Alexander Green

Preliminary Matters
Service

1. The Panel had been provided with evidence that the Notice of Hearing letter dated 20 May 2025, had been served upon the Registrant electronically. The details within that letter, relating to the time, date and mode of hearing were considered by the Panel and found to be accurate. That letter had been sent sufficiently far in advance of the hearing, and to the email address shown for the Registrant upon the HCPC Register. Having taken legal advice, the Panel found that there had been good service.

Proceedings in absence

2. The HCPC made an application to proceed in the Registrant’s absence. In so doing the HCPC relied upon the Panel’s discretionary power to do so within rule 11 of the Conduct and Competence Committee (Procedure) Rules 2003. The HCPC referred the Panel to the matters which it should take into account at this stage. The HCPC emphasized that there was nothing before the Panel that indicated that the Registrant had made anything other than an informed decision not to attend.

3. The HCPC took the Panel to the Registrant’s Representative’s letter, in which it was explained that the Registrant was not working in a capacity that required his registration and due to current work commitments was not able to attend. It was indicated by the Registrant’s Representative that this position was unlikely to change should another hearing date be provided, therefore an adjournment today would serve no purpose.

4. The HCPC submitted that there was public interest in this matter proceeding, particularly as there was a witness ready and able to give evidence today.

5. The Panel sought and accepted legal advice and took into account the HCPTS guidance within the Practice Note entitled Proceeding in absence. The Panel noted that the Registrant is recorded as not intending any discourtesy by his non-attendance and stated that he was content with the matter proceeding in his absence. The Panel has therefore decided to proceed in the Registrant’s absence for all the reasons recorded above and so that in the public interest there is no unnecessary delay.

Proceeding in private

6. On behalf of the Registrant the HCPC made an application for part of the hearing to proceed in private. This was to ensure that when and if there were occasion to make reference to issues relating to the Registrant’s health they would not be in public session. The application was for discrete portions of the hearing to be in private.

7. The Panel again sought and accepted the advice of the Legal Assessor. The Panel had before it details of the reasons given by the Registrant for wishing part of the hearing to be in private although it noted that there was no supporting medical evidence of any health condition. The Panel however accepted that should there be reference to any matter of a personal nature, it would hear those within a private portion of the hearing.

Amendments - allegation 1

8. The Panel received an application from the HCPC to amend allegation 1 in two regards.

i. First, it was apparent from the paperwork before the Panel, that since this matter was initially considered the date of the incident in 2008 had been established as being 9 October 2008. This amendment was therefore required for clarity and accuracy.

ii. Secondly, the reference within the allegation to ‘Formal Warning’ was not accurate in that its adoption related to one reference within the Police evidence to the nature of the matter. There were however other references to Street Caution. A Street Caution was an expeditious means of disposing of a matter at the scene of an incident. In support the HCPC referenced the fact that the Registrant’s representations for this hearing referred to the fact that the Registrant had received a Street Caution, and not a Formal Warning.

9. The HCPC stated that it would be within the Panel’s powers to make these amendments which it was submitted did not cause the Registrant any prejudice or injustice as they do not change materially the nature or seriousness of the matters alleged and the change is supported by the evidence placed before the Panel.

10. In questioning, the Presenting Officer accepted that further questioning of the HCPC witness, PC Wiggins (PCW) was required for the Panel to appreciate the exact distinction between a Formal Warning and a Street Caution, neither of which were considered to be a Police Caution.

11. The Panel had before it the written representations of the Registrant’s Representative in which the Registrant’s objections to the proposed amendment to the allegation were recorded. It was stated that there has been more than sufficient time for the HCPC to have considered this issue, and it should not have waited until it received the Registrant’s statement of his position for this hearing before making such an application. The issue was made clear by the Registrant before the Investigating Committee in July 2024. The statement of PCW is dated 1 October 2024 and from this the difference is identified. It was submitted that ‘the HCPC is only seeking to revise the allegation after receiving and considering the Registrant’s submissions, presumably in recognition that the allegation could not be found proven due to the wording.’

12. The Panel was advised by the Legal Assessor that in line with the dictum in the Court of Appeal case of ‘Doree’, the Panel had the ability to amend an allegation at any time to ensure that there is no under prosecution.

13. The Panel accepted the HCPC’s submission at paragraph 8(i) in relation to the date in Particular 1.

14. There being some confusion as to the distinction, and therefore the relative seriousness, of the two terms used to describe the nature of the means of disposal adopted by the Police, the Panel decided to consider this matter again after having the benefit of the live evidence of PCW.

15. The Panel considered this matter again with the benefit of the testimony of PCW. It was clear from that evidence that there was nothing called specifically a Formal Warning in 2008 and it was a term then used within the recording system to cover what was more correctly known as a Street Caution.

16. The Panel focused upon the issue of proportionality and the issue of prejudice to the Registrant if it agreed to this proposed amendment. The Panel considered that it was unjust and unfair to the Registrant for the HCPC to make an application at this late stage having only put the Registrant on notice of an intention to do so was on 30 June 2025. The argument made by the HCPC that it was only following the Registrant’s representations that the issue of whether to consider a change of the wording of the allegation was looked at, was in the Panel’s view, unsupportable.

17. The HCPC had been on notice since July 2024 that there was a question about the nature of the steps taken by the police and there was evidence that the Registrant had brought this to the HCPC’s attention when this matter was being considered by the Investigating Committee in July 2024. Further, the witness statement of PCW had been in the HCPC’s possession since October 2024, and there had been plenty of time to identify the various inconsistent references within the statement. The Registrant had for many months been aware of the terms of the allegation he was to face and to change the wording of the allegation at this stage, based on his evidence, would be unfair to him. Further, the lateness of the change had taken from the Registrant the ability to give a full admission, rather than a partial one.

Background

18. The Registrant is a registered Radiographer, and he was admitted as a qualified practitioner to the HCPC Register on 16 August 2016.

19. On 12 July 2023, the Registrant’s employers, Royal Shrewsbury Hospital (the hospital) made a referral to the HCPC. The Registrant was employed by that hospital as a Radiographer. The hospital’s referral informed the HCPC that the Registrant had been arrested in relation to an allegation that he had been in possession of cannabis, a class B illegal substance.

20. The hospital’s referral also made reference to the police disclosing a previous incident of possession of cannabis in 2008. This possession of cannabis incident had resulted in a Street Caution.

21. On 16 July 2023, the Registrant made a self-referral to the HCPC. He informed the HCPC that he had been arrested on 10 July 2023 for possession of cannabis.

22. The Police had found at the Registrant’s home address evidence of cannabis use, consisting of four pre-rolled cannabis joints and a plastic container containing a quantity of cannabis bush consistent with personal use.

23. On or around 15 March 2024, the Registrant accepted a Community Resolution from West Mercia Police in relation to the possession of cannabis in July 2023. As part of the Community Resolution the Registrant was directed to undertake a course entitled DIVERT, which involved an online consultation with a drugs’ worker. The intention of this course was to redirect those found in possession of drugs away from repeating that behaviour. The Registrant successfully completed DIVERT.

24. The Registrant had a period of absence from work due to sickness and then had resigned his position.

25. During the HCPC’s investigation, the information supplied by the Police disclosed the detail of that earlier incident in 2008. The circumstances were that at 1:40 on 9 October 2008, a vehicle which was being driven by the Registrant, was seen to wander into the middle of the road. The Police stopped the vehicle and they could smell what they believed to be cannabis. When the Police searched the vehicle a 4-inch cigarette was discovered which the Registrant admitted contained cannabis and that he was going to smoke it upon arrival at home. The Registrant was interviewed at the side of the road for being in possession of cannabis and issued with a Street Caution.

HCPC witness evidence

26. The HCPC called PWC to provide the Panel with further insight into the nature of the events in 2023 in which he had been personally involved. PWC’s statement records the fact that at the time of arrest the Registrant had provided a no comment interview but when later spoken to by the police had been open about his possession of cannabis and had accepted the option of a Community Resolution and undertaken the DIVERT course.

27. PWC had been in the Police force at the time that Street Cautions were being issued and so was able to give the Panel an insight into their nature and the process which was employed in their use in 2008. The Panel considered the evidence of PWC to be honest, open, and candid and that he was a credible witness.

HCPC submissions

28. The HCPC provided oral submissions on the factual elements of the Allegation. In relation to allegation 1, which predates the registration of the Registrant the HCPC was able to confirm that under the terms of Article 22(3), the Panel has the power to consider this incident as something going to misconduct. In the HCPC’s view, the two events, although years apart, are linked and the Registrant has admitted to possession in both instances. It was accepted by the HCPC that there was no evidence of the Registrant working or arriving for work under the influence of drugs.

29. The HCPC drew attention to the differences in the understanding and interpretation of the 2008 incident. The Registrant had admitted to the possession of cannabis at the scene and is recorded as stating that there were no records and that he had not been required to sign nor receive any paperwork. PCW, however, had told the Panel that Street Cautions were the quick and informal way of issuing a sanction. Street Cautions were a pink form that was signed at the scene and a copy given to the offender. The issue of this Street Caution was recorded on the Police National database as a Formal Warning.

30. In relation to the July 2023 incident, the Panel have the Registrant’s admission and the evidence of PCW that the matter had been resolved at a meeting between PWC and the Registrant on 11 March 2024, when it was agreed and accepted that a Community Resolution would be made. The HCPC took the Panel to the relevant pages of the documentation that identified and supported the nature of the incident and its resolution. The HCPC reminded the Panel of PWC’s evidence that there had been no comment made about the possession of cannabis in July 2023 but there had in March 2024.

31. [In Private]

Registrant’s submissions

32. The Registrant had produced written submissions and those relating to the factual basis of the allegation are set out below. These submissions had been prepared and submitted on the Registrant’s behalf by his Representative from the Society of Radiographers.

33. The Registrant had provided this Panel with:

i. written submissions for this hearing;
ii. a copy of the report prepared by Lord Falconer for the Mayor of London entitled The Cannabis Conundrum: a way forward for London;
iii. the Registrant’s representations to the Investigating Committee.

34. The Registrant’s representations are set out below:

i. Mr Green admits to possession of cannabis as described in allegation one however he believes that the “roadside warning” he received was not considered a “Formal Warning” as alleged.
ii. He was not required to accept and / or sign any document nor attend a police station. It is submitted that the lack of records from the police regarding this was made supports his view.
iii. D.C 3193 Wiggins, in his statement provided to the panel on pages 23 to 24 of the pdf bundle states in paragraph 7: “Mr Green had previously received a ‘Street Caution’ for the possession of Cannabis on 9 October 2008. I exhibit the Crime Report from this warning at Exhibit CW4. A ‘Street Caution’ at that time was an adult caution which could be administered to a member of the public by an officer without the need for attendance at a police station, nor the authority of a supervisor. There was no limit to the number of cautions a person could receive for similar offences. It was a quick and easy means of resolution to an operational officer, and represented an informal sanction."
iv. This ‘Street Caution’ had not appeared on any Disclosure and Baring Service Certificates including, it is believed, at the “Enhanced” level indicating again its informal nature.
v. This incident occurred long before Mr Green entered the profession as he commenced training on 16 September 2013 and qualified on 16 June 2016.
vi. In light of these submissions the panel is respectfully asked to consider Mr Green’s limited admission to allegation 1 to be the case due to its wording rather than any attempt to distract from his admission of cannabis possession at this time.
vii. As regards allegation 2 Mr Green admits being in possession of a small quantity of Cannabis for personal use as alleged. D.C 3193 Wiggins confirms in his statement that: “The outcome of the investigation, in respect of Mr Green’s possession of Cannabis was a Community Resolution. This outcome was reached because Mr Green acknowledged that he was in possession of cannabis, and that it was for his own personal use. Mr Green was booked onto a Drug Diversion course called ‘DIVERT’ which took place on 11 March 2024. No formal action was taken against Mr Green in respect of his possession of cannabis.”
viii. In Private
ix. In Private
x. In Private
xi. In Private
xii. In Private
xiii. There is no evidence that Mr Green ever did attend work either in possession of, or under any influence of Cannabis.
xiv. The absence of this evidence is because Mr Green did not, and would never have attended work with the drug in his possession or under its influence, fully understanding the risk that doing so would present to the profession or public.
xv. At the time Mr Green was employed by The Royal Shrewsbury Hospital. After a brief period of suspension to allow for the facts of matter to be considered he returned to work, with some sickness leave, until he decided to resign his post. No disciplinary action or sanction was undertaken.
xvi. As far as facts, it is submitted that Mr Green admits to the possession of cannabis on the two occasions alleged but does not believe that either “warning” was in any way “formal”.

Decision on Facts

35. The Panel sought and accepted the advice of the Legal Assessor on the matters that should feature during the Panel’s deliberations. The Panel appreciated at this time that the burden of proof was upon the HCPC. The requisite standard was that of balance of probabilities.

36. The Panel noted that the Registrant had made a full admission to the issue of possession of cannabis in relation to both incidents. In relation to the terms in which allegation 1 was framed, the Registrant made a denial as he maintained that he was not given a Formal Warning. He submitted that the incident had been the subject of a Street Caution. In relation to allegation 2, the Registrant admitted that he had been the subject of a Community Resolution. The Panel noted the partial and the full admission.

Particular 1

37. The HCPC noted that notwithstanding that the incident in 2008 predated the Registrant’s period of training and qualification it was a matter that could be taken into account. The HCPC relied in this respect on the terms of Article 22(3) of the 2001 Health Professions Order 2001.

38. The evidence of PCW was that there was no such thing as a Formal Warning and that a Street Caution was the lowest level of administration for recording the detection and disposal of a minor offence. Whilst this was recorded upon the Police Database, it was not considered a Police Caution, requiring the attendance at a Police station, however it was logged as an Adult Caution which could and would have an adverse impact on individuals. PWC stated that there was no guidance as to how they should be used or when to be issued and that their import and effect was poorly understood by those who received ‘a pink form’. That is why they were no longer used. They allowed officers to bolster figures of detection and resolution of minor offences. They were issued by the Police Officer at the scene and the import was to be explained to the recipient although this level of information varied widely. The copy paperwork was then taken back and inputted on the database by civilians and ‘Formal Warning’ was a systems term for logging the issuing of a Street Caution. If an individual was noted on the system with a lot of Street Cautions then further consideration would be given to whether any further incidents should be given to more serious action being taken.

39. The Panel finds that the HCPC has failed to discharge the burden upon it. The evidence it has supplied shows that the Registrant is recorded as having received a Formal Warning but in fact this is reference to a systems term and not a process of disposal. The terms of the allegation are clear that the Registrant had received a Formal Warning and this is not the case. The Panel therefore find this Particular not proven

Particular 2

40. The Panel had the admission of the Registrant, the evidence and supporting documentation from PCW that there had been a Community Resolution issued in March 2024 relating to an incident in July 2023. Community Resolution was the lowest level of resolution available at this time to the Police for a minor incident. The Panel are satisfied that this allegation is made out and find it proven.
HCPC written submissions on grounds

41. The comments of Lord Clyde in Roylance v General Medical Council [1999] UKPC 16 provide assistance when seeking to define misconduct:

‘Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a practitioner in the particular circumstances’.

42. The panel may further be assisted by the comments of Elias LJ in R (on the application of Remedy UK Ltd) v General Medical Council [2010] EWHC 1245 (Admin) who stated that misconduct must be ‘sufficiently serious that it can properly be described as misconduct going to fitness to practise’.

43. Where the acts or omissions of a registered Radiographer are in question, what would be proper in the circumstances (per Roylance) is, in the HCPC’s submission, to be answered by reference to the Standards of Conduct performance and Ethics 2016, and the Standards of Proficiency of Radiographers current in July 2023.

44. The HCPC submits that the following parts of the HCPC’s Standards of Conduct, Performance, and Ethics standards are engaged and have been breached by the Registrant:

9 Be honest and trustworthy Personal and professional behaviour
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

45. The HCPC submits that the following parts of the Standards of proficiency for Radiographers are engaged and have been breached by the Registrant:

2. Practise within the legal and ethical boundaries of their profession
2.1 maintain high standards of personal and professional conduct.

46. The misconduct in this case involves the Registrant on two occasions being found by the Police to be in possession of Cannabis.

47. Radiographers occupy a position of trust, patients and their families must be able to trust them. To justify that trust, Radiographers must maintain high standards of personal and professional conduct. To be in possession of cannabis damages the reputation of the profession and may cause the public to lose trust and confidence in Radiographers. The Registrant has failed to maintain high standards of personal and professional conduct. He failed to be considerate to the reputation of Radiographers when he was in possession of cannabis.

48. The Registrant in all the circumstances of this case, departed from good professional practice and the facts, as found, are sufficiently serious to constitute misconduct.

The Registrant’s written submission

49. It is acknowledged that the decision upon grounds is for the professional opinion of the panel and that they will consider if they believe the cannabis possession in these two cases amounts to the ground of misconduct.

50. In regards to consideration of current impairment to Mr Green’s Fitness to Practice, it is anticipated that the HCPC will seek to portray these two incidents as evidence of a concerning pattern of drug use.

51. In our submission, it is no such thing. These two separate occasions are separated by around 16 years with the first occurring some 5 years before Mr Green commenced training.

52. Both incidents resulted in a course of action described by D.C 3193 Wiggins as “informal”.

53. Both occasions involved a small amount of cannabis, readily accepted by the police as being for personal use and there is absolutely no evidence of any connection to Mr Green’s workplace at all.

Decision on Grounds

54. The Panel appreciated that at this stage there is no onus on the HCPC and it is a matter for the Panel’s professional judgment. The Panel sought and accepted the Legal Assessor’s advice and referred to the relevant HCPTS Practice Notes. The Panel had taken into consideration the representations of the parties. At this stage the Panel is focusing upon the incident in 2023, having made no finding in relation to the 2009 matter.

55. The Panel appreciated that a breach of the standards does not of itself constitute misconduct and it is an indicator of the standard of appropriate conduct expected The Panel considers that the Registrant has breached the standards identified by the HCPC. His actions have failed to uphold the standards of personal conduct expected of a Radiographer.

56. In terms of whether this conduct constituted a ‘serious’ departure, the Panel took into account the fact that there is no evidence of continual personal use of an illegal drug, nor is there any indication that there had been any impact upon his professional work: it was a matter of his personal conduct outside of work. In terms of seriousness the Panel also considered the impact that the Registrant’s conduct would have on fellow practitioners and members of the public and in this respect the Panel came to the conclusion that those bodies of people would consider the Registrant’s actions in July 2023 as a serious departure from what is expected of him. The Panel identified HCPC Standards 9.1 to be breached. When considering the Standards of Proficiency for Radiographers, the Panel noted that the Standards quoted by the HCPC in their submissions (2.1) were those that applied after September 2023 and therefore did not apply to the date of the incident. The Panel therefore applied Standard 3.1 from those relevant at the time – ‘Understand the need to maintain high standards of personal and professional conduct’ and found it to be breached. The Panel therefore makes a finding of misconduct.

HCPC submissions on impairment

57. Impairment is conceptually forward looking and therefore the question for the Panel is whether the Registrant is impaired as at today’s date (per Cohen (see above) also Zgymunt v General Medical Council [2008] EWHC 2643 (Admin)).

58. The HCPC submitted that the Panel is likely to find the questions outlined by Dame Janet Smith in the 5th Shipman Report (as endorsed in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin)) helpful. Those questions are:
has [the Registrant] in the past acted and/or is liable in the future to act as so to put a patient or patients at unwarranted risk of harm; and/or
has [the Registrant] in the past brought and/or is liable in the future to bring the profession into disrepute; and/or
has [the Registrant] in the past committed a breach of one of the fundamental tenets of the profession and/or is liable to do so in the future.
has [the Registrant] in the past acted dishonestly and/or is liable to act dishonestly in the future.

59. In the view of the HCPC, points 2-3 can be answered in the affirmative in respect of past conduct.

60. The Registrant being found on two separate occasions by the Police to be in possession of cannabis is liable to bring the profession into disrepute. He has not maintained high standards of personal and professional conduct.

61. Current impairment can be found either on the basis that there is a continuing risk or that the public confidence in the profession and the regulator would be undermined if such a finding were not made. This is expressed in the Practice Note as the public and personal components.

62. With regard to future risk, the panel will likely find assistance in the questions asked by Silber J in Cohen, namely, is the misconduct easily remediable, has it in fact been remedied and is it is highly unlikely to be repeated.

63. As to the risk of repetition, the Registrant has not attended the hearing. He has taken an opportunity to explain why he was in possession of cannabis. In regards to Particular 2 he admits that he was in possession of cannabis for his own personal use.

64. The HCPC acknowledges that there is a gap of over fifteen years between Particular 1 and Particular 2. However, it indicates a pattern of cannabis use as the Registrant has been found in possession of cannabis on two separate occasions.

65. You have not heard any information to persuade you that, should the Registrant find himself in the same situation in the future, he would not again choose the same path.

66. For all the reasons detailed above, I submit that a risk of repetition remains and the Registrant’s behaviour falls far below that expected of a registered health profession. Therefore, a finding of current impairment is required in order to maintain public confidence in the profession and to uphold proper professional standards.
Registrant’s submissions on impairment

67. It is submitted that Mr Green co-operated fully with the police investigations and complied with the resultant DIVERT course which led to him seeking the correct care and advice from his GP.

68. Mr Green has resigned from his post in The Royal Shrewsbury Hospital and is not currently practising as a Radiographer while he contemplated his future career pathway. At this point he is undecided if he will seek to enter Radiography practice again but, should he do so, he will ensure that he has maintained his knowledge to practice and he will complete a period of induction and assessment at the point of returning to practice.

69. It is submitted that Mr Green, by his co-operation and admissions, demonstrated his insight into his offending and will not be found in possession of cannabis, or other drugs in the future.

70. It is submitted that the personal component of fitness is not engaged.

71. Turning to the public component, there is no evidence that Mr Green has or would have attended work with cannabis in his possession or whilst under its influence. His professional abilities have not been brought into question through the lengthy investigation that has taken place and which has led to this hearing. It is submitted that Mr Green presents no risk to public safety.

72. In terms of public interest, it is respectfully submitted that the views of ordinary, decent people would comprise a range of views. In view of the above it seems most probable that, whilst not condoning Mr Green for the two occasions of personal possession of a controlled drug, the public would be of the view that the matter has been dealt with appropriately by the police and, in the absence of a connection to the workplace, the matter does not require a finding of current impairment by the regulator. Indeed the fact that the matter has been carefully investigated to establish the facts as above, the public would be satisfied that the regulator has fulfilled its obligations in full.

Decision on Impairment

73. The Panel again sought and accepted legal advice and noted the representations of the parties. The Panel referred to the relevant guidance issued by the HCPTS. At this stage the Panel was considering the Registrant’s current fitness to practice in the light of all surrounding circumstances. The Panel appreciated that in assessing this it will consider the personal component and the public component. In this regard the Panel noted the Legal Assessor’s advice in relation to the case of Grant, in which it was emphasised by Mrs Justice Cox, that a finding of impairment in the wider public interest was of separate and equal importance as a finding upon the personal component.

74. The Panel noted that the HCPC considered that there was a pattern of behaviour and that the two incidents over fifteen years apart show this to be the case. The Panel has limited information about the first incident. In relation to the second, in July 2023, it is noted that this discovery of cannabis flowed from another matter, which is of no concern to this Panel, but which appeared to take some time to resolve. The Panel noted that the Registrant records the wider issue as resulting in no further action and that the incident arose from ‘[In private]’. Clearly there were stressors and personal issues at that time which, according to the Registrant’s representations, had taken a toll on the Registrant’s wellbeing. The Panel has no evidence before it of an obvious and continuing connection between the two incidents, such to support a conclusion that the Registrant is a habitual drug user.

75. The Panel considers that the Registrant’s misconduct is capable of being remedied. The Panel has noted and accepted that the Registrant has demonstrated personal remediation through undertaking the Community Resolution DIVERT course.

76. Turning then to the possibly of a repetition of the Registrant’s misconduct in the future, the Panel noted that the Registrant is now following and accepting guidance from his GP. Although there is nothing before this Panel to identify the success of that course of treatment, the Panel have no information contradicting the submissions of the Registrant. The Registrant’s employer had no further concerns about his practice. There is nothing to indicate that there has been any further subsequent use of cannabis and the Panel notes that the Registrant’s representations are that he will not do so again. The Police Crime Report notes that there is no ongoing risk and this, amongst other factors, led to the low-level police disposal in relation to the personal use of cannabis. The Panel rejected the submission from the HCPC that the events of 2008 and 2023 were sufficient to constitute a pattern of behaviour in relation to cannabis use. The Panel considers that the likelihood of a repetition in the future is low. The Panel therefore finds no impairment on the personal component.

77. Turning to the public component of its decision, the Panel has reached the conclusion that in this regard, there is justification for a finding of impairment in the wider public interest. The Registrant’s actions, no matter what the reasons were, and what the personal triggers may have been, had voluntarily chosen to use a controlled drug. The Panel has noted previously that the Registrant maintained that at the time he believed the cannabis would address any issues he had with stressors in his life at that time, however there were alternatives. The Registrant’s Representative has indicated that the Registrant is now following the GP supported medical route. The Panel considered that the public’s view of the reputation of the profession would be adversely affected by the Registrant’s actions. The Panel has therefore made a finding of impairment of the Registrant’s fitness to practise on the public component.

HCPC submissions on sanction

78. The HCPC did not recommend a particular sanction but took the opportunity to provide the Panel with indications of the matters which it should take into account at this stage and what it may consider when identifying any aggravating and mitigating elements of the case.

79. The HCPC suggested that the following were aggravating factors:
• Limited insight into the impact his actions in 2023 would have on the reputation of the profession.
• Whilst the Registrant has suggested that the issue had been addressed by the Police DIVERT course that remediation did not address the public interest in his actions.
• There is a lack of remediation in relation to his practice in that the Registrant is not in practice and there is no evidence of current practice.

80. In terms of mitigation the HCPC identified:
• There had been an admission.
• There were no work based concerns.

81. The HCPC directed the Panel to paragraphs 52, 53 and 90 of the Sanctions Policy which state:

52. Registrants who lack a genuine recognition of the concerns raised about their fitness to practise, and fail to understand or take responsibility for the impact or potential impact of their actions, are unlikely to take the steps necessary to safeguard service user safety to address the concerns raised. For this reason, in these cases panels are likely to take more serious action in order to protect the public

53. If a registrant chooses not to undertake remediation activities to address their deficiencies, or fails to remediate when they have promised to do so, it could indicate a lack of insight. This might significantly increase the risk of repetition and therefore risk to the public. It is therefore likely that cases involving little or no remediation might require more serious sanctions, to protect the public.

90. Community sentences are non-custodial sentences aimed at punishing offenders’ behaviour so they don’t commit crime in the future, and are used to address different aspects of an individual’s offending behaviour. Therefore they may not simply be an order to undertake unpaid community work but may also include other orders such as:
• compliance with a curfew;
• exclusion from certain areas; or
• participation in mental health, drug or alcohol treatment.

Registrant’s written submissions on sanction

82. It follows from the Registrant’s previous representations that in the Registrant’s view the issue of sanction does not require consideration but, should the panel disagree and consider that the Registrant is, indeed, currently impaired, our secondary submission is that any sanction should reflect the informality that the police applied. Additionally, considering the considerable time between the two incidents, any sanction beyond a short caution period would seem to be excessive and punitive in nature and, we submit, not appropriate in these circumstances.

83. The evidence is that the Registrant had been complaint with the Police investigation and entered into the Community Resolution.

Decision on Sanction

84. The Panel noted and accepted the representations of the parties and the advice of the Legal Assessor. The Panel as advised referred to the Sanctions Policy and reminded itself that this was guidance only but any departure from that guidance had to be supported by reasons for such departure.

85. The Panel has made a finding of impairment on the sole basis of the public component. This reflects the public concerns about the Registrant’s personal use of a controlled drug. The Panel further noted that there are no service user protection issues raised by this case.

86. The Panel started, as advised, with identifying the factors in this case which may assist in establishing the correct level of sanction that would reflect the level of seriousness of the Registrant’s action.

Aggravating factors:
• Limited insight into the impact his actions would have on the profession and public confidence in the profession.

Mitigating factors:
• Limited in nature and minor, as evidence by the lowest level of possible disposal adopted by the Police in applying a Community Resolution.
• Does not pose a risk of harm to service users, this being personal behaviour outside of the work place. No concerns have been expressed about the Registrants clinical practice or about attending work under the influence of cannabis or any other substance.
• Remediation through the attendance at the DIVERT drug consultation.
• No persistent or permanent concerns about his behaviour.
• Low risk of repetition in the future
• Appropriate self-referral to the HCPC in a timely manner
• Engagement with the HCPC process albeit limited by his inability to attend this hearing
• Some management of his health issues.
• An apology was offered by his representative ‘he offers no excuse but apologises for his poor decision making and the impact this has had on him his profession and the service users.’
• Admitted his conduct to both the police and the HCPC so that could be considered as taking responsibility for his action.

87. In terms of the sanctions there is nothing to support the undertaking of the sanction of mediation. Taking no further action is unsupportable given the Panel’s finding that the Registrant’s actions had an adverse reputational impact on the profession.

88. The Panel noted the guidance relating to the imposition of a Caution Order as set out in paragraphs 100 to 102 of the Sanctions Policy. They state as follows;

100. Where a panel finds that a registrant’s fitness to practise is impaired, the least restrictive sanction that can be applied is a caution order.

101. A caution order is likely to be an appropriate sanction for cases in which:
• the issue is isolated, limited, or relatively minor in nature;
• there is a low risk of repetition;
• the registrant has shown good insight; and
• the registrant has undertaken appropriate remediation

102. A caution order should be considered in cases where the nature of the allegations mean that meaningful practice restrictions cannot be imposed, but a suspension of practice order would be disproportionate. In these cases, panels should provide a clear explanation of why it has chosen a non-restrictive sanction, even though the panel may have found there to be a risk of repetition (albeit low).

89. The Panel considers that Registrant’s actions were limited and minor in nature, and this is supported by the level of disposal adopted by the Police. The Panel considers that the imposition of a Caution Order would act as a deterrent to other professionals from acting the same way and would adequately address the public’s reputational concerns.

90. To ensure that the Caution Order is the correct level of sanction the Panel gave consideration to higher levels of sanction. Meaningful conditions could not be imposed in this instance, not just because the Registrant is not in employment which requires his registration, but as his behaviour has not been identified as having any impact on his practice: the Registrant’s behaviour having taken place in his home environment. In the Panel’s view a period of suspension would be too harsh for a practitioner where there had been no cause for concern about his practice or conduct within the workplace. The issues engaged in this matter do not fulfil the criteria for such levels of sanction as identified in the Policy. In the Panel’s view, the Registrant’s conduct is not a serious breach and relatively minor in nature and so both would be disproportionate.

91. The Panel took into account the guidance within paragraph 103 which states:

103. The panel can impose a caution order for any period between one and five years. As discussed earlier, the panel should take the minimum action required to protect the public and public confidence in the profession, so should begin by considering whether or not a caution order of one year would be sufficient to achieve this. It should only consider imposing the caution order for a longer period where one year is insufficient.

92. The Panel can therefore impose a Caution Order for any period between one and five years. As advised, the Panel should take the minimum action required to reflect the concerns involved. In the Panel’s view a Caution Order for a period of one year does serve that purpose of public censure for possession of an illegal substance; would act as a deterrent to fellow practitioners; and would address the public reputational concerns.

93. In imposing a Caution Order for a period of one year the Panel took into account the personal and financial impact on the Registrant but came to the conclusion that in this instance his interests were secondary to the of the wider public interest.

ORDER: That the Registrar is directed to annotate the register entry of Mr Alexander Green with a caution which is to remain on the register for a period of 1 year from the date this order comes into effect.

Right of Appeal

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

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

History of Hearings for Alexander Green