Andrew Stenning

Preliminary Matters
Service

1. At the outset of the proceedings the Registrant was neither present by video link or telephone, nor was he represented.

2. The Chair invited the Hearings Officer to set out the steps that had been taken to serve notice of the hearing on the Registrant.

3. The Hearings Officer put before the Panel the following documents:

a. an email dated 29 April 2025 headed “Health and Care Professions Council – Conduct and Competence Committee Hearing”.

i. The Panel observed that this document informed the Registrant that his case would be considered by a Panel meeting on Monday 2nd June 2025 at 10 AM and on Tuesday 3 June 2025.
ii. It set out the powers of the Panel and said that “if you do not attend, the committee may proceed with the hearing in your absence…”
iii. The document also informed the Registrant of the steps he needed to take to attend the hearing.

b. An e-mail document dated 29 April 2025 and timed at 14:26 confirming that the notice had been delivered to the Registrant’s e-mail address, which the Panel confirmed was the address held for him by the HCPC Operating department practitioner part of the HCPC Register (the Register).

4. The Panel received the advice of the Legal Assessor, which it followed in its decision set out below.

5. The Panel reminded itself of Rule 3(ii) of the Health and Care Professions Council (Health Committee) (Procedure) Rules 2003 (the Rules) which provides that notice may be served by sending of electronic mail to an electronic mail address which the Registrant has notified to the Council as an address for communication.

6. The Panel also had regard to Rule 6 which provides that the notice must be served at least 28 days in advance of the hearing and shall contain, “notice of the day, time and venue for the hearing.”

7. Having examined the documents set out above, the Panel was satisfied that the HCPC had served notice of this hearing, in accordance with the Rules.

Proceeding in the absence of the Registrant

8. In light of that decision, Mr Slack applied to the Panel to proceed in the Registrant’s absence.

9. He drew the Panel’s attention to the relevant law and guidance, to which the Panel refers below. He also drew the Panel’s attention to the following documents:

a. A record of two telephone conversations on 13 May 2025 between a representative of Capsticks solicitors, acting on behalf of the HCPC, during which the representative explained the purpose of the hearing and that the Registrant could attend to make submissions. It was recorded that the Registrant indicated that he did not want to argue his case, and that he would not object to any ‘argument or decision’ of the HCPC.

b. An email dated 13 May 2025 from Capsticks sending the Registrant a complete bundle of the evidence upon which the HCPC relied. The Panel observed that a bundle of evidence had already been sent to the address of the Registrant held by the HCPC on the Register and received at that address on 16 April 2025. However, it became apparent during the above telephone conversations that the Registrant had moved from that address sometime before.

c. An email from the Registrant dated 13 May 2025 and timed at 15.39, in which he stated, “I will not be attending the hearing.”

10. Mr Slack submitted that The Registrant had been notified that the hearing could proceed in his absence and had replied stating clearly that he would not attend. In those circumstances, he had waived his right to attend and there was no reason to conclude that he would attend on any future date if the hearing were adjourned.

11. Mr Slack reminded the Panel of the public interest in deciding this case within a reasonable time.

12. The Panel again received the advice of the Legal Assessor which it accepted and followed in the decision set out below.

13. The Panel reminded itself that Rule 11 provided that the Panel had a discretion to proceed in the absence of the Registrant if satisfied that “all reasonable steps have been taken to serve notice of the hearing under rule 6 (1).”

14. The Panel had regard to the HCPTS Practice Note entitled Proceeding in the Absence of the Registrant dated June 2022, the decision of the House of Lords in R v Jones [2002] UKHL 5 and the further guidance given to Panels by the Court of Appeal in GMC v Adeogba [2016] EWCA Civ 162. These include the following:

• The discretion to continue in the absence of the Registrant should be exercised with great caution and with close regard to the fairness of the proceedings;
• The decision about whether or not to proceed must be guided by the HCPC’s primary objective of protecting the public;
• Fairness to the Registrant is very important, but so is fairness to the HCPC and the public;
• Whether all reasonable efforts have been taken to serve the Registrant with notice;
• The Panel should consider the nature of the Registrant’s absence and in particular whether it was voluntary;
• Whether there is any reason to believe the Registrant would attend or make submissions at a subsequent hearing;
• Any disadvantage that the Registrant was likely to suffer if the Panel proceeded in his absence;
• The duty of professionals to engage with their regulator;
• There must be an end to the “adjournment culture”.

15. The Panel had regard to the direction given by the Court of Appeal in Adeogba (above) “Where there is good reason not to proceed, the case should be adjourned; where there is not, however, it is only right that it should proceed.”

16. The Panel reminded itself of the correspondence set out above and was satisfied that the Registrant knew of the hearing and had decided to absent himself and so waived his right to attend.

17. The Registrant had not asked for an adjournment and the Panel concluded that there was no reason to believe that an adjournment would secure the Registrant’s attendance on a future date.

18. The Panel acknowledged that there is almost inevitably a potential disadvantage to a Registrant in not attending a final hearing but concluded that any disadvantage to the Registrant must be balanced against the reason for his non-attendance and the public interest in proceeding with this hearing.

19. Having regard to all these matters, the Panel concluded that there was no good reason to adjourn this hearing, and it should proceed in the absence of the Registrant.

Background

20. The Registrant is registered with the HCPC as an Operating Department Practitioner (ODP14483). He had been employed in that capacity by Epsom and St Helier University Hospitals NHS Trust (“the Trust”).

21. On 31 August 2023, the Trust made a referral to the HCPC. In the referral it was alleged that on 15 August 2023, the Registrant engaged in an online chat forum and stated that he had sexually abused a child under 4 years old whilst she was sleeping.

22. On 18 August 2023, the Registrant was interviewed by the Police in relation to these allegations. The Police informed the Local Authority Designated Officer (LADO) of the allegations. The LADO contacted the Trust on 18 August 2023 and informed it of the allegations. At this time the Registrant was on sick leave but following his return to work he was suspended by the Trust on 10 October 2023.

23. After an investigation, the police decided not to pursue an allegation that the Registrant had in fact abused a small child but charged him with publishing an obscene publication.

24. On 8 May 2023 at Chelmsford Magistrates Court the Registrant pleaded guilty to publishing an obscene article under the Obscene Publications Act 1959 and, on 6 June 2024, was sentenced to a term of imprisonment for four months.

Decision on Facts

25. Mr Slack drew the Panels attention to the signed and certified copy of the Court Register dated 6 December 2024 and to Rule 10(d) which provides that:

(d) where the Registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction (or, in Scotland, an extract conviction) shall be admissible as proof of that conviction and of the findings of fact upon which it was based;

26. The Panel again received the advice of the Legal Assessor which it accepted and followed in the decision set out below.

27. The Panel was satisfied that the document referred to above, was sufficient to discharge the burden on the HCPC of proving, on the balance of probabilities, that the Registrant had been convicted of the offence set out above.

28. The Panel also examined the findings of fact upon which the conviction was based.

29. The Panel read police statements which showed that on 15 August 2023 a police officer had joined an online platform in order to intercept communications between users who were potentially abusing children. He engaged in a conversation with the Registrant and received messages from him stating that he had sexually abused a small girl. He stated explicitly in these messages that he had “licked” and ejaculated on the child’s behind and private parts and also (indirectly) her mouth.

30. Police subsequently identified and arrested the Registrant, and he was interviewed by police on 18 August 2023. The Panel observed that the Registrant had been represented by a solicitor, had made written statement denying that he had in fact sexually abused a small child and thereafter declined to answer any questions.

Decision on Grounds and impairment

31. Mr Slack drew the Panel's attention to article 22 (iii) of the Health Professions Order 2001, which provides that a Registrant’s fitness to practise can be impaired by a conviction or caution in the United Kingdom for a criminal offence, or a conviction elsewhere for an offence which, if committed in England and Wales, would constitute a criminal offence.

32. Mr Slack addressed the Panel on the relevant provisions of the law and HCPC guidance, to which the Panel refers below.

33. He submitted that the Registrant fitness to practise was currently impaired by reason of the conviction in this case because of the following:

a. The conviction and the matters giving rise to it are extremely serious, and represent a serious breach of standard 9.1 of the Standards of Conduct, Performance and Ethics in force in 2023 (the Code);

b. The conviction and the matters giving rise to it indicate that the Registrant is liable to cause significant harm to the public;

c. the conviction and the matters giving rise to it bringing the profession into disrepute and the Registrant is liable to do so again in the future;

d. the conviction and the matters giving rise to it breach a fundamental tenet of the profession.

34. The Panel again received the advice of the Legal Assessor which it accepted and followed in the decision set out below.

The Panel’s Approach

35. The Panel is aware that impairment is a matter for its own professional judgement. In reaching its decision, the Panel had regard to the nature, circumstances and gravity of the conduct giving rise to the Registrant’s conviction and the critically important public policy issues, in particular the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour for the profession.

36. The Panel also bore in mind that it was concerned with whether the Registrant’s fitness to practise is currently impaired and focused on the need to protect the public and the wider public interest in the future.

37. The Panel bore in mind that a finding of impairment is separate from the finding of a conviction and not all convictions will lead to a finding of impairment.

38. The Panel had at the forefront of its mind that nearly two years have elapsed since the Registrant’s conduct leading to his conviction and there is no evidence that the Registrant has offended in this way either before or since the matters proved.

39. On this issue, the Panel noted in particular the observations of Silber J in Cohen v GMC [2008] EWHC 581 (Admin):

“There must always be situations in which a Panel can properly conclude that the act of misconduct was an isolated error on the part of a medical practitioner and that the chance of it being repeated in the future is so remote that his or her fitness to practice has not been impaired. Indeed the Rules have been drafted on the basis that once the Panel has found misconduct, it has to consider as a separate and discreet exercise whether the practitioner’s fitness to practice has been impaired.”

40. The Panel also bore in mind that in deciding whether the Registrant’s fitness to practise is still impaired it should follow the approach of Dame Janet Smith endorsed by the High Court in CHRE v NMC and P Grant [2011] EWHC 927 (Admin): "Do our findings of fact in respect of the (Registrant’s) misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he:

a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or
b. has in the past brought and/or is liable in the future to bring the …..profession into disrepute; and/or
c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or
d. has in the past acted dishonestly and/or is liable to act dishonestly in the future."

41. The Panel also had regard to the passage from the Cohen case above and cited by Cox J which reminds panels that there may need to be a finding of impairment in the public interest, even if the misconduct can be characterised as an isolated incident:

“Any approach to the issue of whether a doctor's fitness to practise should be regarded as 'impaired' must take account of 'the need to protect the individual patient, and the collective need to maintain confidence [in the] profession as well as declaring and upholding proper standards of conduct and behaviour of the public in their doctors and that public interest includes amongst other things the protection of patients, maintenance of public confidence in the (profession)'(sic).

42. The Panel also had regard to the direction given to panels by the High Court that they must have regard to all three aspects of the overarching objective, to protect the public, when reaching a decision.

43. It also reminded itself that the overarching objective involves acting:

I. to protect, promote and maintain the health, safety and wellbeing of the public
II. to maintain public confidence in the profession
III. to promote and maintain proper professional standards and conduct for members of that profession."

44. The Panel also had regard to the HCPC practice note on Fitness to Practise Impairment dated February 2022. It reminded itself that a finding of fitness to practise must be focused upon the need to protect the public. In accordance with the guidelines, it considered the personal component of impairment which focuses on the likelihood of the Registrant repeating his behaviour and also the public component which is focused upon the need to uphold proper standards of conduct for and maintain public confidence in the profession.

45. The Panel reminded itself, that when considering the personal component it should examine the risk of repetition by asking:

a. are the acts or omissions which led to the allegation remediable?

b. has the Registrant taken remedial action?

c. are those acts or omissions likely to be repeated?

46. An important factor will be the Registrant’s insight into those acts or omissions, that is to say the extent to which the Registrant:

a. accepts that their behaviour fell below professional standards, understands how and why it occurred and its consequences for those affected; and

b. can demonstrate they have taken action to address that failure in a manner which remedies any issue and avoids any future repetition.

47. The Panel also had regard to paragraph 9.1 of the Code, which provides:

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

The Panel’s decision

48. The Panel considered the questions set out in the case of Grant referred to above. The Panel concluded that the Registrant has not been proved to have caused direct harm to a member of the public or service user. Nevertheless, the Panel was satisfied that his conduct and conviction struck at the heart of public confidence in the profession and gave rise to a significant risk that members of the public who knew of this case, would be harmed by a reluctance to seek medical attention, and in particular surgery, by reason of the matters proved against the Registrant.

49. The Panel was satisfied that there was no doubt that the Registrant had acted in a way that brought the profession into disrepute and breached a fundamental tenet of the profession by behaving in a way that was not merely illegal but undermined the respect for people which is at the heart of a caring profession.

50. The Panel then considered whether the Registrant was liable to repeat the matters giving rise to the conviction in this case.

51. The Panel was satisfied that the conduct and conviction in this case were likely to reflect a deep-seated attitude to children in particular which would be difficult to remediate.

52. The Panel observed that, despite the passage of nearly two years, there is no material before the Panel that indicates that the Registrant has developed understanding of the seriousness of his behaviour much less an understanding of why it occurred or how he should avoid it in the future.

53. The Panel observed that in those circumstances it is perhaps unsurprising that there is no evidence that he has taken any steps to even try to reduce the risk of repetition in the future.

54. For those reasons the Panel concluded that the risk of repetition is likely to be high.

55. Accordingly, the Panel found the Registrant’s fitness to practise impaired under the personal component.

56. The Panel also considered the public component of impairment and was satisfied that it would be failing in its duty to uphold proper standards for the profession and maintain public confidence in the profession if it made no finding of impairment this case. The Panel was satisfied that an informed member of the public would be deeply shocked to find that there was no finding of impairment in this case.

57. For those reasons the Panel concluded that the Registrant's fitness to practise is currently impaired and both the personal end public component.

Decision on Sanction

58. Having found that the Registrant's fitness to practise impaired, the Panel then considered what, if any sanction to impose.

59. The Panel heard submissions from Mr Slack who took the Panel through the Sanctions Policy and invited the Panel to consider carefully whether anything other than the most serious sanction could be appropriate in this case, in particular in order to uphold public confidence in the profession.

60. The Panel also received the advice of the Legal Assessor which it accepted and has followed in the decision set out below.

61. The Panel is aware that the purpose of a sanction is not to be punitive but to protect the public and the wider public interest, which includes the deterrent effect on other registrants, the reputation of the profession and public confidence in the profession and the regulatory process. The Panel reminded itself that this is particularly pertinent in a conviction case where the Registrant has already been punished by a period of imprisonment.

62. The Panel also bore in mind the principle of proportionality and balanced the Panel’s duty to protect the public against the rights of the Registrant.

63. The Panel first identified any aggravating or mitigating features and assessed the seriousness of the misconduct in this case.

64. The Panel found that it was an aggravating factor that, despite the passage of time, the Registrant had not demonstrated any, insight or remediation. The Panel concluded that the only mitigating feature in this case was that there are no other matters, either criminal or regulatory, recorded against the Registrant.

65. The Panel was satisfied that taken as a whole, The Registrant’s conviction and the matters giving rise to it were serious, in particular because they struck at the confidence that a member of the public should have in a professional whose job was to look after them when they were anaesthetised and at their most vulnerable.

66. The Panel then considered the sanctions available to it in ascending order of severity.

67. The Panel considered that to take no action or to impose mediation would not be appropriate given the serious nature of the conviction. Such a course would not be sufficiently restrictive to protect the wider public interest.

68. The Panel next considered whether it should impose a caution order. The Panel had regard to paragraph 101 of the SP, which provides:

101. A caution order is likely to be an appropriate sanction for cases in which:

i. the issue is isolated, limited, or relatively minor in nature;
ii. there is a low risk of repetition;
iii. the Registrant has shown good insight; and
iv. the Registrant has undertaken appropriate remediation.

69. The Panel found that the facts giving rise to the convictions appear to cover a short time span, the matter is not relatively minor and there is no material before the Panel which could satisfy that the risk of repetition was low or that the Registrant had developed insight and undertaken remediation.

70. The Panel considered whether a conditions of practice order would be sufficient to protect the public.

71. the Panel had regard to paragraph 108 of SP which provides that:

i. Conditions are also less likely to be appropriate in more serious cases, for example those involving:

ii. “• criminal convictions for serious offences”

72. The Panel also bore in mind that there had been insufficient engagement by the Registrant to give a Panel any confidence that he could engage with conditions or abide by them.

73. However, the Panel was satisfied that most important consideration was that the registrants conduct giving rise to the conviction took place out of working hours, so that supervision could not reduce the risk to the public and the wider public interest.

74. The Panel also concluded that a conditions of practice order would be insufficient to protect the public interest including maintaining public confidence in the profession.

75. The Panel then went on to consider whether a Suspension Order would be sufficient to protect the public and the wider public interest and had regard to paragraph 121 of Sanction Policy which provides that:

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:

i. the concerns represent a serious breach of the Standards of conduct, performance and ethics;
ii. the Registrant has insight;
iii. the issues are unlikely to be repeated; and
iv. there is evidence to suggest the Registrant is likely to be able to resolve or remedy their failings.”

76. For the reasons set out above, the Panel was not satisfied that there was material before it from which it could conclude that the Registrant had insight, was unlikely to repeat the conduct giving rise to the conviction and that he was likely to be able to remedy the personality and attitudinal issues that likely to underlie his conduct.

77. The Panel then considered whether it should impose a striking off order. It had regard to paragraph 130 of sanctions policy which provides that:

130. A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts involving (this list is not exhaustive: …..criminal convictions for serious offences.

78. The Panel also had regard to paragraph 131 which provides that:

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:

i. lacks insight;

ii. continues to repeat the misconduct or, where a Registrant has been suspended for two years continuously, fails to address a lack of competence; or

iii. is unwilling to resolve matters.

79. The Panel acknowledged that there is no direct evidence that the Registrant is unwilling to resolve matters, much less that he has repeated his misconduct. Nevertheless, the Panel is satisfied that the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public and in particular public confidence in the profession and the regulatory process.

80. The Panel was satisfied that this is particularly so in circumstances where there was no material before it that could indicate that any period of suspension was likely to achieve anything.

81. Accordingly, the Panel is satisfied that the proportionate sanction in this case is a striking off order.

ORDER: The Registrar is directed to strike off from the Register the name of Andrew Stenning.

Right of Appeal
An appeal may be made to the High Court in England and Wales against the Panel’s decision and the order it has made.

History of Hearings for Andrew Stenning