018 in respect of the Registrant relating to an appointment with the Complainant on 26 February 2018. As a result of providing papers to the HCPC, it was alleged that a further concern was noted over the Registrant’s practice. Following a meeting with the Registrant, the employer conducted an audit of the Registrant’s practice, which eventually gave rise to a full audit. It was alleged that further failures were identified as a result.
15. The case against the Registrant was that he had communicated in an unprofessional manner with the Complainant at the consultation on 26 February 2018, but also that he had not consistently carried out assessments and tests of patients, completed questionnaires, recorded key information and made necessary onward referrals. It was alleged that the Registrant’s conduct amounted to misconduct, or alternatively there was a lack of competence concerning the patients considered in the audit.

Evidence
16. The Panel heard oral evidence from:
• the Complainant,
• MB (Colleague 1) a Hearing Aid Dispenser (at the time of the event that gave rise to the allegation they were a trainee Hearing Aid Dispenser)
• SD formerly National Audiology Professional Development Manager for Specsavers
The Panel received a bundle of evidence including the witness statements of the witnesses, together with the original referral, and correspondence associated with the complaint. It also received documentation from the patient audit conducted into Specsavers investigation of the Registrant’s practice.

Submissions
17. The HCPC had provided the Panel with a Case Summary in advance of the hearing. Mr Anderson made closing submissions at the conclusion of the evidence.
18. Mr Anderson invited the Panel to find that all the factual particulars in the Allegation had been proved, on the evidence presented. He submitted that the burden of proof lay on the HCPC. Mr Anderson reminded the Panel of the key points of the evidence it had received.

Legal advice
19. The Legal Assessor reminded the Panel that the burden of proving the facts of the Allegation lay on the HCPC. The standard to be met was the ‘balance of probabilities’. The Registrant did not have a burden of proof to show that he was innocent of the Allegation. He reminded the Panel of the guidance of the courts concerning the assessment of evidence, taken from R(Dutta) v GMC [202] EWHC 1974 (Admin) and Byrne v GMC [2021] EWHC 2231 (Admin). He advised that the best starting point is the known or probable facts and also that the documentary record has importance as a source of evidence. The courts had warned against the danger of over-reliance on witness’ demeanour in giving evidence. There may be conflicting oral accounts, and some inconsistency and confusion, but the Panel’s task is to decide whether the core allegations are proved.

Decision on Facts
1. On 26 February 2018, you did not communicate professionally with the Complainant during their consultation, in that:
a) you said to the Complainant “I own the business and can do what I like” or words to that effect;
20. The Complainant set out in her written statement and confirmed in oral evidence that the Registrant had made this statement in the consultation on 26 February 2018. The Panel considered the available documentary evidence. It took into account that in her letter dated 25 March 2018 to Specsavers’ Managing Director, the Complainant had been consistent as to her account.
21. The Panel considered the Complainant to be a credible and measured witness in giving evidence, who made appropriate concessions as to her recollections.
22. The Panel also found that the evidence from MB tended to support the Complainant’s account. He had stated: “I cannot remember the exact words that he used but [the Registrant] effectively said he would speak to her as he wanted because she was in his room”. He gave evidence as to the tension in the communications between the Complainant and the Registrant.
23. The Panel concluded that it was more likely than not that the Registrant had spoken to the Complainant as she had stated. It found the facts in (a) proved.
b) you said to the Complainant “I have recorded the appointment” or words to that effect, when you had not;
24. Also consistently with her written complaints, the Complainant gave evidence that the Registrant told her that he had recorded the appointment. MB’s evidence was that the Registrant had told him there was no recording, but that the Registrant had told the Complainant that he was recording it. In addition, the Panel noted that the Registrant admitted in his account to Specsavers, dated 30 April 2018, that “I’ve told her this conversation is recorded so she doesn’t talk … down on me any longer”.
25. The Panel was satisfied that, on the balance of probabilities, the Registrant had said to the Complainant that “I have recorded the appointment”.
c) you did not inform the Complainant that Colleague 1 would be observing the consultation.
26. The Complainant’s evidence was that, during her consultation, a man who she later learned was MB had walked into the room. She stated that the Registrant said at that point that he was a colleague who was working with the Registrant. The Complainant’s evidence was that she was not asked by the Registrant if she had any objections to being observed by MB.
27. In his oral evidence, MB told the Panel that he had seen a non-verbal signal from the Registrant that he should enter the room but did say that there was no further conversation about his own presence, having entered the room. The Panel noted that this was not consistent with his witness statement but took into account that he had not supported the written account when giving oral evidence.
28. The Panel considered that the meaning of the Allegation was that the Registrant had not given the Complainant appropriate information in advance of the consultation commencing and seeking her consent. The Complainant’s account was to the effect that she had been presented with a fait accompli, and no opportunity to consent.
29. The Panel considered that the Complainant’s account was credible. It was consistent with her letters of complaint. The Panel preferred the Complainant’s account. It took into account that MB’s account, in any event, had not suggested that any information had been given about himself to the Complainant.
30. The Panel was satisfied that the Registrant had not informed the Complainant that Colleague 1 would be observing the consultation.
31. The Panel took into account that, as an HCPC registered professional, the Registrant had been subject to the relevant HCPC Standards of conduct, performance and ethics. This had included obligations to:
Communicate with service users and carers
2.1 You must be polite and considerate.
2.2 You must listen to service users and carers and take account of their needs and wishes.
2.3 You must give service users and carers the information they want or need, in a way they can understand.
2.4 You must make sure that, where possible, arrangements are made to meet service users’ and carers’ language and communication needs.
32. The Panel considered that, in respect of his statements to the Complainant in particulars 1(a) and 1(b) and his failure to inform the Complainant in particular 1(c), the Registrant had not met his obligations and had not communicated professionally with the Complainant.
33. The Registrant found paragraphs 1(a), 1(b) and 1(c) proved.
Particulars 2 to 6 of the Allegation
34. As a result of corresponding with the HCPC, SD stated, further concerns had come to light over the Registrant’s practice and Specsavers had decided to conduct an audit. The remainder of the Allegation concerned findings from the Specsavers audit.
35. SD gave evidence that a full audit on the Registrant’s practice had been carried out by Specsavers. In some cases these had resulted in a ‘Category 1’ letter (“Cat 1”) or a ‘Category 2’ letter (“Cat 2”). A Cat 1 recall, she explained, is where a clinical procedure had to be repeated to eliminate the presence of referable conditions; a Cat 2 recall occurred when further questioning of the patient was required to ensure the patient had been managed appropriately.
36. SD’s evidence detailed the 35 patient records which had been referred by SD to the HCPC. These she said had been considered as part of the Audit and had resulted in either Cat 1 or Cat 2 recalls by Specsavers. In her witness statement SD detailed the auditors’ criticisms and comments. She confirmed that those patient appointment records listed could be attributed to the Registrant. SD is a qualified and registered Hearing Aid Dispenser and very experienced, having held a senior position in Specsavers. She was a clear and credible witness.
37. Panel gave close consideration the patient notes and records in relation to these 35 patients and the comments and criticisms of the auditors as recorded in the documents and SD’s witness statement.
38. The Panel considered, in respect of each of the 35 patients whether the evidence demonstrated on the balance of probabilities that:
a. assessments and/or testing which had been required had not been carried out (for particular 2);
b. there was evidence that the Registrant had “utilised” his own template (in the sense of relying solely on it), and if so whether this did not cover all potential referable conditions and/or criteria (for particular 3);
c. the Registrant did not adequately record his reasons for not consistently carrying out assessments or testing or onward referrals (for particular 4);
d. onward referrals where required for the specified patients had not been made (for particular 5);
e. patient questionnaires for the specified patients had not been fully completed (for particular 6).
39. In the case of each Particular 2, 3, 5 and 6, the Panel took into account that the particulars related to a date range between 1 February and 31 July 2018. The Panel took into account that Particular 4 related to a date range between 1 February and 28 July 2018. The Panel therefore took into account only those appointments in the records which occurred between these dates.
2. Between 1 February and 31 July 2018, on one or more occasions you did not consistently carryout assessments and/or testing on patients as required, including:
a) otoscopies;
b) bone conduction testing;
c) air conduction testing; and
d) masking
40. The Panel accepted SD’s evidence relying on the audit, that concerns had been raised that no adequate record of reasons had been made for not carrying out assessments and/or testing on patients and onward referrals in a number of cases.
41. The Panel considered the patient records where this was said to be the case. It found the following:
(a) Otoscopy not carried out for patients:
F, H, N, I
(b) Bone conduction not carried out for patients:
F, L, H, M, N, I, O, P, Q, V, AB, AF, AG
(c) Air conduction not carried out for patients:
F, N, I
(d) Masking not carried out for patients:
F, H, B, C, D, E, R, S, T, Y, Z, AA
42. The Panel found on consideration of the patient records that these supported the auditor’s concerns and that there had been a failure to carry out the assessments and tests. Further, since the Registrant had not carried out the tests on a number of occasions and the particular failures had varied in type, the Panel found that there had been a failure to consistently carry out such assessments and tests, as required.
43. The Panel found Particular 2 proved, in relation to the matters in (a) to (d) inclusive.
3. Between 1 February and 31 July 2018, on one or more occasions you utilised your own notes template when carrying out procedures on patients, which did not cover all potential referable conditions and/or criteria, including:
a) history of pain;
b) hyperacusis;
c) fluctuating hearing;
d) sudden hearing loss within 90 days;
44. The Panel found evidence of the content of the Registrant’s own notes template and a comparison of the Sycle template. The Panel found instances of the use of the Registrant’s own template recorded in the patient notes. It noted that the Registrant’s own template omitted to ask the questions in (a) (b) (c) and (d) above. The Panel accepted SD’s evidence that the Sycle questionnaire covered the potential referable conditions that needed to be asked of patients.
45. On consideration of the evidence, the Panel found that there were a number of occasions when the records showed that the Registrant had used his own template, instead of the fuller Sycle template.
46. These included Patients: L, H, M, N, A, E, S, J
47. The Panel noted that, on a number of occasions, the Registrant had used his template in addition to completing the Sycle template. However, the Panel considered that the allegation that the Registrant “utilised” his template meant that he had relied on it. Since the Registrant had used the proper Sycle template in these instances, the Panel was not satisfied that the additional use of his own template amounted to “utilising” this template.
48. Nevertheless, the Panel found that the patient records showed that, on more than one occasion the Registrant had utilised only his own template with patients, and that this template omitted potential referable conditions or criteria.
49. The Panel found paragraph 3 proved, as to more than one occasion.
4. Between 1 February and 28 July 2018, on one or more occasions you did not adequately record your reasons for not consistently carrying out:
a) assessments and/or testing on patients; and
b) onward referrals for patients.
50. The Panel accepted SD’s evidence relying on the audit, that concerns had been raised that no adequate record of reasons had been made for not carrying out assessments and/or testing on patients and onward referrals in a number of cases.
51. The Panel considered the patient records where this was said to be the case. It found the following:
• Failure in respect of 4(a) for Patients: L, M, N, I, A, B, C, D, E, O, P, Q, R, S, T, V, Y, Z, AA, AB, AF, AG;
• Failure in respect of 4(b) for Patients: L, A, B, C, D, E, Q, R, S, T.
52. The Panel concluded that the records supported the audit concerns. It concluded that, on more than one occasion, the Registrant had not adequately recorded his reasons for not carrying out assessments and tests which had from the record not been carried out. In addition, there was more than one occasion when the Registrant had not made an onward referral and had not recorded in the patient notes his reasons for not doing so.
53. The Panel was satisfied that on the balance of probabilities the Registrant, on more than one occasion did not adequately record his reasons for not consistently carrying out assessments or testing and onward referrals.
54. The Panel found Particular 4 proved, as to (a) and (b).
5. Between 1 February and 31 July 2018, on one or more occasions you did not consistently make onward referrals where required for the following patients:
a) Patient A
b) Patient B
c) Patient C
d) Patient D
e) Patient E
55. The Panel accepted SD’s evidence relying on the audit, that concerns had been raised that no onward referrals had been made by the Registrant in a number of cases.
56. The Panel considered the patient records for Patients A to E inclusive where this was said to be the case. It found that the records indicated that referrals had been required in respect of Patients A, B, C, D and E.
57. The Panel concluded that the records supported the audit concerns. It found that there had been a lack of referral in a number of cases where the records supported the auditor’s concerns that an onward referral was required due to the patient assessment or testing outcomes, but no onward referral was recorded as having been made. The Panel found that this amounted to a lack of consistently making onward referrals.
58. The Panel found particular 5 proved, in relation to Patients A to E inclusive.
6. Between 1 February and 31 July 2018, on one or more occasions you did not consistently complete and/or ensure patient questionnaires had been fully completed for the following patients:
a) Patient F
b) Patient G
c) Patient H
d) Patient I
e) Patient J
59. The Panel accepted SD’s evidence relying on the audit, that concerns had been raised that patient questionnaires had not been fully completed by the Registrant, or that he had not ensured their full completion, in a number of cases.
60. The Panel considered the patient records for Patients F to J inclusive where this was said to be the case. It found the following:
• for Patient F, there was no questionnaire at all
• for Patient G, there had been no appointment within the relevant date range
• for Patient H, the Registrant had utilised his own template, rather than the Sycle template
• for Patient I, the Registrant had utilised his own template, rather than the Sycle template
• for Patient J, the Sycle template had not been fully completed and the Registrant had used his own template in addition
61. The Panel concluded that the records supported the audit concerns. It found that there had been a lack of consistent completion of questionnaires in a number of cases. The Panel found that this had been in respect of Patients F, H, I and J.
62. The Panel found Particular 6 proved accordingly.

Submissions on Grounds and Impairment
63. Having found facts proved in relation to the Allegation, the Panel went on to invite submissions on statutory grounds and impairment.
64. Mr Anderson on behalf of the HCPC provided written submissions on the matter of misconduct, lack of competence and impairment of fitness to practise.
65. Mr Anderson submitted that the facts the Panel had found proved should also be found to be misconduct and a lack of competence by the Registrant, as a result of which his fitness to practise is impaired. He submitted that certain of the HCPC’s Standards of Conduct Performance and Ethics (2016) had been breached, along with certain professional standards and reminded the Panel of its findings of fact.
66. The Panel took into account the Registrant’s comments in his email to the HCPC dated 05 June 2018 which addressed Particular 1 of the Allegation. The Registrant said that he understood the importance of ensuring public confidence in him and in the profession by creating a safe and trusting environment. He offered his regrets for the miscommunication or upset caused to the Complainant. He described having undertaken learning modules on ‘iLearn’ on managing aggression, bullying and harassment. The Registrant had reviewed HCPC and BSHAA guidelines and had implemented local policies including on customer relations.
67. The Legal Assessor advised that whether the Registrant’s fitness to practise is impaired is a matter for the Panel’s judgement. First the Panel had to decide whether the facts found proved amounted to misconduct, which was serious professional misconduct or a lack of competence, and if so whether the Registrant’s fitness to practise is impaired, whether in relation to the risk of repetition or the public components of impairment. He advised that the Panel should first consider the statutory ground of misconduct, and then lack of competence.

Decision on Grounds
68. The Panel bore in mind that not every breach of professional standards will amount to misconduct. The Panel had to be satisfied that the breach had been serious professional misconduct, if it was to find the statutory ground of misconduct.
69. The Panel considered the evidence and its findings in relation to particular 1. The Panel had found that the Registrant had communicated in an unprofessional manner in the consultation on 26 February 2018.
70. The Panel was of the view that the Registrant’s conduct had been contrary to the HCPC’s Standards of conduct, proficiency and ethics, in paragraphs 2.1 to 2.4, as set out above. The Panel considered that the Registrant had not been polite with the Complainant, failed to take into account her needs and wishes and not given her the necessary information about MB’s involvement.
71. The Panel considered that the Registrant’s comment that he could ‘do what he liked’ was more than a trivial lack of unprofessional behaviour and was deliberately confrontational. Telling the Complainant that he was recording the consultation was a deliberate attempt to mislead the Complainant and a threat to her personal rights of privacy. The Registrant had then further failed to respect the Complainant’s rights to privacy by not asking for her consent to MB observing the consultation. The Complainant’s evidence to the Panel had been that she felt threatened as a result.
72. The Panel decided that the Registrant’s lack of professional communication in Particulars 1(a), 1(b) and 1(c) was serious misconduct in the course of a professional consultation and was misconduct.
73. In relation to Particulars 2 to 6 and the evidence of broader practice failures, the Panel considered that this engaged in addition the following HCPC Standards of the time:
3.2 You must refer a service user to another practitioner if the care, treatment or other services they need are beyond your scope of practice.
6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
8.1 You must be open and honest when something has gone wrong with the care, treatment, or other services that you provide by:
- informing service users or, where appropriate, their carers, that something has gone wrong;
- apologising;
- taking action to put matters right if possible; and
- making sure that service users or, where appropriate, their carers, receive a full and prompt explanation of what has happened and any likely effects.
10.1 You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to.
10.2 You must complete all records promptly and as soon as possible after providing care, treatment or other services.
74. In relation to Particular 2, the Panel had found that the Registrant had consistently failed to carry out elementary and fundamental audiology procedures in relation to his consultation of a significant number of patients. There had been clear failures to take reasonable steps to ensure appropriate tests were carried out to minimise a risk of harm. The importance of the assessments and tests and the degree of the lack of consistency led the Panel to conclude that this was misconduct.
75. The Panel noted, in considering Particular 3, that the Registrant had held a relatively senior position in the Specsavers branch. Therefore, he would have known the correct questionnaire to use and the evidence showed that the Registrant had on occasion completed the Sycle questionnaire. The Panel took into account that the use of the Registrant’s use of a more limited questionnaire had exposed service users to a risk that certain referable conditions might be missed. As a result, the audiology records relating to a number of patients were not full and clear and they had to be contacted again by Specsavers. It appeared to the Panel that the Registrant had chosen to use his own template for no reason that benefitted the patients. The Panel was satisfied that this was misconduct.
76. In relation to Particular 4, the Panel considered that where assessments or tests had not been carried out, or appropriate referrals not been made, it had been clearly incumbent on the Registrant to maintain the integrity of the patient records, in the interests of the patient and other treating professionals. The frequency with which there had been a failure led the Panel to conclude that this was misconduct by the Registrant.
77. The Panel considered that the Registrant’s failure to make referrals for the patients in Particular 5 had the potential to place them at risk that serious conditions may have been missed. As a result, the patients may have been deprived of appropriate further treatment, which clearly breached the HCPC standard 3.2. The patients had been reliant on the Registrant for an appropriate referral to other health professionals. The Panel considered that the Registrant’s omissions were serious and was misconduct.
78. The Panel had received evidence that the Sycle questionnaires had been designed to support clinicians in recording evidence of the investigations that they have completed with patients and the presence of the symptoms might suggest referable conditions. The Sycle questionnaires related to the 11 criteria in the British Society of Hearing Aid Audiologists (BSHAA) Guidance. The evidence was that these had not all been included in the Registrant’s own template, further that the Sycle questionnaire was not always fully completed, breaching HCPC standard 10.1.
79. The Panel was satisfied that the lack of full completion of questionnaires involved a risk to the Registrant’s patients and this conduct in relation to particular 6 was misconduct.
80. The Panel found that, in each particularised element of the Allegation from 1 to 6, the Registrant had engaged in misconduct. Having found the facts amounted to misconduct, the Panel decided that it was not necessary to consider lack of competence in the alternative.

Decision on Impairment
81. The Panel having found misconduct, considered whether, in its judgement the Registrant’s fitness to practise is currently impaired. It had regard to the HCPTS’ Practice Note on Fitness to Practise Impairment and bore in mind that impairment is a matter for the Panel’s judgement, based on its findings.
82. The Panel considered that the misconduct in particular 1 was potentially remediable. It credited the Registrant with having demonstrated a degree of insight, having expressed his regret and undertaken some reflection and courses. The Panel noted that it had not been provided with any detailed evidence of the Registrant’s reflections or CPD, nor any character references or testimonials which supported the Registrant’s remediation.
83. The Panel considered that the insight demonstrated in the Registrant’s email and elsewhere in the bundle was limited, however. He did not reflect on what had gone wrong in the particular consultation, or how he personally had played a part in it.
84. The Panel also considered that the misconduct in relation to particulars 2 to 6 was remediable. The Registrant was clearly an experienced and senior audiologist and the failures are related to fundamental areas of practice. There were indications from the records that the Registrant was capable of appropriate practice. This led the Panel to be concerned that the lack of consistency may indicate problems with the Registrant’s attitude towards practice, more than his capability.
85. The Panel noted that the Registrant’s email above pre-dated the audit of his practice. However, it noted from SD’s evidence that soon after SD had been asked to conduct her audit, the Registrant had resigned from Specsavers. She stated that there was no further information about his engagement with professional development.
86. The Panel was concerned to note from SD’s evidence that, Specsavers having been willing to support the Registrant going forward, he had not taken this up but had resigned. The Panel was therefore without further information concerning his remediation.
87. In addition, whilst the Panel acknowledged that the Registrant has a right not to defend regulatory allegations, he had not engaged with the hearing. Consequently, the Panel is without any information as to any further steps that the Registrant had taken to remediate the misconduct the Panel had found in relation to the outcomes of the audit.
88. Therefore, whilst the Registrant’s misconduct in relation to all the particulars of the Allegation was potentially remediable, the Panel was not satisfied that remediation demonstrated by the Registrant was anywhere near sufficient. The Panel concluded that there was, as a result, a risk of the Registrant repeating his misconduct and a risk of harm to the public as a result of the kind of misconduct involved. The Panel decided that the Registrant’s fitness to practise is impaired, in relation to the ‘personal’ component.
89. The Panel having found that there was a risk of repetition of misconduct which involved a risk of harm to the public, the need to protect the public was engaged. Further, the allegations found proved demonstrated that the Registrant had on several occasions failed to meet the requirements to meet professional and regulatory standards. Therefore, the Panel considered a finding of impairment was merited in order to send a message to the profession of the standards expected.
90. In addition, the Panel considered that members of the public would be alarmed at the misconduct which had occurred, and a finding of impairment was also required in order to maintain public confidence in the profession. The Panel therefore found the Registrant’s fitness to practise is impaired on the ‘public’ component of impairment.
91. The Panel found that the Registrant’s fitness to practise as a Hearing Aid Dispenser is impaired.

Decision on Sanction
92. Having found that the Registrant’s fitness to practise is impaired and the Allegation is well-founded, the Panel was required to consider what action it should take under Article 29 of the Health Professions Order 2001 (as amended) (“the Order”).
93. Mr Anderson informed the Panel that the Registrant had no adverse fitness to practise history other than the current Allegation. He submitted that the Panel should have public protection as the focus of its considerations. He referred to the HCPC’s Sanctions Policy (March 2019) (“Sanctions Policy”) and submitted that this indicates that the Panel should impose the least restrictive sanction which was necessary. Mr Anderson submitted that mitigating and aggravating factors, as determined by the Panel, could be taken into account, although mitigation was less significant in comparison with protection of the public.
94. The Legal Assessor advised the Panel that it was required to consider its powers under Article 29 of the Order, having found the Allegation well-founded. He set out the available options and sanctions set out in Article 29 and advised the Panel to be guided by the Sanctions Policy. The Legal Assessor advised the Panel that the purpose of sanctions is not to punish, but to protect the public, citing paragraph 21 of the Sanctions Policy. Therefore, the Panel had to approach the sanctions from the least restrictive and moving upwards. In order to act proportionately, the Panel had to weigh the Registrant’s interests with the public interest.
95. The Panel decided, in assessing the seriousness of the misconduct for the purposes of any sanction, to take into account and weigh the mitigating and aggravating features of the case. It noted that the Sanctions Policy does state that mitigating factors may be of less significance compared to the overarching concern of public protection.
96. In terms of mitigation, the Panel took into account that there had been no previous regulatory findings. It had found that the Registrant had shown a degree of insight into particular 1, though to a limited degree and had expressed his regret towards the Complainant’s experience. The Registrant said that he had undertaken some relevant courses and reflection, but this was not before the Panel.
97. As to aggravating features, the Panel considered that, on its findings, the Registrant had engaged in behaviour which exhibited a pattern of disregard for proper procedures in particular to assessment, testing and referral of patients. Although no evidence of actual harm had been provided, the Panel was satisfied that those patients had been exposed to a risk of potential harm to their health as a result.
98. The Panel considered that it was relevant that the Registrant was dealing with a vulnerable patient group who were concerned to protect their hearing. The Registrant’s behaviour in relation to the Complainant had been unprofessional and unethical and the Panel had concerns about the Registrant’s attitude also in relation to the remainder of particulars 2 to 6. The evidence was that, following the audit, a significant number of patients had to be recalled for further assessment by Specsavers.
99. The Panel considered that there was some, though limited, mitigation but this related primarily to Particular 1. The aggravating features were given a degree of weight, due to the number of patients in respect of whom the misconduct had occurred, and the pattern of misconduct. Having considered its findings of fact and the determination on misconduct and impairment and having taken into account the mitigating and aggravating features, the Panel considered that the misconduct in the case was towards top end of the spectrum and was serious misconduct.
100. The Panel decided that the case is not suited to mediation because regulatory action is necessary to protect the public. Therefore, the Panel proceeded to consider the available sanctions, starting from the least restrictive and working upwards, as necessary.
101. The Panel decided that taking no action would fail to protect the public in a case where the Panel had found a risk of future harm, as the Registrant would continue in unrestricted practice. There were no exceptional factors about the case which would justify such a course.
102. The Panel noted the Sanctions Policy, at paragraph 106:
“106. A conditions of practice order is likely to be appropriate in cases where:
• the registrant has insight;
• the failure or deficiency is capable of being remedied;
• there are no persistent or general failures which would prevent the registrant from remediating;
• appropriate, proportionate, realistic and verifiable conditions can be formulated;
• the panel is confident the registrant will comply with the conditions;
• a reviewing panel will be able to determine whether or not those conditions have or are being met; and
• the registrant does not pose a risk of harm by being in restricted practice.”
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103. The Panel had determined that the misconduct was in theory capable of remediation. However, the Panel had significant doubts over the Registrant’s insight, particularly into particulars 2 to 6. In light of the Registrant’s lack of willingness to address the audit concerns with Specsavers and his lack of engagement with the regulator, the Panel had no confidence that the Registrant would engage with conditions of practice. The Panel had insufficient information about the Registrant’s current working circumstances to be able to determine workable conditions of practice, in any event.
104. Further, the Panel had found that there is a risk of the Registrant repeating his misconduct which poses a risk of harm to service users. As a result, the Panel considered that imposing conditions of practice did not meet the seriousness of the impairment and would not protect the public.
105. The Panel next considered imposing a suspension of the Registrant’s registration. It noted paragraph 121 of the Sanctions Policy:
“121. 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. 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.”
106. The Panel noted that suspension protects the public for the period of its duration and sends a signal to the profession and the public of conduct which is unacceptable. The Panel had found that the Registrant’s misconduct was potentially remediable. However, the Panel also found that any insight and remediation was very limited in extent.
107. The Panel had found there to have been serious breaches of the Standards of Conduct, Performance and Ethics. The findings had amounted to a failure to consistently meet the required standards, as a matter of misconduct and the misconduct had involved a significant number of patients. The Panel was not satisfied as to the Registrant’s insight and had determined that there was a risk of repetition. The Panel did not have evidence that the Registrant was likely to resolve or remedy his failings.
108. The Panel therefore concluded that there were not good grounds for imposing a Suspension Order. The Panel next considered whether it should make a Striking Off Order. It took into account paragraph 131 of the Sanctions Policy, which states:
“131. A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:
• lacks insight;
• continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or
• is unwilling to resolve matters.”
109. The Panel was aware that a Striking Off Order is an order of ‘last resort’ when no lesser sanction will protect the public. The Panel took into account that, whereas Particular 1 concerned matters of professional communication, in Particulars 2 to 6, the Panel had found a pattern of repeated failures in respect to fundamental matters of assessment, recording and referral of a significant number of patients, who were vulnerable. In his approach to Specsavers after the audit was started, the Registrant had shown no willingness to address matters. The Panel further found no evidence of insight in respect of Particulars 2 to 6 on the part of the Registrant at any time.
110. The Panel acknowledged that, in making a Striking Off Order, there is likely to be a serious impact on the Registrant’s professional reputation and financial circumstances. However, no lesser sanction than a Striking Off Order would adequately protect the public, and therefore the Order was proportionate, in the Panel’s view.
111. The Panel decided to make a Striking Off Order.

Order: The Registrar is directed to strike the name of Mr Houman Motamedi off the register.

Interim Order
Application
1. Following the Panel having made a Striking Off Order under Article 29(5)(a), Mr Anderson asked the Panel to hear an application for an Interim Order, on the basis that the substantive order would not take effect until after the end of the appeal period or until the appeal was dealt with. It was conceded that the Notice of Hearing which had been sent had not warned the Registrant directly that an application for such an interim order could be made at the end of the hearing.

2. The Legal Assessor advised the Panel that Article 31(15) states that an interim order shall not be made under Article 31(2) unless the person has been afforded an opportunity to appear and be heard on the question of whether such an order is made. The Registrant was not in attendance at the hearing.

3. The Panel accepted the advice of the Legal Assessor and decided that it could not in the circumstances consider an application for an interim order at the conclusion of the hearing today, because the Registrant has not been afforded an opportunity to attend.

History of Hearings for Houman Motamedi