Adrian Patrick

The panel at the Substantive Hearing found the following:

Facts proved: 1 and 2
Facts not proved: Not applicable
Grounds: Misconduct
Sanction: Suspension Order 6 months

Preliminary Matters

Service

1. The Panel was satisfied that the Registrant had been correctly served with notice of today’s hearing by email dated 7 August 2024 in accordance with the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003, as amended. Delivery of that email was confirmed on the same date.

Proceeding in the Registrant’s absence

2. Ms Sampson, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence. She submitted that the Panel could infer from the Registrant’s lack of engagement that he had voluntarily absented himself from the hearing and waived his right to attend.

3. The Panel had regard to the HCPTS Practice Note on “Proceeding in the Absence of a Registrant” and accepted the advice of the Legal Assessor. Today’s hearing is a mandatory review and must take place before the expiry of the suspension order order on 6 October 2024.

4. The Panel noted that no communications had been received from the Registrant in response to the notice of hearing. The Registrant had not requested an adjournment and the Panel did not consider that there was any good reason to adjourn, or that an adjournment would secure his attendance at a future date. The Panel concluded that the Registrant had voluntarily absented himself from the hearing and waived his right to attend.

5. In balancing the Registrant’s rights against those of the public interest, the Panel was satisfied that it was appropriate and fair to proceed in the Registrant’s absence.

Background

6. The Registrant is a registered Biomedical Scientist who was previously employed by Nottingham University Hospital NHS Trust (the Trust) within the Microbiology Department (the Department). The Registrant began working for the Trust in 1998.

7. From 2 December 2019, the Registrant was working in the Serology section of the Department, where he was the Specialist Biomedical Scientist with responsibility for supervising serology testing, which meant he was responsible for interpreting serology results and authorisingreports in line with serology algorithms and Standard Operating Procedures.

8. A core part of the Registrant’s role was the interpretation of test results and specific test results including Hepatitis B Surface Antigen Testing (HBsAg) using, at that time, a Centaur XPT analyser to perform the tests.

9. The process for completing HBsAg testing was, in summary, for serum samples to be loaded into an analyser that had already been loaded with the correct assay kit which tested for a specific antigen that is looked for when these tests are carried out. The Centaur would then process the sample and provide a negative, positive, reactive or indeterminate result. If the result was negative, the Biomedical Scientist would, unless there were any other concerns, authorise the report. Equally, if the result was positive, and related to a patient known to be positive for the HBsAg then they would also authorise the result. However, if there were any concerns about a sample, if it was reactive or insufficient, or if there was a positive result for a new patient, not known to be positive for that antigen, the sample would be added to an authorisation queue for consideration, review, and authorisation by a Duty Virologist.

10. On 21 July 2020, the Band 8a Deputy Service Manager for the Registrant’s Department, was informed of concerns that her colleague, a Consultant Clinical Scientist within the Department, had about the wording of a result for a HBsAg test carried out by the Registrant. The wording was “insufficient sample to confirm the HBsAg result”.

11. The factual particulars that the substantive hearing panel found proved were that the Registrant had failed to document whether there had been any HBsAg reactivity in the sample when he should have done and that he should, having noted that the sample size had been insufficient, have flagged this with the Duty Virologist by adding a code on the Trust’s internal reporting system. Escalation of the result was required to ensure that a further sample was obtained from the patient to avoid any delay in diagnosis or treatment. The Duty Virologist was concerned that the Registrant stated, “I was trying to remind people to send sufficient samples for the test they are requesting, rather that continually asking for a repeat sample”.

12. An internal Trust investigation was conducted, which concluded on 6 September 2020. On 15 January 2021, in written correspondence with the Trust, the Registrant accepted the allegations against him and as a result, a written warning was issued. On 1 February 2021, the Registrant retired from the Trust.

13. Between 5 and 8 September 2023, a panel of the Conduct and Competence Committee of the HCPC was convened and a substantive hearing was held in respect of the matter. The Registrant did not attend the hearing, nor did he provide any written submissions or evidence for that panel to consider. The factual allegations were found proved against him and that they amounted to the statutory ground of misconduct.

14. The substantive panel had found that the Registrant had shown some insight, as he had recognised and accepted the concerns, although he had told the Trust’s investigator that he did not know why he had failed to follow the Standard Operating Procedures and could not explain why he had not done so. That panel noted that the Registrant had also told the Trust’s investigator that he had completed a period of self-reflection. However, the substantive panel had not been provided with any evidence of such self-reflection or any other evidence of developed insight. It therefore concluded that the Registrant’s insight was limited. In respect of remediation, the substantive panel concluded that there was no evidence before it that the Registrant had taken steps to address the concerns.

15. The substantive panel concluded that, given the nature of the misconduct, not to make a finding of impairment would undermine public confidence in the profession, and in the regulator, as well as fail to declare and uphold proper professional standards.

16. The substantive panel found that the Registrant’s fitness to practise was impaired on both the personal and public components.

17. In respect of sanction, the substantive panel imposed a Suspension Order for a period of 6 months. Mindful that the Order would be reviewed by a future reviewing panel before its expiry, the substantive panel set out some recommendations for the Registrant as to what may assist the future reviewing panel as follows:
• The Registrant’s attendance at future reviews;

• A reflective statement addressing the issues of record keeping and communication;
• Any practical steps taken to address maintaining professional standards and any evidence of CPD addressing the issues;
• Testimonials

The first substantive review

18. The first Substantive Order Review took place on 11 March 2024. The Registrant did not attend that hearing and was not represented.

19. The panel noted that, since the substantive hearing, the Registrant had not engaged with the HCPC. He had not acted on the recommendations of the panel at the substantive hearing as to what might assist the next review hearing. In particular, he had not provided any evidence that he had reflected on his practice, developed his insight or taken any steps by way of remediation.

20. The panel took into account that the longer the period that had elapsed without the issues being addressed, the greater the risk of the Registrant becoming de-skilled, which in turn could increase the risk of repetition and the consequent risk of harm to service users.

21. The panel decided that the risks identified by the substantive panel remained and that, as a result, the Registrant’s fitness to practise remained impaired on the grounds of both public protection and the wider public interest in maintaining public confidence in the profession and declaring and upholding proper professional standards.

22. The panel decided that a further sanction was necessary to protect the public and address the wider public interest.

23. Given the Registrant’s lack of engagement, the panel was not reassured that the Registrant was willing or able to comply with a Conditions of Practice Order and therefore such an Order would not be appropriate.

24. The panel decided that a further Suspension Order for a period of six months would allow the Registrant to engage with the HCPC if he wished and give him sufficient time to reflect on the impact of his conduct on the reputation of the profession and the risk to service users.

25. The panel considered whether or not to impose a Striking Off Order and decided not to do so but noted that a future reviewing panel might take a different view.

26. The panel endorsed the recommendations of the previous review panel as to the steps which the Registrant could take to assist the next review panel in its determining whether he had remediated the concerns relating to his practice.

Today’s hearing

27. On behalf of the HCPC, Ms Sampson submitted that, in view of the Registrant’s continued lack of engagement in these proceedings, and in the absence of any evidence of insight or remediation, his fitness to practise remained impaired. She invited the Panel to consider making a Striking Off Order.

28. The Panel received no information or submissions from the Registrant.

The Panel’s decision

29. The Panel took into account the HCPTS Practice Notes “Review of Article 30 Orders” and “Fitness to Practise Impairment” and accepted the advice of the Legal Assessor.

30. The Panel first considered whether the Registrant’s fitness to practise remained impaired by reason of the allegations found proved at the substantive hearing.

31. The Panel took into account the decision of the High Court in Abrahaem v GMC [2008] EWHC 183 [Admin] where it was stated that in practical terms there is a “persuasive burden” on the Registrant to demonstrate at a review hearing that he has fully acknowledged the deficiencies which led to the original findings and has addressed his impairment sufficiently “through insight, application, education, supervision or other achievement”.

32. The Panel found that the Registrant had failed to take any steps to discharge this burden by addressing the fitness to practise concerns identified at the substantive hearing or by providing the Panel with any evidence of insight or remediation.

33. It followed that the Registrant had not discharged the persuasive burden referred to above. The Panel could not be satisfied that the Registrant is currently safe to practise without restriction. The Panel therefore found that his fitness to practise remains impaired in respect of both the personal and public components.

34. With regard to sanction, the Panel took into account the HCPC’s Sanctions Policy and accepted the advice of the Legal Assessor.

35. The Panel considered the need to protect the public and gave appropriate weight to the wider public interest, which includes the reputation of the profession and public confidence in the regulatory process. The Panel applied the principle of proportionality and considered the available sanctions in ascending order of seriousness.

36. The Panel considered that the initial concerns which were remediable and not too serious had not been addressed, but to take no action or impose a Caution Order would not in these circumstance be appropriate and would undermine trust in the regulatory process.

37. The Panel considered whether to impose a Conditions of Practice Order to give the Registrant an opportunity to demonstrate that he had taken steps to address the issues underlying his failures in practice. Given, however, the Registrant’s failure to engage with the HCPC in these proceedings at any time since the decision at the substantive hearing, the Panel could not be confident that:

• the Registrant would comply with any conditions imposed; or
• he would not pose a risk of harm to service users, if he were permitted to practise subject to conditions; or
• he is genuinely committed to resolving the concerns raised; or
• he would take any effective measures within a reasonable time, or at all, to mitigate the risk posed to service users.

38. The Panel concluded that a Conditions of Practice Order would not be appropriate because the Registrant has shown no willingness to engage with the HCPC in remediating his practice.

39. The Panel considered whether to impose a further period of suspension. However, in circumstances where the Registrant had been continuously suspended since 5 September 2023 and had not used the intervening period to address the failures in his practice, the Panel considered that no useful purpose would be served by a further period of suspension.

40. The Panel noted that the Indicative Sanctions Policy states that “A Striking Off Order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession and public confidence in the regulatory process, in particular where the registrant:

• lacks insight; or
• is unwilling to resolve matters.”

41. In the Panel’s judgement, the indicative criteria referred to above apply in this case. The Registrant’s unwillingness to engage with the HCPC in remediating his practice is incompatible with his remaining on the register. It follows that the appropriate and proportionate sanction is a Striking Off Order, which will come into effect upon the expiry of the current Suspension Order.

Order:

The Registrar is directed to remove name of of Mr Adrian Patrick from the register upon the expiry of the current Suspension Order.

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

Under Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

History of Hearings for Adrian Patrick